ABSTRACT
Lichen planopilaris and frontal fibrosing alopecia are primary scarring alopecias where diagnosis can be suggested by clinical and trichoscopy features, especially in the early stages, but scalp biopsy is the standard exam for definitive diagnosis. Frontal fibrosing alopecia is considered a variant of lichen planopilaris, as the histopathological findings are similar, with a perifollicular lymphohistiocytic infiltrate, sometimes with a lichenoid pattern. A thorough clinical examination, trichoscopy and photographic documentation are essential to assess the evolution and therapeutic response. To date, there are no validated treatments or guidelines for these diseases, but there are recommendations that vary with the individual characteristics of each patient. This article presents a comprehensive review of the literature, including an update on topics related to the diagnosis, follow-up, histopathological aspects and available treatments for lichen planopilaris and frontal fibrosing alopecia, highlighting their similarities, differences and peculiarities.
Subject(s)
Lichen Planus , Scalp Dermatoses , Alopecia/diagnosis , Alopecia/drug therapy , Alopecia/pathology , Humans , Lichen Planus/diagnosis , Lichen Planus/drug therapy , Lichen Planus/pathology , Scalp/pathology , Scalp Dermatoses/diagnosis , Scalp Dermatoses/drug therapy , Scalp Dermatoses/pathologyABSTRACT
Abstract Panitumumab is a monoclonal antibody against the epidermal growth factor receptor used in metastatic colorectal cancer; in addition to tumor cells, it acts on epidermal keratinocytes and on the outer root sheath and presents skin toxicity in up to 90% of cases. A scanning electron microscope was used to examine the eyelashes and hairs of a 65-year-old patient with eyelash trichomegaly, curly hair, and paronychia undergoing treatment with panitumumab. Grooving in the hair shafts were identified, which were more evident in the eyelashes. Similar to oral epidermal growth factor inhibitors (erlotinib and gefitinib), panitumumab can cause acquired pili canaliculi.
ABSTRACT
Although zoophilic dermatophytes remain the predominant cause of tinea capitis in Spain, an increase due to anthropophilic species has been reported. We report a retrospective observational study that included twenty-four children, who were diagnosed with tinea capitis due to anthropophilic species between 2004 and 2019. 75% of the patients were males with a mean age of 4,88 years. We observed 83,3% of cases from Africa, 4,2% from South America and 12,5% from Spain. Clinically, 70,8% of the patients presented scaly patches and non-scaring alopecia. Trichophyton soudanense was the main dermatophyte of the series (45,8%), followed by Microsporum audouinii (20,8%), Trichophyton tonsurans (12,5%) and Trichophyton violaceum (12,5%). Although this pattern of infection appears to be linked to immigration from Africa, we saw three native cases. The easier transmission of anthropophilic rather than zoophilic dermatophytes could predict a rise in the incidence of tinea capitis and a public health problem.
ABSTRACT
Although zoophilic dermatophytes remain the predominant cause of tinea capitis in Spain, an increase due to anthropophilic species has been reported. We report a retrospective observational study that included 24 children, who were diagnosed with tinea capitis due to anthropophilic species between 2004 and 2019. 75% of the patients were males with a mean age of 4,88 years. We observed 83,3% of cases from Africa, 4,2% from South America and 12,5% from Spain. Clinically, 70,8% of the patients presented scaly patches and non-scaring alopecia. Trichophyton soudanense was the main dermatophyte of the series (45,8%), followed by Microsporum audouinii (20,8%), Trichophyton tonsurans (12,5%) and Trichophyton violaceum (12,5%). Although this pattern of infection appears to be linked to immigration from Africa, we saw three native cases. The easier transmission of anthropophilic rather than zoophilic dermatophytes could predict a rise in the incidence of tinea capitis and a public health problem.
ABSTRACT
Panitumumab is a monoclonal antibody against the epidermal growth factor receptor used in metastatic colorectal cancer; in addition to tumor cells, it acts on epidermal keratinocytes and on the outer root sheath and presents skin toxicity in up to 90% of cases. A scanning electron microscope was used to examine the eyelashes and hairs of a 65-year-old patient with eyelash trichomegaly, curly hair, and paronychia undergoing treatment with panitumumab. Grooving in the hair shafts were identified, which were more evident in the eyelashes. Similar to oral epidermal growth factor inhibitors (erlotinib and gefitinib), panitumumab can cause acquired pili canaliculi.
