Skin Appendage Disorders最新文献

Introduction: Chlorotrichosis, commonly known as "green hair," is an unusual trichological condition characterized by the accumulation of exogenous copper in individuals with light-colored hair and prior hair damage. It is primarily associated with inadequately maintained swimming pools.

Case presentation: We report a case of chlorotrichosis in a 16-year-old female who presented with a sudden and pronounced change in hair color after initiating regular swimming. Clinical examination revealed a distinctive greenish discoloration, primarily affecting the distal portions of her hair. The diagnosis of chlorotrichosis was confirmed based on clinical presentation and history. Treatment involved the use of an ethylenediaminetetraacetic acid (EDTA)-containing shampoo, leading to significant pigmentation regression within 8 weeks. Additionally, preventive measures included the application of a quaternary ammonium-enriched conditioner before exposure to copper-rich environments.

Discussion/conclusion: Chlorotrichosis remains underreported and potentially underdiagnosed, partly due to its cosmetic nature. Various factors, including occupational copper exposure and serum extravasation containing dipyridamole, have been associated with green hair. Treatment options encompass the use of EDTA-containing shampoos, among others. Dermatologists should be knowledgeable about its causes, predisposing factors, and effective management to enhance the diagnosis and treatment of this distinctive hair disorder.

Introduction: Scalp seborrheic dermatitis (SSD) is a chronic, relapsing, and inflammatory condition impacting quality of life (QoL). This study evaluated the efficacy and impact on QoL of a 1% selenium disulphide-containing shampoo (SeS₂ shampoo) compared to a 2% ketoconazole shampoo.

Methods: This multi-centric, double-blinded, randomized 4-week study was conducted in 64 adult subjects with moderate to severe SSD (SSD severity score (SSSD) > 6). Shampoo was applied on the scalp and hair, according to product indications. Clinical examinations at baseline and on Day (D) 3, 7, 14, and 28 included the assessment of SSSD, total scales score (TSS, sum of adherent, and non-adherent scales), erythema, irritation, seborrhea, and itching. Self-evaluations included QoL and hair quality assessment (scales and greasiness).

Results: The SSSD improved in both groups as early as D3, after one application of shampoo. This significant (p < 0.001) improvement was -71% for SeS₂ and -69% for ketoconazole at D28. The decrease of the TSS was significant (p < 0.001) at D28 in both groups (-75% SeS₂ and -68% for ketoconazole). The SSSD severity of all subjects decreased to mild at D28. Signs and symptoms had significantly (p < 0.001) improved in both groups after 28 days. QoL improved earlier with SeS₂ than with ketoconazole shampoo. The cosmetic acceptability of SeS₂ shampoo was higher than that of ketoconazole shampoo. Both shampoos were very well tolerated.

Conclusion: SeS₂ shampoo is a reliable and well-tolerated alternative care to ketoconazole shampoo in patients with moderate to severe scalp seborrheic dermatitis.

Background: Nail avulsion is a procedure with numerous nuanced iterations and uses within the management of nail diseases, that when performed with intention and skill can imbue the clinician with the ability to manage myriad nail conditions.

Summary: This manuscript serves as a reference for the multiple techniques of nail avulsion as well as clinical indications in various disease states.

Key messages: Nail avulsion is an often over-simplified procedure with a multitude of uses and variations in technique. This manuscript should serve as an introduction to nail avulsion in the diagnosis and treatment of multiple nail conditions.

Background: Frontal fibrosing alopecia (FFA) is a scarring hair loss condition primarily affecting the frontotemporal hairline and often leading to partial or complete loss of eyebrows in a significant number of cases. It is characterized by slow progression and typically shows poor response to available treatments. Diagnosis relies on clinical, trichoscopic, and histopathological assessments, with specific criteria proposed by Vañó-Galván et al. in 2018 [J Am Acad Dermatol. 2018;78(1):e21-2].

Summary: This literature review examines trichoscopic observations of FFA in Caucasians, focusing on both scalp and eyebrow manifestations. A comprehensive search of the PubMed database from 2010 to 2023 yielded 6 relevant articles. Trichoscopic findings varied across studies but highlighted common features such as empty follicles, perifollicular erythema, follicular hyperkeratosis, and the presence of "lonely hair" on the scalp. Additional research is warranted to thoroughly characterize demographic traits and FFA peculiarities within the Caucasian population, given the limited existing data in the literature.

