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1.
An. bras. dermatol ; 95(3): 307-313, May-June 2020. tab, graf
Article in English | ColecionaSUS, LILACS, ColecionaSUS | ID: biblio-1130882

ABSTRACT

Abstract Background: Clinical and histological features may overlap between lichen planopilaris-associated and discoid lupus erythematosus-associated scarring alopecia. Objectives: The aim of this study was to demonstrate the cutaneous infiltration of plasmacytoid dendritic cells and to compare their distribution pattern in discoid lupus erythematosus and lichen planopilaris. Methods: Twenty-four cases of discoid lupus erythematosus and 30 cases of lichen planopilaris were examined for immunostaining of the CD123 marker. The percentage and distribution pattern of plasmacytoid dendritic cells and the presence of the plasmacytoid dendritic cells clusters were evaluted in the samples. Results: The number of plasmacytoid dendritic cells was higher in the discoid lupus erythematosus specimens. Aggregations of 10 cells or more (large cluster) were observed in half of the discoid lupus erythematosus specimens and only 2 lichen planopilaris, with 50% sensitivity and 93% specificity for differentiating discoid lupus erythematosus from lichen planopilaris. Study limitations: Incidence and prevalence of discoid lupus erythematosus-associated scarring alopecia in the scalp are low, so the samples size of our study was small. Conclusions: We suggest that a plasmacytoid dendritic cells cluster of 10 cells or more is highly specific for distinguishing discoid lupus erythematosus from lichen planopilaris. It also appears that CD123 immunolabeling is valuable in both active and late stages of the disease.


Subject(s)
Humans , Male , Female , Adult , Dendritic Cells/pathology , Lupus Erythematosus, Discoid/pathology , Interleukin-3 Receptor alpha Subunit/immunology , Lichen Planus/pathology , Reference Values , Staining and Labeling , Immunohistochemistry , Biomarkers , Retrospective Studies , Alopecia/pathology , Middle Aged
3.
An. bras. dermatol ; 94(4): 416-421, July-Aug. 2019. tab, graf
Article in English | LILACS | ID: biblio-1038289

ABSTRACT

Abstract: Background: Frontal fibrosing alopecia is a condition of unknown origin, histologically similar to classic lichen planopilaris and generally observed in postmenopausal women with alopecia of the frontal-temporal hairline. Objectives: To describe the clinical, dermatoscopic, and histopathological characteristics and the treatment used in patients who have frontal fibrosing alopecia at the Alopecia Outpatient Clinic in a university hospital. Methods: Retrospective descriptive study performed by reviewing medical charts and biopsies of the scalp. Results: Sixteen patients were analyzed, all of them female, 93.75% of them postmenopausal, and 56.25% brown-skinned. All had frontal alopecia (100%), followed by temporal alopecia (87.5%) and madarosis (87.5%). On dermatoscopy, perifollicular erythema and tubular scales were found as a sign of disease activity. Of the patients, 68.75% had associated autoimmune diseases, including lupus, thyroid disease and vitiligo. Of the 13 biopsies from 8 patients, 10 showed microscopic aspects compatible with frontal fibrosing alopecia. Laboratory tests did not show major abnormalities and minoxidil was the most used treatment. Study limitation: Data collection limited by the study's retrospective design associated to flaws while filling in the medical charts and absence in standards to the collection and processing of the pathology and histopathological examination. Conclusions: A demographical, clinical, and histopathological description of 16 patients diagnosed with frontal fibrosing alopecia, which remains a challenging disease, of unknown origin, and frequently associated with autoimmune diseases. This study reinforces literary findings. However, more research is needed to establish the pathogenesis and effective treatments.


Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Alopecia/pathology , Scalp/pathology , Biopsy , Fibrosis , Retrospective Studies , Hair Follicle/pathology , Dermoscopy/methods , Alopecia/drug therapy , Hospitals, University
7.
An. bras. dermatol ; 93(2): 274-276, Mar.-Apr. 2018. graf
Article in English | LILACS | ID: biblio-887172

ABSTRACT

Abstract: Lupus erythemathosus is a chronic, relapsing disease with acute, subacute, and chronic lesions. Effluvium telogen occurs in the setting of systemic activity of the disease, and cicatricial alopecia results from discoid lesionsin on the scalp. Other types of alopecia, like alopecia areata, may rarely be found in lupus. Frontal fibrosing alopecia is characterized by frontotemporal hairline recession and eybrow loss. Histophatologically, it cannot be differentiated from lichen planopilaris.It is controversial whether frontal fibrosing alopecia is a subtype of lichen planopilaris.. A pacient with chronic lichenoid lupus erythematosus is described with clinical, histophatological and dermoscopic features of frontal fibrosing alopecia.We have not been able to find in the literature cases of frontal fibrosing alopecia as a clinical manifestation of lupus.


Subject(s)
Humans , Female , Middle Aged , Lupus Erythematosus, Discoid/complications , Lupus Erythematosus, Discoid/pathology , Alopecia/complications , Alopecia/pathology , Scalp/pathology , Biopsy , Fibrosis/pathology , Lichenoid Eruptions/pathology , Dermoscopy
9.
An. bras. dermatol ; 92(6): 867-869, Nov.-Dec. 2017. graf
Article in English | LILACS | ID: biblio-887117

ABSTRACT

Abstract: Piccardi-Lassueur-Graham-Little syndrome is a rare entity characterized by progressive scarring alopecia of the scalp and keratotic papules on hairless skin, associated with non-scarring alopecia in the axilla and pubic area or lichen planus lesions. We describe the case of a 70-year-old woman who presented a Piccardi-Lasseur-Graham-Little syndrome, along with frontal fibrosing alopecia.


Subject(s)
Humans , Female , Aged , Scalp/pathology , Cicatrix/pathology , Alopecia/pathology , Syndrome , Biopsy , Fibrosis , Dermoscopy , Keratosis/pathology , Lichen Planus/pathology , Mouth Mucosa/pathology
10.
An. bras. dermatol ; 92(4): 543-545, July-Aug. 2017. graf
Article in English | LILACS | ID: biblio-886991

ABSTRACT

Abstract: Lichen planopilaris is a disease that appears with lymphocytic cicatricial alopecia. It is considered a follicular variant of lichen planus. The examination of affected areas shows alopecia with perifollicular erythema and scaling, revealing a predilection for hair follicles. The involvement of children is uncommon, with few reports in this population in the literature. This study presents a clinical case of a male patient of 15 years of age with characteristic lesions of lichen planopilaris.


Subject(s)
Humans , Male , Adolescent , Scalp/pathology , Alopecia/pathology , Lichen Planus/pathology , Biopsy , Hair Follicle/pathology , Dermoscopy , Hair/diagnostic imaging
11.
An. bras. dermatol ; 92(3): 430-431, May-June 2017. tab, graf
Article in English | LILACS | ID: biblio-1038249

ABSTRACT

Abstract The etiopathogenesis of female pattern hair loss is still poorly understood. In addition to genetic and hormonal elements, environmental factors could be involved. The aryl hydrocarbon receptor is expressed in keratinocytes and can be activated by environmental pollutants leading to alterations in the cell cycle, inflammation, and apoptosis. Here we demonstrate the overexpression of nuclear aryl hydrocarbon receptors in miniaturized hair follicles in female pattern hair loss.


Subject(s)
Humans , Female , Receptors, Aryl Hydrocarbon/metabolism , Hair Follicle/metabolism , Alopecia/metabolism , Up-Regulation , Hair Follicle/pathology , Hair Follicle/chemistry , Alopecia/pathology
13.
An. bras. dermatol ; 92(5,supl.1): 79-81, 2017. graf
Article in English | LILACS | ID: biblio-887090

ABSTRACT

Abstract Frontal fibrosing alopecia is a variant of lichen planopilaris with marginal progressive hair loss on the scalp, eyebrows and axillae. We report a case of frontal fibrosing alopecia and lichen planus pigmentosus in a postmenopausal woman, that started with alopecia on the eyebrows and then on the frontoparietal region, with periocular and cervical hyperpigmentation of difficult management. The condition was controlled with systemic corticosteroid therapy and finasteride. Lichen planus pigmentosus is an uncommon variant of lichen planus frequently associated with frontal fibrosing alopecia in darker phototipes. It should be considered in patients affected by scarring alopecia with a pattern of lichen planopilaris and areas of skin hyperpigmentation revealing perifollicular hyperpigmentation refractory to multiple treatments. This case illustrates diagnostic and therapeutic challenge in face of scarring alopecia and perifollicular hyperpigmentation.


