IADVL Atlas of DERMOSCOPY
IADVL Atlas of DERMOSCOPY
Editor-in-Chief
Balachandra S Ankad MD
Professor and Head Department of Dermatology S Nijalingappa Medical College
Bagalkot, Karnataka, India
Associate Editor
Yasmeen J Bhat MD FACP
Associate Professor Department of Dermatology, Venereology and Leprosy Government Medical College
Srinagar, Jammu and Kashmir, India
Assistant Editor
Kinjal D Rambhia MD DNB Fellowship in Diagnostic Dermatology (MUHS) Professional Diploma in Clinical Research
Assistant Professor Department of Dermatology HBT Medical College and Dr RN Cooper Hospital
Mumbai, Maharashtra, India
Foreword
Enzo Errichetti
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IADVL Atlas of Dermoscopy / Balachandra S Ankad
First Edition: 2022
9789390595648
Printed at:
EDITOR-IN-CHIEF
- Balachandra S Ankad MD
- Professor and Head
- Department of Dermatology
- S Nijalingappa Medical College
- Bagalkot, Karnataka, India
ASSOCIATE EDITOR
- Yasmeen J Bhat MD FACP
- Associate Professor
- Department of Dermatology, Venereology and Leprosy
- Government Medical College
- Srinagar, Jammu and Kashmir, India
ASSISTANT EDITOR
- Kinjal D Rambhia MD DNB Fellowship in Diagnostic Dermatology (MUHS) Professional Diploma in Clinical Research
- Assistant Professor
- Department of Dermatology
- HBT Medical College and Dr RN Cooper Hospital
- Mumbai, Maharashtra, India
CONTRIBUTING AUTHORS
- Abhijeet Kumar Jha MD
- Assistant Professor
- Department of Dermatology
- Patna Medical College
- Patna, Bihar, India
- Anuradha Bishnoi MD
- Assistant Professor
- Department of Dermatology Venereology and Leprology
- Postgraduate Institute of Medical Education and Research
- Chandigarh, India
- Anuradha Jindal MD FRGUHS
- Co-founder and Chief Dermatologist
- Skin Win Clinics, Santhekatte and Udupi
- Karnataka, India
- Ashwini PK MD FRGUHS
- Associate Professor
- Department of Dermatology
- JSS Medical College
- JSS Academy of Higher Education and Research
- Mysuru, Karnataka, India
- Aswath Rajan MD
- Senior Resident
- Goa Medical College
- Bambolim, Goa, India
- Atul Bothra MD FRGUHS
- Chief Dermatologist
- Skin Square Clinic
- Guwahati, Assam, India
- Balachandra S Ankad MD
- Professor and Head
- Department of Dermatology
- S Nijalingappa Medical College
- Bagalkot, Karnataka, India
- Biswanath Behera MD DNB
- Assistant Professor
- Department of Dermatology and Venereology
- All India Institute of Medical Sciences
- Bhubaneswar, Odisha, India
- Chander Grover MD DNB MNAMS
- Professor
- Department of Dermatology and STD
- University College of Medical Sciences and GTB Hospital, New Delhi, India
- Debjit Kar MD
- Chief Consultant Dermatologist
- DEBJIT DERMA 360
- Department of Dermatology
- JP Hospital
- Rourkela, Odisha, India
- Deepak Jakhar MD
- Co-founder and Medical Director
- Dermosphere Clinic
- New Delhi, India
- Devayani Pol MD
- Assistant Professor
- Department of Dermatology
- Dr DY Patil Medical College, Hospital
- and Research Center, Pimpri
- Pune, Maharashtra, India
- Dilip Kumar NR MD DDVL
- Assistant Professor
- Department of Dermatology
- Akash Institute of Medical Sciences and Research Center
- Bengaluru, Karnataka, India
- Dincy Peter CV MD
- Professor
- Department of Dermatology, Venereology and Leprosy
- Christian Medical College
- Vellore, Tamil Nadu, India
- Dipali Rathod DNB DDVL
