Indian Journal of Dermatology, Venereology, and Leprology: Published on 2019

A 28-year-old man, undergoing treatment for vitiligo, presented with complaints of new lesions on the neck for the last 1 week. On examination, multiple hypopigmented macules were seen on the neck.

Figure 1: Patient with vitiligo (red arrow) showing multiple hypopigmented to depigmented macules (black arrows) on the neck

 “Scratch sign” or “coup d'ongle sign” was negative on examination with naked eye.On examination with a dermoscope (Dermlite dl3 dermoscope, noncontact, polarizing, 10× magnification), very fine scales were present along the natural skin creases on a background of hypopigmented skin. Scaling was inconspicuous on the area between the skin creases.

On stretching the skin these fine scales appeared more prominent under dermoscope but were still inconspicuous with naked eye. 

Figure 2: Dermoscopic picture showing fine scales along the skin markings with sparing of the skin between the markings

Potassium hydroxide (KOH) mount confirmed the diagnosis of pityriasis versicolor.

The dermoscopic feature of presence of fine scaling along the normal skin markings on a background of hypopigmented/hyperpigmented skin, giving it a “wire fence” appearance, may serve as a useful clue for easy and quick diagnosis of pityriasis versicolor. 

Figure 3: Magnified dermoscopic picture showing scales arranged along diamond-shaped skin markings giving a “wire fence” or “fish net appearance”