Subject(s)
Eyelashes , Hair Diseases , Aged , Eyelashes/pathology , Hair/pathology , Hair Diseases/chemically induced , Hair Diseases/pathology , Humans , Microscopy, Electron, Scanning , Panitumumab/adverse effectsABSTRACT
Although zoophilic dermatophytes remain the predominant cause of tinea capitis in Spain, an increase due to anthropophilic species has been reported. We report a retrospective observational study that included twenty-four children, who were diagnosed with tinea capitis due to anthropophilic species between 2004 and 2019. 75% of the patients were males with a mean age of 4,88 years. We observed 83,3% of cases from Africa, 4,2% from South America and 12,5% from Spain. Clinically, 70,8% of the patients presented scaly patches and non-scaring alopecia. Trichophyton soudanense was the main dermatophyte of the series (45,8%), followed by Microsporum audouinii (20,8%), Trichophyton tonsurans (12,5%) and Trichophyton violaceum (12,5%). Although this pattern of infection appears to be linked to immigration from Africa, we saw three native cases. The easier transmission of anthropophilic rather than zoophilic dermatophytes could predict a rise in the incidence of tinea capitis and a public health problem (AU)
Aunque los dermatofitos zoófilos son aparentemente aún la causa principal de tinea capitis en España, se está observando un repunte por especies antropófilas. Presentamos un estudio observacional retrospectivo de veinticuatro niños con tinea capitis antropófila, diagnosticados en nuestro centro entre 2004 y 2019. El 75% de los pacientes fueron varones con una media de edad de 4,88 años. El 83,3% eran africanos, el 4,2% de América del Sur y el 12,5% de España. Clínicamente, en el 70,8% de los casos se observaron parches descamativos con alopecia no cicatricial. Trichophyton soudanense fue el dermatofito más aislado (45,8%), seguido de Microsporum audouinii (20,8%), Trichophyton tonsurans (12,5%) y Trichophyton violaceum (12,5%). Aunque este patrón parece estar relacionado con la inmigración africana, observamos 3 casos nativos. La facilidad de transmisión de los dermatofitos antropófilos permite predecir un aumento en la incidencia de la tinea capitis y un potencial problema de salud pública (AU)
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Tinea Capitis/epidemiology , Retrospective Studies , Spain/epidemiology , IncidenceABSTRACT
Aunque los dermatofitos zoófilos son aparentemente aún la causa principal de tinea capitis en España, se está observando un repunte por especies antropófilas. Presentamos un estudio observacional retrospectivo de veinticuatro niños con tinea capitis antropófila, diagnosticados en nuestro centro entre 2004 y 2019. El 75% de los pacientes fueron varones con una media de edad de 4,88 años. El 83,3% eran africanos, el 4,2% de América del Sur y el 12,5% de España. Clínicamente, en el 70,8% de los casos se observaron parches descamativos con alopecia no cicatricial. Trichophyton soudanense fue el dermatofito más aislado (45,8%), seguido de Microsporum audouinii (20,8%), Trichophyton tonsurans (12,5%) y Trichophyton violaceum (12,5%). Aunque este patrón parece estar relacionado con la inmigración africana, observamos 3 casos nativos. La facilidad de transmisión de los dermatofitos antropófilos permite predecir un aumento en la incidencia de la tinea capitis y un potencial problema de salud pública (AU)
Although zoophilic dermatophytes remain the predominant cause of tinea capitis in Spain, an increase due to anthropophilic species has been reported. We report a retrospective observational study that included twenty-four children, who were diagnosed with tinea capitis due to anthropophilic species between 2004 and 2019. 75% of the patients were males with a mean age of 4,88 years. We observed 83,3% of cases from Africa, 4,2% from South America and 12,5% from Spain. Clinically, 70,8% of the patients presented scaly patches and non-scaring alopecia. Trichophyton soudanense was the main dermatophyte of the series (45,8%), followed by Microsporum audouinii (20,8%), Trichophyton tonsurans (12,5%) and Trichophyton violaceum (12,5%). Although this pattern of infection appears to be linked to immigration from Africa, we saw three native cases. The easier transmission of anthropophilic rather than zoophilic dermatophytes could predict a rise in the incidence of tinea capitis and a public health problem (AU)
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Tinea Capitis/epidemiology , Retrospective Studies , Spain/epidemiology , IncidenceABSTRACT
BACKGROUND: The common inflammatory scalp diseases, such as psoriasis, seborrheic dermatitis, lichen planopilaris, discoid lupus erythematosus, contact dermatitis, or pemphigus may share similar clinical features. OBJECTIVE: To identify and systematically review the available evidence on the accuracy of trichoscopy in inflammatory scalp disorders. METHODS: A systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 58 articles were included in the analysis. RESULTS: The following trichoscopy features were found to show the highest specificity for the respective diseases: in psoriasis: diffuse scaling, simple and twisted red loops, red dots and globules, and glomerular vessels; in seborrheic dermatitis: atypical vessels, thin arborizing vessels, and structureless red areas; in discoid lupus erythematosus: follicular plugs and erythema encircling follicles; in lichen planopilaris: milky red areas or fibrotic patches; in contact dermatitis: twisted red loops; in pemphigus foliaceus: white polygonal structures and serpentine vessels; in pemphigus vulgaris: red dots with whitish halo and lace-like vessels; and in dermatomyositis: lake-like vascular structures. LIMITATIONS: Different nomenclature and variability in parameters, which were analyzed in different studies. CONCLUSION: This systemic analysis indicates that trichoscopy may be used with high accuracy in the differential diagnosis of inflammatory scalp diseases.
