The International Dermoscopy Society (IDS) recently introduced a set of five fundamental dermoscopic parameters to standardize the use of dermoscopy in non-neoplastic dermatoses. These parameters include vessels, scales, follicular findings, “other structures” and specific clues, with a total of 31 subitems. However, these criteria were developed primarily considering Caucasian/Asian skin, and there may be limitations when applied to individuals with dark skin.

The present study validated the aforementioned criteria for use in patients with dark skin (phototypes IV-VI) through expert consensus. The researchers employed the two-round Delphi method, which involved two rounds of email questionnaires, to gather opinions from a panel of experts worldwide who had expertise in dermoscopy of non-neoplastic dermatoses in skin of color.

Twenty-two panelists participated in the validation process. In the first round, all five proposed parameters and subitems reached a consensus agreement, except for “follicular red dots”. Furthermore, during the first round, five new subitems were suggested: perifollicular scale distribution, follicular openings obliteration, broken hairs, eccrine pigmentation and eccrine ostia obliteration. There was also a proposal to change the name of parameter three from “follicular findings” to “follicular/eccrine findings” and to split it into two subparameters (“follicular findings” and “eccrine findings”). All of these proposals achieved agreement in the second round and were consequently included in the final list, resulting in a total of 37 items.

In conclusion, while most of the dermoscopic criteria initially proposed by the IDS can be applied to individuals with darker phototypes, several additional variables need to be evaluated to effectively use dermoscopy in this population.

Source: Errichetti E, Ankad BS, Jha AK, et al. International Dermoscopy Society criteria for non-neoplastic dermatoses (general dermatology): validation for skin of color through a Delphi expert consensus. Int J Dermatol. 2022;61(4):461-71.