Lichen planopilaris epidemiology: a retrospective study of 80 cases

AbstractBACKGROUND:Lichen planopilaris is a frequent presentation of primary cicatricial alopecia. Scalp distribution characterizes the main clinical presentations: classic lichen planopilaris, frontal fibrosing alopecia and Graham-Little Piccardi-Lassueur Syndrome (GLPLS).OBJECTIVE:Description of the clinical, dermoscopic and histopathological findings of Lichen planopilaris in public and private practices.METHOD:A retrospective observational study was performed by reviewing medical records of patients with lichen planopilaris.RESULTS:Eighty patients were included, 73 (91,25%) were female. Prototype II was seen in 53 (66,25%) patients. Classic lichen planopilaris was seen in 62,5% of the cases. Frontal fibrosing alopecia was seen in 31% of the patients and only one patient presented Graham-Little Piccardi-Lassueur Syndrome (GLPLS). Scalp lesions were scattered throughout the scalp in 47 (58,75%) of the patients, while 24 (30%) presented mainly central scalp lesions, 29 (36,25%) presented marginal lesions and only 4 (5%) patents had vertex lesions.CONCLUSIONS:Clinical presentation of Lichen planopilaris varies. To recognize the heterogeneity of the clinical appearance in lichen planopilaris is important for differential diagnosis.

Erosive pustular dermatosis of the scalp successfully treated with oral prednisone and topical tacrolimus / Dermatose pustular erosiva do couro cabeludo tratada com sucesso com prednisona oral e tacrolimus topico

Erosive pustular dermatosis of the scalp is a rare inflammatory disorder of the scalp, affecting elderly patients after local trauma and leading to scarring or cicatricial alopecia. Case Report: An elderly female patient complained of painful pustules on the parietal region bilaterally with progressive enlargement and ulceration. A biopsy suggested erosive pustular dermatosis of the scalp and the patient was treated with prednisone 40 mg/day and 0.1% topical tacrolimus. After 10 weeks complete closure of the eroded areas was observed and a stable scarring alopecia developed.

A dermatose pustular erosiva do couro cabeludo é uma doença inflamatória rara do couro cabeludo, de ocorrência preferencial em pacientes idosos após trauma local e com evolução para alopecia cicatricial. O caso relatado é de uma paciente idosa feminina que iniciou com pústulas dolorosas em região parietal bilateral com aumento das lesões e exulceração local. Após o diagnóstico histológico de dermatose pustular erosiva do couro cabeludo, foi iniciada prednisona 40 mg/dia e tacrolimus 0,1% tópico. Após 10 semanas evoluiu com cicatrização completa das áreas erosadas e alopecia cicatricial.

Estudo comparativo do uso de pigmentação exógena como adjuvante à luz intensa pulsada no tratamento de melanoses solares do dorso das mãos / Comparative study of the use of exogenous pigmentation as an adjuvant therapy to Intense Pulsed Light in the treatment of melanoses on the dorsum of the hands

Introdução: O fotodano intenso e crônico geralmente produz inúmeras queratoses actínicas, sendo importante o tratamento precoce e global da pele acometida. Objetivo: Avaliar a efetividade de dois tratamentos distintos para ceratoses actínicas múltiplas. Métodos: Foram selecionados 5 pacientes com ceratoses actinicas difusas no dorso de mãos e antebraços foram submetidos ao seguinte protocolo: lado A (direito) peeling químico superficial quinzenal com ácido glicólico 70% em gel seguido de solução de 5-fluoracil 5%; lado B (esquerdo) criopeeling mensal. O número de sessões variou de quatro a seis no lado A e de duas a três no lado B, de acordo com o grau de fotodano. Resultados: Todos os pacientes apresentaram resposta clínica satisfatória, com melhora das ceratoses actínicas e de toda área de dano actínico, com boa tolerância dos pacientes ao tratamento, apenas com a ressalva de que ao criopeeling segue-se eritema mais intensoe persistente. Conclusões: As duas terapêuticas utilizadas constituem-se em alternativas válidas e eficazes para tratamento do "campo de cancerização".

Introduction: The use of exogenous pigmentation as an adjuvant therapy to Intense Pulsed Light in the treatment of melanoses is routine, nevertheless there is an absence of published comparative studies. Objective: To compare Intense Pulsed Light therapy in isolation, or combined with exogenous pigmentation in the treatment of solar lentigines on the dorsum of the hands. Methods: Twenty women (mean age = 56.5 years) with skin types from I to III, underwent three sessions of Intense Pulsed Light, with a brown makeup pencil pigment reinforcement being applied to the lesions on the right hand. The patients were queried about the degree of discomfort, swelling, crusting, and improvement experienced, their treatment of preference and which they felt provided greater effectiveness, and the incidence of side effects. Results: When assessing all three of the treatment sessions together, the median discomfort score, as well as the degree of inflammation and crusting (p < 0.01), were higher on the right hand. Regarding the subjective impression of the final result, 15 in 20 patients preferred the technique applied on the right hand, considering it more effective (p < 0.01). Eleven in 20 patients reported fewer side effects in the un-pigmented side (p = 0.12). The degree of discomfort did not correlate significantly with the preferred technique (p = 0.67). Conclusions: In this sample, there was a preference for the method with the adjuvant use of exogenous pigmentation, however the incidence of pain and side effects was higher in this group.