Prachi Srivastava, A. Saxena, Shivansh Kanchan, Prateek Chauhan, Mohini Chaturvedi
Basal cell carcinoma (BCC) is one of the commonest cutaneous malignancies and usually presents as a nodular or ulcerative lesion on the face and neck region. A rare subtype of BCC known as horrifying BCC, which is a locally destructive and invasive subtype of BCC, was seen in our patient, who had presented with a very large and grotesque-looking lesion covering the entire left half of the face, leading us to suspect noma or cancrum oris as the first differential diagnosis. However, on histopathology, it was confirmed as a case of BCC, thereby reinforcing the fact that as clinical presentations may be variable, histopathology should always be the gold standard for diagnosis. BCC has long since been known as a mimicker, with BCC mimicking lesions being a separate entity, but to the best of our knowledge, noma as a BCC mimicker has never been reported earlier. We are therefore presenting this case for its rarity.
{"title":"Basal cell carcinoma mimicking noma: an unreported entity","authors":"Prachi Srivastava, A. Saxena, Shivansh Kanchan, Prateek Chauhan, Mohini Chaturvedi","doi":"10.4103/jewd.jewd_59_22","DOIUrl":"https://doi.org/10.4103/jewd.jewd_59_22","url":null,"abstract":"Basal cell carcinoma (BCC) is one of the commonest cutaneous malignancies and usually presents as a nodular or ulcerative lesion on the face and neck region. A rare subtype of BCC known as horrifying BCC, which is a locally destructive and invasive subtype of BCC, was seen in our patient, who had presented with a very large and grotesque-looking lesion covering the entire left half of the face, leading us to suspect noma or cancrum oris as the first differential diagnosis. However, on histopathology, it was confirmed as a case of BCC, thereby reinforcing the fact that as clinical presentations may be variable, histopathology should always be the gold standard for diagnosis. BCC has long since been known as a mimicker, with BCC mimicking lesions being a separate entity, but to the best of our knowledge, noma as a BCC mimicker has never been reported earlier. We are therefore presenting this case for its rarity.","PeriodicalId":17298,"journal":{"name":"Journal of the Egyptian Women's Dermatologic Society","volume":"20 1","pages":"140 - 142"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41434425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Narrow-band ultraviolet B (NB-UVB) is a crucial and effective line of treatment for nonsegmental vitiligo. Objective To compare the effect of adding platelet-rich plasma (PRP) injections versus microneedling sessions on the response to NB-UVB in patients who stopped giving response or did not give response from the start. Patients and methods An intrapatient randomized comparative study including 30 patients with stable, nonsegmental vitiligo was performed. Three lesions were assessed in each participant and randomly allocated to undergo PRP injections or microneedling every 2 weeks for four sessions. The third lesion was left as a control. Throughout the study, all lesions were subjected to NB-UVB three times a week. Photographic assessment by an independent dermatologist and a patient satisfaction questionnaire were used to assess repigmentation. Results PRP injection showed better results than microneedling in terms of repigmentation, complications, and patient satisfaction. The mean percentages of repigmentation in PRP, microneedling-treated, and control lesions were 58.17±21.52, 24.5±18.77, and 15.17±13.49, respectively (P<0.001). The onset of repigmentation was earlier in the PRP-injected lesions compared with microneedling (3.97±1.607 and 7.8±2.683 weeks, respectively; P<0.001). Follicular repigmentation was the predominant pattern in PRP sites (50%). Conclusion PRP therapy is a secure and effective procedure that helps patients with vitiligo and speeds up their reaction to NB-UVB as well as supports and encourages their recall response.
