Efluvio telógeno y Covid-19 / Telogen effluvium and Covid-19

The first case of infection by the virus SARS-CoV-2 was reported in China in the late 2019. The disease caused by this virus was called COVID-19 and was declared as a global pandemic by World Health Organization in March 2020. Among the consequences caused by the virus, some dermatological pathologies have been reported, such as Telogen effluvium (TE). In this review we will address the relation between Telogen effluvium and COVID-19. Material and methods: All literature related to Telogen effluvium and COVID-19 was searched in PubMed. Results: Since the beginning of the pandemic, the number of patients diagnosed with TE has increased. This is explained on one hand by the infection itself of the virus, generating a proinflammatory and procoagulant answer that lead to TE. On the other hand, it can be explained due to the stress caused by the lockdowns and the psychological consequences of a global pandemic. Also, the therapies used to treat the infection may increase the severity of the TE. The relation between TE and Covid-19 is not totally clear yet, but it is important due to the great impact that generates in the lives of the patients. (AU)

Yellow dots in trichoscopy: relevance, clinical significance and peculiarities

Abstract: Yellow dots are follicular ostium filled with keratin and/or sebum. Initially, they were exclusively associated with alopecia areata. Currently they have also been described in androgenetic alopecia, chronic cutaneous (discoid) lupus erythematosus, and dissecting cellulitis. Due to the growing importance of trichoscopy and its findings in the evaluation of the scalp, this article describes the main diseases in which yellow dots are a common trichoscopic finding, highlighting its characteristics in each dermatosis.

Anagen effluvium.

Disturbances of hair follicle cycling lie at the heart of most hair growth disorders, and have dramatic effects on visible hair growth and shedding. The two common disorders due to aberration in hair follicle cycling are telogen and anagen effluvium. Though a lot of literature addresses the problem of telogen effluvium, there are not many reviews on anagen effluvium or anagen hair loss. Anagen effluvium is considered synonymous with chemotherapy-induced alopecia and other causes are rarely considered. In this review, we try to discuss the etiopathogenesis, clinical presentation, differentials, and management issues in anagen effluvium. Anagen effluvium is the abrupt loss of hairs that are in their growing phase (anagen) due to an event that impairs the mitotic or metabolic activity of hair follicle. Chemotherapy, radiation and toxic chemicals, and sometimes inflammatory diseases like alopecia areata and pemphigus are also capable of diminishing the metabolic activity of hair follicles resulting in anagen hair loss. Although it is reversible, and hair regrowth occurs after a delay of 1-3 months; sometimes it can lead to permanent alopecia and can be psychologically devastating with negative impact on individual perceptions of appearance, body image, sexuality, and self-esteem. For some patients, the emotional trauma may be so severe that it may lead to discontinuing or refusing therapy that might otherwise be beneficial. In such cases, a psychosomatic approach as well as empathic consideration of the patients concerns and fears as well as the provision of practical medical-aesthetic and styling tips are equally important and can be integrated in management.

Alopecia areata: An update.

Alopecia areata (AA) is a common form of non-scarring hair loss of scalp and/or body. Genetic predisposition, autoimmunity, and environmental factors play a major role in the etiopathogenesis of AA. Patchy AA is the most common form. Atopy and autoimmune thyroiditis are most common associated conditions. Peribulbar and intrabulbar lymphocytic infl ammatory infi ltrate resembling “swarm of bees” is characteristic on histopathology. Treatment is mainly focused to contain the disease activity. Corticosteroids are the preferred treatments in form of topical, intralesional, or systemic therapy. Camoufl age in the form of wigs may be an alternative option in refractory cases.

Alopecia areata of dental origin in a child.

Alopecia areata (AA) is a chronic inflammatory disease that involves the hair follicle. Current evidence indicates that hair follicle inflammation in AA is caused by a T-cell-mediated autoimmune mechanism occurring in genetically predisposed individuals. AA has a reported incidence of 0.1%-0.2%, with a lifetime risk of 1.7%. It has also been found that AA accounts for roughly 2% of new dermatology outpatient cases in the US and the UK, 3.8% of cases in China and 6.7% of cases in Kuwait. Pediatric AA constitutes approximately 20% of all AA cases. AA affects males and females equally. The most common site to be affected is the scalp (90%). The face, eyebrows, eyelashes, beard, underarm hair, and pubic hair may be affected and, sometimes, even the entire body. AA requires combined therapy, involving topical or intralesional corticosteroids, immune therapy with diphenylcyclopropenone, and even psychotherapy. In some cases, treatment consists of simply eliminating the dental infectious process. This case report describes AA of dental origin in a 9-year-old girl, which resolved after management of the dental problem.

