Dermoscopy in general dermatology (non-neoplastic dermatoses): pitfalls and tips

Background: Dermoscopy is gaining appreciation in the spectrum of non-neoplastic skin conditions, especially papulosquamous and granulomatous dermatoses. However, the use of dermoscopy in such diseases has not yet acquired a standard role in daily practice due to the lack of a structured approach as well as possible pitfalls limiting its accuracy. Methods: A descriptive analysis of the most common limitations/pitfalls described in the literature regarding dermoscopy of non-neoplastic dermatoses was performed, also providing possible tips to deal with them. Results: The following items were analyzed: “two-step” dermoscopic procedure and basic dermoscopic parameters in non-neoplastic dermatoses, uniform dotted vessels in dermatoses other than psoriasis, pseudo-Wickham striae, yellow sero-crusts in non-eczematous dermatoses, peripheral scaling collarette in conditions other than pityriasis rosea, orange areas in non-granulomatous dermatoses, and dermoscopic variability of Grover disease according to histological subtype. Conclusions: Dermoscopy is candidate to become a relevant part of diagnostic approach to non-neoplastic dermatoses, yet only the use of a systematic/validated methodology and the in-depth knowledge of possible pitfalls may optimize its use in this field.