Skin Appendage Disorders最新文献

Introduction: Clinical examinations of the scalp have shown that patients may grow hair preferentially at higher density on one side of their scalp, yet review of the literature to date has not yield studies that directly assess differences in scalp hair density laterality. The objective of this study was to examine whether scalp hair growth occurs preferentially and on which side of the scalp, the right or left, in healthy patients.

Method: Scalps of healthy subjects with no history of hair loss or scalp disease were imaged with digital trichoscopy at a university dermatology clinic. Bilateral temporal photos were uploaded to trichoscopy software for quantitative analysis.

Results: Scalp hair laterality was observed in both male and female, with no trend in left or right preference. While subjects who identified as Asian or Hispanic exhibited a strong laterality preference, statistical significance was not reached among African American or Caucasian subjects.

Conclusion: No overall side preference was observed in the study population, yet many of the healthy individuals tend to preferentially grow more hair on one side of their scalp. It is possible that in addition to genetics, certain behavioral or environmental factors may play a role in laterality.

Introduction: Lichen planopilaris (LPP) is an uncommon cicatricial alopecia clinically characterized by follicular hyperkeratosis, perifollicular erythema, and permanent hair loss. The association of LPP with certain underlying diseases and environmental factors has been evaluated but there are limited data about this association. This study was designated to evaluate the environmental risk factors and comorbidities in LPP patients.

Method: This case-control study was performed on LPP patients referred to two dermatology referral centers from 2019 to 2022. A group of non-LPP healthy individuals referring for cosmetic concerns was recruited as control group. Data collection was performed using two questionnaires: a general questionnaire, including demographic information, comorbidities, environmental risk factors, and disease-related information, and the lichen planopilaris activity index (LPPAI) questionnaire.

Results: One hundred LPP patients as case group were compared with 100 healthy people without LPP as control group. Unemployment, history of major stressful events, thyroid disorder, history of hair dyeing, using face soaps, taking supplements, postmenopausal status, and family history of LPP or other types of alopecia had significant relationship with LPP (all p values <0.05).

Conclusion: LPP has associations with environmental and non-environmental risk factors and, also, genetic component.

Introduction: Autologous platelet-rich plasma (PRP) technologies offer an attractive treatment option for various medical fields. Owing to its high concentration of growth factors, PRP has been posited to induce proliferation, differentiation, and angiogenesis at the cellular level, as well as wound-healing and remodeling at the tissue level. The goal of the present bibliometric analysis was to characterize the growing body of literature concerning PRP use in various medical applications.

Methods: A comprehensive literature search was performed on June 28, 2024, using Web of Science and SCOPUS databases, covering all available publications in selected categories from 2001 to present.

Results: PRP use for hair restoration had both the greatest number of total publications among the investigated applications, whereas PRP use in dental procedures had the longest-standing history of publications. PRP use in hair restoration and facial rejuvenation had the greatest number of placebo-controlled and double-blinded randomized controlled trials; however, the impact of results may suffer from a lack of consistency in PRP preparation and outcome measurement between different studies.

Conclusion: To effectively validate the utility of PRP across various medical interventions, careful consideration of methodology should be undertaken for future studies to ensure validity of results.

Introduction: Onychomatricoma is a benign tumor that originates from the nail matrix. The main clinical features reported include longitudinal thickening of the nail plate, splinter hemorrhages, and xanthonychia.

Objective: The aims of the study were to describe epidemiological, clinical, and dermoscopy data of patients with dark skin phototypes (Fitzpatrick IV, V, VI) diagnosed with onychomatricoma and to compare the findings with previously reported cases.

Methods: The medical records of 24 patients with dark skin phototype, and a diagnosis of onychomatricoma, collected from 2015 to 2023, were reviewed and analyzed.

Results: Thirteen tumors (54.17%) occurred in the fingers and eleven tumors (45.83%) in the toenails. The main clinical and dermoscopic features found were increased nail thickness (21 cases; 88%), xanthonychia (20 cases; 83%), longitudinal melanonychia (18 cases; 75%), transverse hypercurvature of the nail plate (18 cases; 75%), and free edge cavitations (18 cases; 75%).

Conclusion: The clinical and dermoscopic features of onychomatricoma in patients with dark phototypes are similar to those in fair phototypes, except for the higher prevalence of melanonychia (75% vs. 24.2%).

Introduction: Alopecia is a frequent reason for consultation and is often associated with psychological, self-esteem, and quality of life (QoL) impact, particularly in women. To date, QoL assessment studies including all alopecia types are lacking. This study evaluated QoL and sensitivity to change of the Skindex-29 and the Dermatology Life Quality Index (DLQI) in these.

Methods: This was an observational study with a longitudinal design, including two measurements over time and prospective data. It was carried out in four outpatient centers in Medellín, between 2023 and 2024. We included sociodemographic and clinical data, as well as the DLQI and Skindex-29 QoL questionnaires before and after treatment.

Results: Participation of women was 51%; the most frequent types of alopecia were androgenic alopecia (52%), alopecia areata (AA) (19%), and telogen effluvium (TE) (9%). The alopecia types with the greatest impact on QoL (pretreatment) measured through the DLQI and the Skindex-29, respectively, were TE (10.29 [±9.32] and 40.39 [±32.04]), AA (9.27 [±9.13], and 33.91 [±26.47]), dissecting cellulitis (8.67 [±8.33] and 29.6 [±15.33]), and lichen planus pilaris (6.75 [±6.55] and 6.75 [±6.55]).

