Moniletrix of the scalp from almost normal aspect to total alopecia: variable intrafamilial expressiveness

Abstract Monilethrix is a rare defect of the hair shaft, with most cases showing an autosomal dominant pattern of inheritance and variable clinical expression. It is characterized by hypotrichosis secondary to hair fragility. The diagnosis is made through trichoscopy, detecting typical findings such as periodic narrowing at regular intervals, giving the hair the appearance of beads in a rosary. This article reports the case of six members of a family diagnosed with monilethrix with alopecia of varying degrees.

Perfil clínico, histopatológico e tricoscópico da alopecia frontal fibrosante: estudo retrospectivo de casos de um serviço de referência de dermatologia / Clinical, histopathological and trichoscopic of frontal alopecia fibrosing: retrospective study of cases of a service of dermatology reference

Contexto: Alopecia frontal fibrosante (AFF) é uma alopecia cicatricial que acomete a região frontotemporal, e predomina em mulheres pós-menopausadas. Objetivo: Descrever o perfil clínico, histopatológico e tricoscópico de pacientes com diagnóstico de AFF. Desenho e local: Estudo de coorte retrospectivo observacional que foi desenvolvido no ambulatório de tricologia do departamento de dermatologia do Hospital Santa Casa de Misericórdia de Vitória, Vitória (ES), Brasil. Métodos: O estudo foi realizado por meio da análise de prontuários e de revisão histopatológica de pacientes com diagnóstico de AFF atendidos entre 1 de março de 2019 a 29 de fevereiro de 2020. Resultados: No período, 17 pacientes do sexo feminino foram diagnosticadas com AFF, 76,5% delas na pós-menopausa. Todas apresentavam alopecia frontotemporal e madarose. À tricoscopia, ausência de pelos velus, aberturas foliculares reduzidas, hiperceratose folicular e eritema perifolicular foram encontrados na maioria dos casos. Todas as biópsias mostraram aspectos microscópicos compatíveis com AFF. O tratamento mais utilizado foi tacrolimo 0,1%. Discussão: A patogênese da AFF ainda não é compreendida. A associação com doenças autoimunes sugere a influência da imunidade no quadro. A tricoscopia é uma ferramenta de fácil acesso e não invasiva que pode auxiliar no diagnóstico. Histopatologicamente a AFF é indistinguível do líquen plano pilar. O tratamento objetiva reduzir a inflamação e retardar a progressão da doença. Conclusões: Embora apresentações clínicas e tricoscópicas tenham sido descritas ao longo dos anos, a patogênese, a histologia e os tratamentos eficazes para AFF ainda são debatidos. O reconhecimento e o tratamento precoce da doença permitiriam a redução da progressão da doença.

Acné queloideo de la nuca: excelente respuesta al tratamiento con imiquimod 5% / Keloid acne of the nape: excellent response to treatment with imiquimod 5%

El acné queloideo de la nuca (AKN) o foliculitis esclerosante es un proceso inflamatorio crónico del folículo piloso en la región de la nuca. Su incidencia es baja y su etiología desconocida. Afecta con mayor frecuencia a hombres de mediana edad y de raza negra. A lo largo del tiempo se han utilizado diferentes modalidades terapéuticas con resultados variables. Presentamos el caso de un paciente con AKN que mostró una excelente respuesta al uso diario de imiquimod 5% tópico durante ocho semanas

Keloid acne of the neck (AKN) or sclerosing folliculitis of the nape of the neck is a chronic inflammatory process of the nape region. Its incidence is low and its etiology is unknown. It mainly affects brown-black males in middle age. Different treatment modalities have been used with different responses. We present the case of a patient with AKN who presented an excellent response to the daily use of topical imiquimod 5% for eight weeks

Desmoplakin and clinical manifestations of desmoplakin cardiomyopathy / 中华医学杂志(英文版)

