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Bedside Dermoscopy and Demonstration of Tin-tack Sign in Discoid Lupus Erythematosus
*Corresponding author: Debdeep Mitra, Department of Dermatology, Command Hospital Air Force, Bengaluru, Karnataka, India. debdeep5000@gmail.com
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How to cite this article: Mitra D, Bhatnagar A, Sanoj PK, Singh A. Bedside Dermoscopy and Demonstration of Tin-tack Sign in Discoid Lupus Erythematosus. Indian J Postgrad Dermatol. 2024;2:50-1. doi: 10.25259/IJPGD_83_2023
Discoid lupus erythematosus (DLE) has characteristic features on dermoscopy and examination of the scales reveal a tin-tack sign due to follicular plugging. Tin-tack sign occurs as a result of the deposition of scales in the hair follicles leading to cicatricial alopecia. Later, when scales are removed, characteristic keratotic spikes that provide the ‘carpet-tack or tin-tack sign’ become visible.
On removing the adherent scales of the DLE lesions, the horny plugs that have occupied the patulous hair follicles become evident and this is known as tin-tack sign, carpet-tack sign or cat tongue sign. One characteristic of DLE that has been well portrayed is a positive ‘tin-tack’ sign.
Dermoscopy (polarised ×10) showed branching and linear vessels and keratin plug, structureless white and brown areas in the background of scarring alopecia [Figure 1].
- (a) Dermoscopy (polarised ×10) showed branching and linear vessels and keratin plug, structureless white and brown areas in the background of scarring alopecia. (b) Discoid lupus erythematosus of scalp characterised by persistent scaly plaques, with associated scarring, atrophy and dyspigmentation. (c) Closer view of the scale showing tin-tack sign.
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