- Assistant Professor
- Department of Dermatology
- Seth GS Medical College; KEM Hospital
- Mumbai, Maharashtra, India
- Faizan Younus Shah MD
- Senior Resident
- Department of Dermatology, Venereology and Leprosy
- Government Medical College
- Srinagar, Jammu and Kashmir, India
- Harshit D Ranpara MD DVD
- Diplomate of the American Board of Hair Restoration Surgery
- Consultant Dermatologist
- Rajkot, Gujarat, India
- Ishmeet Kaur MD
- Assistant Professor
- Department of Dermatology
- NDMC Medical College and Hindu Rao Hospital
- New Delhi, India
- Kinjal D Rambhia MD DNB Fellowship in Diagnostic Dermatology (MUHS) Professional Diploma in Clinical Research
- Assistant Professor
- Department of Dermatology
- HBT Medical College and
- Dr RN Cooper Hospital
- Mumbai, Maharashtra, India
- Kumudhini Subramanian MD DVL FAGE DNB DVL FRGUHS
- Chief Dermatologist
- Deep Skin Dialogues
- Chennai, Tamil Nadu, India
- Malcom Noronha MD FRGUHS
- Consultant Dermatologist
- Skin Win Clinic
- Udupi, Karnataka, India
- Brig Dr Manas Chatterjee MD DNB
- Brig Medical HQ 14 Corps
- Consultant Dermatologist
- 153 General Hospital
- C/O 56 APO
- Mansi Kansal MD
- Consultant Dermatologist
- Kansal ENT and Skin Center
- Patiala, Punjab, India
- Muhammed Razmi T MD DNB MNAMS
- Consultant Dermatologist and
- Clinical Head
- IQRAA Aesthetics
- IQRAA International Hospital
- Kozhikode, Kerala, India
- Nirmal B MD FRGUHS
- Consultant Dermatologist and Head
- Department of Dermatology
- Meenakshi Mission Hospital and
- Dermal Square Skin Clinic
- Madurai, Tamil Nadu, India
- Niti Khunger MD DNB DDV
- Consultant Dermatologist
- Professor and Head
- Department of Dermatology and STD
- Vardhman Mahavir Medical College
- Safdarjung Hospital
- New Delhi, India
- Priyanka Jaju MD FRGUHS
- Consultant Aesthetic Dermatologist
- Leelawanti Skin and Laser Center
- New Delhi, India
- Rachita Dhurat MD
- Professor and Head
- Department of Dermatology
- LTM Medical College and
- LTMG Hospital Sion
- Mumbai, Maharashtra, India
- Samipa S Mukherjee MBBS DDV DDVL (CMC, Vellore) FRGUHS (Pediatric Dermatology)
- Chief Dermatologist and Director
- Dr Samipa's – The Skin Hair Nail Clinic
- Consultant Pediatric Dermatologist
- Cloudnine Hospitals
- Bengaluru, Karnataka, India
- Sanjeev Gupta MD DNB
- Professor and Head
- Department of Dermatology
- MMIMSR, Mullana
- Ambala, Haryana, India
- Savitha L Beergouder MBBS DDVL
- Consultant Dermatologist
- Anagha Skin and Cosmetic Clinic
- Bagalkot, Karnataka, India
- Shagufta Rather MD
- Associate Professor
- Department of Dermatology, Venereology and Leprosy
- Government Medical College
- Srinagar, Jammu and Kashmir, India
- Sharmila Patil MD DDV
- Professor and Head
- Department of Dermatology
- Dr DY Patil Medical College, Nerul
- Navi Mumbai, Maharashtra, India
- Shazia Jeelani MD
- Assistant Professor
- Department of Dermatology, Venereology and Leprosy
- Government Medical College
- Srinagar, Jammu and Kashmir, India
- Shekhar Neema MD
- Associate Professor
- Department of Dermatology
- Armed Forces Medical College
- Pune, Maharashtra, India
- Shishira R Jartarkar MD DNB
- Assistant Professor
- Department of Dermatology
- Vydehi Institute of Medical Sciences and Research Center
- Bengaluru, Karnataka, India
- Shital Poojary MD DNB FCPS
- Professor and Head
