Werner Druck, Basel Medien AG, Dimitrios Rigopoulos – National, Dr Manuel Gea Gonzalez, Mexico City, Mexico, James Q. Del Rosso, Aditya K. Gupta, M. Hordinsky, Bryan C. Markinson, Andrew G. Messenger, J. Shapiro, R. Godse, M. P. P. Dany, S. Tamazian, PA Pittsburgh, J. Wan, M. Baltimore, M. Jen, A. I. P. P. Rubin, Espinoza-González, E. M. N.A. Carmona Hernandez, N. Okwundu, WA Kennewick, C. Ogbonna, A. McMichael, P. Kakizaki, L. A. Contin, M. Barletta, São Paulo, C. Machado, N. E. Trupiano, K. Z. Young, T. M. Benitez, J. Mervak, Ann Arbor, Cortez de Almeida, R. F. Melo, R. Janeiro, L. Drake, Ma Boston, J. M. I. Han, S. Boston, FL MAMiami, A. Mostaghimi, K. Huang, Guimerá Martin-Neda, La Laguna, A. K. Leroy, R. F. Cortez de Almeida, D. L. Obadia, Rio, A. Nwosu, M. Miteva, N. Kluger, P. R. Lindsø Andersen, Køge
{"title":"Contents 2023, Vol. 9","authors":"Werner Druck, Basel Medien AG, Dimitrios Rigopoulos – National, Dr Manuel Gea Gonzalez, Mexico City, Mexico, James Q. Del Rosso, Aditya K. Gupta, M. Hordinsky, Bryan C. Markinson, Andrew G. Messenger, J. Shapiro, R. Godse, M. P. P. Dany, S. Tamazian, PA Pittsburgh, J. Wan, M. Baltimore, M. Jen, A. I. P. P. Rubin, Espinoza-González, E. M. N.A. Carmona Hernandez, N. Okwundu, WA Kennewick, C. Ogbonna, A. McMichael, P. Kakizaki, L. A. Contin, M. Barletta, São Paulo, C. Machado, N. E. Trupiano, K. Z. Young, T. M. Benitez, J. Mervak, Ann Arbor, Cortez de Almeida, R. F. Melo, R. Janeiro, L. Drake, Ma Boston, J. M. I. Han, S. Boston, FL MAMiami, A. Mostaghimi, K. Huang, Guimerá Martin-Neda, La Laguna, A. K. Leroy, R. F. Cortez de Almeida, D. L. Obadia, Rio, A. Nwosu, M. Miteva, N. Kluger, P. R. Lindsø Andersen, Køge","doi":"10.1159/000535260","DOIUrl":"https://doi.org/10.1159/000535260","url":null,"abstract":"","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":" 17","pages":"479 - 486"},"PeriodicalIF":1.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138620500","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}
S. Atluri, D. De, T. Shih, Caitlyn B. Dagenet, Rahul Masson, Khiem A Tran, Vivienne Ng, Jennifer L. Hsiao, Vivian Y Shi
Introduction: Hidradenitis suppurativa (HS) is a chronic skin condition that often requires acute care during periods of flares, with many patients visiting the emergency department over 5 times before receiving a proper diagnosis. However, little is known about emergency medicine (EM) providers’ experiences and knowledge of HS management. Methods: In this study, an anonymous survey was distributed to EM providers to identify knowledge and practice gaps in HS care. Results: The results showed that most respondents lacked confidence in HS diagnosis and management, especially in knowing available treatment options and managing patients with moderate to severe HS. Attendings were more confident than non-attendings in diagnosing and managing HS, and providers who saw more HS patients per month were more confident in referring patients to appropriate specialists. Over 80% of respondents referred HS patients to dermatology, which is an important initial step in HS management. Conclusion: The study highlights the importance of educating EM providers in HS recognition, timely referral to dermatology, and initial management to improve quality of life among patients and mitigate disease progression.
