ABSTRACT
BACKGROUND: Facial lesions in frontal fibrosing alopecia (FFA) have been poorly described in published series. OBJECTIVE: We sought to describe facial lesions in FFA. METHODS: We reviewed our series of 55 cases of FFA, selecting 12 cases with clinically significant facial lesions. We performed a histologic study of these lesions. RESULTS: In addition to the observations already described in the literature such as facial papules or follicular red dots, we observed perifollicular and diffuse erythema, sometimes with a reticular pattern, and the gradual appearance of pigmented macules on facial skin. Biopsy specimens from the areas with facial erythema showed perifollicular and interfollicular lymphocytic infiltrate and fibrosis around vellus hair follicles. Histologic evaluation of pigmented macules sometimes exhibited an increased epidermal pigmentation and on occasions, pigmentary incontinence. LIMITATIONS: More patients are needed to determine the prevalence of these lesions in FFA. CONCLUSION: On facial skin of patients with FFA, we can observe papules or perifollicular erythema secondary to vellus hair follicle involvement. We describe diffuse erythema, owing to follicular and interfollicular lichenoid infiltrate, and the gradual appearance of pigmented macules, which could be secondary to an increased epidermal pigmentation or to pigmentary incontinence.
Subject(s)
Alopecia/pathology , Facial Dermatoses/pathology , Hair Follicle/pathology , Adult , Age Factors , Alopecia/physiopathology , Biopsy, Needle , Disease Progression , Facial Dermatoses/physiopathology , Female , Fibrosis/pathology , Fibrosis/physiopathology , Humans , Immunohistochemistry , Lichen Planus/pathology , Lichen Planus/physiopathology , Middle Aged , Postmenopause/physiology , Rare Diseases , Retrospective Studies , Risk Assessment , Sampling StudiesABSTRACT
La queratodermia acuagénica es un cuadro poco frecuente caracterizado por pápulas y placas translúcidas con una superficie lisa y ductos ecrinos prominentes, limitado a palmas, que aparece o se hace más pronunciado tras la exposición del agua. Histopatológicamente se aprecia hiperqueratosis y dilatación de los ductos ecrinos. Este cuadro se ha descrito en adolescentes y mujeres jóvenes. Presentamos el caso de una mujer de 31 años de edad con una artritis reumatoide que había comenzado tratamiento con celecoxib un mes antes del inicio de sus síntomas cutáneos. Cambios similares se han descrito en asociación con fribosis quística y está descrito un caso inducido por rofecoxib. El incremento de sodio en la piel asociado a la toma de celecoxib podría causar un incremento en la capacidad de captación de agua por la queratina y ser el causante del cuadro clínico
Aquagenic keratoderma is an infrequent condition characterized by translucent, smooth-surfaced papules and plaques and prominent eccrine ducts. It is limited to the palms and appears or becomes more pronounced after exposure to water. Histopathologically, hyperkeratosis and dilation of the eccrine ducts are seen. This condition has been described in adolescents and young women. We present the case of a 31-year-old woman with rheumatoid arthritis who had begun treatment with celecoxib one month before the onset of her cutaneous symptoms. Similar changes have been described in association with cystic fibrosis, and a case induced by rofecoxib has also been reported. Higher levels of sodium in the skin associated with celecoxib could increase the keratin's ability to take in water, and this may cause the clinical symptoms
Subject(s)
Female , Adult , Humans , Keratoderma, Palmoplantar/diagnosis , Keratoderma, Palmoplantar/therapy , Zinc Sulfate/therapeutic use , Erythromycin/therapeutic use , Anti-Inflammatory Agents/adverse effects , Hyperhidrosis/complications , Hyperkeratosis, Epidermolytic/complications , Keratoderma, Palmoplantar/drug therapy , Anti-Inflammatory Agents , Keratins/adverse effects , Keratins/toxicityABSTRACT
Aquagenic keratoderma is an infrequent condition characterized by translucent, smooth-surfaced papules and plaques and prominent eccrine ducts. It is limited to the palms and appears or becomes more pronounced after exposure to water. Histopathologically, hyperkeratosis and dilation of the eccrine ducts are seen. This condition has been described in adolescents and young women. We present the case of a 31-year-old woman with rheumatoid arthritis who had begun treatment with celecoxib one month before the onset of her cutaneous symptoms. Similar changes have been described in association with cystic fibrosis, and a case induced by rofecoxib has also been reported. Higher levels of sodium in the skin associated with celecoxib could increase the keratin's ability to take in water, and this may cause the clinical symptoms.