- Department of Dermatology
- KJ Somaiya Medical College
- Mumbai, Maharashtra, India
- Smitha S Prabhu MD DVD
- Additional Professor
- Department of Dermatology and Venereology
- Kasturba Medical College
- Manipal
- Manipal Academy of Higher Education
- Mangalore, Karnataka, India
- Soumil Khare MD
- Assistant Professor
- Department of Dermatology
- BRLSABVM Government Medical College and Hospital
- Rajnandgaon, Chhattisgarh, India
- Suman Patra MD DNB MRCP SCE
- Assistant Professor
- Department of Dermatology, Venereology and Leprology
- All India Institute of Medical Sciences
- Jodhpur, Rajasthan, India
- Sunanda Mahajan MD DVD
- Additional Professor
- Department of Dermatology
- Seth GS Medical College and
- KEM Hospital
- Mumbai, Maharashtra, India
- Sushrut Nitin Save DNB MNAMS
- Consultant Dermatologist
- Dr Save's Clinic
- Mumbai, Maharashtra, India
- Tejas Vishwanath MD DNB MRCP
- SCE (UK) Fellow in Diagnostic Dermatology Seth GS Medical College and KEM Hospital
- Associate Consultant
- Disha Skin and Laser Center
- Thane, Maharashtra, India
- Tejinder Kaur MD
- Professor and Head
- Department of Dermatology, Venereology and Leprology
- Government Medical College
- Amritsar, Punjab, India
- Tishya Singh DNB MNAMS SCE (UK)
- Consultant Dermatologist
- Reviva Transplant Clinic
- Apollo Clinic, Chandigarh
- Chaudhary Hospital
- Mohali, Punjab, India
- Usha N Khemani MD
- Associate Professor and Head
- Department of Dermatology, Venereology and Leprology
- Gokuldas Tejpal Hospital—Grant Medical College
- Mumbai, Maharashtra, India
- Vidya Kharkar MD DVD
- Professor and Head
- Department of Dermatology
- Seth GS Medical College and
- KEM Hospital
- Mumbai, Maharashtra, India
- Vinay Keshavamurthy MD DNB
- FRCP (Lon)
- Associate Professor
- Postgraduate Institute of Medical Education and Research
- Chandigarh, India
- Vishal Gupta MD
- Assistant Professor
- All India Institute of Medical Sciences
- New Delhi, India
- Vrutika Hasmukh Shah MD DNB DVL
- Consultant Dermatologist
- Dr Vrutika's Dermanation
- Thane, Maharashtra, India
- Yasmeen J Bhat MD FACP
- Associate Professor
- Department of Dermatology, Venereology and Leprosy
- Government Medical College
- Srinagar, Jammu and Kashmir, India
- Jayadev Betkerur
- President, IADVL 2021
- Professor, Department of Dermatology
- JSS Medical College
- Mysuru, Karnataka, India
Examination of a lesion by naked eye or through a magnifying lens gives good information and we are able to diagnose. The finer details of the lesion will add to our diagnosis. Dermoscope is an instrument that gives us this information. The changes just below the epidermis can be delineated very well by a dermoscope. Various dermoscopic changes of different diseases have been described. The “Atlas of Dermoscopy” with details of these diseases and dermoscopic pictures will be of immense help to the dermatologist. This atlas in conjunction with histopathology will give us a correct diagnosis and help us in managing the disease better.
The chapters are well written and cover all dermatological diseases. The editors, Dr Balachandra S Ankad, Dr Yasmeen J Bhat and Dr Kinjal D Rambhia, are the pioneers of dermoscopy in India. I am sure their experience and valuable contributions by all the authors will make this atlas a most sought-after book by all of us.
