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Zanna G, Abramo F, Contiero B, Zini E, Albanese F, Borio E, Godizzi F, Necci F, Luciani L, Roccabianca P. Dermoscopic findings and comparison of usefulness of longitudinal versus transversal sections in the histological diagnosis of alopecia X. Vet Dermatol 2024; 35:126-137. [PMID: 37867253 DOI: 10.1111/vde.13212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 07/05/2023] [Accepted: 10/10/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND A combination of dermoscopic and histological findings may provide useful information for the diagnosis of hair follicle diseases. However, there are no studies on dermoscopic-histopathological correlations in dogs affected by alopecia X, and comparison of longitudinal versus transversal sectioning of skin biopsy specimens in the assessment of this hair loss disorder has not been thoroughly investigated. HYPOTHESIS/OBJECTIVES The aim of this study was to correlate dermoscopic and histological features using both longitudinal and transversal sectioning of skin biopsy samples to gain additional information for the diagnosis of alopecia X. ANIMALS Nineteen Pomeranian dogs affected by alopecia X and five healthy Pomeranians as controls. MATERIALS AND METHODS Dermoscopic-histological correlation was performed within the diseased group, whereas histological comparisons against controls. The demographic and clinical characteristics also were related to the histological findings. RESULTS The dermoscopic findings revealed scattered, thinned, short hairs mixed with amorphous keratoseborrhoeic-like material (follicular plugging), perifollicular and intrafollicular scaling, and hyperpigmentation varying from pinpoint black spots to a diffuse texture. Dermoscopic findings correlated with histological findings for selected qualitative and quantitative findings. The usefulness of transversal sections was demonstrated in accurately determining the hair follicular density and counts, growth arrest phases and in identifying mineralisation of hair follicle basement membrane when compared to the longitudinal. Conversely, no correlations between histological findings and demographic and clinical characteristics were detected. CONCLUSIONS AND CLINICAL RELEVANCE These data provide evidence of the usefulness of dermoscopic evaluation as an accessory diagnostic tool and of transversal sections of skin biopsies as complementary to the diagnosis of alopecia X.
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Affiliation(s)
- Giordana Zanna
- Anicura-Istituto Veterinario di Novara, Granozzo con Monticello, Italy
| | - Francesca Abramo
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - Barbara Contiero
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Italy
| | - Eric Zini
- Anicura-Istituto Veterinario di Novara, Granozzo con Monticello, Italy
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Italy
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | | | - Elena Borio
- Clinica Veterinaria San Martino, Novara, Italy
| | | | - Fabiano Necci
- CDVet- Laboratorio Analisi Veterinarie Roma, Rho, Italy
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Conto Quispe PN, Tapia Martinez AC, Vilcapoma Guerra HJ, Lavado García L, Torres Ramos G. Aesthetic oral rehabilitation of the upper-anterior sector with supra-nano filling resin in a patient with woolly hair syndrome: case report. SPECIAL CARE IN DENTISTRY 2024. [PMID: 38375899 DOI: 10.1111/scd.12979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/08/2023] [Accepted: 02/09/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND Woolly Hair Syndrome (WHS) is a rare birth condition that affects the structure of hair in non-black people. The pathogenesis is not yet defined. It is postulated that the hair follicle's desmosomes (specifically desmoplaquine, placoglobin and placofilin-1, which are cell structural proteins that keep the adhesion among close cells) would be altered in this pathology, leading to fragility in the cellular union. It is subdivided into two large groups: the localized or circumscribed variant and the generalized variant. From birth or first months of life, patients with WHS are clinically characterized by the presence of a portion or entire scalp area of very short frizzy hair, usually of a smaller diameter, brittle and lighter color. The most frequent skin manifestations are pilar keratosis and palmo-plantar keratodermia. The diagnosis is based on the clinical findings, and it is facilitated by trichotoscopic examination. However, a definitive diagnosis of WHS requires genetic testing. Oral agenesis, enamel defects (such as hypomineralization), atypical caries, dental inclusion, and malformed pin-shaped teeth may occur. OBJECTIVE To describe an aesthetic alternative of oral rehabilitation using the mock-up technique in a patient with WHS. CLINICAL CASE A 5-year-old female patient diagnosed with WHS from the National Institute of Child Health NIHCH: Breña, Lima, who was referred from the Genetic service to the Pediatric Dentistry service in order to screen outbreaks of infection associated with odontogenic origin and dental anomalies. At the ectoscopy, a patient with short capillary length, brittle and curly hair, dry skin, and nail dystrophy was observed. At the intraoral clinical examination, anterior pieces of 52, 51, 61, 62, and enamel hypomineralization were observed in all teeth. The radiographic examination showed agenesis of parts 41, 34, and 45. Integral dental treatment was performed in the operating room under general anesthesia due to the complexity of the case. Pulpectomy in pieces 52, 51, 61, 62, post of composite resin, and rehabilitation with supra-nanow filling resin using the mock-up technique were proposed as alternative treatments. CONCLUSION The making of supra-nano filling resin-based crowns using the mock-up technique is an alternative treatment for aesthetic oral rehabilitation in deciduous dentition of patients with WHS. The aesthetic treatment was achieved using supra nano-filling resins. After 12 months of dental treatment, a favorable response was observed, improving the chewing, phonation and aesthetics of the patient.
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Affiliation(s)
| | - Akemy Celeste Tapia Martinez
- Faculty of Dentistry, Universidad Nacional Mayor de San Marcos, Lima, Peru and Dentistry Department, National Police Hospital of Peru Luis N. Saenz, Lima, Peru
| | - Henry Jesús Vilcapoma Guerra
- Faculty of Dentistry, Universidad Nacional Mayor de San Marcos, Lima, Peru and Dentistry Department, Central Hospital of the Peruvian Air Force, Lima, Peru
| | - Lenny Lavado García
- Faculty of Dentistry, Universidad Nacional Mayor de San Marcos, Lima, Peru and Dentistry Department, Instituto Nacional de Salud del Niño, Lima, Peru
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3
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Li M, Wang F, Li X, Ding X, Du J. A Prospective Study of Dermoscopic and Ultrastructural Features of Vitiligo-Associated Leukotrichia. Clin Cosmet Investig Dermatol 2023; 16:3673-3680. [PMID: 38146405 PMCID: PMC10749579 DOI: 10.2147/ccid.s435900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 12/09/2023] [Indexed: 12/27/2023]
Abstract
Background Dermoscopic and ultrastructural features of vitiligo-associated leukotrichia (VAL) have not been well studied. This study is aimed at the dermoscopic and ultrastructural features of VAL. Methods We present a cross-sectional study of VAL-related dermoscopic signs and their relationship with disease stages and duration of leukotrichia. Characteristics of hair surface and finer details including melanosomes, macrofibrils, and remnant nucleus were observed under Electron Microscopy (EM). Results One hundred and forty samples on distinct sites from 100 patients were collected. Among 75 VAL from the scalp, the prevalence of diameter diversity of leukotrichia (52.6% vs 8.1%), Pohl-Pinkus constrictions (34.2% vs 0), and depigmented hair roots signs (34.2% vs 8.1%) in patients with progressive vitiligo was much higher than that in patients with stable vitiligo (all P<0.05). The EM result of VAL showed that melanosomes were smaller with vesicles formation, reduced counts, and incomplete shape, and macrofibrils were irregularly arranged with widened spaces and vesicles formation. Limitations No conclusions about the histopathologic characteristics or dermoscopic-histopathologic correlation of the VAL. Conclusion The dermoscopic signs of diameter diversity of leukotrichia, Pohl-Pinkus constrictions, and depigmented hair roots are related to progressive vitiligo. The process of melanin synthesis and formation of VAL are impaired at the early stage of VAL under Electron microscopy.
