What are dermoscopy findings in Riehl melanosis (pigmented contact dermatitis)?

Updated: May 27, 2021
  • Author: Elizabeth K Satter, MD, MPH; Chief Editor: William D James, MD  more...
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The most distinctive dermatoscopic features are a pseudonetwork consisting of prominent nonpigmented follicular openings associated with peripheral pigmentation admixed with gray dots/granules, which corresponds to pigment incontinence (melanophages located in papillary dermis). Additional dermatoscopic features include a perifollicular whitish halo, follicular keratotic plugs, and telangiectasias. Lastly, flourlike slight scale has also been reported, and this feature seems to be unique to Riehl melanosis because it is not seen in other acquired macular hyperpigmentation disorders. [41, 42, 43] A 2019 study reviewed the dermatoscopic features on the face, as compared to the neck, and found that although these regions show similar dermatoscopic findings, there were subtle differences. [44] For example, on the cheek, a hypopigmented network pattern was not observed, whereas on the neck, follicular keratotic plugs and a perifollicular halo were less common. [44]

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