Subject(s)
Dermatitis, Contact , Dermatitis, Seborrheic , Lichen Planus , Lupus Erythematosus, Discoid , Pemphigus , Psoriasis , Scalp Dermatoses , Dermoscopy , Humans , Lichen Planus/diagnosis , Scalp , Scalp Dermatoses/diagnostic imagingABSTRACT
Abstract Lichen planopilaris and frontal fibrosing alopecia are primary scarring alopecias where diagnosis can be suggested by clinical and trichoscopy features, especially in the early stages, but scalp biopsy is the standard exam for definitive diagnosis. Frontal fibrosing alopecia is considered a variant of lichen planopilaris, as the histopathological findings are similar, with a perifollicular lymphohistiocytic infiltrate, sometimes with a lichenoid pattern. A thorough clinical examination, trichoscopy and photographic documentation are essential to assess the evolution and therapeutic response. To date, there are no validated treatments or guidelines for these diseases, but there are recommendations that vary with the individual characteristics of each patient. This article presents a comprehensive review of the literature, including an update on topics related to the diagnosis, follow-up, histopathological aspects and available treatments for lichen planopilaris and frontal fibrosing alopecia, highlighting their similarities, differences and peculiarities.
ABSTRACT
O tricograma configura-se em método semi-invasivo de fácil aplicabilidade e baixo custo, útil na avaliação dos diversos tipos de queda capilar no consultório dermatológico. Até o momento, não há padronização da técnica para coleta e realização do exame. A utilização de meios de interface entre lâmina e lamínula para a leitura do tricograma à microscopia óptica varia amplamente na literatura. Dentre as alternativas, a utilização de base de esmalte incolor configura-se em opção barata, acessível e prática, além de permitir a visualização das hastes capilares com mínima formação de artefato
The trichogram pictures an easy and semi-invasive method useful in the evaluation of different types of hair loss in daily practice. As of yet, there is no standardized methodology on how to collect and perform the exam. The use of liquid interface between blade and coverslip to read the trichogram under optical microscopy varies widely in the literature. Among the alternatives, the use of translucid fingernail polish is an inexpensive, accessible, and practical option, providing the examiner with proper visualization of the hair shafts with minimal artifact formation.
ABSTRACT
Cistos são tumores epiteliais benignos extremamente comuns. O cisto triquilemal ou pilar tem origem no istmo do pelo anágeno, representa cerca de 20% dos cistos e localiza-se mais frequentemente no couro cabeludo (90%). Vários métodos podem ser usados para a retirada dos mesmos. A escolha da técnica depende de suas características, como: tamanho, mobilidade, consistência, quiescência, inflamação e quantidade. Porém, eles podem reaparecer se houver remoção incompleta da cápsula. Os autores apresentam uma variante simples da técnica de marsupialização que permite a sua retirada total.
Cysts are benign epithelial tumors widespread. The trichilemmal cysts, originating from the anagen's isthmus, represent about 20% of the cysts and are located more frequently in the scalp (90%). Several methods can be used for the removal of the cysts. The choice of technique depends on its characteristics, such as size, mobility, consistency, quiescence, inflammation, and quantity. However, they may grow again if the capsule is incomplete removed. The authors present a simple variant of the marsupialization technique that allows its complete removal.
