Dermatoscopic features of pityriasis lichenoides

Introduction. The relevance of this study is determined by the rarity of pityriasis lichenoides and the limited number of scientific publications describing the dermatoscopic presentation of the disease. On the one hand, identification of characteristic dermatoscopic patterns would enable clinicians to establish a presumptive diagnosis; on the other hand, it would optimize clinical diagnosis across all age groups, including cases where histopathological examination is not feasible.
Aim. To analyze dermatoscopic patterns in patients with different clinical subtypes of pityriasis lichenoides.
Materials and methods. The study included 60 patients (median age 13 [7; 19] years) diagnosed with pityriasis lichenoides et varioliformis acuta (PLEVA) and pityriasis lichenoides chronica (PLC), who were under observation at the Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology of Moscow Health Department from 2022 to 2024. All patients had Fitzpatrick skin phototype I or II. Dermatoscopic examination of the lesions was performed using 20-fold magnification. In patients with widespread skin involvement, at least two lesions were evaluated to account for all possible dermatoscopic patterns. Pattern descriptions followed the standardized terminology based on the consensus document of the International Dermoscopy Society.
Results. In PLEVA, dotted vessels were visualized in 100.0% of all examined cases. Linear and/or glomerular vessels were detected in 60.0% of patients. The frequency of focal dotted vessels and glomerular vessels was statistically significant (p < 0.01) in PLEVA, whereas in PLC, the frequency of linear vessels was statistically significant (p < 0.01). The presence of light brown and yellowish structureless areas reliably (p < 0.001) indicates PLC, while targetoid lesions are more characteristic of PLEVA.
Conclusion. Dermoscopy is a simple, non-invasive, and informative diagnostic method that, upon detection of characteristic dermatoscopic features, can be useful for diagnosis and determining management strategies in patients with pityriasis lichenoides prior to obtaining histopathological confirmation.

1. Ankad BS, Beergouder SL. Pityriasis lichenoides et varioliformis acuta in skin of color: new observations by dermoscopy. Dermatol Pract Concept. 2017;7(1):27–34. https://doi.org/10.5826/dpc.0701a05.

2. Errichetti E, Stinco G. The practical usefulness of dermoscopy in general dermatology. G Ital Dermatol Venereol. 2015;150(5):533–546. Available at: https://www.minervamedica.it/en/journals/Ital-J-Dermatol-Venereol/article.php?cod=R23Y2015N05A0533.

3. Lacarrubba F, Micali G. Dermoscopy of pityriasis lichenoides et varioliformis acuta. Arch Dermatol. 2010;146(11):1322. https://doi.org/10.1001/archdermatol.2010.263.

4. Sonthalia S, Varma S, Khopkar U. Dermoscopy of Pityriasis Lichenoides Chronica in an Indian Girl. Indian Dermatol Online J. 2020;11(3):477–478. https://doi.org/10.4103/idoj.IDOJ_455_18.

5. Alba-Rojas E, Guerra-Garza AS, Ocampo-Candiani J. Diagnostic Dermoscopy in Pityriasis Lichenoides Chronica and Pityriasis Lichenoides et Varioliformis Acuta: A Case Series. Dermatol Pract Concept. 2025;15(2):5078. https://doi.org/10.5826/dpc.1502a5078.

6. Jindal R, Chauhan P, Sethi S. Dermoscopic characterization of guttate psoriasis, pityriasis rosea, and pityriasis lichenoides chronica in dark skin phototypes: An observational study. Dermatol Ther. 2021;34(1):e14631. https://doi.org/10.1111/dth.14631.

7. Clarey DD, Lauer SR, Trowbridge RM. Clinical, Dermatoscopic, and Histological Findings in a Diagnosis of Pityriasis Lichenoides. Cureus. 2020;12(6):e8725. https://doi.org/10.7759/cureus.8725.

8. Lallas A, Kyrgidis A, Tzellos TG, Apalla Z, Karakyriou E, Karatolias A et al. Accuracy of dermoscopic criteria for the diagnosis of psoriasis, dermatitis, lichen planus and pityriasis rosea. Br J Dermatol. 2012;166(6):1198–1205. https://doi.org/10.1111/j.1365-2133.2012.10868.x.

9. Arias-Rodriguez C, Hoyos-Gaviria JG, Muñoz-Monsalve AM, Hernandez-Martinez A. Dermoscopy of pityriasis lichenoides et varioliformis acuta (PLEVA). An Bras Dermatol. 2024;99(1):120–123. https://doi.org/10.1016/j.abd.2022.04.017.