Oral Lymphangiomas: A Rare Presentation of Two Cases with Dermoscopic Findings.

Lymphangiomas are benign hamartomatous malformations, infrequently seen in the oral cavity. They can cause aesthetic issues and functional impairments if not treated in the initial stages, thus necessitating the need to diagnose early. Two presentations were observed: a 35-year-old male with classical frog-egg appearance involving lower buccal mucosa with macrocheilia for two years, which was diagnostic on mucoscopy and histopathology, confirming acquired capillary lymphatic malformation. The second case was of a 12-year-old girl with a gradual appearance of reddish lesions over the tongue and episodic history of bleeding, which was confirmed on mucoscopy, and histopathology is highlighted. Mucoscopy of both the cases showed yellowish-pink lacunae with a hypopyon-like feature and surrounding pale septa. We present two cases of oral lymphangiomas with different presentations and highlight the importance of dermoscopy of oral lesions to bypass invasive techniques such as biopsy.

Dermoscopic Evaluation of Extragenital Lichen Sclerosus et Atrophicus.

Introduction: Lichen sclerosus (LS), is an uncommon inflammatory dermatosis with preferential involvement of anogenital region. Diagnosis of LS is mainly clinical, but clinical differentiation from conditions like vitiligo, morphea may be a difficult task at times that often requires histological analysis. Dermoscopy is one such non-invasive tool which can help diagnose the disease. There is paucity of Indian data on dermoscopy of LS. Objectives: To evaluate clinical, dermatoscopic patterns of LS and correlate them with histopathology. Methods: The study was conducted in a tertiary hospital after obtaining consent from 20 patients. OITEZ e-scope digital microscope was used to evaluate the lesions. Both polarized and nonpolarized mode were used and skin biopsy was done to confirm diagnosis. Results: Based on morphology, LS was classified as scleroatrophic lesions (61.5%), guttate lesions (30.8%) and hyperkeratotic lesions (7.7%). Dermoscopic analysis revealed structureless white to yellow areas as most common finding (100%) followed by chrysalis like structure (80.8%). Linear irregular vessels were seen in 61.5% lesions and perifollicular scaling in 50.0% lesions. Keratotic plugs were seen in 50.0% lesions. A new characteristic finding, "rosettes" was seen in 38.5% lesions has never been reported with LS before. Non polarized mode was particularly useful for identifying texture changes, keratotic plugs and minute scales which were not visible otherwise. Conclusions: Dermoscopy is a simple diagnostic tool that helps in the early diagnosis of LS with specific pattern which can avoid invasive procedure like biopsy. Both non-polarised and polarized dermoscopy must be done to visualize the changes of LS well.

Unusual presentation of crusted scabies with osteolysis in immunocompetent.

BACKGROUND: Crusted scabies results from a failure of the host immune response to control the proliferation of the scabies mite in the skin, with resulting hyperinfestation and a concomitant inflammatory and hyper-keratotic reaction. However, it has also been recognised in people with no evident immunological deficit. CASE HISTORY: We present a case report of apparently immunocompetent 16-year-old female presenting with multiple hyperkeratotic vegetating plaques over limbs, excoriated papules over trunk with minimal itching since 2 years without any positive family history. The microscopic examination of the skin scales with potassium hydroxide demonstrated numerous scabies mites and eggs. Histopathology showed hyperkeratosis with multiple mites in stratum corneum. Numerous mites were seen on biopsy of lesion. X-ray showed osteolysis of distal phalanges secondary to chronic pressure. Repeated topical treatments with permethrin and oral ivermectin led to the considerable resolution of her lesions. CONCLUSION: We present a rare case of crusted scabies with osteolysis in an immunocompetent female.