Dermoscopy of discoid lupus erythematosus.

A 34-year-old female presented with cicatricial alopecia over the scalp with erythema, areas of atrophy and scaling and dyspigmentation [Figure 1]. Dermoscopy (DermLite II hybrid m; 3Gen; polarized mode, 10 × magnification) revealed linear as well as branching vessels, focal keratin plugs, perifolicular whitish halo, rosettes, and structure-less white and brown areas [Figure 2]. Histopathology confirmed the diagnosis of discoid lupus erythematosus. In discoid lupus erythematosus, the most common findings reported by Estrada et al.[1] included white patches, branching capillaries, keratin plugs, and a reduction in the number of follicular ostia. Rosettes vary in size from 0.2–0.5 mm, and are believed to stem from an optical effect of the polarized light and its interaction with adnexal openings that are narrowed or filled with keratin; larger rosettes may be attributed to concentric perifollicular fibrosis.[2]

Figure 1

Cicatricial alopecia over the scalp with eythema, minimal scaling, hyper and depigmentation, and areas of atrophy

Figure 2

Dermoscopy (polarised ×10) showing branching (blue arrow) and linear (white arrow) vessels, and keratin plug (yellow arrow), perifollicular whitish halo (green circle), rosettes (black square), structure-less white areas (red arrow), and structure-less brown areas (black hexagon)

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