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Anna Liza C. Agero, MD; Salvatore Taliercio; Stephen W. Dusza, MPH; Cristina Salaro, MD; Paul Chu, MD; Ashfaq A. Marghoob, MD

Arch Dermatol. 2006;142:1431-1437.

Objective  To evaluate dermoscopic features and patterns of dermatofibromas using conventional and polarized light dermoscopy.

Design  Dermatofibromas were imaged using conventional nonpolarized contact dermoscopy (NPD), polarized contact dermoscopy (PCD), and polarized noncontact dermoscopy, followed by evaluation and comparison of dermoscopic features of the lesions.

Setting  Dermatology clinic specializing in pigmented lesions.

Patients  Fifty patients with dermatofibromas.

Results  The most common features of dermatofibromas observed with NPD and PCD were central white scarlike patches (37 [74%] and 42 [84%], respectively), brown globulelike structures (21 [42%] and 22 [44%]), vascular structures (24 [48%] and 22 [44%]), and a peripheral fine pigmented network (36 [72%] for both). A newly described feature observed with PCD was a central white patch characterized by shiny white streaks. With polarized noncontact dermoscopy, the most characteristic feature was a central pink hue or "vascular blush" (44 [88%]) and visibility of blood vessels (41 [82%]). The most common pattern identified with NPD and PCD was the combination of a peripheral pigmented network and a central white patch in 28 (56%) and 31 (62%) of lesions, respectively. With polarized noncontact dermoscopy, the most common pattern was a central pink hue with a peripheral pigmented network (23 [46%]). There was good to excellent agreement when comparing NPD with PCD images, but there was a variable level of agreement when polarized noncontact dermoscopy images were compared with NPD and PCD images.

Conclusions  Conventional and polarized light dermoscopy are not equivalent but may be complementary. This study highlights some salient differences. We were able to identify new dermoscopic features and patterns not previously described with conventional dermoscopy. These new criteria can aid in the diagnosis of dermatofibroma.

Author Affiliations: Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York (Drs Agero, Salaro, and Marghoob and Mr Dusza); Albany Medical College, Albany (Mr Taliercio); and Pathology Associates, Port Chester (Dr Chu), NY.

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