ABSTRACT
O carcinoma basocelular (CBC) gigante é uma variante rara, sendo o reparo de grandes defeitos no couro cabeludo, gerados após ressecção oncológica, um desafio cirúrgico. Relata-se o caso de um paciente submetido à reconstrução tardia do couro cabeludo após ressecção oncológica de CBC gigante no couro cabeludo, com associação de técnicas. A reconstrução das lesões do couro cabeludo depende de uma compreensão abrangente da anatomia desse local, um conhecimento do arsenal de técnicas cirúrgicas e uma avaliação detalhada dos fatores e expectativas do paciente, tendo em vista o impacto na qualidade de vida e a morbidade relacionada a cada opção terapêutica
The giant BCC is a rare variant, and the repair of large defects in the scalp, generated after oncologic resection, is a surgical challenge. We report the case of a patient submitted to late scalp reconstruction after oncologic resection of giant BCC in the scalp with the association of techniques. Reconstruction of scalp lesions depends on a comprehensive understanding of the anatomy of this site, knowledge of the arsenal of surgical techniques, and a detailed assessment of patient factors and expectations, given the impact on the quality of life and morbidity related to each therapeutic option
ABSTRACT
Dissecting cellulitis is an inflammatory, chronic, and recurrent disease of the hair follicles that mainly affects young Afro-descendent men. Trichoscopy is a method of great diagnostic value for disorders of the scalp. Clinical and trichoscopic findings of dissecting cellulitis are heterogeneous and may present features common to non-cicatricial and scarring alopecia. This article presents the trichoscopic findings of dissecting cellulitis that help in the diagnosis and consequent institution of the appropriate therapy and better prognosis of the disease.
Subject(s)
Cellulitis/diagnostic imaging , Cellulitis/pathology , Dermoscopy/methods , Hair Follicle/diagnostic imaging , Hair Follicle/pathology , Scalp Dermatoses/diagnostic imaging , Scalp Dermatoses/pathology , Skin Diseases, Genetic/diagnostic imaging , Skin Diseases, Genetic/pathology , Erythema/diagnostic imaging , Erythema/pathology , Hair/diagnostic imaging , Hair/pathology , HumansABSTRACT
Abstract Dissecting cellulitis is an inflammatory, chronic, and recurrent disease of the hair follicles that mainly affects young Afro-descendent men. Trichoscopy is a method of great diagnostic value for disorders of the scalp. Clinical and trichoscopic findings of dissecting cellulitis are heterogeneous and may present features common to non-cicatricial and scarring alopecia. This article presents the trichoscopic findings of dissecting cellulitis that help in the diagnosis and consequent institution of the appropriate therapy and better prognosis of the disease.
Subject(s)
Humans , Scalp Dermatoses/diagnostic imaging , Cellulitis/pathology , Cellulitis/diagnostic imaging , Hair Follicle/pathology , Hair Follicle/diagnostic imaging , Dermoscopy/methods , Scalp Dermatoses/pathology , Skin Diseases, Genetic/pathology , Skin Diseases, Genetic/diagnostic imaging , Erythema/diagnosis , Erythema/pathology , Hair/pathology , Hair/diagnostic imagingABSTRACT
BACKGROUND: Cutis Verticis Gyrata (CVG) is a rare skin disease caused by overgrowth of the scalp, presenting as cerebriform folds and wrinkles. CVG can be classified into two forms: primary (essential and non-essential) and secondary. The primary non-essential form is often associated with neurological and ophthalmological abnormalities, while the primary essential form occurs without associated comorbidities. DISCUSSION: We report on a rare case of primary essential CVG with a 4-year history of normal-colored scalp skin mass in the parietal-occipital region without symptom in a 34-year-old male patient, retrospectively summarizing his pathological and Computer Tomography (CT) and magnetic resonance imaging (MRI) findings. The major clinical observations on the CT and MR sectional images include a thickened dermis and excessive growth of the scalp, forming the characteristic scalp folds. With the help of CT and MRI Three-dimensional (3D) reconstruction techniques, the characteristic skin changes could be displayed intuitively, providing more evidence for a diagnosis of CVG. At the 5-year followup, there were no obvious changes in the lesion. CONCLUSION: Based on our observations, we propose that not all patients with primary essential CVG need surgical intervention, and continuous clinical observation should be an appropriate therapy for those in stable condition.
Subject(s)
Magnetic Resonance Imaging , Scalp/abnormalities , Scalp/diagnostic imaging , Skin Abnormalities/diagnostic imaging , Tomography, X-Ray Computed , Adult , Follow-Up Studies , Humans , Male , Multimodal Imaging , Time FactorsABSTRACT
Abstract: Lichen simplex chronicus is a skin disease that mostly affects female patients, with a peak incidence between ages 35 and 50 years. On the scalp, it appears as a single or multiple oval lesions, showing scaling and hair shaft loss or breakage. An important dermoscopic feature of the disease are the "broom fibers." Histopathology reveals the "hamburger" and the "gear wheel" signs. The aim of this report is to demonstrate a case of lichen simplex chronicus on the scalp with typical and exuberant clinical, dermoscopic, and histopathological findings.