Subject(s)
Humans , Female , Aged , Hyperpigmentation/pathology , Hyperpigmentation/drug therapy , Alopecia/pathology , Alopecia/drug therapy , Lichen Planus/drug therapy , Skin/pathology , Biopsy , Treatment Outcome , Adrenal Cortex Hormones/therapeutic use , Postmenopause , Finasteride/therapeutic use , Dermoscopy , Forehead/pathology , Lichen Planus/pathology
14.
An. bras. dermatol ; 92(5,supl.1): 76-78, 2017. graf
Article in English | LILACS | ID: biblio-887058

ABSTRACT

Abstract We present the case of a 72-year-old Caucasian woman with frontal fibrosing alopecia of one year's duration. Eighteen months later, she presented with sudden hyperpigmentation on the submental area, neck and upper chest. Histopathological examination was consistent with lichen planus pigmentosus. This is the report of a unique case of a FFA and extrafacial lichen planus pigmentosus.


Subject(s)
Humans , Female , Aged , Hyperpigmentation/pathology , Alopecia/pathology , Lichen Planus/pathology , Skin/pathology , Hyperpigmentation/complications , Dermoscopy , Alopecia/complications , Forehead/pathology , Lichen Planus/complications
15.
An. bras. dermatol ; 91(6): 776-780, Nov.-Dec. 2016.
Article in English | LILACS | ID: biblio-837986

ABSTRACT

Abstract The transforming growth factor-beta 1 (TGFβ1) promotes fibrosis, differentiating epithelial cells and quiescent fibroblasts into myofibroblasts and increasing expression of extracellular matrix. Recent investigations have shown that PPAR (peroxisome proliferator-activated receptor*) is a negative regulator of fibrotic events induced by TGFβ1. Dehydroepiandrosterone (DHEA) is an immunomodulatory hormone essential for PPAR functions, and is reduced in some processes characterized by fibrosis. Although scarring alopecia characteristically develops in the female biological period in which occurs decreased production of DHEA, there are no data in the literature relating its reduction to fibrogenic process of this condition. This article aims to review the fibrogenic activity of TGFβ1, its control by PPAR and its relation with DHEA in the frontal fibrosing alopecia.


Subject(s)
Humans , Female , Dehydroepiandrosterone/physiology , Alopecia/physiopathology , Alopecia/pathology , Fibrosis , PPAR gamma/physiology , Alopecia/etiology , Alopecia/therapy , Transforming Growth Factor beta1/physiology , Fibroblasts/physiology , Fibroblasts/pathology , Lichen Planus/pathology
16.
An. bras. dermatol ; 91(5,supl.1): 45-47, Sept.-Oct. 2016. graf
Article in English | LILACS | ID: biblio-837937

ABSTRACT

Abstract Tyrosine kinase inhibitors are effective as a target therapy for malignant neoplasms. Imatinib was the first tyrosine kinase inhibitor used. After its introduction, several other drugs have appeared with a similar mechanism of action, but less prone to causing resistance. Even though these drugs are selective, their toxicity does not exclusively target cancer cells, and skin toxicity is the most common non-hematologic adverse effect. We report an eruption similar to lichen planopilaris that developed during therapy with nilotinib, a second generation tyrosine kinase inhibitor, in a patient with chronic myeloid leukemia resistant to imatinib. In a literature review, we found only one report of non-scarring alopecia due to the use of nilotinib.


