The use of UV‐light, as a diagnostic tool for dermatologists, dates to the eve of the previous century. In its 100 years of existence the small, mobile and easy‐to‐use Wood's lamp has proven to be a valuable contribution to the diagnosis of pigmented skin disorders, infections of the skin, porphyria and non‐melanoma skin cancer. 1
On the other hand, dermoscopy has been established as a necessary part of the clinical evaluation of pigmented and non‐pigmented skin tumours, as well as of inflammatory and infectious diseases of the skin. The ability of dermoscopy to reveal morphological structures, which could not be identified by the naked eye or a magnifying lens, can improve the recognition of any skin eruption in daily practice. 2
In inflammatory and infectious entities, however, the main dermoscopic features do not result from the deposition of pigment, like in skin tumours, but from certain histologic alterations. These include cellular infiltrations, vascular structures and alterations of the thickness or the anatomy of the epidermis, findings that could not easily be detected by the common light‐based dermoscopy. Therefore, the use of a dermatoscope with polarized light that preserves these morphological features, especially of those of vessels, is necessary when applying dermoscopy in general dermatology. 3
After the application of polarized dermoscopy, the combination of the ultraviolet light use, ‘borrowed’ by the Wood's lamp, with the hand‐held dermatoscope was a natural evolution. In this study, 4 Enzo Erricheti, Pawel Pietkiwicz, Yasmeen Bhat, et al. moved forward and compared the accuracy of the polarized light‐based dermoscopic findings with the UV‐induced fluorescent dermoscopic features (UVF dermoscopy) in the diagnosis of general dermatologic disorders in 208 patients. The application of UVF dermoscopy has the advantage, as compared to wood light, that a darkened room is not necessary to perform the diagnostic procedure.
The dermatoses included in the study were foot intertrigo, intertrigo of major creases, papulopustular acne, malassezia folliculitis, papulosquamous dermatoses and hypopigmented macular dermatoses of the trunk. UVF dermoscopy was found to show the finding with the highest D‐OR value in nine out of 17 analysed dermatoses, including pseudomonas, Corynebacterium and dermatophytic foot intertrigo, erythrasma, candidiasis, acne, Malassezia folliculitis, macular hypomelanosis and achromic pityriasis versicolor. Additionally, the most accurate feature on polarized dermoscopy was seen in inverse psoriasis, tinea of the major creases, guttate psoriasis, lichen planus, pityriasis rosea and lichenoides chronica, idiopathic guttate hypomelanosis and vitiligo.
One other interesting finding of this study is that UVF dermoscopy may offer substantial evidence for the diagnosis in clinical scenarios, in which clues on polarized‐based dermoscopy assessment were lacking. Such scenarios are the discrimination among different subtypes of foot intertrigo and the differentiation of papulopustular acne from Malassezia folliculitis. Moreover, it has been shown that UVF dermoscopic assessment may offer further diagnostic clues even in cases, where polarized dermoscopic examination highlights various distinctive findings, such as intertrigo of major folds, papulosquamous dermatoses and hypopigmented macular dermatoses of the trunk.
With the UVF dermoscopy, special chromophores, 5 produced mainly or exclusively in certain dermatoses, are detected. Consequently, overlap between skin diseases is less frequently observed, unlike polarized light dermoscopy in which similar histologic findings may lead to similitudes in the dermoscopic findings. In contrast, some chromophores may fade away following washing, thus affecting UVF examination.
It should be emphasized, however, that in any type of dermoscopic investigation practice is needed to reach perfection and that dermoscopy cannot replace histology or microbial and fungal cultures, which may be necessary for the diagnosis in certain cases of various dermatologic conditions.
FUNDING INFORMATION
There is no funding that supported this work.
CONFLICT OF INTEREST STATEMENT
DI: Medical lectures, medical advisory boards and clinical investigational protocols for Abbvie, Amgen, Eli Lilly, Genesis, Janssen, LEO, Novartis, Pfizer, Sanofi and UCB. IP: none.
Ioannides D, Papadimitriou I. Ultraviolet‐induced fluorescence dermoscopy improves the differential diagnosis in the field of general dermatology. J Eur Acad Dermatol Venereol. 2025;39:15–16. 10.1111/jdv.20436
Linked article: E. Errichetti et al. J Eur Acad Dermatol Venereol 2025;39:97–108. https://doi.org/10.1111/jdv.19795.
DATA AVAILABILITY STATEMENT
Data sharing is not applicable to this article, as no datasets were generated or analysed during the current study.
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Associated Data
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Data Availability Statement
Data sharing is not applicable to this article, as no datasets were generated or analysed during the current study.