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Varsha MG, Shilpa K, Revathi TN, Shanmukhappa AG, Loganathan E. Telltale signs of skin trespassers: Clues to superficial mycosis. Indian J Dermatol Venereol Leprol 2023; 89:144-148. [PMID: 35146987 DOI: 10.25259/ijdvl_105_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 08/01/2021] [Indexed: 02/03/2023]
Affiliation(s)
- Manche Gowda Varsha
- Department of Dermatology, Venereology and Leprosy, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Kanathur Shilpa
- Department of Dermatology, Venereology and Leprosy, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - T N Revathi
- Department of Dermatology, Venereology and Leprosy, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Asha Gowrappala Shanmukhappa
- Department of Dermatology, Venereology and Leprosy, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Eswari Loganathan
- Department of Dermatology, Venereology and Leprosy, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
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Kumar P, Pandhi D, Bhattacharya SN, Das S. Trichoscopy as a monitoring tool in assessing treatment response in 98 children with tinea capitis: A prospective clinical study. Dermatol Ther 2021; 34:e15010. [PMID: 34041831 DOI: 10.1111/dth.15010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/24/2021] [Indexed: 12/01/2022]
Abstract
Tinea capitis (TC) is the most common dermatophyte infection in children. Fungal culture the gold standard diagnostic method takes several weeks and has poor yields. Trichoscopy helps in rapid diagnosis and could work as a monitoring tool during antifungal therapy. Our main objective is to document the evolution of trichoscopic features with treatment and their correlation with clinical parameters in patients of TC. Forty-six and 52 children with clinically diagnosed TC that was confirmed by potassium hydroxide microscopy, received griseofulvin and terbinafine, respectively. Recruited children were subjected to clinical and trichoscopic assessment by calculation of CASS (clinical assessment severity score) and counting of TAHC (Total Altered hair count; negative and positive), respectively, at baseline and follow-up at 2, 4, and 6 weeks. McNemar, Wilcoxon singed ranked test and Spearman-rho correlation of various parameters was evaluated. Follow-up trichoscopy revealed significant (p < 0.009) disappearance of negative TAHC like black dot (second week onward), corkscrew, horseshoe and zigzag hair at 4 weeks and short broken hair, erythema telangiectasia hemorrhage (ETH) resolved at 6 weeks. Positive TAHC (regrowing hair) shows significant increase at 6 weeks (p < 0.001). CASS and negative TAHC showed significant difference at 4 weeks (p < 0.001) by analyzing boxplot graph. Therefore, trichoscopic resolution occurred before the clinical cure. Terbinafine subjects showed a higher clinical cure rate at 4 weeks (p = 0.02) as compared to griseofulvin. To conclude, trichoscopy is a good monitoring tool that could document the disappearance of almost all dystrophic hair at 4 to 6 weeks and is a more sensitive tool than microscopic examination. Regrowing hair and perifollicular scaling are markers of recovery.
