Cutaneous leishmaniasis: new dermoscopic findings.

Background: Cutaneous leishmaniasis (CL) has a worldwide distribution. Delayed and incorrect diagnosis may cause the significant spread of this disease and consequent increases in morbidity and drug resistance.

Objectives: We aimed to determine dermoscopic features of CL that may help to improve the accuracy of clinical diagnosis of the disease.

Methods: A total of 145 lesions in 102 patients were evaluated dermoscopically. Following the diagnosis of CL, all lesions were evaluated by experienced dermoscopists.

Results: A total of 51 papules, 40 nodulo-ulcerative lesions, 31 plaques, and 23 nodules were evaluated by dermoscopy. Generalized erythema appeared in all lesions (100%), yellow tears in 58 lesions, both crust and ulcer in 51 lesions, white starburst-like patterns in 27 lesions, ovoid salmon-colored structures in 19 lesions, and a perilesional hypopigmented halo pattern in four lesions. Various vascular structures were present in 126 lesions. The most common vascular structure observed was an irregular linear pattern in 78 lesions, followed by a tree-like pattern in 53 lesions. The rest of the vascular structures included hairpin vessels in 25 lesions, glomerulus-like vessels in 24 lesions, dotted vessels in 23 lesions, comma-shaped vessels in six lesions, and polymorphous/atypical vessels in four lesions. We did not identify the types of parasite involved.

Conclusions: Yellow tears, white starburst-like patterns and salmon-colored ovoid structures seem to appear specifically in CL lesions. In geographical areas in which CL is common, dermoscopy may be utilized as a useful diagnostic tool that is practical and non-invasive.