Desmoplakin (DSP), encoded by the DSP gene, is the main desmosome component and is abundant in the myocardial tissue. There are three DSP isoforms that assume the role of supporting structural stability through intercellular adhesion. It has been found that DSP regulates the transcription of adipogenic and fibrogenic genes, and maintains appropriate electrical conductivity by regulating gap junctions and ion channels. DSP is essential for normal myocardial development and the maintenance of its structural functions. Studies have suggested that DSP gene mutations are associated with a variety of hereditary cardiomyopathy, such as arrhythmia cardiomyopathy, dilated cardiomyopathy (DCM), left ventricular noncompaction, and is also closely associated with the Carvajal syndrome, Naxos disease, and erythro-keratodermia-cardiomyopathy syndrome with skin and heart damage. The structure and function of DSP, as well as the clinical manifestations of DSP-related cardiomyopathy were reviewed in this article.

Solitary fibrofolliculoma: a retrospective case series review over 18 years / Fibrofoliculoma solitário: revisão de série retrospectiva de casos de 18 anos

ABSTRACT Purpose: The purpose of this study was to report a series of cases of solitary fibrofolliculoma, a lesion seldom observed in the lids. Demographics, as well as clinical and histological aspects of the lesion were evaluated. Methods: This was a retrospective case series spanning a period of 18 years. All the included patients were diagnosed with solitary fibrofolliculoma confirmed by histological examination. Data regarding patient demographics, signs, and symptoms, course of the disease, location of the lesion, clinical and histological diagnosis, and outcome were collected. Results: Eleven cases of solitary fibrofolliculoma were diagnosed in the study period. The median age of patients was 51 ± 16.3 years (range: 27-78 years). Most patients were females (7/11; 64%). Five of the patients (45%) were asymptomatic; four (36%) reported bleeding, one (9%) had referred itching, and one (9%) rubbing of the lesion. The lesion occurred in a wide range of locations; one of them was located in the lids. The diagnosis for all lesions was histological based on characteristic findings of a hair follicle occasionally dilated and containing keratin material surrounded by a moderately well-circumscribed thick mantle of fibrous tissue. The infundibular follicular epithelium extended out into this fibrous mantle forming epithelial strands or cords. There were no relapses after exeresis. Conclusion: Solitary fibrofolliculoma is a rare lesion, seldom affecting the eyelids. We reported 11 cases, and the third case reported thus far in the literature affecting the lids. Diagnosis may be easily missed due to the nonspecific symptoms and clinical appearance. Therefore, it is necessary to perform excisional biopsy and histological examination for the recognition of this lesion.

RESUMO Objetivo: o objetivo deste estudo foi relatar uma série de casos de fibrofoliculoma solitário, uma lesão raramente observada nas pálpebras. Demografia, bem como aspectos clínicos e histológicos da lesão foram avaliados. Métodos: Trata-se de uma série de casos retrospectivos, com um período de 18 anos. Todos os pacientes incluídos foram diagnosticados com fibrofoliculoma solitário confirmado por exame histológico. Foram coletados dados referentes à demografia, sinais e sintomas dos pacientes, evolução da doença, localização da lesão, diagnóstico clínico e histológico e desfecho. Resultados: Onze casos de fibrofoliculoma solitário foram diagnosticados no período do estudo. A média de idade dos pacientes de 51 ± 16,3 anos (variação: 27-78 anos). A maioria dos pacientes era do sexo feminino (7/11, 64%). Cinco dos pacientes (45%) eram assintomáticos; quatro (36%) relataram sangramento, um (9%) referiu coceira e um (9%) fricção da lesão. A lesão ocorreu em luma ampla variedade de locais; um deles sendo nas pálpebras. O diagnóstico de todas as lesões foi histológico com base nos achados característicos de um folículo piloso ocasionalmente dilatado e contendo material de queratina, cercado por um manto espesso de tecido fibroso moderadamente bem circunscrito. O epitélio infundibular folicular se estendeu até esse manto fibroso, formando cordões ou cordões epiteliais. Não houve recaídas após exérese. Conclusão: Fibrofoliculoma solitário é uma lesão rara, mais ainda quando afeta as pálpebras. Relatamos 11 casos, e o terceiro relatado até o momento na literatura que afeta as pálpebras. O diagnóstico pode ser facilmente esquecido devido a sintomas inespecíficos e aparência clínica. Portanto, é necessário realizar biópsia excisional e exame histológico para o reconhecimento dessa lesão.