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Affiliation(s)
- Man Li
- Department of Dermatology, Peking University People’s Hospital, Beijing, 100044, People’s Republic of China
| | - Fang Wang
- Department of Dermatology, Peking University People’s Hospital, Beijing, 100044, People’s Republic of China
| | - Xinxin Li
- Department of Dermatology, Peking University People’s Hospital, Beijing, 100044, People’s Republic of China
| | - Xiaolan Ding
- Department of Dermatology, Peking University People’s Hospital, Beijing, 100044, People’s Republic of China
| | - Juan Du
- Department of Dermatology, Peking University People’s Hospital, Beijing, 100044, People’s Republic of China
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4
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Annunziata MC, Tosti A, Fattore D, Potestio L, Maddy AJ, Fabbrocini G. Trichoscopic Patterns and Confocal Microscopy Features of Chemotherapy-Induced Alopecia. Skin Appendage Disord 2023; 9:346-350. [PMID: 37900779 PMCID: PMC10601955 DOI: 10.1159/000531183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 04/24/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction Chemotherapy-induced alopecia (CIA) can seriously affect the quality of life of cancer patients. Trichoscopic patterns and confocal microscopy (RCM) features of CIA have been scarcely studied. This study aimed to investigate the dermoscopic and RCM features of CIA in 19 females and 5 males, with CIA due to current or recent chemotherapy. Methods Patients with CIA and current or recent (within 2 months) history of chemotherapy treatment were enrolled. After clinical examination, standard pictures were taken by digital camera (SLR Canon PowerShot G10) and trichoscopic images were captured by the Handyscope device (20x). Images of RCM were acquired by VivaScope 3000 with the VivaStack option. The trichoscopic and confocal images were acquired by three independent observers after central parting on three areas: vertex, middle, and frontal scalp. Results A total of 24 patients were enrolled. CIA has features of anagen effluvium at trichoscopy but with low frequency of yellow dots and prominence of black dots. The simultaneous presence of pseudo-monilethrix and black dots at trichoscopy confirms the hypothesis that chemotherapy insults the hair follicle intermittently. At RCM, the presence of abnormal hair shaft morphology highlights that the insults affect hair shaft production. Conclusion These are the first data in this field, so further studies with a higher number of patients analyzed are needed to confirm these findings.
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Affiliation(s)
- Maria Carmela Annunziata
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Antonella Tosti
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Davide Fattore
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Luca Potestio
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Austin John Maddy
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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Legiawati L, Suseno LS, Sitohang IBS, Yusharyahya SN, Ardelia A, Paramastri K. Trichoscopy Features of Indonesian Males with Androgenetic Alopecia in Association with Disease Severity. Int J Trichology 2023; 15:144-148. [PMID: 38765725 PMCID: PMC11098145 DOI: 10.4103/ijt.ijt_31_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 05/22/2024] Open
Abstract
Introduction Androgenetic alopecia (AGA) is a progressive loss of terminal hairs in a specific pattern distribution related to androgen. The dermoscopy of hair and scalp, known as trichoscopy, is a noninvasive method for diagnosing alopecia and other hair and scalp disorders. Objective This study aims to report the correlation between the severity of males with AGA based on Hamilton-Norwood's scale with the clinical characteristics found in trichoscopy. Materials and Methods This study included 40 patients aged 25-58 years who visited the dermatology outpatient clinic in a tertiary health facility in Indonesia. Clinical diagnosis was determined through history taking, physical examination, and trichoscopy. Based on Hamilton-Norwood's criteria, patients were divided into two groups: early and late stage. Parameters examined in trichoscopy include yellow dots, white dots, peripilar sign, vellus hair, hair diameter diversity, single-hair follicles, and empty follicles. The Chi-square test and Fisher's exact test were used to analyze the statistical significance between the groups. Results All participants presented with hair diameter diversity, vellus hair, and empty follicles (100%). None of the study participants had yellow dots. White dots and single-hair follicles were seen in 32 (80%) and 30 cases (75%), respectively. In the late-stage group, these features were more prevalent. Peripilar sign was found in 25 participants (62.50%), and it was more common in the early-stage group. No significant association was found between disease severity and trichoscopy features. Conclusion The most common trichoscopy findings in particular order were hair diameter diversity, vellus hair, and empty follicles, followed by white dots, single-hair follicles, and peripilar signs. No significant association between alopecia severity and trichoscopy parameters was observed. Studies with a larger number of participants, including a control group, should be conducted to yield more significant results.
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Affiliation(s)
- Lili Legiawati
- Department of Dermatology and Venereology, Faculty of Medicine, Dr. Cipto Mangunkusumo General Hospital, Universitas Indonesia, Central Jakarta, Indonesia
| | - Lis Surachmiati Suseno
- Department of Dermatology and Venereology, Faculty of Medicine, Dr. Cipto Mangunkusumo General Hospital, Universitas Indonesia, Central Jakarta, Indonesia
| | - Irma Bernadette S. Sitohang
- Department of Dermatology and Venereology, Faculty of Medicine, Dr. Cipto Mangunkusumo General Hospital, Universitas Indonesia, Central Jakarta, Indonesia
| | - Shannaz Nadia Yusharyahya
- Department of Dermatology and Venereology, Faculty of Medicine, Dr. Cipto Mangunkusumo General Hospital, Universitas Indonesia, Central Jakarta, Indonesia
| | - Athaya Ardelia
- Department of Dermatology and Venereology, Faculty of Medicine, Dr. Cipto Mangunkusumo General Hospital, Universitas Indonesia, Central Jakarta, Indonesia
| | - Kanya Paramastri
- Department of Dermatology and Venereology, Faculty of Medicine, Dr. Cipto Mangunkusumo General Hospital, Universitas Indonesia, Central Jakarta, Indonesia
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Salve VJ, Viswanath V, Joshi P, Dhakne M. A Potpourri of Trichoscopic Findings: Unique Presentation of Hyperthyroidism-Induced Hair Changes. Int J Trichology 2023; 15:160-162. [PMID: 38765722 PMCID: PMC11098137 DOI: 10.4103/ijt.ijt_98_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 06/14/2022] [Indexed: 05/22/2024] Open
Abstract
Hyperthyroidism is known to cause thin, brittle hair, and premature graying. Hair shaft abnormalities in hyperthyroidism have not been described in the literature. A visible and microscopic change in the hair shaft due to cosmetic procedures and environmental factors is known as hair weathering. Herein, we report a case of hair weathering in an adult female with hyperthyroidism with unique dermoscopic features.
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Affiliation(s)
- Vrushali Jaysing Salve
- Department of Dermatology, Rajiv Gandhi Medical College and Chhatrapati Shivaji Maharaj Hospital, Thane, Maharashtra, India
| | - Vishalakshi Viswanath
- Department of Dermatology, Rajiv Gandhi Medical College and Chhatrapati Shivaji Maharaj Hospital, Thane, Maharashtra, India
| | - Pradnya Joshi
- Department of Dermatology, Rajiv Gandhi Medical College and Chhatrapati Shivaji Maharaj Hospital, Thane, Maharashtra, India
| | - Mayuri Dhakne
- Department of Dermatology, Rajiv Gandhi Medical College and Chhatrapati Shivaji Maharaj Hospital, Thane, Maharashtra, India
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Al‐Dhubaibi MS, Alsenaid A, Alhetheli G, Abd Elneam AI. Trichoscopy pattern in alopecia areata: A systematic review and meta-analysis. Skin Res Technol 2023; 29:e13378. [PMID: 37357664 PMCID: PMC10236002 DOI: 10.1111/srt.13378] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/13/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND The incidence of alopecia areata (AA) has increased over the last few decades. Trichoscopy is a noninvasive procedure performed in dermatology clinics and is a helpful tool in determining the correct diagnosis of hair loss presentations. OBJECTIVE Through mapping the researches that have been done to represent the spectrum of trichoscopic findings in AA and to identify the most characteristic patterns. METHODS Thirty-nine studies were eligible for the quantitative analysis. Meta-analysis and subgroup analysis were performed. RESULTS Thirty-nine studies (29 cross-sectional, five retrospective, two descriptive, one case series, one observational, and one cohort) with a total of 3204 patients were included. About 66.7% of the studies were from Asia, 25.6% from Europe, and 7.7% from Africa. The most characteristic trichoscopic findings of AA were as follows; yellow dots, black dots, broken hairs, short vellus hairs, and tapering hairs. CONCLUSION There is no single pathognomonic diagnostic trichoscopic finding in AA rather than a constellation of characteristic findings. The five most characteristic trichoscopic findings in AA are: yellow dots, black dots, broken hairs, short vellus hairs, and tapering hairs. Yellow dots and short vellus hairs considered the most sensitive clues for AA, while black dots and tapering hairs are the most specific ones. Furthermore, trichoscopy is a useful tool that allows monitoring of response during the treatment of AA. Treatment responded cases will show an increase in short vellus hairs, but loss of tapering hairs, broken hairs, and black dots, while yellow dots are the least responsive to the treatment.