{"title":"Platelet-rich plasma versus microneedling effects in NB-UVB non-responder vitiligo patients","authors":"K. Khalil, S. Ibrahim","doi":"10.4103/jewd.jewd_1_23","DOIUrl":"https://doi.org/10.4103/jewd.jewd_1_23","url":null,"abstract":"Background Narrow-band ultraviolet B (NB-UVB) is a crucial and effective line of treatment for nonsegmental vitiligo. Objective To compare the effect of adding platelet-rich plasma (PRP) injections versus microneedling sessions on the response to NB-UVB in patients who stopped giving response or did not give response from the start. Patients and methods An intrapatient randomized comparative study including 30 patients with stable, nonsegmental vitiligo was performed. Three lesions were assessed in each participant and randomly allocated to undergo PRP injections or microneedling every 2 weeks for four sessions. The third lesion was left as a control. Throughout the study, all lesions were subjected to NB-UVB three times a week. Photographic assessment by an independent dermatologist and a patient satisfaction questionnaire were used to assess repigmentation. Results PRP injection showed better results than microneedling in terms of repigmentation, complications, and patient satisfaction. The mean percentages of repigmentation in PRP, microneedling-treated, and control lesions were 58.17±21.52, 24.5±18.77, and 15.17±13.49, respectively (P<0.001). The onset of repigmentation was earlier in the PRP-injected lesions compared with microneedling (3.97±1.607 and 7.8±2.683 weeks, respectively; P<0.001). Follicular repigmentation was the predominant pattern in PRP sites (50%). Conclusion PRP therapy is a secure and effective procedure that helps patients with vitiligo and speeds up their reaction to NB-UVB as well as supports and encourages their recall response.","PeriodicalId":17298,"journal":{"name":"Journal of the Egyptian Women's Dermatologic Society","volume":"20 1","pages":"114 - 119"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47454519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Skin tags are benign condition; however, their appearance may be associated with some risk factors. There are no studies correlating clinical criteria of skin tags with the associated comorbidities whether isolated or mixed. Objective To evaluate prevalence, clinical criteria of skin tags, and risk factors that may be associated with skin tags. Patients and methods This study included 1000 participants, who were screened for the presence of skin tags and examined to detect clinical criteria. Patients with skin tags were screened for the presence of comorbidities (obesity, hypertension, diabetes mellitus, and dyslipidemia) and were classified into patients without associated comorbidities and those with isolated or mixed comorbidities. Results Overall, 30% of patients presented with skin tags. Most skin tags were brown (72%), small (50.8%), sessile (81.6%), and located on neck (56.6%). Comorbidities were reported in 95% of patients with skin tags, with predominance of mixed comorbidities (65.96%). In comparison with patients without associated comorbidities, skin tags with isolated comorbidities were more sessile (P=0.043) and medium sized (P=0.002). However, skin tags with mixed comorbidities were more sessile (P=0.011), more numerous (P≤0.001), and with older age of onset (P<0.001) compared with those without comorbidities. On comparing the two groups of comorbidities, skin tags with mixed comorbidities were more black (P≤0.001), large (P≤0.011), more numerous (P≤0.001), and older age of onset (P≤0.001). There was a significant correlation between lesion duration and numbers and age, BMI, random blood sugar, hemoglobin A1c, and dyslipidemia. Conclusion Skin tags are very common and considered as cutaneous markers for risk factors such as age, BMI, random blood sugar, hemoglobin A1c, cholesterol, and low-density lipoproteins. Presence of mixed comorbidities can increase the liability of skin tags to be more numerous, larger, and with late age of onset compared with presence of isolated comorbidity or even absence of comorbidity.
