Role of Dermoscopy for Diagnosis of Atypical Ulcers: A Case Series.

Objective: This case series emphasizes the role of dermoscopic evaluation and the multidisciplinary approach for the correct diagnosis and treatment of atypical ulcers.

Methods: The authors documented the clinical and dermoscopic features of 5 cases of atypical, previously misdiagnosed ulcers to emphasize the dermatologist's role in approaching these difficult lesions.

Results: This report will present 5 clinical cases of skin ulcers treated as typical ulcers on which, following worsening of the manifestations, a skin biopsy was performed and the histologic examination revealed neoplastic and autoimmune lesions. The clinical and dermoscopic evaluation by the dermatologist was decisive in achieving the diagnosis of the cases described.

Conclusions: The prevalence of skin ulcers of the lower limbs is around 1% of the general population, of which a large part consists of the typical ulcers, with vascular, neuropathic or mixed etiology. Atypical ulcers include ulcers from inflammatory, neoplastic, autoimmune diseases, infections and vasculopathies. This case series encourages the dermoscopic evaluation of atypical ulcers and the multidisciplinary approach to achieve their healing.