Dermoscopy is a new diagnostic tool in diagnosis of common hypopigmented macular disease: A descriptive study.

One of the most frequent complaints in dermatology clinics is the eruption of hypopigmented patchy skin lesions. The aim of the study was to investigate the utility of dermoscopy in common hypopigmented macular diseases. Patients with the followings diseases were examined by dermoscopy: vitiligo, pityriasis alba, nevus depigmentosus, achromic pityriasis versicolor, idiopathic guttate hypomelanosis, and extragenital guttate lichen sclerosus. This study showed that these hypopigmented macular diseases might display specific dermoscopic features. In vitiligo, the mean dermoscopic features were the presence of a diffuse white glow with perifollicular pigment, perilesional hyperpigmentation, leukotrichia and the pigmentary network. In idiopathic guttate hypomelanosis, the characteristic features were the presence of multiple, shiny, scaly macules with welland ill-defined edges borders that coalesced into polycyclic macules. For nevus depigmentosus, the mean features were hypopigmented patches with irregular border with a faint reticular network. For pityriasis alba, the fairly ill-demarcated hypopigmented macules with fine scales were the mean feature. In lichen sclerosus, there were white structureless areas, perilesional erythematous halo, follicular plugging and white chrysalis like structures. Dermoscopy of achromic pityriasis versicolor showed a fairly demarcated white area with fine scales localized in the skin creases.

Clinical Significance of Trichoscopy in Common Causes of Hair Loss in Children: Analysis of 134 Cases.

INTRODUCTION: Hair loss is a common and distressing clinical complaint in the dermatology clinics. Common causes of hair loss in children include alopecia areata, tinea capitis, traction alopecia, and trichotillomania. Newly, trichoscopy allows differential diagnosis of hair loss in most cases and allows visualization of hair shafts and scalps without the need of removing hair. OBJECTIVE: The main objective is to compare the different trichoscopic features of common causes of patchy hair in children loss including tinea capitis, alopecia areata, traction alopecia, and trichotillomania. PATIENTS AND METHODS: This study included 134 patients, 63 patients with tinea capitis, 38 patients with alopecia areata, 18 patients with traction alopecia, and 15 patients with trichotillomania. The diagnostic tools for the diagnosis of hair loss problem included a detailed history, evaluation of the child's hair and scalp, fungal scrapping, and trichoscopy. RESULTS: Tinea capitis was the most common, and the trichoscopic features were comma-shaped hairs, corkscrew hairs, short broken hairs, and interrupted hairs. While in alopecia areata patients, the most specific features were yellow dots and black dots, microexclamation mark, hair shafts with variable thickness, and vellus hairs, with uncommon features included: monilethrix, coiled, zigzag, and tulip hairs. Trichoscopy of trichotillomania showed hair with fraying of ends, breakage at different lengths, short and coiled hairs, and amorphous hair residues. The trichoscopic features of traction alopecia were similar to those of trichotillomania. However, flame hairs and coiled hairs were less common. CONCLUSIONS: Trichoscopy is a noninvasive method of examining hair and scalp. It allows differential diagnosis of hair loss in most cases.

Pityriasis rotunda. A clinical study in Jordan: experience of 10 years.

BACKGROUND: Pityriasis rotunda is a rare skin disease characterized by the presence of multiple, round or oval, sharply demarcated hyperpigmented scaly patches. It has been described in Japan, South Africa, and in some other countries. The cause of pityriasis rotunda is usually idiopathic but may be associated with certain internal malignancy or systemic diseases. OBJECTIVE: The aim of this study is to describe this rare entity in Jordan in a retrospective study during the last 10 years. Jordan, as a Middle Eastern country, had no previous reports about this rare disease. In addition, the intention was to report any systemic association with the disease. Some of the cases were examined by dermoscopy. No previous reports documented dermatoscopic features of the disease. RESULTS: We could report 23 cases during the last 10 years. Eighteen cases were females and five males, in an age range of 9-38 years. There were three familial cases. The dermatoscopic findings were well demarcated, hyperpigmented with brownish patches with polygonal scales. These scales were more defined, not homogeneous in color, and separated from each other by paler stria. CONCLUSIONS: The cases of the study seem to indicate the rarity of the disease in Jordan. Our case fits neatly into the benign form of the disease with lack of association with any underlying diseases.

Hair loss in children: common and uncommon causes; clinical and epidemiological study in jordan.

BACKGROUND: Alopecia is a common complaint in dermatology clinics, and can be caused by a number of conditions, and has patterns that are different from that seen in adults. AIM OF STUDY: No previous studies investigating the clinical types of hair loss in Jordan and its epidemiology. The ultimate aim was to provide a guide for the evaluation of hair loss commonly occurring in childhood in our environment. PATIENTS AND METHODS: A total of 2800 children were seen at the dermatology clinics (Karak teaching hospital and Mutah university medical center) during January 2009 to October 2013 complaining of various clinical dermatological symptoms. RESULTS: Of these patients, 210 children were complaining of hair loss and scalp disorders (7.5% of pediatric dermatology cases seen in Jordan). The most common presentation was asymptomatic patchy hair loss (40%). Other symptoms were scaly scalp (22.9%), diffuse hair loss (21.4%), change in hair texture and color (8.1%), pruritus (5.7%), and pain in the scalp (1%). Tinea capitis was the commonest causes of hair loss (40.0%) followed by alopecia areata (26.2%) and telogen effluvium (17.6%). Other common causes of hair loss were observed in this study, these include chronic diffuse form of hair loss, trichotillomania, and traction alopecia. CONCLUSIONS: As has been observed in this study, hair problem may be due to important nutritional deficiency such as iron and zinc elements, and this is very important problem to think of especially in developing countries. Therefore, hair examination by a pediatrician or dermatologist is an important part of the physical examination.

Vitiligo in children: a clinical-epidemiologic study in Jordan.

Two thousand consecutive children were analyzed in a 2-year period to establish a clinical and epidemiologic profile of vitiligo in Jordan; 71 had vitiligo, with the prevalence increasing with age (0.45% <1 yr, 1% aged 1-5 yrs, 2.1% aged 5-12 yrs). Nonsegmental-type vitiligo was seen in 67 of the patients (92.9%).

Hair follicle stem cells in the pathogenesis of the scarring process in cutaneous lupus erythematosus.

Lupus erythematosus (LE) is an autoimmune disease that can affect one or more internal organs (systemic LE [SLE]) as well as the skin (CLE). Common cutaneous subtypes of CLE are chronic CLE (CCLE) and subacute CLE (SCLE). CCLE is the only type of CLE which heals with scarring and this may affect any site in the body. The fact that inflammation in CCLE generally involves the bulge area of the follicles (where the stem cells reside) raises the possibility that damage to the stem cells may be one process leading to permanent loss of follicles. One of the most useful distinctive markers of the stem cells is cytokeratin 15 (CK15) and this has been used in some studies to demonstrate the involvement of the bulge region in the scarring process in primary cicatricial alopecia and DLE. The bulge region appears to be involved in the scarring process in CLE and other types of cicatricial alopecia as part of broader involvement of the hair follicles; it is secondarily affected by the surrounding inflammatory cell infiltrate. Expression of the stem cell marker CK15 diminished and was then absent indicating either damage to stem cells or differentiation to help in the repair process.