Multiple pilomatricomas in twins with Rubinstein-Taybi syndrome

Abstract Pilomatricomas are benign tumors originating from the capillary matrix, which may present as solitary lesions or, less commonly, multiple. Myotonic dystrophy and familial adenomatous polyposis are the most frequently associated disorders with multiple pilomatricomas. There are few reports relating these tumors to other genetic syndromes. Rubinstein-Taybi syndrome is a rare autosomal dominant disorder characterized by intellectual disability and typical dysmorphic characteristics. There are five case reports relating to multiple pilomatricoma to Rubinstein-Taybi syndrome, an association that needs to be clarified. For this reason, we report the first case of multiple pilomatricoma in monozygotic twins with typical Rubinstein-Taybi syndrome.

Dermatoscopic findings of syphilitic alopecia

Abstract Syphilis is an infectious disease that has afflicted mankind for centuries, but a recent increase in worldwide incidence has been evidenced. The authors describe a patient with typical lesions of secondary syphilis and moth-eaten alopecia, whose dermoscopic examination demonstrated empty hair follicles, vellus hair, follicular hyperkeratosis, peripheral black dots, dilated and tortuous vessels, reddish brown background, and hypopigmentation of the hair shafts. Furthermore, this case presented an erythematous background more evident than previously described cases.

Pilomatrix carcinoma of the lacrimal caruncle: a case report / Carcinoma pilomatricial da carúncula lacrimal: relato de caso

ABSTRACT A 45-year-old man presented with a 3-month history of a mass located in the caruncle of his right eye. An incisional biopsy had been performed one month prior by another specialist, and the histopathology report showed basal cell carcinoma. The mass was completely excised with a 2 mm safety margin, and the large conjunctival defect was reconstructed with one sheet of amniotic membrane allograft. A histological diagnosis of pilomatrix carcinoma was established. To prevent recurrence after surgery, we added bevacizumab (25 mg/mL, 1.25 mg/mL per drop) eye drops four times per day for three months. At the one-year follow-up, the patient showed no evidence of local recurrence or distant metastasis after initial excision and remains under close follow-up. Pilomatrix carcinoma should be considered in the differential diagnosis of a caruncular mass.

RESUMO Um homem de 45 anos apresentou história de massa na carúncula no olho direito durante 3 meses. Uma biópsia incisional foi realizada 1 mês antes por outro especialista e o laudo histopatológico mostrava carcinoma basocelular. A massa foi completamente excisada, com uma margem de segurança de 2 mm, e a grande lesão conjuntival foi reconstruída com uma folha de aloenxerto de membrana amniótica. Foi estabelecido um diagnóstico histológico de carcinoma pilomatricial. Para evitar a recorrência após a cirurgia, adicionamos colírio de bevacizumabe (25 mg/mL, 1,25 mg/mL por gota) quatro vezes ao dia durante três meses. No seguimento de 1 ano, o paciente não apresentou evidência de recidiva local ou metástase distante após a excisão inicial e continua sob acompanhamento próximo. O carcinoma pilomatricial deve ser considerado no diagnóstico diferencial de uma massa caruncular.

Pilomatrixoma buloso: una rara pero característica variante clínica / Bullous pilomatrixoma: a rare but characteristic clinical variant

El pilomatrixoma es un tumor anexial benigno, que muestra diferenciación hacia células matriciales y supramatriciales del folículo piloso. Es el segundo tumor benigno más frecuente en la población infantil luego del quiste epidérmico. Su presentación clínica habitual consiste en una lesión única, de consistencia firme y generalmente indolora.1 La variante anetodérmica o bulosa es poco frecuente, en general de rápido crecimiento y en ocasiones dolorosa.2 Se presenta a continuación un caso clínico de esta rara variante, por la importancia de conocer esta particular forma presentación.