I express my thanks to all those involved: The editors, authors, IADVL Academy headed by Chairperson Dr Deepika Pandhi and Convener Dr Dipankar De, and the publisher, in bringing out this “Atlas of Dermoscopy”. As President of IADVL, I take pleasure in presenting you all this great work.
Long Live IADVL!
MESSAGE FROM THE HONORARY SECRETARY GENERAL IADVL
- Feroz K
- Honorary Secretary General, IADVL (2020–2022)
- Dr Feroz's Skin Care Clinic
- Kannur, Kerala, India
The Indian Association of Dermatologists, Venereologists and Leprologists (IADVL) is happy to present the first edition of the book “Atlas of Dermoscopy.” This will serve as a ready reckoner for all dermatology residents and practitioners.
This book “Atlas of Dermoscopy” has been designed to address various dermatological conditions. The chapters have been contributed by dermatologists with experience, expertise, and interest in dermoscopy.
The editors have made sure to include details about basics, dermoscopic and histopathological correlation, clinical dermatology, cutaneous malignancies, infections, trichology, etc. The book will be a valuable addition for all residents as well as practitioners in dermatology, to sharpen their skills and to refresh their knowledge.
I sincerely congratulate the hard work and dedicated efforts of the editorial team—Drs Balachandra S Ankad, Yasmeen J Bhat, and Kinjal D Rambhia—and all the contributors. I also thank Dr Deepika Pandhi, Dr Dipanker De, and all the members of Academy for their support and help.
I wish this initiative all success!
MESSAGE FROM IADVL ACADEMY
Deepika Pandhi
Chairperson, IADVL Academy
Dipankar De
Convener, IADVL Academy
Dermoscopy is an in vivo, noninvasive technique for examination of the skin by the use of a handheld device, which allows illumination and 10–14 times magnification of the lesion. While dermoscopy was initially used for the evaluation of melanocytic skin lesions, it has since been incorporated as a diagnostic modality for a wide variety of dermatoses. Due to its diagnostic accuracy and convenience, the interest in dermoscopy has increased in recent years with more dermatologists incorporating it in their diagnostic as well as interventional armamentarium. However, being a visual science, it has a learning curve and also the features may vary in skin of color. The specialty of dermoscopy has evolved tremendously over the years in India, with a steady rise in publications in Asian skin and reports of innovations in the technique of performing dermoscopy at various sites, which has paved the way for the growth of this specialty over the last decade. The Indian Association of Dermatologists, Venereologists and Leprologists (IADVL) is happy to present the first edition of the “Atlas of Dermoscopy.”
The editorial team, comprising Drs Balachandra S Ankad, Yasmeen J Bhat, and Kinjal D Rambhia, has done a commendable job. They drafted an exhaustive table of content and selected eminent experts as authors from applications received from IADVL members. There are 19 chapters including details of “types of dermoscope and basic principles; dermoscopic and histopathological correlation; papulosquamous, pigmentary, and granulomatous disorders; infections; nevi; erythemas; cutaneous malignancies; mucoscopy, trichoscopy, and onychoscopy; and facial dermatoses.” The chapters have been contributed by dermatologists with experience and expertise in dermoscopy and are well illustrated with more than 750 color images.
It has been a pleasure to be a part of the process of publication of this Atlas from conception to review and finally publication. Our thanks are due to members of the IADVL Academy 2021 for their critical inputs and to Dr Jayadev Betkerur, President, IADVL 2021, and Dr Feroz K, Honorary Secretary General, IADVL 2021, for their support for this endeavor.
We congratulate the dedicated efforts of the editors and all the contributors for achieving this mammoth task in a short while to bring out a book that will be a valuable reference material for all students and practitioners in dermatology.
We wish the “Atlas of Dermoscopy” great success!