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Affiliation(s)
| | - Adel Alsenaid
- Department of DermatologyCollege of Medicine, Shaqra UniversityDawadmiSaudi Arabia
- Division of DermatologyJohns Hopkins Aramco HealthcareDhahranSaudi Arabia
| | - Ghadah Alhetheli
- Division of Dermatology and Cutaneous SurgeryCollege of Medicine, Qassim UniversityBuraydahSaudi Arabia
| | - Ahmed Ibrahim Abd Elneam
- Department of Clinical Biochemistry, Department of Basic Medical SciencesCollege of Medicine, Shaqra UniversityDawadmiSaudi Arabia
- Molecular Genetics and Enzymology DepartmentHuman Genetics and Genome Research Institute, National Research CenterDokkiCairoEgypt
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8
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Rafik D, Younis I, Atef R, Eid H. Claudin-3 is a novel intestinal integrity marker in patients with alopecia areata: Correlation with the disease severity. J Cosmet Dermatol 2023; 22:1377-1381. [PMID: 36606388 DOI: 10.1111/jocd.15582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/17/2022] [Accepted: 12/11/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND The development of alopecia areata is suggested to be influenced by intestinal permeability and gut dysbiosis. Claudin-3, an essential component of tight junctions which may act as an indicator of intestinal barrier integrity. AIMS The study's objective was to evaluate the plasma concentration level of Claudin-3 in alopecia areata patients and its relationship to the severity of the condition. PATIENTS AND METHODS In this case-control study, 50 alopecia areata patients and 30 healthy age and sex controls were involved. An enzyme-linked immunosorbent assay was used to determine the concentration of claudin-3 in the blood. RESULTS Patients with alopecia areata had significantly higher plasma claudin-3 concentrations than healthy controls [median (interquartile range), 7.73 ng/ml (4.49-33.7) vs. 6.14 ng/ml (4.45-15.6), p < 0.005]. Positive relations were found between claudin-3 and SALT score (r = 0.675 & p-value < 0.001). CONCLUSIONS Claudin-3, a gut permeability biomarker, is elevated in alopecia areata and correlates with disease severity.
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Affiliation(s)
- Dina Rafik
- Dermatology Department, Faculty of Medicine, Benha University, Benha, Egypt
| | - Ihab Younis
- Dermatology Department, Faculty of Medicine, Benha University, Benha, Egypt
| | - Rana Atef
- Clinical Pathology and Chemistry Department, Faculty of Medicine, Benha University, Benha, Egypt
| | - Hanaa Eid
- Dermatology Department, Faculty of Medicine, Benha University, Benha, Egypt
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9
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Gomes TF, Soares RO. Pediatric androgenetic alopecia: an updated review. J Dtsch Dermatol Ges 2023; 21:19-25. [PMID: 36688435 DOI: 10.1111/ddg.14940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 09/23/2022] [Indexed: 01/24/2023]
Abstract
Pediatric androgenetic alopecia is an underrecognized disorder. A clinical evaluation with trichoscopy should be made in children and adolescents with hair loss and/or reduced hair density. Diagnosis is usually clinical, by observation of the hair loss pattern and performance of trichoscopy. In some cases, hyperandrogenism should be excluded. Although there is no approved therapy for androgenetic alopecia in pediatric age, topical minoxidil, oral minoxidil and topical finasteride may be very useful. Hair transplant may be an option for girls in selected cases. This article is a review of the current state of evidence concerning pediatric androgenetic alopecia.
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[Translated article] Trichoscopy in Alopecia Areata. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:T25-T32. [PMID: 36368582 DOI: 10.1016/j.ad.2022.08.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 08/07/2022] [Indexed: 11/09/2022] Open
Abstract
Alopecia areata is an autoimmune disease that affects the hair follicle and can present as bald patches on the scalp and hair loss in other parts of the body. Diagnosis is clinical but can be aided by trichoscopy, a simple, rapid technique that reduces the need for invasive procedures and can also help with monitoring treatment response. We review the usefulness of trichoscopy in alopecia areata. The most common trichoscopic findings are yellow dots, black dots, exclamation mark hairs, short vellus hairs, and coudability hairs. Other, less common, findings can also help establish a diagnosis. Good response to treatment is indicated by the disappearance of black dots, broken hairs, and exclamation mark hairs. The observation of yellow dots, by contrast, indicates chronic disease and poor response to treatment.
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11
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Gomes TF, Soares RO. Aktuelle Übersicht zur androgenetischen Alopezie bei Kindern und Jugendlichen. J Dtsch Dermatol Ges 2023; 21:19-26. [PMID: 36721944 DOI: 10.1111/ddg.14940_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 09/23/2022] [Indexed: 02/02/2023]
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12
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Gómez-Quispe H, Muñoz Moreno-Arrones O, Hermosa-Gelbard Á, Vañó-Galván S, Saceda-Corralo D. Trichoscopy in Alopecia Areata. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:25-32. [PMID: 36067826 DOI: 10.1016/j.ad.2022.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 07/21/2022] [Accepted: 08/07/2022] [Indexed: 01/11/2023] Open
Abstract
Alopecia areata is an autoimmune disease that affects the hair follicle and can present as bald patches on the scalp and hair loss in other parts of the body. Diagnosis is clinical but can be aided by trichoscopy, a simple, rapid technique that reduces the need for invasive procedures and can also help with monitoring treatment response. We review the usefulness of trichoscopy in alopecia areata. The most common trichoscopic findings are yellow dots, black dots, exclamation mark hairs, short vellus hairs, and coudability hairs. Other, less common, findings can also help establish a diagnosis. Good response to treatment is indicated by the disappearance of black dots, broken hairs, and exclamation mark hairs. The observation of yellow dots, by contrast, indicates chronic disease and poor response to treatment.
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Affiliation(s)
- H Gómez-Quispe
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Departamento de Medicina, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Madrid, España.
| | - O Muñoz Moreno-Arrones
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Departamento de Medicina, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Madrid, España; Unidad de Tricología, Grupo de Dermatología Pedro Jaén, Madrid, España
| | - Á Hermosa-Gelbard
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Departamento de Medicina, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Madrid, España; Unidad de Tricología, Grupo de Dermatología Pedro Jaén, Madrid, España
| | - S Vañó-Galván
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Departamento de Medicina, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Madrid, España; Unidad de Tricología, Grupo de Dermatología Pedro Jaén, Madrid, España
| | - D Saceda-Corralo
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Departamento de Medicina, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Madrid, España; Unidad de Tricología, Grupo de Dermatología Pedro Jaén, Madrid, España
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13
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Abedini R, Jafferany M, Goodarzi A, Ansari MS, Ansari M, Khosravi S, Mozafarpoor S. Can hair cast be a helpful dermoscopic diagnostic clue in telogen effluvium? J Cosmet Dermatol 2022; 21:7219-7221. [PMID: 36066389 DOI: 10.1111/jocd.15362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 08/06/2022] [Accepted: 09/02/2022] [Indexed: 01/06/2023]
Affiliation(s)
- Robabeh Abedini
- Autoimmune Bollous Disease Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Jafferany
- Department of Psychiatry, Behavioral and Social Sciences, Central Michigan University, CMU Medical Education Partners, Saginaw, Michigan, USA
| | - Azadeh Goodarzi
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahshid Sadat Ansari
- Autoimmune Bollous Disease Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Ansari
- Autoimmune Bollous Disease Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sepehr Khosravi
- Student Research Center, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran.,Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Samaneh Mozafarpoor
- Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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El Mulla KF, Elmorsy EH, Halwag DI, Hassan EM. Transepidermal Delivery of Triamcinolone Acetonide or Platelet Rich Plasma Using Either Fractional Carbon Dioxide Laser or Micro-needling in Treatment of Alopecia Areata. Dermatol Pract Concept 2022; 12:e2022196. [PMID: 36534509 PMCID: PMC9681232 DOI: 10.5826/dpc.1204a196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2022] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Trans-epidermal drug delivery, using "laser-assisted drug delivery", or micro-needling, are new treatment modalities, that can improve drug penetration into skin in treatment of alopecia areata patients. OBJECTIVES To evaluate the use of fractional carbon dioxide laser versus micro-needling in trans-epidermal delivery of triamcinolone acetonide and platelet rich plasma in alopecia areata treatment. METHODS Interventional comparative study carried out on 60 patients, randomly divided into four equal groups. Group I: Fractional Carbon dioxide laser and triamcinolone acetonide. Group II: micro-needling with Dermapen and triamcinolone acetonide. Group III: fractional carbon dioxide laser and platelet-rich plasma. Group IV: micro-needling with Dermapen and platelet-rich plasma. Patients were evaluated clinically, using Severity of Alopecia Tool score and hair regrowth scale, and dermoscopically. RESULTS In all treatment groups, there was improvement in the Regrowth scale, with statistical significance between the different groups at fourth (P = 0.001) and last (P = 0.008) visits, with highest, most significant changes in Pen-Steroid group. Comparing Regrowth scale at last visit, results were in favor of Dermapen, compared to Carbon dioxide laser for trans-epidermal drug delivery (P = 0.023); and in favor of triamcinolone acetonide, compared to platelet-rich plasma as topical medication (P = 0.015). Dermoscopic signs of improvement included decrease in black dots, and appearance of Upright regrowing hairs (P < 0.001). CONCLUSIONS Micro-needling and fractional carbon dioxide laser are effective tools for trans-epidermal drug delivery for Alopecia areata treatment. Micro-needling for delivery of Triamcinolone acetonide showed best treatment outcomes. Dermoscopy is highly beneficial in evaluating treatment response in alopecia areata.