Conclusion: The version validated in Colombia of the Skindex-29 and the Colombian Spanish version of the DLQI showed a moderate responsiveness when evaluating the QoL of patients with scarring and non-scarring alopecia, before and after starting specific treatment.

Introduction: Pemphigus foliaceus (PF) and pemphigus vulgaris (PV) are bullous diseases characterized by loss of keratinocyte adhesion, easily ruptured blisters, and erosions. The scalp is involved in up to 60% of patients due to the high concentration of antigens in hair follicles. Trichoscopy has been studied in bullous diseases. However, research on pemphigus trichoscopy remains scarce. This study aimed to analyze the main trichoscopic features of pemphigus on the black scalp, a topic poorly appraised thus far.

Methods: Ten male and 8 female patients were enrolled, evenly distributed between PV (aged 16-59) and PF (aged 20-72), with Fitzpatrick phototypes equal to or greater than IV. Scalp evaluations were conducted using digital dermoscopy, with 20-to-70-fold magnification. Our results were compared with original research on Caucasian scalp pemphigus.

Results: Our study identified the previously published and also novel trichoscopic features. Our patients exhibited higher percentages (p < 0.05) of eight classic structures, considering both PF and PV; PF only; PV only. Aside from yellow dots (p = 0.002), our sample showed no statistically significant differences between the PV and PF groups in black patients.

Conclusion: Peculiarities of black scalp trichoscopy did not interfere in the diagnosis of pemphigus. Trichoscopy should be a routine diagnostic tool in patients with bullous scalp diseases, especially in the early stages, and to guide biopsy. To our knowledge, this is the first study focused on trichoscopy of pemphigus affecting black scalp. It indicates that, among other findings, yellow dots may be a relevant hallmark of scalp PV.

Introduction: Eccrine angiomatous hamartoma (EAH) is a benign tumor characterized by the proliferation of eccrine glands and vascular structures. It can be congenital or appear during childhood, with rare cases arising in adults. EAH typically presents as a solitary purplish plaque or nodule but a multifocal presentation in a blaschkoid or segmental distribution has been described.

Case presentation: We report the case of an extensive EAH following the territory of the superficial veins of the lower limbs, arising in an adult diagnosed with venous insufficiency at a young age and that worsened after saphenectomy.

Conclusion: The histopathological and ultrasonographic characteristics suggest that this case may represent a new instance of EAH associated with arteriovenous malformation. We hypothesize that there might be common molecular pathways linking both conditions and that, in predisposed patients, saphenectomy can exacerbate EAH.

Introduction: Direct mycological examination and culture are the gold standard methods for diagnosing tinea capitis (Tc) despite 4-6 weeks of culture time. Meanwhile, specific trichoscopy patterns may be helpful in its diagnosis.

Methods: This retrospective, cross-sectional, observational study included 31 patients among 110 records from children with presumable clinical and trichoscopic Tc diagnosis, from two dermopediatrics centers, within 10 years. After trichoscopy, skin scraping from the patients was taken for direct mycological examination with 10% KOH and cultures in Sabouraud and Mycosel media; patients with positive cultures for M. canis and T. tonsurans were selected. The association between the trichoscopic and etiological findings of Tc was statistically evaluated using Fisher's exact test.

Results: Some trichoscopy findings, such as perifollicular desquamation and broken hair, were nonspecific to determine the Tc agent. The presence of Morse code (barcode-like) whitish sheath was more common in M. canis infection, even in the small number of patients of our sample. In contrast, comma hairs and black dots were more common in T. tonsurans infection.

Conclusion: The trichoscopy findings suggest the pathophysiology of tinea infection according to the type of parasitism: ectothrix or endothrix and can be a useful tool where there are limited facilities.

Background: Alopecia is common and can lead to significant distress for patients. Patients often seek medical information on the Internet, which may leave them susceptible to misinformation from poor-quality sources. The aim of this study was to qualitatively assess misinformation available online related to alopecia.

Summary: Several alopecia-related myths were identified, including false causes, criticism of conventional treatments, and bogus "natural" cures or remedies. False causes included headwear, haircare practices, and sexual practices. Treatments which were criticized included minoxidil, finasteride, topical corticosteroids, ciclosporin, methotrexate, and Janus kinase inhibitors. Alternative unfounded therapies which were touted included mineral supplements, biotin, B vitamin complexes, fish oils, shark cartilage, onion juice, rosemary oil, horsetail extract, and saw palmetto.

Key messages: Misinformation related to alopecia is prevalent online and may lead to suboptimal therapeutic outcomes. Dermatologists and other healthcare professionals should combat misinformation when encountered.

Introduction: Topical and systemic drugs, as methotrexate (MTX), do not control the frontal fibrosing alopecia (FFA) activity in most of the cases showing the need for new therapies. Therefore, we aimed to evaluate the effectiveness of MTX microinfusion in FFA.

Methods: Prospective, controlled clinical trial, carried out with 17 volunteers with clinical and histological diagnosis of FFA. Applications of MTX by MMP^® (microinfusion of drugs into the skin method) were made every 30 days, in a total of 03 applications, in the right half of the alopecia area; the other half served as a control.

Results: There was a significant reduction in frontal-glabella and frontal temporoparietal measurements at treated site while in the untreated site the FFA increased. Patient's referred improvement of pruritus and desquamation but not in hair loss and local erythema. Analysis of the dermoscopic photos and the LPPAI calculation did not show relevant changes. About 95% of the participants were satisfied or very satisfied with the results and none of them had alteration in the laboratory test results.

Conclusion: The MTX application by MMP^® improved symptoms associated with FFA, and the frontal-glabella and frontal temporoparietal measurements. This technique proved to be safe and well tolerated.