ĐẶC ĐIỂM HÌNH ẢNH DERMOSCOPY VÀ MÔ BỆNH HỌC CỦA 14 CA BỆNH LICHEN ĐƠN DẠNG MẠN TÍNH VÙNG DA DẦU CỦA BỆNH VIỆN DA LIỄU HÀ NỘI

Abstract

Objective: To describe the dermoscopic and histopathological features of chronic lichen simplex in the scalp area, contributing to differential diagnosis with other chronic inflammatory diseases of the scalp such as psoriasis, seborrheic dermatitis, or chronic discoid lupus erythematosus. Subjects and methods: 14 cases of chronic lichen simplex in the scalp area diagnosed at Hanoi Dermatology Hospital from 2019-2025. All patients underwent dermoscopy (20x–140x device) and skin biopsy for Hematoxylin–Eosin histopathology. Dermoscopic features were recorded and correlated with histopathological results. A cross-sectional descriptive study was applied. Research results: Out of a total of 14 patients, female 57.1% and male 42.9%. The average age was 33.1± 11.7 years, ranging from 17 to 59 years. The duration of the disease was less than 2 years. The lesion location was 100% on the vertex, with 5 cases (35.7%) having only 1 lesion patch on the vertex, and 9 cases (64.3%) having 2 lesion patches on the vertex. Typical dermoscopic features included erythema (100%), scaling around hair follicles and broken hair shafts (89.5%), Broom fiber sign (100%), dilated hair follicles "peripilar white halo" (47.3%), localized hair follicle loss (63.2%), and dotted vessels (57.9%). Histopathological features of chronic lichen simplex of the scalp included epidermal hyperplasia with hyperkeratosis, thickened granular layer (100%), perivascular lymphocytic inflammatory infiltrate in the dermis (100%) with the Gear wheel sign (70%) and no hamburger sign. Conclusion: Dermoscopy provides characteristic signs that suggest the diagnosis of chronic lichen simplex of the scalp, especially in cases of chronic lesions that are difficult to differentiate clinically. The combination of dermoscopy and histopathology helps increase diagnostic accuracy and avoid unnecessary biopsies