Skin Appendage Disorders最新文献

Introduction: Onychomycosis presents significant therapeutic challenges, with high recurrence rates and the need for prolonged treatment adherence. While previous studies have explored the contamination risks of cosmetic nail polishes, little is known about the microbiological safety of antifungal nail polishes used in onychomycosis treatment.

Methods: This study investigated potential contamination in antifungal nail polish bottles containing ciclopirox olamine 8% (CO) and amorolfine 5% (AM) used by patients diagnosed with onychomycosis confirmed by mycological exams. After treatment, applicators were analyzed using Sabouraud and Mycosel^® culture media.

Results: Of the 67 randomly selected nails treated, 100% showed positive direct mycological examination, and 49% had fungal growth in culture. However, none of the 67 applicators (49 CO and 18 AM) exhibited fungal growth.

Conclusion: The study findings suggest that antifungal nail polishes do not act as contamination reservoirs, likely due to their inherent antifungal properties. Nonetheless, patients should be educated on proper hygiene to minimize cross-contamination risks.

Introduction: Severity of alopecia areata (AA) has been commonly defined by clinician assessment of scalp hair loss. Our aim was to characterize patient-reported factors beyond scalp hair loss that contribute to AA severity while modifying for socioeconomic factors.

Methods: Patients with AA were recruited to take a survey. Multivariable linear regression was performed to evaluate lifetime AA severity while adjusting for socioeconomic variables, current AA severity at the time of survey, and patient-reported disease burden.

Results: Patient-reported AA severity was associated with scalp hair loss (OR: 4.19, 95% CI: [1.35-13], p = 0.013), facial hair loss (OR: 3.55, 95% CI: [1.75-7.21], p < 0.001), increased financial burden (OR: 2.41, 95% CI: [1.21-4.8], p = 0.013), and greater emotional burden (OR: 2.96, 95% CI: [1.48-5.93], p = 0.002), while presence of comorbidities were linked to less severe AA (OR: 0.38, 95% CI: [0.17-0.84], p = 0.017).

Conclusion: Survey population was homogeneous and may not reflect the general community with AA. Self-reported data may introduce recency or recall bias. Scalp and facial hair loss, along with emotional and financial burdens, correlate with increased patient-reported AA severity. This suggests factors beyond scalp hair loss should be considered when assessing AA severity.

Background: Nail surgery complications have not been addressed thoroughly.

Summary: This review aimed to provide a robust literature review of nail surgery complications by identifying relevant data using a search of PubMed. It examines various complications, including general complications such as bleeding and infection; specific nail complications such as nail dystrophy; and common complications associated with specific nail procedures.

Key messages: This literature reviews better familiarizes dermatologists who perform nail procedures with relevant complications.

Background: Alopecia areata (AA) is an autoimmune disorder and the second most common form of non-scarring hair loss, affecting approximately 1.7-2% of the global population. Although it predominantly presents before the age of 40, AA can occur at any age and is strongly associated with genetic predisposition. Environmental, hormonal, and psychological factors have been implicated in disease onset and progression. Recent evidence highlights the immunomodulatory role of vitamin D, traditionally recognized for its functions in bone metabolism and calcium homeostasis, in skin health and immune regulation, raising interest in its potential relevance to AA pathogenesis and treatment.

Summary: This review examines the epidemiology, genetic predisposition, and immunological mechanisms underlying AA, emphasizing the loss of immune privilege in hair follicles as a key pathogenic event. Additionally, it examines the role of vitamin D and its receptor (VDR) in hair follicle homeostasis, discussing the association between vitamin D deficiency, altered VDR expression, and disease severity. Emerging clinical data suggest that vitamin D supplementation and analogs, such as calcipotriol, may serve as adjunctive therapeutic strategies, with potential benefits in mitigating disease severity and reducing relapse rates.

Key messages: (1) Vitamin D serves as a critical immunomodulator in AA, regulating follicular immune privilege and key inflammatory pathways involved in disease pathogenesis. (2) Vitamin D deficiency is frequently observed in patients with AA and has been associated with increased disease severity, prolonged duration, and a higher risk of relapse. (3) Emerging evidence supports the therapeutic potential of vitamin D analogs and supplementation in AA, positioning vitamin D as a promising adjunct or primary treatment modality.

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.