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Affiliation(s)
- Khaled Fawzy El Mulla
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Alexandria University, Egypt
| | - Eman Hamed Elmorsy
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Alexandria University, Egypt
| | - Dalia Ibrahim Halwag
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Alexandria University, Egypt
| | - Eman Mohamed Hassan
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Alexandria University, Egypt
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15
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Saki N, Aslani FS, Sepaskhah M, Shafiei M, Alavizadeh S, Hosseini SA, Asl FA, Ahramiyanpour N. Intermittent chronic telogen effluvium with an unusual dermoscopic finding following
COVID
‐19. Clin Case Rep 2022; 10:e6228. [PMID: 35957778 PMCID: PMC9361802 DOI: 10.1002/ccr3.6228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 07/11/2022] [Accepted: 07/13/2022] [Indexed: 11/20/2022] Open
Abstract
Various conditions, including infections, can cause telogen effluvium (TE). One of them is coronavirus disease 2019 (COVID‐19), where hair loss usually begins between 2 and 12 weeks after the illness. TE can be acute or chronic, and the chronic type can be intermittent. Here, we present the case of a 17‐year‐old girl with severe and widespread hair loss following an upper respiratory infection suspected to be COVID‐19, with the patient having a history of such attacks since childhood. Evidence from biopsy and dermoscopy indicated a diagnosis of TE.
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Affiliation(s)
- Nasrin Saki
- Molecular Dermatology Research CenterShiraz University of Medical SciencesShirazIran
- Department of Dermatology, School of MedicineShiraz University of Medical SciencesShirazIran
| | - Fatemeh Sari Aslani
- Molecular Dermatology Research CenterShiraz University of Medical SciencesShirazIran
- Pathology DepartmentShiraz University of Medical SciencesShirazIran
| | - Mozhdeh Sepaskhah
- Molecular Dermatology Research CenterShiraz University of Medical SciencesShirazIran
- Department of Dermatology, School of MedicineShiraz University of Medical SciencesShirazIran
| | - Mohadese Shafiei
- Department of Dermatology, Afzalipour Hospital, Afzalipour Faculty of MedicineKerman University of Medical SciencesKermanIran
| | - Sara Alavizadeh
- Department of Dermatology, School of MedicineShiraz University of Medical SciencesShirazIran
| | | | - Fatemeh Ansari Asl
- Department of Dermatology, School of MedicineShiraz University of Medical SciencesShirazIran
| | - Najmeh Ahramiyanpour
- Department of Dermatology, Afzalipour Hospital, Afzalipour Faculty of MedicineKerman University of Medical SciencesKermanIran
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16
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The Use of Natural Collagen Obtained from Fish Waste in Hair Styling and Care. Polymers (Basel) 2022; 14:polym14040749. [PMID: 35215659 PMCID: PMC8876148 DOI: 10.3390/polym14040749] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/01/2022] [Accepted: 02/09/2022] [Indexed: 02/01/2023] Open
Abstract
Chemically speaking, polymers are multi-molecular compounds that have specific physicochemical properties. Hair cosmetics utilize their ability to create a protective film and make the cosmetic formulation more viscous, which facilitates its application. Natural polymers are encountered in nature, but, in hair cosmetics, artificially modified ones are more often used. Unfortunately, artificially modified polymers are characterized by high resistance to biological factors, which creates an ecological problem. Another reason for a search for natural polymers is their milder action when compared to synthetic ones. One of the new sources of obtaining collagen is the waste connective tissue materials of aquatic animals—skins, spines, dorsal chords and scales, and swim bladders. These raw materials are most often disposed of in landfills, processed into fish meal, or destined for food for animals. The conducted research was aimed at proving the action of natural collagen in hair cosmetics as a substitute for synthetic polymers. In the patients using collagen laminate, it is possible to notice the complete elimination of excessive sebum production, restoration of the correct pH value, and reduction in skin inflammations.
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17
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Claves diagnósticas en displasias pilosas I. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:141-149. [DOI: 10.1016/j.ad.2021.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 06/01/2021] [Accepted: 06/06/2021] [Indexed: 11/19/2022] Open
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18
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Claves diagnósticas en displasias pilosas II. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:150-156. [DOI: 10.1016/j.ad.2021.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/31/2021] [Accepted: 06/06/2021] [Indexed: 11/21/2022] Open
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19
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Giacaman A, Ferrando J. [Translated article] Keys to the Diagnosis of Hair Shaft Disorders: Part I. ACTAS DERMO-SIFILIOGRAFICAS 2022. [DOI: 10.1016/j.ad.2022.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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20
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[Translated article] Keys to the Diagnosis of Hair Shaft Disorders: Part II. ACTAS DERMO-SIFILIOGRAFICAS 2022. [DOI: 10.1016/j.ad.2022.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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21
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Limtong P, Suchonwanit P. Circle Hairs in a Patient with Multiple Myeloma. Clin Cosmet Investig Dermatol 2021; 14:1767-1772. [PMID: 34848987 PMCID: PMC8627239 DOI: 10.2147/ccid.s343365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 11/13/2021] [Indexed: 11/23/2022]
Abstract
Circle hair is a rare body-hair disorder of unknown etiology, typically characterized by perfectly or nearly perfectly coiled hair located below the cornified layer of the skin. Its main histopathological features are dilated hair-follicle infundibula and entrapped hair shafts. After its first description in 1963, there have only been a small number of reported cases, and its pathophysiology remains unclear. Herein, we report a case of an 80-year-old woman with skin lesions and abnormal hairs on both legs. We also propose a possible mechanism of her circle hairs: it may have occurred as an effect of her acquired ichthyosis secondary to her underlying multiple myeloma. There is no specific treatment for circle hairs, and reassurance that it is a harmless condition is sufficient. We prescribed a topical humectant and keratolytic agent to moisten the skin and lessen the hair entrapment, which resulted in clinical improvement. As the pathogenesis of the disease is unknown, further studies are warranted.