{"title":"Prevalence, clinical criteria, and risk factors of skin tags: a hospital-based study","authors":"A. Abdel‐Rahman, Seham Elsaied, S. Mohammed","doi":"10.4103/jewd.jewd_52_22","DOIUrl":"https://doi.org/10.4103/jewd.jewd_52_22","url":null,"abstract":"Background Skin tags are benign condition; however, their appearance may be associated with some risk factors. There are no studies correlating clinical criteria of skin tags with the associated comorbidities whether isolated or mixed. Objective To evaluate prevalence, clinical criteria of skin tags, and risk factors that may be associated with skin tags. Patients and methods This study included 1000 participants, who were screened for the presence of skin tags and examined to detect clinical criteria. Patients with skin tags were screened for the presence of comorbidities (obesity, hypertension, diabetes mellitus, and dyslipidemia) and were classified into patients without associated comorbidities and those with isolated or mixed comorbidities. Results Overall, 30% of patients presented with skin tags. Most skin tags were brown (72%), small (50.8%), sessile (81.6%), and located on neck (56.6%). Comorbidities were reported in 95% of patients with skin tags, with predominance of mixed comorbidities (65.96%). In comparison with patients without associated comorbidities, skin tags with isolated comorbidities were more sessile (P=0.043) and medium sized (P=0.002). However, skin tags with mixed comorbidities were more sessile (P=0.011), more numerous (P≤0.001), and with older age of onset (P<0.001) compared with those without comorbidities. On comparing the two groups of comorbidities, skin tags with mixed comorbidities were more black (P≤0.001), large (P≤0.011), more numerous (P≤0.001), and older age of onset (P≤0.001). There was a significant correlation between lesion duration and numbers and age, BMI, random blood sugar, hemoglobin A1c, and dyslipidemia. Conclusion Skin tags are very common and considered as cutaneous markers for risk factors such as age, BMI, random blood sugar, hemoglobin A1c, cholesterol, and low-density lipoproteins. Presence of mixed comorbidities can increase the liability of skin tags to be more numerous, larger, and with late age of onset compared with presence of isolated comorbidity or even absence of comorbidity.","PeriodicalId":17298,"journal":{"name":"Journal of the Egyptian Women's Dermatologic Society","volume":"20 1","pages":"106 - 113"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45521402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pragya Singh, Atokali Chophy, Sweety Gupta, P. Saini, R. Phulware, Manoj Gupta
Carcinoma erysipeloides (CE) is a rare type of cutaneous metastasis. It can be observed during any stage of active carcinoma or after completion of radical treatment or may represent as the first clinical sign of an unknown primary. The diagnosis of CE is usually delayed as it mimics many benign skin conditions such as erysipelas. It is mostly associated with advanced breast cancer but can be seen in other malignancies like colon, pancreas, esophagus, and uterus. We report a case of CE in a patient with locally advanced breast cancer.
{"title":"Carcinoma erysipeloides: an unusual cutaneous metastasis in breast cancer","authors":"Pragya Singh, Atokali Chophy, Sweety Gupta, P. Saini, R. Phulware, Manoj Gupta","doi":"10.4103/jewd.jewd_56_22","DOIUrl":"https://doi.org/10.4103/jewd.jewd_56_22","url":null,"abstract":"Carcinoma erysipeloides (CE) is a rare type of cutaneous metastasis. It can be observed during any stage of active carcinoma or after completion of radical treatment or may represent as the first clinical sign of an unknown primary. The diagnosis of CE is usually delayed as it mimics many benign skin conditions such as erysipelas. It is mostly associated with advanced breast cancer but can be seen in other malignancies like colon, pancreas, esophagus, and uterus. We report a case of CE in a patient with locally advanced breast cancer.","PeriodicalId":17298,"journal":{"name":"Journal of the Egyptian Women's Dermatologic Society","volume":"20 1","pages":"137 - 139"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49296661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vulvar edema (VE) is a rare condition that may occur in either pregnant or nonpregnant women. A methodical approach through historical and physical examination is fundamental to diagnose the underlying etiology, but some patients may require further biological and radiological assessments. Recurrence of VE in successive pregnancies is a peculiar condition and has not yet been described in the literature. We report a case of an isolated VE reoccurring in two successive pregnancies with a particular cauliflower-like appearance.