{"title":"Perspectives of Emergency Medicine Physicians on Hidradenitis Suppurativa Care","authors":"S. Atluri, D. De, T. Shih, Caitlyn B. Dagenet, Rahul Masson, Khiem A Tran, Vivienne Ng, Jennifer L. Hsiao, Vivian Y Shi","doi":"10.1159/000535189","DOIUrl":"https://doi.org/10.1159/000535189","url":null,"abstract":"Introduction: Hidradenitis suppurativa (HS) is a chronic skin condition that often requires acute care during periods of flares, with many patients visiting the emergency department over 5 times before receiving a proper diagnosis. However, little is known about emergency medicine (EM) providers’ experiences and knowledge of HS management. Methods: In this study, an anonymous survey was distributed to EM providers to identify knowledge and practice gaps in HS care. Results: The results showed that most respondents lacked confidence in HS diagnosis and management, especially in knowing available treatment options and managing patients with moderate to severe HS. Attendings were more confident than non-attendings in diagnosing and managing HS, and providers who saw more HS patients per month were more confident in referring patients to appropriate specialists. Over 80% of respondents referred HS patients to dermatology, which is an important initial step in HS management. Conclusion: The study highlights the importance of educating EM providers in HS recognition, timely referral to dermatology, and initial management to improve quality of life among patients and mitigate disease progression.","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":"112 12","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138623066","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}
Introduction: Pityriasis amiantacea (PA) is a rare presentation characterized by the presence of extensive adherent scaling that tightly encircles and affixes tufts of hairs secondary to inflammatory or infectious dermatoses. However, the occurrence of PA as a consequence of leukaemia cutis has not been previously reported. Case Report: A 32-year-old man with B-cell acute lymphoblastic leukaemia (B-ALL) presented with severe scalp scaling and hair loss for 2 months. Examination revealed extensive, tightly adherent scales encircling and binding down hairs, along with haemorrhagic crusts. Skin examination showed nontender, partially blanchable papules forming ill-defined plaques, giving a cobblestone appearance. Trichoscopy revealed white crusts, tufting, and micro-haemorrhages. Scalp biopsy confirmed precursor B-ALL infiltration. He was diagnosed with PA with secondary cutis verticis gyrata due to leukaemia cutis and referred to a haemato-oncologist for further management. Discussion: Leukaemia cutis is a rare condition where leukaemia cells infiltrate the skin, often associated with acute myeloid leukaemia and ALL. It can lead to secondary verticis gyrata. The co-occurrence of PA and cutis verticis gyrata is rare and previously unreported, highlighting the need for increased awareness among clinicians.
导言：毛囊角化症（Pityriasis amiantacea，PA）是一种罕见的病症，其特征是继发于炎症或感染性皮肤病的广泛附着性鳞屑，紧紧包裹和粘附着一簇簇毛发。然而，因皮肤白血病而出现 PA 的病例此前却未见报道。病例报告：一名 32 岁的男子患有 B 细胞急性淋巴细胞白血病（B-ALL），2 个月来出现严重的头皮脱屑和脱发。检查发现大量紧密附着的鳞屑包裹并束缚着头发，同时伴有出血结痂。皮肤检查显示，患者头皮上有不发软、部分发白的丘疹，形成界限不清的斑块，外观呈鹅卵石状。三镜检查发现白色结痂、丛生和微出血。头皮活检证实了前体B-ALL浸润。他被诊断为因白血病引起的PA伴继发性脊髓灰质炎，并被转诊至血液肿瘤科接受进一步治疗。讨论白血病是一种罕见的白血病细胞浸润皮肤的疾病，通常与急性髓性白血病和ALL有关。它可导致继发性脊髓灰质炎。PA 和脊髓灰质炎同时出现的情况非常罕见，以前也未见报道，这就凸显出临床医生需要提高对这种疾病的认识。