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Affiliation(s)
- Pradeep Kumar
- Department of Dermatology and STD, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Deepika Pandhi
- Department of Dermatology and STD, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Sambit Nath Bhattacharya
- Department of Dermatology and STD, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Shukla Das
- Department of Microbiology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
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Rodríguez‐Cerdeira C, Martínez‐Herrera E, Szepietowski J, Pinto‐Almazán R, Frías‐De‐León M, Espinosa‐Hernández V, Chávez‐Gutiérrez E, García‐Salazar E, Vega‐Sánchez D, Arenas R, Hay R, Saunte D. A systematic review of worldwide data on tinea capitis: analysis of the last 20 years. J Eur Acad Dermatol Venereol 2020; 35:844-883. [DOI: 10.1111/jdv.16951] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 09/03/2020] [Indexed: 12/18/2022]
Affiliation(s)
- C. Rodríguez‐Cerdeira
- Efficiency, Quality, and Costs in Health Services Research Group (EFISALUD) Health Research InstituteSERGAS‐UVIGO Vigo Spain
- Dermatology Department Hospital do Meixoeiro and University of Vigo Vigo Spain
- Psichodermatology Task for (CILAD) Buenos Aires Argentina
| | - E. Martínez‐Herrera
- Efficiency, Quality, and Costs in Health Services Research Group (EFISALUD) Health Research InstituteSERGAS‐UVIGO Vigo Spain
- Psichodermatology Task for (CILAD) Buenos Aires Argentina
- Unidad de Investigación Hospital Regional de Alta Especialidad de Ixtapaluca Ixtapaluca México
| | - J.C. Szepietowski
- Department of Dermatology, Venereology and Allergology Wroclaw Medical University Wroclaw Poland
| | - R. Pinto‐Almazán
- Unidad de Investigación Hospital Regional de Alta Especialidad de Ixtapaluca Ixtapaluca México
| | - M.G. Frías‐De‐León
- Unidad de Investigación Hospital Regional de Alta Especialidad de Ixtapaluca Ixtapaluca México
| | - V.M. Espinosa‐Hernández
- Unidad de Investigación Hospital Regional de Alta Especialidad de Ixtapaluca Ixtapaluca México
| | - E. Chávez‐Gutiérrez
- Unidad de Investigación Hospital Regional de Alta Especialidad de Ixtapaluca Ixtapaluca México
| | - E. García‐Salazar
- Psichodermatology Task for (CILAD) Buenos Aires Argentina
- Unidad de Investigación Hospital Regional de Alta Especialidad de Ixtapaluca Ixtapaluca México
| | - D.C. Vega‐Sánchez
- Psichodermatology Task for (CILAD) Buenos Aires Argentina
- Sección de Micología Hospital General ‘Dr. Manuel Gea González’ Ciudad de México México
| | - R. Arenas
- Efficiency, Quality, and Costs in Health Services Research Group (EFISALUD) Health Research InstituteSERGAS‐UVIGO Vigo Spain
- Psichodermatology Task for (CILAD) Buenos Aires Argentina
- Sección de Micología Hospital General ‘Dr. Manuel Gea González’ Ciudad de México México
| | - R. Hay
- St Johns Institute of Dermatology King's College London London UK
| | - D.M. Saunte
- Department of Dermatology Zealand University Hospital Roskilde Denmark
- Health Sciences Faculty University of Copenhagen Copenhagen Denmark
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4
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Genedy RM, Sorour OA, Elokazy MAW. Trichoscopic signs of tinea capitis: a guide for selection of appropriate antifungal. Int J Dermatol 2020; 60:471-481. [PMID: 33141453 DOI: 10.1111/ijd.15289] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/01/2020] [Accepted: 10/07/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Tinea capitis is the most common pediatric dermatophyte infection. Optimal treatment regimen differs according to the type of the dermatophyte involved. OBJECTIVES The aim of this work was to study the trichoscopic signs in relation to isolated organism in a sample of Egyptian patients with tinea capitis and the possibility of using them as a guide for selection of appropriate antifungal. METHODS This study was carried out on 60 subjects with tinea capitis. Patients were mycologically examined, both direct microscopy with KOH preparation and culture of the scraped hair materials on Sabouraud dextrose agar. Culture mounts were used for identification of the organism. Trichoscopic examination of all patients was performed using the Dermlite DLIII dermoscope. RESULTS There was significant higher prevalence of both comma and corkscrew hair in endothrix infection and T. violaceum-infected cases. On the other hand, there was significant higher prevalence of zigzag, barcode hairs, and white sheaths in ectothrix infection and M. canis-infected cases. CONCLUSION While some trichoscopic findings are nonspecific, others were found to be more specific. Finding zigzag hairs and barcode hairs points to ectothrix infection (M. canis), and it is recommended to start treatment with griseofulvin. On the other hand, finding comma hairs and corkscrew hairs without zigzag hairs and barcode hairs points to endothrix infection (T. violaceum), and it is recommended to start treatment with terbinafine in the usual dose.
