ABSTRACT
The first diagnostic step when clinically evaluating non-pigmented skin lesions is to assess whether they are skin tumors or represent manifestations of an inflammatory skin disease. A biopsy followed by histopathologic examination is usually required to solve the diagnostic dilemma. In this setting, dermoscopy, by providing submacroscopic morphologic information, might improve the differential diagnosis and/or enable the clinician to detect the tumor among the several inflammatory lesions. Dermoscopy enhances the clinical differential diagnosis by revealing either the typical pattern of psoriasis, consisting of regularly distributed dotted vessels and white scales, or the well-known patterns of Psoriasis Versus Superficial Basal Cell Carcinom or Bowen’s Disease. The differentiation between psoriasis and skin tumors is relevant in the context of psoriatic patients undergoing phototherapy or immunosuppressive treatments, who are at increased risk of developing skin neoplasms. Dermoscopy has the potential to uncover the hidden tumor, highlighting the value of applying dermoscopy on all lesions, even in patients with inflammatory skin diseases.