Key messages: Distinct trichoscopic features: trichoscopic examination of FFA among Caucasians reveals specific markers such as empty follicles, perifollicular erythema, and follicular hyperkeratosis, aiding in diagnosis and monitoring. Limited literature data: more investigation is needed to fully understand the demographic characteristics and FFA peculiarities among Caucasians, considering the scarcity of available data in existing literature.

Introduction: Focal acantholytic dyskeratosis is a distinctive histological pattern first described by Ackerman in 1972, consisting of focal suprabasal clefts in the epidermis and dyskeratotic cells at all levels of the epidermis with hyperkeratosis and parakeratosis. The first case of subungual acantholytic dyskeratosis acanthoma (ADA) was reported in 1990. This subungual variant is a very rare entity.

Case presentation: A 63-year-old female patient consulted for a longitudinal erythronychia (LE) associated with distal onycholysis. Dermoscopy showed LE with a few splinter hemorrhages, with localized hyperkeratosis and thinning of the nail plate at the free edge. Histopathology confirmed the diagnosis of ADA.

Conclusion: ADA is a rare tumor that could mimic various inflammatory or neoplastic conditions. To our knowledge, this is the eighth reported case in the literature. This uncommon entity could mimic various inflammatory or neoplastic conditions.

Introduction: Previous studies have demonstrated association of alopecia areata (AA) with anxiety and depression. However, few case-control studies have evaluated AA association with posttraumatic stress disorder and lifestyle factors, including alcohol use. We aimed to assess associations of AA with psychiatric disorders and lifestyle factors using a national database.

Methods: A nested case-control study using the National Institutes of Health All of Us database was conducted analyzing patients ≥18 years with AA diagnosis and controls matched 1:4 by age, sex at birth, and self-reported ethnicity/race.

Results: There were 957 AA patients and 3,828 controls included in the final analysis. AA patients versus controls had higher odds of depression, posttraumatic stress disorder, anxiety, and alcohol use. AA patients had decreased odds of smoking.

Conclusion: Our study demonstrates previously understudied AA associations with posttraumatic stress disorder, obesity, and alcohol use, and corroborates high burden of anxiety and depression among AA patients. We recommend screening AA patients for psychiatric disorders and alcohol use and appropriate referrals to psychiatry.

Background: Scalp discoid lupus erythematosus in Caucasians is still a rare disease with a variable clinical presentation. Its dermoscopic characteristics are poorly described in literature, especially in the white population. The aim of this review was to critically analyze published papers on this topic and summarize relevant features.

Summary: A comprehensive search for eligible articles was conducted in the databases of MEDLINE/PubMed. Results were analyzed following dermoscopic patterns such as follicular openings, hair shafts, perifollicular surface, and vessel pattern.

Key messages: The most representative features appeared the absence of follicular openings and the presence of follicular keratotic plugs, along with yellow-brown and red dots. In long-lasting lesions with chronic stage, trichoscopy showed the absence of follicular openings, white or milky red cicatricial patches, white and brown structureless areas, and thick arborizing vessels.

Introduction: Oral finasteride and topical minoxidil are long-standing androgenetic alopecia (AGA) treatments; topical finasteride is a more recent medicine. Few studies have compared their therapeutic effects in postmenopausal women. We compared the therapeutic impact of topical finasteride (1-4 sprays of 0.25% topical finasteride solution daily for 12 months), oral finasteride (2.5 mg oral finasteride once daily for 12 months), and topical minoxidil (1 mL of topical minoxidil 5% twice daily for 12 months) in postmenopausal women with AGA.

Methods: We conducted Bayesian network meta-analyses of individual patient-level data insofar as four clinically relevant endpoints, namely, 12-month change in (1) total hair density, (2) hair diameter, (3) clinical photographs, and (4) patients' opinion of efficacy. Data were obtained through medical charts. Regimens' surface under the cumulative ranking distribution (SUCRA) values and relative effects - as per odds ratios - were computed.

Results: As per SUCRA, the most and least effective regimens - across the four outcomes - were oral finasteride, and topical finasteride, respectively; however, no significant statistical differences were found (i.e., p > 0.05).

Conclusion: Oral finasteride is ranked more effective than the topical forms of minoxidil and finasteride; however, more studies are needed to confirm this result.

[This corrects the article DOI: 10.1159/000538581.].

[This corrects the article DOI: 10.1159/000517831.].