{"title":"Recurrent cauliflower-like vulva edema in two consecutive pregnancies","authors":"A. Chehad, N. Boutrid, H. Rahmoune","doi":"10.4103/jewd.jewd_64_22","DOIUrl":"https://doi.org/10.4103/jewd.jewd_64_22","url":null,"abstract":"Vulvar edema (VE) is a rare condition that may occur in either pregnant or nonpregnant women. A methodical approach through historical and physical examination is fundamental to diagnose the underlying etiology, but some patients may require further biological and radiological assessments. Recurrence of VE in successive pregnancies is a peculiar condition and has not yet been described in the literature. We report a case of an isolated VE reoccurring in two successive pregnancies with a particular cauliflower-like appearance.","PeriodicalId":17298,"journal":{"name":"Journal of the Egyptian Women's Dermatologic Society","volume":"20 1","pages":"135 - 136"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41660373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Eftekhari, R. Rafiei, Kaveh Gharaienejad, Behnam Rafiee
Annular lichenoid diseases have many differential diagnoses. Lichen planus (LP) and porokeratosis could show annular-shaped lesions with a lichenoid tissue pattern infiltration, but typical cornoid lamella formation is mainly in favor of porokeratosis. We present a 57-year-old man with papulovesicular and annular lesions on the shins with an exophytic lesion of left great toe nail. Papular lesions showed classic histopathology of LP, but annular lesions revealed imperfect cornoid lamella formation that could be seen in the porokeratotic variant of LP. Nail bed biopsy showed in-situ squamous cell carcinoma and so distal phalangeal amputation was performed. Our patient had no good response to topical and systemic steroid, but he had moderate improvement with oral retinoid. We think that our case had different types of LP including classic, bullous and porokeratotic variants which is a rare association.
{"title":"Porokeratotic variant of lichen planus or lichen planus with porokeratosis: report of a challenging case","authors":"H. Eftekhari, R. Rafiei, Kaveh Gharaienejad, Behnam Rafiee","doi":"10.4103/jewd.jewd_28_22","DOIUrl":"https://doi.org/10.4103/jewd.jewd_28_22","url":null,"abstract":"Annular lichenoid diseases have many differential diagnoses. Lichen planus (LP) and porokeratosis could show annular-shaped lesions with a lichenoid tissue pattern infiltration, but typical cornoid lamella formation is mainly in favor of porokeratosis. We present a 57-year-old man with papulovesicular and annular lesions on the shins with an exophytic lesion of left great toe nail. Papular lesions showed classic histopathology of LP, but annular lesions revealed imperfect cornoid lamella formation that could be seen in the porokeratotic variant of LP. Nail bed biopsy showed in-situ squamous cell carcinoma and so distal phalangeal amputation was performed. Our patient had no good response to topical and systemic steroid, but he had moderate improvement with oral retinoid. We think that our case had different types of LP including classic, bullous and porokeratotic variants which is a rare association.","PeriodicalId":17298,"journal":{"name":"Journal of the Egyptian Women's Dermatologic Society","volume":"20 1","pages":"48 - 51"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48900979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Substantial reduction of basal cell carcinoma tumor size with itraconazole following treatment failure with intralesional 5-fluorouracil","authors":"N. Patil, A. Bubna","doi":"10.4103/jewd.jewd_31_22","DOIUrl":"https://doi.org/10.4103/jewd.jewd_31_22","url":null,"abstract":"","PeriodicalId":17298,"journal":{"name":"Journal of the Egyptian Women's Dermatologic Society","volume":"20 1","pages":"60 - 62"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43704183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eman R. M. Hofny, H. Twisy, Maysaa Bamatraf, Howayda Hasan, N. Mohamed, A. Mahran
Background Vitiligo is a pigmentation disorder characterized by milky white patches. It is caused by destruction of melanocytes because of an uncertain etiology. Oxidative stress (OS) hypothesis is highly considered in vitiligo pathogenesis. Antioxidants, including the Forkhead box O (FoxO) proteins, iron, zinc, and others, were found to be impaired in patients with vitiligo. Objective To assess the role of OS in the pathogenesis of vitiligo and to decide whether is it a local dysfunction, systemic process, or both. Patients and methods A case–control study was conducted, in which serum and tissue levels of FoxO3a, zinc, and iron were estimated in 50 patients with vitiligo and 30 age-matched and sex-matched healthy volunteers. FoxO3 levels were measured using ELISA kits. Iron and zinc levels were measured using colorimetric methods. Results No significant difference was found between serum FoxO3a levels in patients and controls (P=0.427), whereas lesional FoxO3a was significantly lower than its level in the skin of controls (P<0.001). Zinc and iron levels were significantly lower in serum and tissue of patients with vitiligo than in controls (P<0.001 for each). Conclusion Both serum and tissue levels of antioxidants are probably involved in the pathogenesis of vitiligo. However, tissue OS may be affected more. Some antioxidants, such as, zinc, may be involved more than others.