Tratamento dermato-odontológico para a alopécia areata. Relato de caso clínico / Dental-dermatological treatment for alopecia areata: case report

A alopécia areata é uma dermatite frequente, caracterizada pela perda de pelo no couro cabeludo, na barba ou em qualquer área pilosa do corpo, em ambos os gêneros e em qualquer idade. A sua etiopatogenia parece ser diversificada e está, por vezes, relacionada com fatores bem definidos, tais como infecções dentárias. Devido à localização em zonas visíveis, como a face, esta desordem dermatológica apresenta um impacto psicológico signifcativo nos seus portadores. Este artigo apresenta um caso clínico de inclusões dentárias e de alopécia areata, resolvido por meio da eliminação dessas inclusões dentárias conjuntamente com um tratamento dermatológico. Com este trabalho, os autores pretendem demonstrar a relação existente entre a inclusão dentária e o aparecimento da alopécia areata, bem como o tratamento preconizado para essa situação clínica.

Alopecia areata is a common dermatitis described by the loss of hair on the scalp, beard or any area of the body with hair follicles, affecting both sexes in any age. Although its etiology seems somewhat multifactorial, in some clinical cases specifc factors can be identified, like teeth infections. Due to the location in anterior locations like the face, this dermatological disorder has a huge psichologic impact the patients. This paper presents a clinical case of impacted teeth and alopecia areata, which was solved by the removal of those teeth and simultaneously with a dermatological treatment. The authors try to demonstrate the relation between impacted teeth and alopecia areata, as well as the standard treatment for this clinical situation.

Perfil clínico y manejo de pacientes con alopecia areata en el Servicio de Dermatología de la Pontificia Universidad Católica de Chile / Study of patients diagnosed with alopecia areata, and treated at the Dermatological Service of the Diagnostic Center at Universidad Catolica de Chile

Estudio retrospectivo de pacientes atendidos con diagnóstico de Alopecia Areata en el Servicio de Dermatología del Centro de Diagnóstico de la Pontificia Universidad Católica de Chile. Se revisaron las fichas de 77 pacientes con diagnóstico de Alopecia Areata, 38 por ciento hombres, 62 por ciento mujeres, con un promedio de edad de 26.7 (DSI 15.7; rango 2-65): 15 por ciento presentaron depresión, 11 por ciento rinitis alérgica, 6,5 por ciento presentaron ansiedad, 3,9 por ciento hipotiroidismo y 2,6 por ciento, vitíligo. La Alopecia Areata se asocia a un evento estresante en 27 por ciento de los pacientes. Dentro de los exámenes solicitados, un 2/26 tuvieron anticuerpos antitiroídeos positivos y 2/27, TSH alterada. Se discuten las diversas modalidades terapéuticas para tratar la Alopecia Areata.

lady with hair loss

Alopecia [hair loss] often significantly affects social and psychological wellbeing. Likely causes of hair loss depend on age, sex, features on examination and on presence of general medical conditions. Alopecia has several causes. Androgenic alopecia, one of the common forms has a specific pattern of temporal-frontal loss in men and central thinning in women. Topical minoxidil and finasteride are the useful treatment regimens. For Alopecia areata, intralesional and topical steroids are the mainstay of treatment

Actualizaciones en alopecia areata / Alopecia areata updates

La alopecia areata es una enfermedad dermatológica caracterizada por áreas o parches de alopecia con bordes netos en cuero cabelludo (principalmente) y resto del cuerpo. Es no cicatricial y tiene un curso impredecible, incluso la involución espontánea. Corresponde al 2 por ciento de las consultas dermatológicas. Puede asociarse a alteraciones autoinmunes como la tiroiditis de Hashimoto, vitíligo y atopia. Hasta una 20 por ciento de los pacientes tienen antecedentes familiares de la enfermedad. Actualmente puede tratarse con corticoides intralesionales, inmunoterapia tópica o sistémica, antralina, minoxidil y fotoquimioterapia. El tratamiento y la evolución dependen principalmente de dos factores: extensión y la edad de los pacientes.

Dermatosesrelacionadas às doenças da tireóide / Skin diseases related to thiroid disease

As disfunçöes tiroidianas, näo raramente, manifestam-se em associaçäo ou induzem ao aparecimento de quadros cutâneos. Em algumas situaçöes, as queixas iniciais ou principais dos pacientes portadores de tiroidopatias säo relatadas como alteraçöes na pele e, assim sendo,os dermatologistas seräo os primeiros médicos a serem consultados. Neste artigo, descrevemos as alteraçöes cutâneas que ocorrem nos pacientes com doenças tiroidianas, tais como: cisto do ducto tireoglosso, metastase cutânea do câncer de tireóide e lesöes näo específicas relacionadas ao hipo e ao hipertiroidismo.