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Affiliation(s)
- Preeyachat Limtong
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Poonkiat Suchonwanit
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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22
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Bhattarai D, Banday AZ, Sadanand R, Arora K, Kaur G, Sharma S, Rawat A. Hair microscopy: an easy adjunct to diagnosis of systemic diseases in children. Appl Microsc 2021; 51:18. [PMID: 34843009 PMCID: PMC8630179 DOI: 10.1186/s42649-021-00067-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 11/17/2021] [Indexed: 12/11/2022] Open
Abstract
Hair, having distinct stages of growth, is a dynamic component of the integumentary system. Nonetheless, derangement in its structure and growth pattern often provides vital clues for the diagnosis of systemic diseases. Assessment of the hair structure by various microscopy techniques is, hence, a valuable tool for the diagnosis of several systemic and cutaneous disorders. Systemic illnesses like Comel-Netherton syndrome, Griscelli syndrome, Chediak Higashi syndrome, and Menkes disease display pathognomonic findings on hair microscopy which, consequently, provide crucial evidence for disease diagnosis. With minimal training, light microscopy of the hair can easily be performed even by clinicians and other health care providers which can, thus, serve as a useful tool for disease diagnosis at the patient's bedside. This is especially true for resource-constrained settings where access and availability of advanced investigations (like molecular diagnostics) is a major constraint. Despite its immense clinical utility and non-invasive nature, hair microscopy seems to be an underutilized diagnostic modality. Lack of awareness regarding the important findings on hair microscopy may be one of the crucial reasons for its underutilization. Herein, we, therefore, present a comprehensive overview of the available methods for hair microscopy and the pertinent findings that can be observed in various diseases.
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Affiliation(s)
- Dharmagat Bhattarai
- Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Aaqib Zaffar Banday
- Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
| | - Rohit Sadanand
- Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Kanika Arora
- Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Gurjit Kaur
- Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Satish Sharma
- Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Amit Rawat
- Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
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Kinoshita-Ise M, Sachdeva M. Update on trichoscopy: Integration of the terminology by systematic approach and a proposal of a diagnostic flowchart. J Dermatol 2021; 49:4-18. [PMID: 34806223 DOI: 10.1111/1346-8138.16233] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 10/28/2021] [Accepted: 11/01/2021] [Indexed: 01/18/2023]
Abstract
Trichoscopy represents a non-invasive diagnostic modality widely used in daily practice. Despite the common perception that this technique has been fairly established, some key issues remain to be addressed. Complexity and inconsistency in terminology in past literature are likely to confuse investigators when they are recording, reporting, and retrieving the findings. In addition, a diagnostic algorithm adopting sufficiently integrated and updated findings is not readily available. By adopting a systematic review approach, this review attempted to redefine major trichoscopic findings and integrate their synonyms individually into the most frequently used terms besides identifying and discussing terms which potentially cause confusion. The findings are categorized into five subgroups: hair shaft, follicular, perifollicular, scalp findings, and hair distribution pattern abnormalities. The calculation of sensitivities and positive predictive values of such redefined findings was conducted by reviewing the descriptions in the past literature on major hair diseases, including alopecia areata, androgenetic alopecia/female pattern hair loss, telogen effluvium, trichotillomania, lichen planopilaris, frontal fibrosing alopecia, central centrifugal cicatricial alopecia, discoid lupus erythematosus, folliculitis decalvans, tinea capitis, and dissecting cellulitis, to confirm the diagnostically meaningful findings for representative diseases. This attempt redefined, for instance, yellow dots, short vellus hairs, exclamation mark hairs, black dots, and broken hairs as the findings of diagnostic significance for alopecia areata and hair diameter diversity, peripilar sign, and focal atrichia for androgenetic alopecia/female pattern hair loss. An updated diagnostic flowchart is proposed with the instructions to maximize its usefulness. Current limitations and future perspectives of trichoscopy as well as other emerging non-invasive diagnostic modalities for hair diseases are also discussed.
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Affiliation(s)
| | - Muskaan Sachdeva
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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24
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Giacaman A, Ferrando J. WITHDRAWN: Keys to the Diagnosis of Hair Shaft Disorders: Part I. ACTAS DERMO-SIFILIOGRAFICAS 2021. [DOI: 10.1016/j.adengl.2021.11.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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25
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Giacaman A, Ferrando J. WITHDRAWN: Keys to the Diagnosis of Hair Shaft Disorders: Part II. ACTAS DERMO-SIFILIOGRAFICAS 2021. [DOI: 10.1016/j.adengl.2021.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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26
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Bakos RM, Leite LL, Reinehr C, Escobar GF. Dermoscopy of skin infestations and infections (entomodermoscopy) - Part II: viral, fungal and other infections. An Bras Dermatol 2021; 96:746-758. [PMID: 34620527 PMCID: PMC8790190 DOI: 10.1016/j.abd.2021.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/31/2021] [Accepted: 04/17/2021] [Indexed: 02/03/2023] Open
Abstract
In addition to the infestations and bacterial infections reported in part I, the study of entomodermoscopy also involves descriptions of dermoscopic findings of a growing number of viral and fungal infections, among others. In this article, the main clinical situations in viral infections where dermoscopy can be useful will be described, that is in the evaluation of viral warts, molluscum contagiosum, and even in recent scenarios such as the COVID-19 pandemic. As for fungal infections, dermoscopy is particularly important, not only in the evaluation of the skin surface, but also of skin annexes, such as hairs and nails. The differential diagnosis with skin tumors, especially melanomas, can be facilitated by dermoscopy, especially in the evaluation of cases of verruca plantaris, onychomycosis and tinea nigra.
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Affiliation(s)
| | - Leandro Linhares Leite
- Dermatology Service, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Clarissa Reinehr
- Postgraduation in Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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27
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Affiliation(s)
- Meng Yin Wu
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jun Li
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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28
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Clinical and trichoscopic features in 18 cases of Folliculotropic Mycosis Fungoides with scalp involvement. Sci Rep 2021; 11:10555. [PMID: 34006952 PMCID: PMC8131629 DOI: 10.1038/s41598-021-90168-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 05/04/2021] [Indexed: 11/17/2022] Open
Abstract
Folliculotropic Mycosis Fungoides (FMF) is a rare variant of Mycosis Fungoides involving the scalp leading to alopecia. The clinical and trichoscopic features in 18 patients were analyzed and compared with the reports in the literature. Gender, age, disease stage, site of onset were taken into consideration. Clinical and trichoscopic analyses were performed on each patient. From a clinical point of view, Folliculotropic Mycosis Fungoides lesions involving the scalp presented as generalized alopecia (27.8%) or patchy-plaque alopecia (72.2%). Trichoscopic analysis revealed six most frequent features: single hair (83.3%), dotted dilated vessels (77.8%), broken-dystrophic hairs (66.7%), vellus hairs (61.1%), spermatozoa-like pattern vessels (55.6%), and yellow dots (55.6%). Additional identified trichoscopic patterns were dilation of follicular openings, scales-crusts, purpuric dots, short hair with split-end, pigtail hairs, perifollicular hyperkeratosis, milky-white globules, black dots, white dots/lines and absence of follicular dots. These trichoscopic features were further correlated to clinical presentations and stage of the disease. The rarity of the disease is a limitation. The relatively high number of patients allowed to identify several clinical and trichoscopic patterns that could be featured as specific or highly suspicious for FMF in order to consider trichoscopy as a complementary diagnostic approach and improve the differential diagnoses between FMF and other scalp disorders.
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29
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Wu MY, Li J. Syphilis se manifestant par une pelade. CMAJ 2021; 193:E538-E539. [PMID: 33846209 PMCID: PMC8087335 DOI: 10.1503/cmaj.200894-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Meng Yin Wu
- Département de dermatologie, Hôpital médical universitaire Union de Pékin, Académie chinoise de sciences médicales et Collège médical Union de Pékin, Beijing, Chine
| | - Jun Li
- Département de dermatologie, Hôpital médical universitaire Union de Pékin, Académie chinoise de sciences médicales et Collège médical Union de Pékin, Beijing, Chine.