{"title":"Serum versus tissue levels of FoxO3a, zinc, and iron in patients with vitiligo: is oxidative stress a local process?","authors":"Eman R. M. Hofny, H. Twisy, Maysaa Bamatraf, Howayda Hasan, N. Mohamed, A. Mahran","doi":"10.4103/jewd.jewd_40_22","DOIUrl":"https://doi.org/10.4103/jewd.jewd_40_22","url":null,"abstract":"Background Vitiligo is a pigmentation disorder characterized by milky white patches. It is caused by destruction of melanocytes because of an uncertain etiology. Oxidative stress (OS) hypothesis is highly considered in vitiligo pathogenesis. Antioxidants, including the Forkhead box O (FoxO) proteins, iron, zinc, and others, were found to be impaired in patients with vitiligo. Objective To assess the role of OS in the pathogenesis of vitiligo and to decide whether is it a local dysfunction, systemic process, or both. Patients and methods A case–control study was conducted, in which serum and tissue levels of FoxO3a, zinc, and iron were estimated in 50 patients with vitiligo and 30 age-matched and sex-matched healthy volunteers. FoxO3 levels were measured using ELISA kits. Iron and zinc levels were measured using colorimetric methods. Results No significant difference was found between serum FoxO3a levels in patients and controls (P=0.427), whereas lesional FoxO3a was significantly lower than its level in the skin of controls (P<0.001). Zinc and iron levels were significantly lower in serum and tissue of patients with vitiligo than in controls (P<0.001 for each). Conclusion Both serum and tissue levels of antioxidants are probably involved in the pathogenesis of vitiligo. However, tissue OS may be affected more. Some antioxidants, such as, zinc, may be involved more than others.","PeriodicalId":17298,"journal":{"name":"Journal of the Egyptian Women's Dermatologic Society","volume":"20 1","pages":"26 - 32"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42564603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
MohammedN Al Mallah, HaithamB Fathi, QasimS Al Chalabi
Background Trichoscopy is an important tool in detecting alopecia areata activity. Objective To determine the relation of the trichoscopic markers with alopecia areata activity. To demonstrate its discriminative capabilities in classifying alopecia areata activity. Patients and methods One hundred and thirty-seven patients (86 males and 51 females) with alopecia areata underwent dermoscopic assessment of bald patches. Hair-pulling test was used to assess disease activity. A 2×2 table of alopecia areata activity and trichoscopic marker was used to estimate sensitivity, specificity, accuracy, predictive value, and likelihood ratio. Results Trichoscopic markers commonly seen in alopecia areata were short vellus hairs (65.7%), broken hairs (56.9%), exclamation mark hairs (46.7%), and black dots (42.3%). According to disease activity, exclamation mark hairs (91.9%) and broken hairs (87.1%) were the most common markers in active disease while yellow dots (72.3%) and short vellus hairs (69.3%) were in stable disease. Exclamation mark hairs (91.9% vs. 9.3%), broken hairs (87.1% vs. 38.7%), black dots (53.2% vs. 33.3%), and triangular hairs (21.0% vs. 8.0%) were significantly higher in active compared with stable alopecia areata. The discriminative capability index reveals that exclamation mark hairs (91.9%) and broken hairs (87.1%) were the most sensitive signs. Triangular hairs (92.0%), and exclamation mark hairs (90.7%) were the most specific markers. Exclamation mark hairs and broken hairs were the most reliable markers (91.2% and 72.9%, respectively). The presence of exclamation mark hairs, triangular hairs, and broken hairs in bald patches raises the likelihood ratio of activity by 9.88, 2.65, and 2.45 times. Conclusion Exclamation mark hairs are the most important reliable marker of disease activity. Broken hairs, triangular hairs, and black dots found in bald patches increase the chance of disease activity. Other trichoscopic markers(yellow dots, pigtail hairs, short vellus hairs, and upright regrowing hairs) were useless signs in determining disease activity.