Síndrome de Down: aspectos clínicos y manifestaciones cutáneas de la trisomía 21 / Downïs syndrome: clinical aspects and cutaneous manifestations of trisomy 21

El Síndrome de Down (SD) fue la primera aberración cromosómica descrita en el hombre; en la actualidad es la alteración cromosómica más frecuente, con especial importancia clínica por ser el factor etiológico más común de retardo mental. En Chile, su incidencia ha aumentado en las últimas décadas. Se analizan las múltiples alteraciones en los diversos sistemas de las personas con SD y las manifestaciones cutáneas más frecuentes

Uso de difenilciclopropenoma (difenciprona) no tratamento de alopecia areata: estudo preliminar / Diphencyprone in treatmento of alopecia areata: a preliminary study

FUNDAMENTOS - Alopecia areata afeta cerca de 2 porcento dos pacientes ambulatoriais que freqüentam os serviços de Dermatologia. Os tratamentos säo inespecíficos, com taxa de resposta bastante variável. Na categoria dos imunomoduladores, a difenciprona vem-se mostrando a droga mais eficaz e segura. OBJETIVOS - Avaliara resposta ao uso de difenciprona nos pacientes portadores de alopecia areata universal, total e em placas com comprometimento igual a 50 porcento da área do couro cabeludo ou maior, tornando possível essa modalidade terapêutica no país. MÉTODOS - No total, estäo sendo tratados 16 pacientes, porém oito terminaram o estudo até o momento (novembro de 1996 a setembro de 1997). Os pacientes foram sensibilizados com soluçäo de difenciprona a 2 porcento e, entäo, submetidos a aplicaçöes quinzenais com concentraçöes crescentes, variando de 0,1 porcento a 2 porcento, em todo o couro cabeludo. A resposta foi documentada clinicamente e com fotografias. O tratamento foi mantido por aproximadamente oito meses. RESULTADOS - Foram avaliados oito pacientes, sendo seis do sexo masculino e dois do sexo feminino, com idade entre quatro e sessenta anos. Cinco pacientes apresentavam tipo universal, um com alopecia total e dois com apresentaçäo em placas. Houve repilaçäo total em cinco (71,4 pocento) pacientes, parcial em dois (28,6 porcento) e falha terapêutica em apenas um paciente (12,5 porcento). CONCLUSÄO - A difenciprona mostrou-se boa alternativa terapêutica para alopecia areata, mas deve ser restrita a pacientes com doença extensa e refratária a outros tratamentos prévios

Auto antibodies and immunohistochemical studies in alopecia areata

Alopecia areata [AA] is a common and distressing disorder of unknown etiology. The aim of the present work was to investigate some immunological factors that might have a role in the aetiopathogenesis of AA. Autoantibody and immunohistochemical studies were made. Eighty seven patients with AA and 20 controls were studied for the detection of circulating antibodies against thyroid, gastric, smooth muscle, mitochondrial, ovarian, testicular and vascular tissue. Lymphocyte subsets, Langerhans cells, macrophages, histiocytes and HLA-DR were studied by immunohistochemical techniques. Our results showed that AA patients have positive autoantibodies in the following percentages, antitesticular antibodies [38.4%], antinuclear antibodies [9.2%], antithyroid thyroglobulin and antithyroid microsomal antibodies [8%], anticardiolipin [6.9%], antismooth muscle antibodies [5.7%] and antiparietal cell antibodies [4.6%]. T4, T8, B lymphocytes, Langerhan cells, macrophages and histiocytes were increased in the perifollicular cellular infiltrations. There was also an increased incidence of HLA-DR. Conclusions: Our findings regarding the autoantibodies studied and the perifollicular cellular infiltrate support the view that immunological factors play a role in alopecia areata

Alopecia areata: aspectos epidemiológicos etiopatogenicos e inmunológicos / Alopecia areata: epidemiologic aspects aetiopatogenics a immunological

La alopecía areata es un motivo de consulta habitual, afecta a ambos sexos, su mayor incidencia se encuentra entre los 20 y los 50 años. Se caracteriza por el taque de los folículos pilosos en anágeno. Si bien no es posible definir una causa concreta se reconoce la importancia de los mecanismos autoinmunes. En los últimos años se han logrado importantes avances en lo que se refiere a marcadores genéticos, rol de las citoquinas y en estudios sobre la papila como posible blanco de la enfermedad. Se reseñan los factores genéticos, psicológicos, neurológicos, vasculares e infecciosos presuntamente implicados.

Alopecia areata universalis following high dose mebendazole therapy for hydatid disease

Alopecia following mebendazole treatment, is considered to be rare and self-limited. We found this complication in 3 of a total of 57 patient during a 7 year period from 1989 to 1995. Their hair regrew, but its color and quality changed somewhat and remained so for at least one year in 2 patients. The third patient died earlier