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30
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Abdallah MAER, Shareef R, Soltan MY. Efficacy of intradermal minoxidil 5% injections for treatment of patchy non-severe alopecia areata. J DERMATOL TREAT 2020; 33:1126-1129. [PMID: 32643454 DOI: 10.1080/09546634.2020.1793893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Intradermal minoxidil is used as an off-label treatment for patchy non-severe alopecia areata (AA) either alone or in combination with steroids; however, studies estimating its efficacy are still lacking. OBJECTIVES To assess the efficacy of intradermal delivery of minoxidil 5% alone and in combination with intralesional triamcinolone acetonide for treatment of patchy non-severe AA. PATIENTS AND METHODS One hundred patches in twenty patients with patchy non-severe AA, five patches for each patient, were included in this prospective intra-patient comparative controlled clinical study. Four comparative patches per each patient were randomly assigned to receive 4 sessions, at a 4-week interval, of one of the following treatments: intralesional triamcinolone acetonide, intralesional minoxidil 5%, combination treatment, or micro-needling. The fifth patch was observed as the negative control. Treatment outcomes were assessed at baseline, and 1 month after treatment ends. RESULTS Minoxidil intradermal injection was nearly comparable to the micro-needling effect and its combination to steroids had no additive effect. Hair regrowth in response to minoxidil occurred earlier than the spontaneous recovery. CONCLUSION Monotherapy of intralesional minoxidil is of limited efficacy in treating non-severe patchy AA, but it speeds the recovery.
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Affiliation(s)
| | - Rasha Shareef
- Faculty of Medicine, Department of Dermatology and Venereology, Ain Shams University, Cairo, Egypt
| | - Marwa Y Soltan
- Faculty of Medicine, Department of Dermatology and Venereology, Ain Shams University, Cairo, Egypt
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31
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Kremer N, Martinez H, Leshem YA, Hodak E, Zer A, Brenner B, Amitay-Laish I. The trichoscopic features of hair shaft anomalies induced by epidermal growth factor receptor inhibitors: A case series. J Am Acad Dermatol 2020; 85:1178-1184. [PMID: 32244022 DOI: 10.1016/j.jaad.2020.03.055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 02/14/2020] [Accepted: 03/22/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Although the clinical hair changes that occur under treatment with epidermal growth factor receptor inhibitors (EGFRIs) are documented, their trichoscopic features have not been reported. OBJECTIVE To evaluate the trichoscopic findings in scalp and facial hair, induced by EGFRI treatment. METHODS Patients treated with EGFRIs at a tertiary oncodermatology clinic in 2015 through 2017 were evaluated for macroscopic and trichoscopic changes. RESULTS The cohort included 23 patients (13 women; median age, 68 years) treated with EGFRIs for an average of 13 months (range, 2-40 months). Macroscopically, 18 patients (78%) had dry, lusterless, coarse, kinky, brittle scalp hair, and 17 (74%) had trichomegaly of the eyebrows/eyelashes. Trichoscopic findings were of hair shaft anomalies including pili torti, affecting scalp hair in 20 patients (87%), eyebrows in 6 (26%), and eyelashes in 8 (50%), and asymmetric hyperpigmented fusiform widening of hair scalp in 3 (13%), eyebrows in 10 (43%), and eyelashes in 4 (25%). Dermoscopic findings of the peri- and interfollicular skin were scale, whitish erythematous structureless areas, and branching vessels. LIMITATIONS Lack of trichoscopic-histologic correlation, lack of baseline examination. CONCLUSION The trichoscopic correlates of the macroscopic hair changes under EFGRI treatment include pili torti, and asymmetric hyperpigmented fusiform widening, with dermoscopic cutaneous manifestations of scale, whitish erythematous structureless areas, and branching vessels.
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Affiliation(s)
- Noa Kremer
- Division of Dermatology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
| | - Helena Martinez
- Division of Dermatology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Anne Leshem
- Division of Dermatology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Emmilia Hodak
- Division of Dermatology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alona Zer
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Institute of Oncology, Davidoff Cancer Center, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
| | - Baruch Brenner
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Institute of Oncology, Davidoff Cancer Center, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
| | - Iris Amitay-Laish
- Division of Dermatology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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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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Ahmed A, Almohanna H, Griggs J, Tosti A. Genetic Hair Disorders: A Review. Dermatol Ther (Heidelb) 2019; 9:421-448. [PMID: 31332722 PMCID: PMC6704196 DOI: 10.1007/s13555-019-0313-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Indexed: 12/23/2022] Open
Abstract
Hair loss in early childhood represents a broad differential diagnosis which can be a diagnostic and therapeutic challenge for a physician. It is important to consider the diagnosis of a genetic hair disorder. Genetic hair disorders are a large group of inherited disorders, many of which are rare. Genetic hair abnormalities in children can be an isolated phenomenon or part of genetic syndromes. Hair changes may be a significant finding or even the initial presentation of a syndrome giving a clue to the diagnosis, such as Netherton syndrome and trichothiodystrophy. Detailed history including family history and physical examination of hair and other ectodermal structures such as nails, sweat glands, and sebaceous glands with the use of dermoscopic devices and biopsy all provide important clues to establish the correct diagnosis. Understanding the pathophysiology of genetic hair defects will allow for better comprehension of their treatment and prognosis. For example, in patients with an isolated hair defect, the main problem is aesthetic. In contrast, when the hair defect is associated with a syndrome, the prognosis will depend mainly on the associated condition. Treatment of many genetic hair disorders is focused on treating the primary cause and minimizing trauma to the hair.
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Affiliation(s)
- Azhar Ahmed
- Department of Dermatology, King Fahad General Hospital, Medina, Saudi Arabia.
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, University of Miami Hospital, Miami, FL, USA.
| | - Hind Almohanna
- Department of Dermatology and Dermatologic Surgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Jacob Griggs
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, University of Miami Hospital, Miami, FL, USA
| | - Antonella Tosti
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, University of Miami Hospital, Miami, FL, USA
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Waśkiel-Burnat A, Rakowska A, Sikora M, Olszewska M, Rudnicka L. Trichoscopy of alopecia areata in children. A retrospective comparative analysis of 50 children and 50 adults. Pediatr Dermatol 2019; 36:640-645. [PMID: 31294493 DOI: 10.1111/pde.13912] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND/OBJECTIVES Trichoscopic findings characteristic of alopecia areata have been established in adults. The objective of the study was to assess trichoscopic findings in children with alopecia areata. METHODS Retrospective analysis of trichoscopic findings in 50 children (3-11 years old) and 50 adults (19-31 years old) with alopecia areata was performed. RESULTS Yellow dots were less commonly detected in children compared with adults (26/50, 52% vs 48/50, 96%). Pigtail hairs and empty follicular openings were more commonly observed in children compared with adults (14/50, 28% vs 2/50, 4% and 40/50, 80% vs 16/50, 32%, respectively). No significant difference in the frequency of other trichoscopic features between children and adults was found. Black dots, broken hairs, exclamation mark hairs, and tapered hairs were detected in 20/50 (40%), 27/50 (54%), 22/50 (44%), and 6/50 (12%) children, respectively, and in 26/50 (52%), 27/50 (54%), 20/50 (40%), and 11/50 (22%) adults, respectively. Triangular hairs (short hidden hairs), short vellus hairs, and upright regrowing hairs were observed in 22/50 (44%), 35/50 (70%), and 23/50 (46%) children, respectively, and in 24/50 (48%), 37/50 (74%), and 28/50 (56%) adults, respectively. Pohl-Pinkus constrictions were present in 2/50 (4%) children and 4/50 (8%) adults. CONCLUSIONS The most common trichoscopic findings of alopecia areata in children are empty follicular openings and short vellus hairs. Pigtail hairs and empty follicular openings are more commonly presented in children compared with adults. In contrast, yellow dots are less commonly observed in children compared with adults. Triangular hairs (short hidden hairs) are new trichoscopic findings of alopecia areata.
