Pediatric Dermoscopy: Diagnosing Congenital Nevi, Vascular Lesions, and Skin Infections

Conclusions

• Dermoscopy substantially improves diagnostic accuracy in children by helping distinguish melanocytic, vascular, keratinocytic, and inflammatory lesions without immediate biopsy.
• Congenital melanocytic nevi are usually reassuring when they show organized globular or reticular patterns, peripheral maturation, and other benign features such as hypertrichosis.
• Café-au-lait macules can be reliably separated from congenital melanocytic nevi by their more uniform pigmentation and crisp border, which can directly change downstream workup such as genetic testing.
• Infantile hemangiomas have characteristic lacunae and white streaking on dermoscopy, and early white change can signal impending ulceration and the need for urgent treatment.
• Recognizing vascular lesions correctly is especially important in darker skin phototypes, where delayed diagnosis may contribute to worse outcomes and less timely therapy.
• Dermoscopy can prevent unnecessary procedures and redirect management when lesions thought to be CMN are actually infantile hemangioma, café-au-lait macule, or epidermal nevus.
• Inflammatory rashes such as psoriasis can often be diagnosed clinically supported by dermoscopy, avoiding biopsy and helping clinicians start more appropriate treatment sooner.
• Psoriasis is suggested by a milky pink background, uniformly distributed dotted vessels, and scale, whereas eczematous dermatitis more often shows orange-yellow scale, patchier vessels, and excoriation.
• Ultraviolet dermoscopy adds diagnostic value beyond standard polarized and non-polarized dermoscopy by making features like scabies mites, burrows, porphyrins, and molluscum structures easier to see.
• For skin infections, UV dermoscopy can improve sensitivity and confidence, especially for scabies in heavily pigmented skin and for identifying molluscum contagiosum features such as the pearl sign.
• Overall, the presentation argues that dermoscopy should be embraced more broadly in pediatric and primary care settings because it improves diagnosis, speeds referral, and reduces unnecessary interventions.