A clinical case of bullous pilomatrixoma is present. Correspond to the second most frequent benign tumor in children, derived from the matrix cells of the hair follicle. It commonly presents as a single lesion, of firm consistency and mostly painless. The bullous variant corresponds to 2% of the presentations, the morphology is explained by the dilation of the lymphatic vessels and the consequent extravasation of lymph, as well as by the absence of elastic and collagen fibers. Treatment is the surgical excision of the lesion, and a biopsy specimen is necessary to establish a definitive diagnosis. Knowing this form of presentation allows us to pose it as a diagnostic option in clinical practice.

Avaliação das propriedades das fibras capilares tratadas com alisante ácido com diferentes valores de pH / Evaluation of hair fibers properties treated with acid straightener at different pH values

Os produtos para alisamento das fibras capilares são amplamente utilizados no Brasil principalmente, pelo público feminino. Porém, estes procedimentos podem causar danos ao cabelo do usuário e, também, para o profissional que está atuando. Os alisantes químicos podem ser divididos em dois grupos: alcalinos e ácidos. Os primeiros (tioglicolato de amônio e os hidróxidos de sódio ou guanidina) apresentam valor de pH elevado (superior a 9,0) e alisam por meio da quebra e reorganização das pontes de dissulfeto (S-S) presentes na queratina, proteína estrutural da fibra capilar. Os alisantes ácidos como o formaldeído, ácido glioxílico e seus associados, possuem pH baixo (≥ 2,0) e causam uma reorganização no interior da fibra e geralmente leva a formação de um filme na superfície do fio. O ácido glioxílico associado à carbocisteína e aminoácidos (nomenclatura INCI -International Nomenclature of Cosmetic Ingredient apresentada entre parênteses) (Glyoxyloyl Carbocysteine (and) Glyoxyloyl Keratin Aminoacids (and) Water) é o único ingrediente permitido ao uso como alisante ácido até o momento. O objetivo deste trabalho foi estudar o efeito deste alisante ácido incorporado em uma emulsão óleo e água (O/A) com valores de pH 1,0 e 2,0 (com reaplicações); e o impacto que podem causar nas propriedades mecânicas e químicas da fibra capilar, como força de ruptura, coloração, elasticidade e teor de triptofano da fibra capilar. E também o efeito da radiação ultravioleta nos fios alisados. Nos testes realizados observou-se que as mechas tratadas com a emulsão a pH 1,0 obtiveram melhor resultado de alinhamento das cutículas e capacidade alisante da fibra, com penteabilidade superior ao cabelo virgem (59,4 %), enquanto as mechas com a formulação pH 2,0 foi apenas 33,0%. Entretanto, a força de tração para a ruptura do fio foi inferior, diminuindo em 16,0% (pH 1,0) e 9,0 % (pH 2,0). Quanto a variação da coloração, a variação do tom de cor foi mais exacerbada para as mechas tratadas com a formulação em pH 1,0. O teor de triptofano foi inferior nas mechas alisadas com a formulação pH 1,0. Para o teste de DSC e Raman, ambas as mechas tratadas apresentaram modificações nas suas estruturas. As fibras alisadas e expostas à radiação UV apresentaram danos maiores nas cutículas, e certa proteção na degradação de proteínas em relação aquelas sem tratamento e irradiadas ao UV. Considerando as reaplicações do produto alisante ácido, quanto maior o número de aplicações, mais alinhadas e seladas tornaram se as fibras, mas mais rígida e suscetível à quebra ficaram. Devemos considerar a importância do valor do pH da formulação no impacto do alisamento e dano da fibra capilar

