RESUMEN
BACKGROUND: Alopecia areata (AA) is common during childhood and rarely reported in infants. The four reported cases of AA in infants all exhibited circumscribed patches of alopecia that appeared at birth or shortly thereafter. OBJECTIVE: We report a case of alopecia areata universalis that developed after birth along with fingernail changes of shortening (onychomadesis) and onycholysis. Scalp biopsy at 2 years of age revealed rare, intermediate, terminal follicles in catagen associated with sparse peribulbar lymphocytic infiltrates. RESULTS: This constellation of clinicopathologic features was interpreted as AA. We discuss the differential diagnosis of generalized alopecia in healthy infants, in particular, Clouston's syndrome, a hair-nail (hidrotic) ectodermal dysplasia found in this region. Genetic testing for linked polymorphisms to the Clouston gene locus were negative in this child and his parents. CONCLUSIONS: Alopecia areata should be included in the differential diagnosis of generalized alopecia presenting at or shortly after birth. For purposes of genetic counseling and prognosis, it is crucial that a correct diagnosis be made.
Asunto(s)
Alopecia Areata/patología , Uñas Malformadas , Alopecia Areata/complicaciones , Biopsia , Preescolar , Diagnóstico Diferencial , Displasia Ectodérmica/diagnóstico , Displasia Ectodérmica/genética , Asesoramiento Genético , Humanos , Masculino , Polimorfismo Genético/genética , PronósticoRESUMEN
Although not curable or preventable, acne can benefit from adequate, appropriate therapy. Modern therapy for acne includes various topical agents highly effective against noninflammatory lesions, and oral or topical antibiotics effective against the inflammatory lesions. Long-term physical and psychologic scarring can be minimized by controlling acne in its active stages. Acne may flare during the first two to three weeks of intensive therapy. Unless undue side effects occur, any single agent or combination of agents should be tried for at least six weeks before being considered ineffective. Treatment needs to be individualized to achieve maximal effect.
Asunto(s)
Acné Vulgar/tratamiento farmacológico , Fármacos Dermatológicos/uso terapéutico , Acné Vulgar/fisiopatología , Adolescente , Antibacterianos/uso terapéutico , Dermatitis Seborreica/tratamiento farmacológico , Femenino , Humanos , MasculinoRESUMEN
While there is no single treatment plan that will work for every patient, acne can be controlled and long-term scarring can be minimized. Treatment must be individualized. Remember, there may be a "flare" when intensive therapy begins. Useful treatment methods include ultraviolet light, cleansers and soaps, peeling and drying agents, benzoyl peroxide preparations, abrasive soaps and scrubs, retinoic acid and oral antibiotics. The therapeutic choice depends upon the extent and severity of the disease.