A Particular Bicentric Structure in Dermoscopic Demonstration of Degos Disease.

Case Presentation

A 38-year-old woman suffered recurrent abdominal pain and rashes for 1 year. Physical examination showed multiple red papules with porcelain-white centers over her trunk and limbs (Figure 1A). Dermoscopic imaging demonstrated 2 yellow-white structureless centers of different sizes with telangiectasia, similar to a bicentric structure (Figure 1B). Histopathology showed intravascular thrombosis in the dermis (Figure 1C). Abdominal CT scanning confirmed small bowel perforation and abdominal adhesion. A diagnosis of Degos disease was made.

Figure 1

Clinical, dermoscopic, and histopathological figures (A) red papules with porcelain-white atrophic centers (B) two yellow-white structureless centers in different sizes with telangiectasia (C) epidermis atrophy, vacuolar degeneration of basal layer, increased collagen fibers, and intravascular thrombosis of the dermis.

Teaching point

Degos disease is characterized by unusual chronic thrombo-obliterative vasculopathy that affects small vessels. The histopathology of Degos disease is inconsistent, so dermoscopy may be helpful in making a definite diagnosis. The dermoscopic character of Degos disease is a homogeneous yellow-white structureless area in the center, surrounded by a circular hairpin-like small vessel [1,2]. Apart from the features mentioned previously, we noticed a particular bicentric structure, which is related to avascular necrosis caused by thrombosis.