{"title":"Co-Occurrence of Pityriasis Amiantacea and Cutis Verticis Gyrata Secondary to Leukaemia Cutis of the Scalp","authors":"Ankur Lal, Sushant Agrawal, Vishal Gaurav","doi":"10.1159/000535081","DOIUrl":"https://doi.org/10.1159/000535081","url":null,"abstract":"Introduction: Pityriasis amiantacea (PA) is a rare presentation characterized by the presence of extensive adherent scaling that tightly encircles and affixes tufts of hairs secondary to inflammatory or infectious dermatoses. However, the occurrence of PA as a consequence of leukaemia cutis has not been previously reported. Case Report: A 32-year-old man with B-cell acute lymphoblastic leukaemia (B-ALL) presented with severe scalp scaling and hair loss for 2 months. Examination revealed extensive, tightly adherent scales encircling and binding down hairs, along with haemorrhagic crusts. Skin examination showed nontender, partially blanchable papules forming ill-defined plaques, giving a cobblestone appearance. Trichoscopy revealed white crusts, tufting, and micro-haemorrhages. Scalp biopsy confirmed precursor B-ALL infiltration. He was diagnosed with PA with secondary cutis verticis gyrata due to leukaemia cutis and referred to a haemato-oncologist for further management. Discussion: Leukaemia cutis is a rare condition where leukaemia cells infiltrate the skin, often associated with acute myeloid leukaemia and ALL. It can lead to secondary verticis gyrata. The co-occurrence of PA and cutis verticis gyrata is rare and previously unreported, highlighting the need for increased awareness among clinicians.","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":"176 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139226075","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: Vitamins have gained popularity among physicians and patients for purported benefits to hair, skin, and nail health. Safe and efficacious therapies for nail disorders, many of which are chronic conditions, are needed. Summary: We conducted a literature review of studies assessing the efficacy of oral, topical, and intralesional vitamin/vitamin derivatives for the treatment of nail disorders, including yellow nail syndrome, brittle nail syndrome, onychomycosis, habit-tic nail deformity, periungual/subungual verruca, and nail psoriasis. Forty-nine articles were reviewed. There is good evidence to support the use of topical tazarotene and vitamin D analogs for nail psoriasis treatment. We found overall limited evidence for treatment of other nail disorders with vitamin/vitamin derivatives, and further research is needed to support their use. Key Messages: Besides topical tazarotene and vitamin D analogs for nail psoriasis treatment, there is limited evidence for treatment of nail disorders with topical, oral, and intralesional vitamin/vitamin derivatives.
背景：维生素据称对头发、皮肤和指甲健康有益，因此受到医生和患者的欢迎。指甲疾病中有许多是慢性病，需要安全有效的治疗方法。摘要：我们对口服、外用和鞘内维生素/维生素衍生物治疗指甲疾病（包括黄甲综合征、脆甲综合征、甲癣、习惯性甲畸形、甲周/甲下疣和甲银屑病）的疗效进行了文献综述。共审查了 49 篇文章。有充分证据支持使用外用他扎罗汀和维生素 D 类似物治疗甲癣。我们发现使用维生素/维生素衍生物治疗其他指甲疾病的证据总体有限，需要进一步研究以支持其使用。关键信息：除了外用他扎罗汀和维生素D类似物治疗指甲银屑病外，使用外用、口服和鞘内维生素/维生素衍生物治疗指甲疾病的证据也很有限。
{"title":"Vitamins for the Management of Nail Disease: A Literature Review","authors":"Kaya L. Curtis, Shari R. Lipner","doi":"10.1159/000534972","DOIUrl":"https://doi.org/10.1159/000534972","url":null,"abstract":"Background: Vitamins have gained popularity among physicians and patients for purported benefits to hair, skin, and nail health. Safe and efficacious therapies for nail disorders, many of which are chronic conditions, are needed. Summary: We conducted a literature review of studies assessing the efficacy of oral, topical, and intralesional vitamin/vitamin derivatives for the treatment of nail disorders, including yellow nail syndrome, brittle nail syndrome, onychomycosis, habit-tic nail deformity, periungual/subungual verruca, and nail psoriasis. Forty-nine articles were reviewed. There is good evidence to support the use of topical tazarotene and vitamin D analogs for nail psoriasis treatment. We found overall limited evidence for treatment of other nail disorders with vitamin/vitamin derivatives, and further research is needed to support their use. Key Messages: Besides topical tazarotene and vitamin D analogs for nail psoriasis treatment, there is limited evidence for treatment of nail disorders with topical, oral, and intralesional vitamin/vitamin derivatives.","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":"128 10","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139246522","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: Gout is a depositional, inflammatory disorder that is rarely reported to affect the nail unit. Cases of gout involving the nail unit are likely under-recognized and therefore underreported. We present two cases of tophaceous gout affecting the nail unit and a literature review of the various presentations. Summary: Five cases of gout were identified to affect the nail unit. In all cases, these presented as white hyperkeratotic papulonodules with associated nail dystrophy. Chalky discharge was seen in three of the five cases. Nine cases were identified to have demonstrated pseudocarcinomatous changes that histopathologically mimic squamous cell carcinoma (SCC). Literature review highlights a range of findings including subclinical deposits of uric acid in the nail, onychoschizia, onychorrhexis, and Beau’s line. Key Messages: Physicians should be aware of the subtle and nonspecific clinical findings of gout, which may be easily misconstrued for other pathological entities.
{"title":"Gout Affecting the Nail Unit: Report of Two Cases and Literature Review","authors":"Jeffery Z. Hu, N. Jellinek, Molly A. Hinshaw","doi":"10.1159/000534668","DOIUrl":"https://doi.org/10.1159/000534668","url":null,"abstract":"Background: Gout is a depositional, inflammatory disorder that is rarely reported to affect the nail unit. Cases of gout involving the nail unit are likely under-recognized and therefore underreported. We present two cases of tophaceous gout affecting the nail unit and a literature review of the various presentations. Summary: Five cases of gout were identified to affect the nail unit. In all cases, these presented as white hyperkeratotic papulonodules with associated nail dystrophy. Chalky discharge was seen in three of the five cases. Nine cases were identified to have demonstrated pseudocarcinomatous changes that histopathologically mimic squamous cell carcinoma (SCC). Literature review highlights a range of findings including subclinical deposits of uric acid in the nail, onychoschizia, onychorrhexis, and Beau’s line. Key Messages: Physicians should be aware of the subtle and nonspecific clinical findings of gout, which may be easily misconstrued for other pathological entities.","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":"178 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139251160","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}
G. A. Guerrero-González, N. D. Di Chiacchio, Francisco Macedo Paschoa, N. D. Di Chiacchio
Introduction: Bowen’s disease is a squamous cell carcinoma in situ, the most common malignancy of the nail unit. Presenting more frequently in the fingernails, common risk factors include ionizing radiation, oral exposure to arsenic or pesticides, dyskeratosis congenita, and quite commonly diverse subtypes of HPV. We report the first case of multiple periungual pigmented Bowen’s disease in a pediatric patient. Case Presentation: A healthy 13-year-old boy presented with a 9-month history of a pigmented erythematous patch on the proximal nail fold of his 3rd right finger without associated symptoms. A punch biopsy was taken, and the diagnosis of Bowen’s disease was made. The patient received photodynamic therapy and three cycles of imiquimod without response, and two new lesions appeared on the first and second right fingers. Surgical removal was performed on all lesions. A polymerase chain reaction detected an HPV type 16. Discussion/Conclusion: Multiple periungual Bowen’s disease is rare, with the most frequent risk factors being HPV infection and chronic immunosuppression. Less than 10% of the cases present as longitudinal melanonychia. To date, there are no previous reports of multiple pigmented periungual Bowen’s disease. HPV-induced Bowen’s disease is usually present in adults aged between 22 and 89 years as persistent verrucae. In this case, koilocytosis and the fact that all lesions appeared on the right hand are suggestive of HPV infection.