Hair straightening products are widely used in Brazil by the female public. However, these procedures can cause damage to the hair shaft and to professional´s and client´s health. Chemical straighteners can be divided into two groups: alkaline and acid. Alkaline straighteners has a very high pH value (> 9.0) and the straightening process is due to the break followed by reorganization of the disulfide bridges (S-S) present in the keratin, a structural protein of the hair shaft. Some examples of alkaline straighteners are ammonium thioglycolate and sodium or guanidine hydroxides. On the other hand, acid straighteners like formaldehyde, glyoxylic acid, and their associated, present a low pH value (≥ 2.0), which causes a rearranging within the fiber, and sometimes creates a film on the surface of the hair. Nowadays, the glyoxylic acid associated with carbocysteine and amino acids (INCI - International Nomenclature of Cosmetic Ingredient nomenclature presented in parentheses) (Glyoxyloyl Carbocysteine (and) Glyoxyloyl Keratin Aminoacids (and) Water) is the only acid straightener permitted. Therefore, the objective of this work is to study the effect of this acid straightener, incorporated into oil in water (o/w) base emulsions at two different pH values 1.0 and 2.0 ( with reapplication) on the mechanical and physicochemical properties of the hair shaft. Also, the impact of UV radiation in straightened tresses. In the experiments conducted, it was possible to observe that tresses treated with the emulsion at pH 1.0 had a better result on the alignment and the straightening capacity, improving the combing test (59.4%/), while the tresses with the formulation at pH 2.0, 33.0%. However, the tensile strength, to pH 1.0 decreased by 16.0% and to pH 2.0 only 9.0%. As for color, the difference when compared with virgin hair it was major at pH 1.0. The tryptophan content also was lower in tresses treated at pH 1, 0. For the DSC and Raman analyzes all the treated tresses presented modifications in their structure. Straightened strands exposed to radiation had major damage in the cuticles, and some protection in proteins degradation compared to untreated tresses exposed to radiation. Considering the reapplications of the straightening product, as higher the number of applications more aligned and sealed it becomes, however the hair fiber becomes stiffer and susceptible to breakage. Thats why we should consider the importance of the pH value in the product, and the impact of straightening and damage of the hai fiber

Tricho-rhino-phalangeal syndrome due to a novel frameshift variation of the TRPS1 gene / 中华医学遗传学杂志

OBJECTIVE@#To explore the genetic etiology of a pedigree affected with tricho-rhino-phalangeal syndrome.@*METHODS@#Next-generation sequencing (NGS) using a gene panel for hereditary osteopathies was carried out for the proband. Suspected mutation was validated in the proband and her parents by Sanger sequencing.@*RESULTS@#A heterozygous frameshift variation c.1995dupA (p.Gly666Argfs*20) of the TRPS1 gene was detected in the proband but not in her parents.@*CONCLUSION@#The novel c.1995dupA (p.Gly666Argfs*20) mutation of the TRPS1 gene probably underlies the disease in the proband.

Pilomatrixoma quístico con verruga vulgar intraquística: reporte de un caso / Cystic pilomatrixoma with intracystic vulgar wart: case report

El pilomatrixoma es una neoplasia anexial benigna, que habitualmente se presenta como pápula o nódulo subcutáneo, de crecimiento lento y asintomático. Es más frecuente en niños. El diagnóstico se basa en hallazgos clínicos, y la ecografía es útil como examen complementario. El tratamiento es su resección quirúrgica. Se presenta un caso infrecuente de pilomatrixoma quístico con verruga vulgar intraquística en un paciente adulto.

Pilomatricoma is a benign adnexal tumor, usually presenting as a slow growing asymptomatic subcutaneous papule or nodule. It is more common in children. The diagnosis is based on clinical findings, and ultrasound is useful as a complementary workup tool. Its treatment is surgical excision. We present a rare case of a cystic pilomatricoma with an intracystic verruca vulgaris in an adult patient.

Pilomatrixoma proliferante una rara variante histopatológica simulando un carcinoma de células escamosas / Pilomatrixoma proliferating a rare variant histopathological simulating a cell carcinoma scaly