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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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Eftekhari H, Azimi SZ, Rafiei R, Darjani A, Alizadeh N, Rafiei E, Ghadarjani R, Gharaei Nejad K. Dermoscopic features of lichen planopilaris in Northern Iran: a prospective observational study. Int J Dermatol 2019; 58:1406-1414. [PMID: 31372982 DOI: 10.1111/ijd.14589] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 04/08/2019] [Accepted: 06/19/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Dermoscopy can be helpful in assessing nonpigmented lesions and inflammatory processes like lichen planopilaris (LPP). MATERIAL & METHODS In this observational prospective study, 81 patients with a cicatricial alopecic patch on their scalp were included and underwent dermatologic examination. A biopsy was taken from the active part of the lesion based on dermoscopy evaluation. RESULTS Analysis of 44 patients with definite diagnosis of LPP revealed that the mean age at the time of presentation was 44.05 ± 12.62 years. More than 77% of patients had at least one form of the follicular opening disorder. About 75% of patients had shaft disorders. The most common pattern of pigmentation was milky-red (97.73%). The irregular and ectatic vascular network were seen in 59.09% of patients. Patients with coiled and twisted hairs, small yellow dots, large yellow dots, and peripilar sign were more likely to have shorter disease duration (P < 0.05). Those with overall shaft disorders were younger (P = 0.02). Small yellow dots (P = 0.025) and peripilar sign (P = 0.039) were more common in female patients. CONCLUSION Dermoscopy can be a helpful diagnostic tool in differentiating LPP among patients with primary cicatricial alopecia (PCA). Larger cohort studies are recommended to find the role of demographic factors in predicting the dermoscopic patterns among LPP patients.
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Affiliation(s)
- Hojat Eftekhari
- Skin Research Center, Department of Dermatology, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Seyyede Zeinab Azimi
- Skin Research Center, Department of Dermatology, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Rana Rafiei
- Skin Research Center, Department of Dermatology, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Abbas Darjani
- Skin Research Center, Department of Dermatology, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Narges Alizadeh
- Skin Research Center, Department of Dermatology, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Elahe Rafiei
- Epidemiology, Razi Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran
| | - Reyhaneh Ghadarjani
- Department of Pathology, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Kaveh Gharaei Nejad
- Skin Research Center, Department of Dermatology, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
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Sonthalia S, Abhishek A. Tulipoid Hair: An Avoidable Addition to Metaphoric Trichoscopic Terminology. Int J Trichology 2019; 11:138-139. [PMID: 31360045 PMCID: PMC6580811 DOI: 10.4103/ijt.ijt_96_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Sidharth Sonthalia
- SKINNOCENCE: The Skin Clinic and Research Centre, Gurugram, Haryana, India
| | - Ashu Abhishek
- Department of Radiation Oncology, Fortis Memorial Research Institute, Gurugram, Haryana, India
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Lobato-Berezo A, Olmos-Alpiste F, Pujol R, Saceda-Corralo D. Pohl-Pinkus Constrictions in Trichoscopy. What Do They Mean? ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2019.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Haslam IS, Smart E. Chemotherapy-Induced Hair Loss: The Use of Biomarkers for Predicting Alopecic Severity and Treatment Efficacy. Biomark Insights 2019; 14:1177271919842180. [PMID: 31037027 PMCID: PMC6475836 DOI: 10.1177/1177271919842180] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 03/08/2019] [Indexed: 01/08/2023] Open
Abstract
Damage to hair follicles following exposure to toxic chemotherapeutics can cause substantial hair loss, commonly known as chemotherapy-induced alopecia (CIA). Preventive therapies remain limited; however, recent advances in the use of scalp cooling technologies have proved successful in preventing or reducing hair loss in some patients. Further improvements in scalp cooling efficacy and/or development of novel treatments to prevent chemotherapy-induced hair loss are required. To achieve this, post-chemotherapy assessment of hair follicle damage markers, with and without scalp cooling, would provide invaluable mechanistic and prognostic information. At present, the availability of such data is extremely limited. This article describes the potential utility of a combination of biomarkers in assessing drug-induced alopecia and the protective potential of existing or new treatments. A greater understanding of the precise mechanisms of anti-CIA therapies through biomarker analysis would enhance the rationale, use, and development of such treatments.
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Affiliation(s)
- Iain S Haslam
- School of Applied Sciences, University of Huddersfield, Huddersfield, UK
| | - Eleanor Smart
- Centre for Dermatology Research, University of Manchester, Manchester, UK
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Fowler E, Tosti A. A Case of Friction Alopecia in a Healthy 15-Year-Old Girl. Skin Appendage Disord 2019; 5:97-99. [PMID: 30815442 DOI: 10.1159/000490712] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 06/06/2018] [Indexed: 11/19/2022] Open
Abstract
Friction alopecia is a non-scarring alopecia that causes hair breakage and may cause trichorrhexis nodosa. We report a case of a 15-year-old girl with self-inflicting friction alopecia that demonstrated broken hairs and proximal trichorrhexis nodosa on dermoscopy. We review various causes of friction alopecia and clinical findings, as well as trichorrhexis nodosa.
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Affiliation(s)
- Emilie Fowler
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Antonella Tosti
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
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40
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Pohl-Pinkus Constrictions in Trichoscopy. What Do They Mean? ACTAS DERMO-SIFILIOGRAFICAS 2019; 110:315-316. [PMID: 30739656 DOI: 10.1016/j.ad.2018.02.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 02/11/2018] [Accepted: 02/20/2018] [Indexed: 11/20/2022] Open
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Al-Refu K. Clinical Significance of Trichoscopy in Common Causes of Hair Loss in Children: Analysis of 134 Cases. Int J Trichology 2018; 10:154-161. [PMID: 30386074 PMCID: PMC6192235 DOI: 10.4103/ijt.ijt_101_17] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Introduction: Hair loss is a common and distressing clinical complaint in the dermatology clinics. Common causes of hair loss in children include alopecia areata, tinea capitis, traction alopecia, and trichotillomania. Newly, trichoscopy allows differential diagnosis of hair loss in most cases and allows visualization of hair shafts and scalps without the need of removing hair. Objective: The main objective is to compare the different trichoscopic features of common causes of patchy hair in children loss including tinea capitis, alopecia areata, traction alopecia, and trichotillomania. Patients and Methods: This study included 134 patients, 63 patients with tinea capitis, 38 patients with alopecia areata, 18 patients with traction alopecia, and 15 patients with trichotillomania. The diagnostic tools for the diagnosis of hair loss problem included a detailed history, evaluation of the child's hair and scalp, fungal scrapping, and trichoscopy. Results: Tinea capitis was the most common, and the trichoscopic features were comma-shaped hairs, corkscrew hairs, short broken hairs, and interrupted hairs. While in alopecia areata patients, the most specific features were yellow dots and black dots, microexclamation mark, hair shafts with variable thickness, and vellus hairs, with uncommon features included: monilethrix, coiled, zigzag, and tulip hairs. Trichoscopy of trichotillomania showed hair with fraying of ends, breakage at different lengths, short and coiled hairs, and amorphous hair residues. The trichoscopic features of traction alopecia were similar to those of trichotillomania. However, flame hairs and coiled hairs were less common. Conclusions: Trichoscopy is a noninvasive method of examining hair and scalp. It allows differential diagnosis of hair loss in most cases.
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Affiliation(s)
- Khitam Al-Refu
- Department of Medicine, Faculty of Medicine, Mutah University, Mutah, Karak, Jordan
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43
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Rudnicka L, Olszewska M, Waśkiel A, Rakowska A. Trichoscopy in Hair Shaft Disorders. Dermatol Clin 2018; 36:421-430. [DOI: 10.1016/j.det.2018.05.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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44
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Gupta A, Mays R, Versteeg S, Piraccini B, Shear N, Piguet V, Tosti A, Friedlander S. Tinea capitis in children: a systematic review of management. J Eur Acad Dermatol Venereol 2018; 32:2264-2274. [DOI: 10.1111/jdv.15088] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 05/09/2018] [Indexed: 12/01/2022]
Affiliation(s)
- A.K. Gupta
- Mediprobe Research Inc.; London Canada
- Division of Dermatology; Department of Medicine; University of Toronto; Toronto Canada
| | - R.R. Mays
- Mediprobe Research Inc.; London Canada
| | | | - B.M. Piraccini
- Department of Experimental, Diagnostic and Specialty Medicine; University of Bologna; Bologna Italy
| | - N.H. Shear
- Division of Dermatology; Department of Medicine; University of Toronto; Toronto Canada
- Division of Dermatology; Sunnybrook Health Sciences Centre; Toronto Canada
| | - V. Piguet
- Division of Dermatology; Department of Medicine; University of Toronto; Toronto Canada
- Division of Infection and Immunity; Cardiff University School of Medicine; Cardiff UK
- Division of Dermatology; Women's College Hospital; Toronto Canada
| | - A. Tosti
- Fredric Brandt endowed professor of Dermatology; University of Miami; Miami FL USA
| | - S.F. Friedlander
- San Diego School of Medicine; University of California; San Diego CA USA
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45
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Esteves ALV, Serafini NB, Lemes LR, Melo DF. Circular hairs: nomenclature and meanings. An Bras Dermatol 2018; 92:874-876. [PMID: 29364454 PMCID: PMC5786412 DOI: 10.1590/abd1806-4841.20176487] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 01/14/2017] [Indexed: 11/22/2022] Open
Abstract
Trichoscopy has become an essential tool for the diagnosis of various diseases
that affect the hair and scalp. Through dermatoscopy we identified a set of
findings that share a circular shape of hair shafts. The objective of this study
is to distinguish among the various forms of circular hairs in order to identify
their peculiarities and to describe in which skin disorders they can be found.