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Affiliation(s)
- Rasha M Genedy
- Department of Dermatology and Venereology, Alexandria University, Alexandria, Egypt
| | - Osama A Sorour
- Department of Dermatology and Venereology, Alexandria University, Alexandria, Egypt
| | - Miada A W Elokazy
- Department of Dermatology and Venereology, Alexandria University, Alexandria, Egypt
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Xiao H, Pradhan S, Ran X, Ran Y. Tinea capitis: dermoscopy and calcium fluorescent microscopy as highly efficient and precise diagnostic tools. An Bras Dermatol 2020; 95:332-335. [PMID: 32276798 PMCID: PMC7253880 DOI: 10.1016/j.abd.2019.06.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Accepted: 06/13/2019] [Indexed: 02/08/2023] Open
Abstract
Tinea capitis comprising of tinea favosa and kerion is mostly seen in school-aged children. Some tinea capitis often presented with insignificant findings under the naked eyes are easily overlooked. The authors describe an unusual case of tinea capitis caused by Trichophyton violaceum. The patient was an 8-year-old girl, with a history of pruritus on the scalp for more than one year. A diagnosis of tinea capitis was confirmed by clinical examination aided by dermoscopy, calcium fluorescent microscopy and culture. Comma and corkscrew hairs are two specific dermoscopic patterns of tinea capitis. The patient was treated with systemic itraconazole, topical application with 1% naftifine 0.25% ketoconazole cream followed after daily hair wash with 2% ketoconazole shampoo for 8 weeks.
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Affiliation(s)
- Hui Xiao
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Sushmita Pradhan
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Xin Ran
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Yuping Ran
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.
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Waśkiel-Burnat A, Rakowska A, Sikora M, Ciechanowicz P, Olszewska M, Rudnicka L. Trichoscopy of Tinea Capitis: A Systematic Review. Dermatol Ther (Heidelb) 2020; 10:43-52. [PMID: 31907867 PMCID: PMC6994564 DOI: 10.1007/s13555-019-00350-1] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION An increased incidence of tinea capitis has been observed over the last few decades. Trichoscopy is a non-invasive, in-office method helpful in establishing the correct diagnosis in patients with hair loss and inflammatory hair disorders. The objective was to review and analyze current data on the trichoscopy of tinea capitis. METHODS A systematic review of the literature was conducted using the PubMed, EBSCO and Scopus databases. The search terms included 'tinea capitis' combined with 'trichoscopy', 'dermatoscopy', 'dermoscopy', 'videodermatoscopy' or 'videodermoscopy'. RESULTS Of 326 articles, 37 were considered eligible for the quantitative analysis. The most characteristic (with a high predictive value) trichoscopic findings of tinea capitis included comma hairs (51%), corkscrew hairs (32%), Morse code-like hairs (22%), zigzag hairs (21%), bent hairs (27%), block hairs (10%) and i-hairs (10%). Other common, but not characteristic, trichoscopic features were broken hairs (57%), black dots (34%), perifollicular scaling (59%) and diffuse scaling (89%). Morse code-like hairs, zigzag hairs, bent hairs and diffuse scaling were only observed in Microsporum tinea capitis (8/29, 28%; 6/29, 21%; 4/29, 14% and 4/29, 14%, respectively). In Trichophyton tinea capitis, corkscrew hairs were more commonly detected compared to Microsporum tinea capitis (21/38, 55% vs 3/29, 10%). CONCLUSION The presence of characteristic trichoscopic features of tinea capitis is sufficient to establish the initial diagnosis and introduce treatment before culture results are available. Trichoscopy may be useful in distinguishing between Microsporum and Trichophyton tinea capitis.
