Hypotrichosis with Juvenile Macular Dystrophy in Saudi Arabia: A Case Report.

Hypotrichosis with juvenile macular dystrophy is an autosomal recessive disorder due to a mutation in the CDH3 gene. As its name indicates, the disease classically presented with hypotrichosis and early visual impairment. We describe herein a family member with alopecia since birth associated with severe visual impairment in their early life. We suspect the diagnosis of hypotrichosis with juvenile macular dystrophy. Genetic testing confirms the clinical suspension. We emphasize the importance of genetic testing for proper genetic counseling.

Point-of-care hip ultrasound leads to expedited results in emergency department patients with suspected septic arthritis.

BACKGROUND: The evaluation of septic hip arthritis often incorporates the utilization of hip ultrasonography to determine the presence of a hip joint effusion, as well as to guide arthrocentesis. Point-of-care (POC) hip ultrasound has previously been demonstrated to be accurate when performed by the emergency physician. Time to diagnosis and subsequent intervention in septic arthritis (SA) is critical to favorable outcomes. METHODS: Retrospective single-center study of all emergency department (ED) patients who had a POC or radiology hip ultrasound or arthrocentesis as part of their ED evaluation for SA in a 3-year period. We investigated the difference in time to obtain hip ultrasonography results and the time to arthrocentesis between radiology and emergency physician-performed studies in cases of suspected septic hip arthritis. RESULTS: Seventy-four patients met inclusion criteria. The median time to hip ultrasound completion was 68 (interquartile range [IQR], 38.8-132) minutes in the emergency physician-performed ultrasound group versus 208.5 (IQR, 163.8-301.3) minutes for the radiology group (P < 0.001). A total of 17 patients had a hip arthrocentesis performed. Time to arthrocentesis was 211 (IQR 141.3-321.5) minutes in the emergency physician-performed arthrocentesis group and 602 (IQR 500-692) minutes in the radiology arthrocentesis (P < 0.001). CONCLUSION: There was a statistically shorter time to ultrasound result and arthrocentesis when POC hip ultrasound was utilized by the emergency physician. Given that unfavorable outcomes in SA are associated with delay in treatment, further study is warranted to determine if emergency physician-performed hip ultrasound and arthrocentesis could lead to improved patient-centered clinical end points.

Platelet-Rich Plasma in the Treatment of Alopecia Areata: A Review.

Platelet-rich plasma (PRP) is an autologous preparation of plasma with concentrated platelets containing various growth factors and cytokines that enhance the body's inherent capacity to repair and regenerate hair follicles. A few studies and case reports support the use of PRP for the treatment of alopecia areata (AA). Further large-scale studies are needed to evaluate the efficacy of PRP as monotherapy or in association with other therapeutic modalities for AA. Although PRP is relatively safe and potentially effective, there is no standardized protocol or recommendations for the number of PRP sessions required to treat and maintain hair growth.

The Role of Diet as an Adjuvant Treatment in Scarring and Nonscarring Alopecia.

BACKGROUND: Diet is known to affect a wide range of health disorders. Many patients with hair and scalp diseases often inquire about special diets that may improve their symptoms. OBJECTIVE: To evaluate nutrition and diet as adjunct treatments in nonscarring and scarring alopecia. METHODS: A primary literature search using PRISMA guidelines was conducted using the PubMed database in October 2019. RESULTS: Twenty-four articles with 1,787 patients were included. The Mediterranean diet, which is rich in raw vegetables and fresh herbs, and isoflavone-rich soy contain anti-inflammatory nutrients that may promote hair health and growth in androgenetic alopecia (AGA). The gluten-free diet was shown to stimulate hair growth in alopecia areata (AA) patients with concomitant celiac disease, though no effect was seen with a lactose-free diet. Sufficient protein was found to be necessary for hair health. The human chorionic gonadotropin diet, hypocaloric diet, and increased fish, buckwheat, and millet groats consumption were possible triggers of alopecias such as AGA, AA, telogen effluvium, or frontal fibrosing alopecia. LIMITATIONS: This review was limited by the lack of studies and controls. CONCLUSION: The Mediterranean diet as well as diets rich in protein and soy may be potential adjunct therapeutics for the treatment of nonscarring alopecias. The use of diets in alopecia treatment regimens warrants further exploration.

Unusual Clinical Presentation of Autosomal Recessive Woolly Hair.

Autosomal recessive woolly hair/hypotrichosis (ARWH/H) is a rare nonsyndromic hair abnormality characterized by sparse, short, and curly hair. we report a case of a 5-year-old girl from consanguineous parents, who presented with ARWH/H since birth. Dermoscopic findings showed thin sparse hair. Genetic testing showed homozygous mutation in the LPAR6 gene.

Unusual Clinical Presentation of a Primary Cutaneous Follicle Center Lymphoma on the Scalp of a Middle-Aged Female: Case Report and Review of the Literature.

Primary cutaneous follicle center lymphoma (PCFCL) is a rare type of indolent, low-grade cutaneous B-cell lymphoma with an excellent prognosis. It usually presents with erythematous nodules and plaques on the head, neck, or back. The diagnosis is primarily based on histopathology, immunohistochemistry, and molecular studies. We describe a case of PCFCL causing a well-defined alopecic atrophic patch. The patch developed in the area of a large subcutaneous nodule that regressed after treatment with rituximab infusion. We hypothesize that the alopecia could have been caused by pressure.