毛发镜检查是检测斑秃活动性的重要工具。目的探讨毛发镜检查指标与斑秃活动性的关系。以证明其区分能力，分类斑秃活动。患者与方法137例斑秃患者(男86例，女51例)接受皮肤镜检查。采用拔毛试验评估疾病活动性。使用2×2斑秃活动性和毛发镜标记表来评估敏感性、特异性、准确性、预测值和似然比。结果斑秃的毛镜标记为短绒毛(65.7%)、断毛(56.9%)、感叹号毛(46.7%)、黑点(42.3%)。根据疾病活动度，感叹号毛(91.9%)和断毛(87.1%)是疾病活动期最常见的标志，黄点毛(72.3%)和短绒毛(69.3%)是疾病稳定期最常见的标志。感叹号发(91.9% vs. 9.3%)、断发(87.1% vs. 38.7%)、黑点发(53.2% vs. 33.3%)和三角形发(21.0% vs. 8.0%)在活动性斑秃中明显高于稳定性斑秃。判别能力指数显示，感叹号毛(91.9%)和断毛(87.1%)是最敏感的标志。三角毛(92.0%)和感叹号毛(90.7%)是最特异的标记。感叹号毛和断毛是最可靠的标记(分别为91.2%和72.9%)。在秃斑中出现感叹号毛、三角毛和断毛会使活动的可能性比分别提高9.88倍、2.65倍和2.45倍。结论感叹号毛是最重要、最可靠的疾病活动标志。在秃斑上发现的断裂的头发、三角形的头发和黑点增加了疾病活动的机会。其他毛发检查标记(黄点、小辫子、短绒毛和直立再生毛发)在确定疾病活动方面是无用的迹象。
{"title":"Alopecia areata: trichoscopic markers in determining disease activity","authors":"MohammedN Al Mallah, HaithamB Fathi, QasimS Al Chalabi","doi":"10.4103/jewd.jewd_24_23","DOIUrl":"https://doi.org/10.4103/jewd.jewd_24_23","url":null,"abstract":"Background Trichoscopy is an important tool in detecting alopecia areata activity. Objective To determine the relation of the trichoscopic markers with alopecia areata activity. To demonstrate its discriminative capabilities in classifying alopecia areata activity. Patients and methods One hundred and thirty-seven patients (86 males and 51 females) with alopecia areata underwent dermoscopic assessment of bald patches. Hair-pulling test was used to assess disease activity. A 2×2 table of alopecia areata activity and trichoscopic marker was used to estimate sensitivity, specificity, accuracy, predictive value, and likelihood ratio. Results Trichoscopic markers commonly seen in alopecia areata were short vellus hairs (65.7%), broken hairs (56.9%), exclamation mark hairs (46.7%), and black dots (42.3%). According to disease activity, exclamation mark hairs (91.9%) and broken hairs (87.1%) were the most common markers in active disease while yellow dots (72.3%) and short vellus hairs (69.3%) were in stable disease. Exclamation mark hairs (91.9% vs. 9.3%), broken hairs (87.1% vs. 38.7%), black dots (53.2% vs. 33.3%), and triangular hairs (21.0% vs. 8.0%) were significantly higher in active compared with stable alopecia areata. The discriminative capability index reveals that exclamation mark hairs (91.9%) and broken hairs (87.1%) were the most sensitive signs. Triangular hairs (92.0%), and exclamation mark hairs (90.7%) were the most specific markers. Exclamation mark hairs and broken hairs were the most reliable markers (91.2% and 72.9%, respectively). The presence of exclamation mark hairs, triangular hairs, and broken hairs in bald patches raises the likelihood ratio of activity by 9.88, 2.65, and 2.45 times. Conclusion Exclamation mark hairs are the most important reliable marker of disease activity. Broken hairs, triangular hairs, and black dots found in bald patches increase the chance of disease activity. Other trichoscopic markers(yellow dots, pigtail hairs, short vellus hairs, and upright regrowing hairs) were useless signs in determining disease activity.","PeriodicalId":17298,"journal":{"name":"Journal of the Egyptian Women's Dermatologic Society","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134989128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Samar El Tahlawy, S. Bahaa, O. Shaker, Omar El Ghanam, Mai Diaa