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Affiliation(s)
| | - Adriana Rakowska
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland.
| | - Mariusz Sikora
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | | | | | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
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Dhaille F, Dillies A, Dessirier F, Reygagne P, Diouf M, Baltazard T, Lombart F, Hébert V, Chopinaud M, Verneuil L, Becquart C, Delaporte E, Lok C, Chaby G. A single typical trichoscopic feature is predictive of tinea capitis: a prospective multicentre study. Br J Dermatol 2019; 181:1046-1051. [DOI: 10.1111/bjd.17866] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2019] [Indexed: 12/25/2022]
Affiliation(s)
- F. Dhaille
- Department of Dermatology Amiens University Medical Center AmiensFrance
| | - A.‐S. Dillies
- Department of Dermatology Amiens University Medical Center AmiensFrance
| | - F. Dessirier
- Department of Dermatology Amiens University Medical Center AmiensFrance
| | - P. Reygagne
- Centre Sabouraud Hôpital Saint Louis ParisFrance
| | - M. Diouf
- Biostatistics Department Clinical Research and Innovation Directorate Amiens University Medical Center AmiensFrance
| | - T. Baltazard
- Department of Dermatology Amiens University Medical Center AmiensFrance
| | - F. Lombart
- Department of Dermatology Amiens University Medical Center AmiensFrance
| | - V. Hébert
- Department of Dermatology Rouen University Medical Center RouenFrance
| | - M. Chopinaud
- Department of Dermatology Caen University Medical Center CaenFrance
| | - L. Verneuil
- Department of Dermatology Caen University Medical Center CaenFrance
| | - C. Becquart
- Department of Dermatology Lille University Medical Center Lille France
| | - E. Delaporte
- Department of Dermatology Lille University Medical Center Lille France
| | - C. Lok
- Department of Dermatology Amiens University Medical Center AmiensFrance
| | - G. Chaby
- Department of Dermatology Amiens University Medical Center AmiensFrance
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Verzì AE, Lacarrubba F, Dinotta F, Micali G. Dermatoscopy of Parasitic and Infectious Disorders. Dermatol Clin 2018; 36:349-358. [PMID: 30201144 DOI: 10.1016/j.det.2018.05.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The use of dermatoscopy in the diagnosis and management of parasitic and infectious skin disorders has been defined as entodermoscopy, and several studies have confirmed its advantages in dermatology. Dermatoscopic patterns of several parasitic, viral, and fungal skin infections have been identified and herein described. A noninvasive, fast, and accurate diagnosis plays an important role in containing the spread of contagious skin disorders.
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Affiliation(s)
- Anna Elisa Verzì
- Dermatology Clinic, University of Catania, Via Santa Sofia 78, Catania 95123, Italy
| | - Francesco Lacarrubba
- Dermatology Clinic, University of Catania, Via Santa Sofia 78, Catania 95123, Italy
| | - Franco Dinotta
- Dermatology Clinic, University of Catania, Via Santa Sofia 78, Catania 95123, Italy
| | - Giuseppe Micali
- Dermatology Clinic, University of Catania, Via Santa Sofia 78, Catania 95123, Italy.
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9
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Tinea Capitis: Current Review of the Literature. CURRENT FUNGAL INFECTION REPORTS 2018. [DOI: 10.1007/s12281-018-0320-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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10
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Alternative uses of dermoscopy in daily clinical practice: An update. J Am Acad Dermatol 2018; 79:1117-1132.e1. [PMID: 29920317 DOI: 10.1016/j.jaad.2018.06.021] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 05/30/2018] [Accepted: 06/11/2018] [Indexed: 01/06/2023]
Abstract
Dermoscopy is a noninvasive diagnostic tool that is currently being used for neoplastic skin lesions, several inflammatory and infectious diseases, and skin appendage disorders. As the clinical applications of dermoscopy beyond pigmented lesions are constantly increasing, the aim of this article is to provide an update on this topic. This comprehensive review substantiates how several diseases may show peculiar dermoscopy features so as to enhance the diagnosis and avoid (in selected cases) unnecessary histologic confirmation. In other cases, dermoscopy features may be shared with other conditions, with the advantage of narrowing down the differential diagnosis by ruling out those dermatoses with similar clinical aspect but different dermoscopic presentation.