Subject(s)
Humans , Female , Middle Aged , Pyrimidines/adverse effects , Drug Eruptions/etiology , Drug Eruptions/pathology , Protein Kinase Inhibitors/adverse effects , Lichen Planus/pathology , Biopsy , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy , Alopecia/chemically induced , Alopecia/pathology , Imatinib Mesylate/adverse effects , Antineoplastic Agents/adverse effects
17.
An. bras. dermatol ; 91(5,supl.1): 69-71, Sept.-Oct. 2016. graf
Article in English | LILACS | ID: biblio-837954

ABSTRACT

Abstract Leprosy is a chronic infectious disease caused by Mycobacterium leprae. This bacillus has a high predilection for skin and peripheral nerves. The scalp’s anatomical properties do not favor the development of such mycobacterium. We report a case of leprosy with scalp involvement, a rare occurrence in our literature.


Subject(s)
Humans , Male , Adolescent , Scalp Dermatoses/microbiology , Leprosy, Multibacillary/pathology , Scalp/pathology , Scalp Dermatoses/pathology , Biopsy , Alopecia/microbiology , Alopecia/pathology , Leprosy, Multibacillary/complications
18.
An. bras. dermatol ; 91(5,supl.1): 14-16, Sept.-Oct. 2016. graf
Article in English | LILACS | ID: biblio-837955

ABSTRACT

Abstract Frontal fibrosing alopecia is a distinctive form of scarring alopecia considered to be a clinical variant of lichen planopilaris. It predominantly occurs in postmenopausal women and has a slowly progressive course. It was first described by Kossard in 1994. Since then the number of reported cases has increased significantly. Coexistence of frontal fibrosing alopecia and autoimmune disorders - such as discoid erythematosus lupus and Sjögren's syndrome - may suggest a common pathogenic background among the diseases.


Subject(s)
Humans , Female , Middle Aged , Sjogren's Syndrome/complications , Alopecia/complications , Fibrosis , Lupus Erythematosus, Discoid/complications , Lupus Erythematosus, Discoid/pathology , Hair Follicle/pathology , Dermis/pathology , Alopecia/immunology , Alopecia/pathology , Lichen Planus/immunology , Lichen Planus/pathology
19.
Rev. chil. dermatol ; 32(1): 58-60, 2016. ilus
Article in Spanish | LILACS | ID: biblio-946805

ABSTRACT

El Síndrome Graham-Little-Piccardi-Lasseur (GLPLS) corresponde a una variante clínica del llamado Liquen plano pilar y se caracteriza por presentar alopecia cicatrizal progresiva de cuero cabelludo con las características del Liquen plano pilar, alopecia no cicatrizal que compromete axilas y pubis, y erupción folicular liquenoide en tronco, extremidades, cara y/o cejas. Presentamos el caso de una paciente de 19 años que ha sido diagnosticada con GLPLS y cuyo curso ha sido de difícil manejo.


The Graham-Little-Piccardi-Lasseur Syndrome (GLPLS) corresponds to a clinical variant of Lichen planopilaris and is characterized by progressive scarring scalp alopecia with features of flat lichen, non-scarring alopecia localized in the armpits and pubis, and lichenoid follicular eruption in trunk, extremities, face and / or eyebrows. We present the case of a 19-year-old female patient who has been diagnosed with GLPLS and whose course has been difficult to manage.


Subject(s)
Humans , Female , Adult , Cicatrix/diagnosis , Alopecia/diagnosis , Lichen Planus/diagnosis , Syndrome , Cicatrix/pathology , Alopecia/pathology , Darier Disease/diagnosis , Lichen Planus/pathology
20.
An. bras. dermatol ; 90(6): 897-899, Nov.-Dec. 2015. graf
Article in English | LILACS | ID: lil-769510

ABSTRACT

Abstract: Clouston syndrome is a rare genodermatosis that affects skin and annexes. It is a form of ectodermal dysplasia characterized by generalized hypotrichosis, palmoplantar hyperkeratosis and nail dystrophy. This paper reports a 25-year follow-up of a patient with Clouston syndrome, from childhood to adulthood, monitoring diagnosis and clinical course of the disease.


Subject(s)
Adult , Female , Humans , Ectodermal Dysplasia/pathology , Alopecia/pathology , Ectodermal Dysplasia/therapy , Follow-Up Studies , Keratoderma, Palmoplantar/pathology , Nail Diseases/pathology
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