An in-depth Analysis of Pruritus: Insights from Dermoscopy

A dermoscope is a non-invasive diagnostic tool used to visualise subtle clinical patterns of skin lesions and subsurface skin structures not visible to the naked eye. Several dermoscopic patterns exhibit consistent associations with specific diseases, serving as valuable diagnostic indicators to differentiate primary and secondary skin lesions. We evaluated the dermoscopic patterns associated with pruritus and compared these patterns based on specific diagnoses. We performed dermoscopy on skin lesions in 299 patients who presented with itching at the outpatient dermatology clinics of Karaman Training and Research Hospital between June 2022 and August 2022. We documented various dermoscopic findings, such as red globules, purple globules, fabric fiber, white scale, comedone-like openings, follicular plugs,brown dots andpigment network, glomerular vessels, delta signs, and yellow crusts. The study included 299 patients ages 17–89 (mean age: 47.53 ± 17.67) years. Among these patients, 60.2% were females and 39.8% were males. Cutaneous xerosis was observed in 35.8% of the patients, scabies in 19.1%, Prurigo nodularis and atopic dermatitis in 11%, lichen simplex chronicus in 7.7%, pityriasis lichenoides chronica and pityriasis rosea in 2.3% and senile pruritus in 1.7%. The most commonly observed dermoscopic signs included irregular white scales (30.8%), red globules (20.1%), an erythematous background (16.4%), the delta sign (9.4%), nonspecific signs (8.7%), hemorrhagic crust (8%) and arborizing vessels (7.7%). Compared to all other age groups, the incidence of delta signs was significantly higher in patients aged < 20 years (31.6%), whereas the incidence of brown spots was significantly higher in patients aged 30–39 years. Dermoscopy is crucial in the identification of the differential diagnoses of pruritus, a commonly encountered condition in dermatological practice.