291 Diagnostic usefulness of dermoscopy in differentiating lichen aureus from nummular eczema

Lichen aureus is a variant of pigmented purpuric dermatoses, which is characterized clinically by rust macules, papules or plaques, mainly on the lower extremities. In some cases, lichen aureus can be difficult to be distinguished from nummular eczema by the naked eye alone. Dermoscopy can be applied to pigmented and nonpigmented skin lesions, revealing additional features which can be highly valuable for their correct diagnosis. There was no previous study focusing on dermoscopic differences between lichen aureus and nummular eczema. In this respect, this study was conducted to investigate characteristic dermoscopic patterns of lichen aureus, and to find distinctive features that can differentiate them from nummular eczema. Clinical features and dermoscopic patterns were evaluated in 8 patients with lichen aureus and 7 patients with nummular eczema. The dermoscopic features showed increased coppery-orange diffuse coloration of the background, round to oval red globules, gray dots and network of brownish to gray interconnected lines in the lichen aureus (100%, 87.5%, 75% and 62.5%, respectively) compared with the nummular eczema; scales, shiny yellow clods and irregular distributed red globules were commonly seen in the nummular eczema (100%, 85.7% and 42.9% respectively). Dermoscopy provides valuable information for the diagnosis of lichen aureus and aids in the differential diagnosis from nummular eczema.