Evaluation of Light-Emitting Diodes' Effects on the Expression Level of P53 and EGFR in the Gingival Tissues of Albino Rats.

Background and objectives: The light-curing unit is considered an essential piece of equipment in every dental office. This study was conducted to evaluate the effect of Light-Emitting Diodes (LEDs) by the light cure (LC) device on gingival tissues of albino rats histologically and by regarding the expression of P53 and epidermal growth factor receptor (EGFR). Materials and methods: Gingival tissues of the rats were exposed to LEDs for 30 s with an interval of 30 s for periods of 2 and 5 min and were examined after two and four weeks of light exposure. After the set time, histological sections were studied and the P53 and EGFR expressions were evaluated immunohistochemically and by molecular methods. Results: Mild hyperplasia and mild inflammatory response were detected in higher rates after two weeks of exposure when compared to 4 weeks postexposure. Whereas fibrosis was found at a higher rate after four weeks than that found after two weeks postexposure, parakeratosis was seen only in the group that was exposed for 5 min to LC and when biopsies were taken after 2 weeks. We found that the immunohistochemical expression of P53 was not changed. Similarly, the alteration of EGFR expression was statistically nonsignificant (p > 0.05) when compared to the control group. The data obtained from the qRT-PCR reaction was analyzed using the comparative CT (2-ΔΔCT) method. Statistically, there was no significant difference in the expression of EGER and P53 gene transcripts. Conclusions: LED causes no serious alteration in P53 and EGFR expression, and only trivial histopathological changes occurred, most of which recovered after a 4-week interval.

Genetic Hair Disorders: A Review.

Hair loss in early childhood represents a broad differential diagnosis which can be a diagnostic and therapeutic challenge for a physician. It is important to consider the diagnosis of a genetic hair disorder. Genetic hair disorders are a large group of inherited disorders, many of which are rare. Genetic hair abnormalities in children can be an isolated phenomenon or part of genetic syndromes. Hair changes may be a significant finding or even the initial presentation of a syndrome giving a clue to the diagnosis, such as Netherton syndrome and trichothiodystrophy. Detailed history including family history and physical examination of hair and other ectodermal structures such as nails, sweat glands, and sebaceous glands with the use of dermoscopic devices and biopsy all provide important clues to establish the correct diagnosis. Understanding the pathophysiology of genetic hair defects will allow for better comprehension of their treatment and prognosis. For example, in patients with an isolated hair defect, the main problem is aesthetic. In contrast, when the hair defect is associated with a syndrome, the prognosis will depend mainly on the associated condition. Treatment of many genetic hair disorders is focused on treating the primary cause and minimizing trauma to the hair.

The Role of Vitamins and Minerals in Hair Loss: A Review.

People commonly inquire about vitamin and mineral supplementation and diet as a means to prevent or manage dermatological diseases and, in particular, hair loss. Answering these queries is frequently challenging, given the enormous and conflicting evidence that exists on this subject. There are several reasons to suspect a role for micronutrients in non-scarring alopecia. Micronutrients are major elements in the normal hair follicle cycle, playing a role in cellular turnover, a frequent occurrence in the matrix cells in the follicle bulb that are rapidly dividing. Management of alopecia is an essential aspect of clinical dermatology given the prevalence of hair loss and its significant impact on patients' quality of life. The role of nutrition and diet in treating hair loss represents a dynamic and growing area of inquiry. In this review we summarize the role of vitamins and minerals, such as vitamin A, vitamin B, vitamin C, vitamin D, vitamin E, iron, selenium, and zinc, in non-scarring alopecia. A broad literature search of PubMed and Google Scholar was performed in July 2018 to compile published articles that study the relationship between vitamins and minerals, and hair loss. Micronutrients such as vitamins and minerals play an important, but not entirely clear role in normal hair follicle development and immune cell function. Deficiency of such micronutrients may represent a modifiable risk factor associated with the development, prevention, and treatment of alopecia. Given the role of vitamins and minerals in the hair cycle and immune defense mechanism, large double-blind placebo-controlled trials are required to determine the effect of specific micronutrient supplementation on hair growth in those with both micronutrient deficiency and non-scarring alopecia to establish any association between hair loss and such micronutrient deficiency.Plain Language Summary: Plain language summary available for this article.

New-Onset Androgenic Alopecia following Human Chorionic Gonadotropic Diet and Testosterone Pellet Implantation.

A diet involving human chorionic gonadotropic (hCG) injections combined with extreme caloric restriction is sometimes undertaken by people desiring rapid weight loss. We report a patient with new-onset androgenic alopecia following hCG diet combined with the implantation of testosterone pellets.

Crossed testicular ectopia.

Crossed testicular ectopia/transverse testicular ectopia is an extremely rare anomaly, in which both gonads migrate toward the same hemiscrotum. About 100 cases of transverse testicular ectopia have been reported in published studies. We report a case of transverse testicular ectopia in an 8-year-old boy who presented with right inguinal hernia and nonpalpable left testis. On exploration, both testes were present in the right inguinal region. Bilateral orchiopexy was performed by crossing the left testis in the preperitoneal space. The diagnosis could not be made preoperatively in most of reported cases. Magnetic resonance imaging, magnetic resonance venography, and laparoscopy are useful for diagnosis and management.