El Pilomatrixoma es un tumor anexial benigno. Presenta una variante histopatológica infrecuente denominada pilomatrixoma proliferante reportada en 1997 por Kaddu et al. Corresponde a una lesión compuesta predominantemente por una proliferación lobular de células basaloides, con atipia nuclear variable y figuras mitóticas, áreas focales que contienen material cornificado eosinófilo, junto con células sombra. Se propuso al pilomatrixoma proliferante como un subconjunto histopatológico distintivo del pilomatrixoma y se consideró como una variante proliferativa con un perfil histopatológico benigno. La dermatoscopía en este tumor, sobre todo en pacientes de edad avanzada, puede llegar a constituir una trampa dermatoscópica, que es difícil de diferenciar de otras lesiones, como el melanoma o el carcinoma de células basales. Existen múltiples reportes de casos en la literatura donde se informa de pilomatrixomas clásicos o proliferantes simulando otras neoplasias. Presentamos el caso de una paciente de 88 años con pilomatrixoma proliferante facial que simuló clínicamente un carcinoma de células escamosas y llevó a confusión diagnóstica inicial, se destacan las características histopatológicas y clínicas de los pilomatrixomas proliferantes.

Pilomatrixoma is a benign adnexal tumor. It has an infrequent histopathological variant called proliferating pilomatrixoma reported in 1997 by Kaddu et al. It corresponds to a lesion composed predominantly by a lobular proliferation of basaloid cells, with variable nuclear atypia and mitotic figures, focal areas containing eosinophilic cornified material, together with shadow cells. The proliferating pilomatrixoma was proposed as a distinctive histopathological subset of the pilomatrixoma and was considered as a proliferative variant with a benign histopathological profile. Dermatoscopy in this tumor, especially in elderly patients, can result in a dermatoscopic trap, which makes it difficult to differentiate from other lesions, such as melanoma or basal cell carcinoma. There are multiple reports of cases in the literature where classic or proliferating pilomatrixomas were reported simulating other neoplasms. We present the case of an 88-year-old patient with a proliferating facial pilomatrixoma that clinically simulated a squamous cell carcinoma and led to an initial diagnostic confusion, highlighting the histopathological and clinical characteristics of the proliferating pilomatrixoma.

A Case of Localized Trichorrhexis Nodosa Caused by Rubbing / 대한피부과학회지

No abstract available.

Alopecia androgenética masculina de inicio precoz asociada a cáncer de próstata / Early-onset male androgenetic alopecia associated with prostate cancer

Contexto: La alopecia androgenética masculina es usual en hombres entre 30 a 70 años de edad; su presentación precoz ocurre en varones menores de 31 años, relacionada a andrógenos y herencia, factores importantes en su etiopatogenia. Tiene repercusión estética, sin embargo, se asocia a riesgo cardiovascular y cáncer de próstata; se postula que la influencia hormonal en la alopecia androgenética masculina favorece el desarrollo de cáncer prostático y determina su severidad. Objetivo: determinar la asociación entre alopecia masculina precoz y cáncer de próstata. Sujetos y métodos: hombres mayores a 18 años con cáncer de próstata confirmado; el grupo control lo conforman hombres mayores a 18 años sin neoplasias con determinación negativa de antígeno prostático. El estudio se efectuó en el Hospital Carlos Andrade Marín HCAM, en el periodo mayo a septiembre de 2015. Resultados: relación entre alopecia androgenética antes de los 31 años y cáncer de próstata, con un OR de 4,25 (IC 95% 1,7-10, p=0.001). No se observó diferencia estadística entre la severidad del cáncer prostático y el patrón clínico alopécico. Conclusión: los pacientes con alopecia androgenética masculina precoz (31 años), tienen un mayor riesgo de presentar cáncer de próstata, por lo que podría considerarse a la alopecia androgenética precoz como un indicador de riesgo para cáncer prostático, ameritando su tamizaje en pacientes con esta calvicie precoz (AU)

Context: Male androgenetic alopecia is usual in men between 30 to 70 years of age; Its early presentation occurs in males under 31 years, related to androgens and inheritance, important factors in its etiopathogenesis. It has aesthetic repercussion, however, it is associated with cardiovascular risk and prostate cancer; It is postulated that the hormonal influence in male androgenetic alopecia favors the development of prostate cancer and determines its severity. Objective: To determine the association between early male alopecia and prostate cancer. Subjects and methods: men older than 18 years with confirmed prostate cancer; The control group consists of men older than 18 years without neoplasms with negative determination of prostate antigen. The study was carried out at the Carlos Andrade Marín HCAM Hospital, from May to September 2015. Results: relationship between androgenetic alopecia before 31 years and prostate cancer, with an OR of 4.25 (95% CI 1.7-10, p = 0.001). No statistical difference was observed between the severity of the prostate cancer and the clinical alopecic pattern. Conclusion: patients with early male androgenetic alopecia 31 years, have a higher risk of developing prostate cancer; Early androgenetic alopecia could be considered as an indicator of risk for prostate cancer, deserving its screening in patients with this early baldness. (AU)

