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October 2004

Dermoscopy of Pigmented Purpuric Dermatoses (Lichen Aureus): A Useful Tool for Clinical Diagnosis

Arch Dermatol. 2004;140(10):1290-1291. doi:10.1001/archderm.140.10.1290

Dermoscopy is a noninvasive technique that has greatly improved accuracy in diagnosing pigmented skin lesions. Dermoscopy can also be applied to nonpigmented skin tumors, revealing additional features, such as vascular structures, which can be highly valuable for their correct diagnosis. The pigmented purpuric dermatoses are a group of chronic skin disorders with overlapping clinical and histopathologic features. The lesions are purpuric with variable pigmentation resulting from the deposition of hemosiderin, which is a result of the extravasation of red blood cells from dilated and swollen capillaries in the papillary dermis. Lichen aureus is a variant of pigmented purpuric dermatoses that is characterized by discrete or confluent lichenoid macules and papules that may be golden, bronze, or dark brown and clinically resemble a bruise. The lesions are often solitary, occur more often on the lower part of the legs, and are characteristically very persistent. Histologically, lichen aureus is a pigmented purpuric dermatosis with an infiltrate of lymphocytes and histiocytes in the upper dermis, usually distributed in a bandlike fashion.1,2 We believe that it is beneficial to describe some dermoscopic features that can improve the accuracy of the clinical diagnosis of pigmented purpuric dermatoses, particularly lichen aureus.

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