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Visual Treats in Dermatology
2022
:2;
52
doi:
10.25259/CSDM_56_2022

Dermoscopy of acquired perforating dermatosis demonstrating three-zone concentric pattern, white-collar sign, focal red dots, and hairpin vessels

Department of Dermatology and STD, Jawaharlal Institute of Postgraduate Medical Education and Research, Gorimedu, Puducherry, India
Corresponding author: Arunachalam Narayanan, Department of Dermatology and STD, Jawaharlal Institute of Postgraduate Medical Education and Research, Gorimedu, Puducherry, India. narayanan359@gmail.com
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This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Narayanan A, Elango RS. Dermoscopy of acquired perforating dermatosis demonstrating three-zone concentric pattern, white-collar sign, focal red dots, and hairpin vessels. CosmoDerma 2022;2:52.

A 57-year-old man developed multiple pruritic, follicular, and nonfollicular papules with a central keratotic plug over the extensor aspect of upper and lower extremities for the last six months. The patient had diabetes and was on irregular medication. Dermoscopic examination revealed a three-zone concentric pattern with a central keratotic plug [Figure 1a], a white homogenous area (white-collar sign), and an outer zone of hyperpigmentation. Few lesions had a central yellow-to-brown hemorrhagic crust surrounded by red structureless areas [Figure 1b]. There were also hairpin vessels [Figure 1c] and focal red dots [Figure 1d] in the periphery. We made a final diagnosis of acquired perforating dermatosis. Acquired perforating dermatosis present as pruritic papules, with a central keratotic core, on the legs. The dermoscopic appearance of a three-zone concentric pattern, white-collar sign, focal red dots/globules, and peripheral hairpin vessels are helpful clues in the diagnosis of acquired perforating dermatosis.[1]

Figure 1:: (a) Three-zone concentric pattern with a central keratotic plug, white collar of homogenous area, and an outer zone of hyperpigmentation; (b) Central yellow-to-brown hemorrhagic crust surrounded by red structureless areas; (c) Peripheral hairpin vessels in the white homogenous area (white-collar sign) surrounding the central keratotic plug; (d) Focal red dots in the white homogenous area (white-collar sign) surrounding the central keratotic plug.

Declaration of patient consent

Patient’s consent not required as patient’s identity is not disclosed or compromised.

Financial support and sponsorship

Nil.

Conflict of interest

There are no conflicts of interest.

References

  1. , , , , , . Dermoscopy of Kyrle disease. J Am Acad Dermatol. 2016;75:e99-e101.
    [CrossRef] [PubMed] [Google Scholar]

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