Multiple vulvar dilated pores in a postmenopausal woman

Abstract: Winer's dilated pore is an infrequent appendageal tumor characterized by a giant comedone on the face, neck, and upper trunk in adults. We report a 57-year-old woman who developed multiple asymptomatic black papules on both labia majora. Histopathology showed grouped dilated follicles lined by keratinizing squamous epithelium in the superficial dermis. The superficial lining epithelium and interfollicular epidermis were atrophic, while the deep epithelium showed mild proliferation and melanin pigmentation with a few short projections extending into the surrounding dermis. We diagnosed multiple Winer's dilated pores based on late-onset lesions and pathological features. This patient may represent the first case of multiple vulvar Winer's dilated pores. We suggest that electrocautery may be effective for treating this type of superficial entity.

Tricomicosis (tricobacteriosis) en un infante: aspectos microbiológicos, dermatoscópicos y ultraestructurales / Trichomycosis (trichobacteriosis) capitis in an infant: microbiological, dermoscopic and ultrastructural features

La tricomicosis es una infección superficial causada por Corynebacterium flavescens, que afecta por lo regular pelos axilares, en menor grado los púbicos, los escrotales e interglúteos y excepcionalmente los de la cabeza o tricomicosis capitis (TC). Esta infección se caracteriza por formación de nódulos pilosos. Clínicamente se confunde con infecciones como piedra blanca y pediculosis. El diagnóstico se realiza por microscopia y dermatoscopia de masas bacterianas y confirmado por cultivo. OBJETIVO: Presentar un caso de TC en un infante, y mostrar las características microscópicas, dermatoscópicas y ultraestructurales. CASO CLÍNICO: Niño sano de 6 meses de edad, con dermatosis que afectó los pelos de la cabeza en forma de múltiples nódulos-pilosos amarillentos. Se comprobó TC mediante fluorescencia amarilla a la luz de Wood; a la dermatoscopia se observaron cadenas blanco-amarillentas, como "rosarios de piedras cristalinas"; al examen directo se distinguieron masas bacterianas y al cultivo se identificó Corynebacterium flavescens. A la microscopia electrónica se observó infección superficial, sin perforación de los pelos. Se realizó tratamiento con aplicación de ácido fusídico por 3 semanas y se obtuvo curación clínica y microbiológica. CONCLUSIÓN: La TC es una entidad rara que se presenta en niños, y que suele confundirse con otros padecimientos del pelo como la pediculosis e infecciones micóticas.

Trichomycosis is a superficial infection caused by Corynebacterium flavescens, which regularly affects axillary, and to a a lesser extent, pubic, scrotal and intergluteal, and exceptionally, head hairs or trichomycosis capitis (TC). This condition is characterised by the formation of bacterial nodules. Clinically, it can be confused with white piedra or pediculosis. The diagnosis is made by microscopic and dermoscopic observation and confirmed by culture. OBJECTIVE: To present a case of TC in an infant and illustrate the microscopic, dermoscopic, and ultrastructural characteristics. CLINICAL CASE: A 6 month-old boy, otherwise healthy, with multiple yellowish concretions on the hairs of the head. TC was confirmed by yellow fluorescence with Wood’s light; white-yellowish beads, like "rosaries of crystalline stones" were observed on dermoscopy, direct examination showed bacterial masses, and Corynebacterium flavescens was identified by culture. A superficial infection, without perforation of the hairs, was confirmed by electron microscopy. Treatment with fusidic acid for 3 weeks achieved a clinical and microbiological cure. CONCLUSION: TC is a rare condition that affects children, and tends to be mistaken for other diseases of the hair, such as pediculosis and mycotic infections.