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Yin B, Ran X, Ran Y, Zhang Y, Pradhan S. Cover Image: Dermoscopic detection of unusual eyelash
Trichophyton interdigitale
infection mimicking hordeolum. Br J Dermatol 2018; 178:989-990. [PMID: 29668092 DOI: 10.1111/bjd.16434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- B. Yin
- Department of Dermatovenereology Chengdu Second People's Hospital Chengdu China
| | - X. Ran
- Department of Dermatovenereology West China Hospital Sichuan University Chengdu 610041 China
| | - Y. Ran
- Department of Dermatovenereology West China Hospital Sichuan University Chengdu 610041 China
| | - Y. Zhang
- Department of Dermatovenereology Chengdu Second People's Hospital Chengdu China
| | - S. Pradhan
- Department of Dermatovenereology West China Hospital Sichuan University Chengdu 610041 China
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Errichetti E, Stinco G. Dermoscopy in General Dermatology: A Practical Overview. Dermatol Ther (Heidelb) 2016; 6:471-507. [PMID: 27613297 PMCID: PMC5120630 DOI: 10.1007/s13555-016-0141-6] [Citation(s) in RCA: 180] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Indexed: 12/15/2022] Open
Abstract
Over the last few years, dermoscopy has been shown to be a useful tool in assisting the noninvasive diagnosis of various general dermatological disorders. In this article, we sought to provide an up-to-date practical overview on the use of dermoscopy in general dermatology by analysing the dermoscopic differential diagnosis of relatively common dermatological disorders grouped according to their clinical presentation, i.e. dermatoses presenting with erythematous-desquamative patches/plaques (plaque psoriasis, eczematous dermatitis, pityriasis rosea, mycosis fungoides and subacute cutaneous lupus erythematosus), papulosquamous/papulokeratotic dermatoses (lichen planus, pityriasis rosea, papulosquamous sarcoidosis, guttate psoriasis, pityriasis lichenoides chronica, classical pityriasis rubra pilaris, porokeratosis, lymphomatoid papulosis, papulosquamous chronic GVHD, parakeratosis variegata, Grover disease, Darier disease and BRAF-inhibitor-induced acantholytic dyskeratosis), facial inflammatory skin diseases (rosacea, seborrheic dermatitis, discoid lupus erythematosus, sarcoidosis, cutaneous leishmaniasis, lupus vulgaris, granuloma faciale and demodicidosis), acquired keratodermas (chronic hand eczema, palmar psoriasis, keratoderma due to mycosis fungoides, keratoderma resulting from pityriasis rubra pilaris, tinea manuum, palmar lichen planus and aquagenic palmar keratoderma), sclero-atrophic dermatoses (necrobiosis lipoidica, morphea and cutaneous lichen sclerosus), hypopigmented macular diseases (extragenital guttate lichen sclerosus, achromic pityriasis versicolor, guttate vitiligo, idiopathic guttate hypomelanosis, progressive macular hypomelanosis and postinflammatory hypopigmentations), hyperpigmented maculopapular diseases (pityriasis versicolor, lichen planus pigmentosus, Gougerot-Carteaud syndrome, Dowling-Degos disease, erythema ab igne, macular amyloidosis, lichen amyloidosus, friction melanosis, terra firma-forme dermatosis, urticaria pigmentosa and telangiectasia macularis eruptiva perstans), itchy papulonodular dermatoses (hypertrophic lichen planus, prurigo nodularis, nodular scabies and acquired perforating dermatosis), erythrodermas (due to psoriasis, atopic dermatitis, mycosis fungoides, pityriasis rubra pilaris and scabies), noninfectious balanitis (Zoon's plasma cell balanitis, psoriatic balanitis, seborrheic dermatitis and non-specific balanitis) and erythroplasia of Queyrat, inflammatory cicatricial alopecias (scalp discoid lupus erythematosus, lichen planopilaris, frontal fibrosing alopecia and folliculitis decalvans), nonscarring alopecias (alopecia areata, trichotillomania, androgenetic alopecia and telogen effluvium) and scaling disorders of the scalp (tinea capitis, scalp psoriasis, seborrheic dermatitis and pityriasis amiantacea).
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Affiliation(s)
- Enzo Errichetti
- Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Udine, Italy.
| | - Giuseppe Stinco
- Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Udine, Italy
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