Background Acanthosis nigricans (AN) is a skin disorder characterized by symmetrical, thickened, dark plaques comprising hyperkeratosis and acanthosis. Vitamin D (VD) plays an important role in the regulation of skin proliferation and differentiation, and mediates its action by binding to specific vitamin D receptors (VDR) in the nuclei of target cells. Objective To measure the serum levels of VD and tissue levels of VDR in a group of Egyptian patients with AN in comparison to healthy controls, in order to shed more light on the possible relation between VD, VDR, and AN. Patients and methods This study included 25 AN patients and 25 age-matched and sex-matched healthy controls. Blood samples and skin biopsies were taken from all participants for the evaluation of serum VD, glucose, insulin, and tissue VDR levels. Results Serum VD and tissue VDR were significantly lower (P<0.001 for both), while serum insulin and homeostatic model for insulin resistance were significantly higher (P<0.001 and P=0.002, respectively) in patients than controls. Patients had a more deficient pattern of VD status than controls (P<0.001). There was a statistically significant positive correlation between serum VD and tissue VDR in patients (r=0.632, P=0.001). Conclusion The present study suggests a possible role for low serum VD and tissue VDR levels in causing AN, in genetically predisposed individuals.
{"title":"Assessment of serum levels of vitamin D and tissue levels of vitamin D receptors in acanthosis nigricans","authors":"Samar El Tahlawy, S. Bahaa, O. Shaker, Omar El Ghanam, Mai Diaa","doi":"10.4103/jewd.jewd_41_22","DOIUrl":"https://doi.org/10.4103/jewd.jewd_41_22","url":null,"abstract":"Background Acanthosis nigricans (AN) is a skin disorder characterized by symmetrical, thickened, dark plaques comprising hyperkeratosis and acanthosis. Vitamin D (VD) plays an important role in the regulation of skin proliferation and differentiation, and mediates its action by binding to specific vitamin D receptors (VDR) in the nuclei of target cells. Objective To measure the serum levels of VD and tissue levels of VDR in a group of Egyptian patients with AN in comparison to healthy controls, in order to shed more light on the possible relation between VD, VDR, and AN. Patients and methods This study included 25 AN patients and 25 age-matched and sex-matched healthy controls. Blood samples and skin biopsies were taken from all participants for the evaluation of serum VD, glucose, insulin, and tissue VDR levels. Results Serum VD and tissue VDR were significantly lower (P<0.001 for both), while serum insulin and homeostatic model for insulin resistance were significantly higher (P<0.001 and P=0.002, respectively) in patients than controls. Patients had a more deficient pattern of VD status than controls (P<0.001). There was a statistically significant positive correlation between serum VD and tissue VDR in patients (r=0.632, P=0.001). Conclusion The present study suggests a possible role for low serum VD and tissue VDR levels in causing AN, in genetically predisposed individuals.","PeriodicalId":17298,"journal":{"name":"Journal of the Egyptian Women's Dermatologic Society","volume":"20 1","pages":"33 - 39"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44500007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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