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Affiliation(s)
- Ana Luiza Valle Esteves
- Post-graduate student in Dermatology, Hospital Naval Marcílio Dias (HNMD) - Rio de Janeiro (RJ), Brazil
| | - Natália Battisti Serafini
- Post-graduate student in Dermatology, Policlínica Geral do Rio de Janeiro (PGRJ) - Rio de Janeiro (RJ), Brazil
| | - Luciana Rodino Lemes
- Alopecia Outpatient Clinic, Hospital Naval Marcílio Dias (HNMD) - Rio de Janeiro (RJ), Brazil
| | - Daniel Fernandes Melo
- Alopecia Outpatient Clinic, Hospital Naval Marcílio Dias (HNMD) - Rio de Janeiro (RJ), Brazil.,Post-graduate specialization in Medical Sciences, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro (Hupe-UERJ) - Rio de Janeiro (RJ), Brazil
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46
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Waśkiel A, Rakowska A, Sikora M, Olszewska M, Rudnicka L. Trichoscopy of alopecia areata: An update. J Dermatol 2018; 45:692-700. [DOI: 10.1111/1346-8138.14283] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 03/01/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Anna Waśkiel
- Department of Dermatology; Medical University of Warsaw; Warsaw Poland
| | - 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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Xu L, Liu KX, Senna MM. A Practical Approach to the Diagnosis and Management of Hair Loss in Children and Adolescents. Front Med (Lausanne) 2017; 4:112. [PMID: 28791288 PMCID: PMC5522886 DOI: 10.3389/fmed.2017.00112] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Accepted: 07/04/2017] [Indexed: 12/13/2022] Open
Abstract
Hair loss or alopecia is a common and distressing clinical complaint in the primary care setting and can arise from heterogeneous etiologies. In the pediatric population, hair loss often presents with patterns that are different from that of their adult counterparts. Given the psychosocial complications that may arise from pediatric alopecia, prompt diagnosis and management is particularly important. Common causes of alopecia in children and adolescents include alopecia areata, tinea capitis, androgenetic alopecia, traction alopecia, trichotillomania, hair cycle disturbances, and congenital alopecia conditions. Diagnostic tools for hair loss in children include a detailed history, physical examination with a focused evaluation of the child’s hair and scalp, fungal screens, hair pull and tug test, and if possible, light microscopy and/or trichoscopy. Management of alopecia requires a holistic approach including psychosocial support because treatments are only available for some hair loss conditions, and even the available treatments are not always effective. This review outlines the clinical presentations, presents a diagnostic algorithm, and discusses management of these various hair loss disorders.
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Affiliation(s)
- Liwen Xu
- Harvard Medical School, Boston, MA, United States
| | - Kevin X Liu
- Harvard Medical School, Boston, MA, United States
| | - Maryanne M Senna
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, United States
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Kane J, Berrebi K, McLean R, Petkiewicz S, Hay B, Martin M, Wiss K. Noonan syndrome with loose anagen hair associated with trichorrhexis nodosa and trichoptilosis. Clin Case Rep 2017; 5:1152-1154. [PMID: 28680615 PMCID: PMC5494382 DOI: 10.1002/ccr3.1011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 04/27/2017] [Accepted: 04/28/2017] [Indexed: 12/17/2022] Open
Abstract
We report a case of Noonan syndrome with loose anagen hair (NS/LAH), a rare variant of Noonan syndrome, with associated trichorrhexis nodosa and trichoptilosis. The SHOC2 mutation may be responsible for these additional hair shaft defects, revealing the importance of microscopic examination of hairs in these patients.
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Affiliation(s)
- Jennifer Kane
- Department of DermatologyUniversity of Massachusetts Medical School281 Lincoln StreetWorcester01605Massachusetts
| | - Kristen Berrebi
- Department of DermatologyUniversity of Massachusetts Medical School281 Lincoln StreetWorcester01605Massachusetts
| | - Riley McLean
- Department of DermatologyUniversity of Massachusetts Medical School281 Lincoln StreetWorcester01605Massachusetts
| | - Stephanie Petkiewicz
- Department of DermatologyUniversity of Massachusetts Medical School281 Lincoln StreetWorcester01605Massachusetts
- Department of PathologyUniversity of Massachusetts Medical School55 Lake Avenue NorthWorcester01655Massachusetts
| | - Beverly Hay
- Department of PediatricsUniversity of Massachusetts Medical School55 Lake Avenue NorthWorcester01605Massachusetts
| | - Madelena Martin
- Department of PediatricsUniversity of Massachusetts Medical School55 Lake Avenue NorthWorcester01605Massachusetts
| | - Karen Wiss
- Department of DermatologyUniversity of Massachusetts Medical School281 Lincoln StreetWorcester01605Massachusetts
- Department of PediatricsUniversity of Massachusetts Medical School55 Lake Avenue NorthWorcester01605Massachusetts
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Abstract
INTRODUCTION Scalp dysesthesia is characterized by localized pruritus, burning sensations or even pain. AIM To describe characteristic trichoscopic features of scalp dysesthesia. MATERIAL AND METHODS The study was a retrospective analysis (2010-2016) of 9 patients (8 females and 1 male; median age: 52 years; range: 38-66 years). A total of 61 trichoscopic images were analyzed by two independent evaluators. RESULTS In all cases, oval or round areas covered with short hairs: broom hairs (77%; 7/9), block hairs (88%; 8/9), short hairs with trichorrhexis nodosa (78%; 7/9) were found. In 4 of 9 cases these areas were circumscribed by brownish linear discoloration. Background features included: areas lacking hair shafts (44%; 4/9) covered by wavy-shaped scaling, whitish areas with prominent perifollicular yellow discoloration and cloud vessels arranged around follicular openings and around empty follicles (33%, 3/9); focal brownish discoloration with darker wavy lines (78%; 7/9). CONCLUSIONS Trichoscopy can be helpful in establishing the diagnosis of scalp dysesthesia - broom hairs, block hairs and short hairs with trichorrhexis nodosa covering the alopecia patch, uniform in length, can be considered as characteristic for this condition.
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Updates in the understanding and treatments of skin & hair disorders in women of color. Int J Womens Dermatol 2017; 3:S21-S37. [PMID: 28492036 PMCID: PMC5419061 DOI: 10.1016/j.ijwd.2017.02.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 04/15/2015] [Accepted: 04/15/2015] [Indexed: 12/19/2022] Open
Abstract
Skin of color comprises a diverse and expanding population of individuals. In particular, women of color represent an increasing subset of patients who frequently seek dermatologic care. Acne, melasma, and alopecia are among the most common skin disorders seen in this patient population. Understanding the differences in the basic science of skin and hair is imperative in addressing their unique needs. Despite the paucity of conclusive data on racial and ethnic differences in skin of color, certain biologic differences do exist, which affect the disease presentations of several cutaneous disorders in pigmented skin. While the overall pathogenesis and treatments for acne in women of color are similar to Caucasian men and women, individuals with darker skin types present more frequently with dyschromias from acne, which can be difficult to manage. Melasma is an acquired pigmentary disorder seen commonly in women with darker skin types and is strongly associated with ultraviolet (UV) radiation, genetic factors, and hormonal influences. Lastly, certain hair care practices and hairstyles are unique among women of African descent, which may contribute to specific types of hair loss seen in this population, such as traction alopecia, trichorrhexis nodosa and central centrifugal cicatricial alopecia (CCCA).
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