FOREWORD
Enzo Errichetti MD MSc DVD
Senior Consultant Dermatologist and Venereologist
Institute of Dermatology
University Hospital “Santa Maria della Misericordia”, Udine, Italy
General Secretary
Italian Association of Non-Invasive Diagnostics in Dermatology (AIDNID)
Executive Board Member
International Dermoscopy Society (IDS)
Diagnosis in dermatology mainly relies on the physician's ability to finely interpret the morphological changes of the skin, thus making such a discipline one of the most intriguing areas of clinical medicine. For a long time, naked-eye examination has been the only way to characterize skin lesions, with no consideration of all those subclinical dermoscopic details that are known nowadays.
The use of dermoscope has completely changed our daily practice and improved our diagnostic skills as it has let us better figure out microscopic structural changes of the lesions. Indeed, the dermoscopic assessment may be considered as a bridge between clinical and histological examination, with each dermoscopic feature corresponding to a specific histological finding. Besides, dermoscopy has also other invaluable properties, including being cheap, quick, and user-friendly, that have significantly contributed to its success.
The popularity of dermoscopy worldwide is also readily noticeable by the massive number of articles published on this topic in the literature. Indeed, by simply searching the word “dermoscopy” in the PubMed database, nearly 7,000 papers are found at time of this writing. However, it is of utmost importance to underline that dermoscopic assessment should not be regarded as a panacea for dermatologist but as a (relevant) piece in the puzzle of dermatological diagnostic process.
Albeit it has been classically used for the evaluation of both pigmented and nonpigmented skin tumors, dermoscopy has also been shown to be a helpful tool to assist the recognition of nonneoplastic dermatoses (“General Dermatology”), including inflammatory, infectious, and infiltrative disorders as well as nail and hair diseases. The enormous potential of such a technique may, however, be exploited to the full only by detailed knowledge on the topic.
The book you are holding has the virtue of representing a complete but at the same time concise guide for all those dermatologists who are seeking to improve their dermoscopic knowledge all-round. It also has the advantage of putting together information on both clinical and dermoscopic patterns of tumors and nonneoplastic dermatoses, thus letting the reader capture all the morphological dimensions of skin lesions.
I wish you a good reading!
PREFACE
Balachandra S Ankad
Yasmeen J Bhat
Kinjal D Rambhia
Dermoscopy, the visualization of surface and subsurface structures of the skin by a dermoscope, has been a prominent arena in the field of dermatology in the recent past. Factors attributable to its popularity are that it is a noninvasive method, quick and easy to perform. It is a known fact that dermatological conditions pose diagnostic challenges to dermatologists by virtue of varied and complex morphological features. Dermoscopy comes in handy to delineate similar clinical features by revealing definitive and specific patterns.
In view of a huge stride in the field of dermoscopy over the past few years, there is an increased zest among Indian dermatologists to learn dermoscopy. Keeping this in mind, the IADVL Atlas of Dermoscopy has been framed to encompass all the entities in the field of dermoscopy. We have tried to include all the topics which are relevant in the Indian scenario, to the academicians, practicing dermatologists as well as the dermatology residents. The high-quality dermoscopy images from the Indian skin will be of utmost help to the readers in understanding the dermoscopic patterns and structures. All the patterns of dermoscopy are labeled with accurate markings for the benefit of readers. Relevance is given to the histopathological correlation of dermoscopic findings, wherever necessary.
We, the editors, hope and wish that this atlas will be useful for practising the art of dermoscopy to the beginners and experienced dermoscopists as well. We would like to thank all the contributing authors for sharing their expertise and making this atlas possible. We render our heartfelt thanks to Dr Deepika Pandhi and Dr Dipankar De for their constant support and encouragement in bringing out this atlas. We are thankful to Dr Richa Saxena (Associate Director-Professional Publishing), Ms Nedup Denka Bhutia (Development Editor) and entire team of Jaypee Brothers Medical Publishers for their help and cooperation.