{"title":"Multiple-Digit Pigmented Bowen’s Disease Induced by Human Papillomavirus in an Immunocompetent Child","authors":"G. A. Guerrero-González, N. D. Di Chiacchio, Francisco Macedo Paschoa, N. D. Di Chiacchio","doi":"10.1159/000534734","DOIUrl":"https://doi.org/10.1159/000534734","url":null,"abstract":"Introduction: Bowen’s disease is a squamous cell carcinoma in situ, the most common malignancy of the nail unit. Presenting more frequently in the fingernails, common risk factors include ionizing radiation, oral exposure to arsenic or pesticides, dyskeratosis congenita, and quite commonly diverse subtypes of HPV. We report the first case of multiple periungual pigmented Bowen’s disease in a pediatric patient. Case Presentation: A healthy 13-year-old boy presented with a 9-month history of a pigmented erythematous patch on the proximal nail fold of his 3rd right finger without associated symptoms. A punch biopsy was taken, and the diagnosis of Bowen’s disease was made. The patient received photodynamic therapy and three cycles of imiquimod without response, and two new lesions appeared on the first and second right fingers. Surgical removal was performed on all lesions. A polymerase chain reaction detected an HPV type 16. Discussion/Conclusion: Multiple periungual Bowen’s disease is rare, with the most frequent risk factors being HPV infection and chronic immunosuppression. Less than 10% of the cases present as longitudinal melanonychia. To date, there are no previous reports of multiple pigmented periungual Bowen’s disease. HPV-induced Bowen’s disease is usually present in adults aged between 22 and 89 years as persistent verrucae. In this case, koilocytosis and the fact that all lesions appeared on the right hand are suggestive of HPV infection.","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":"56 9","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139257979","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}
I. Aparício Martins, B. Figueira Vilela, Joana Cabete
Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease with a diagnostic delay of 7–10 years. A later diagnosis is associated with development of local sequelae and systemic comorbidities, as well as a reduced response to medical treatment. The aim of this study was to analyze the time required for HS diagnosis and investigate factors associated with diagnostic delay. Method: A retrospective observational study was conducted based on clinical records from HS patients followed at a tertiary hospital, with diagnosis between January 2006 and December 2022. Results: A total of 285 patients were included. The mean diagnostic delay was 10.1 years, and there was no difference in time to diagnosis during the considered period. A diagnostic delay of more than 5 years was significantly associated with an earlier onset of symptoms, location on breasts and thighs, follicular phenotype, and with cardiovascular and psychiatric comorbidities. Smoking and body mass index ≥25 kg/m2 were also associated with a longer diagnostic delay. A personal history of acne and a greater disease severity were associated with an earlier diagnosis. Conclusions: This study reveals the lack of improvement in the diagnostic delay in HS and highlights its association with atypical clinical manifestations and systemic comorbidities, scarcely reported in literature.
{"title":"Diagnostic Delay in Hidradenitis Suppurativa: Still an Unsolved Problem","authors":"I. Aparício Martins, B. Figueira Vilela, Joana Cabete","doi":"10.1159/000534845","DOIUrl":"https://doi.org/10.1159/000534845","url":null,"abstract":"Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease with a diagnostic delay of 7–10 years. A later diagnosis is associated with development of local sequelae and systemic comorbidities, as well as a reduced response to medical treatment. The aim of this study was to analyze the time required for HS diagnosis and investigate factors associated with diagnostic delay. Method: A retrospective observational study was conducted based on clinical records from HS patients followed at a tertiary hospital, with diagnosis between January 2006 and December 2022. Results: A total of 285 patients were included. The mean diagnostic delay was 10.1 years, and there was no difference in time to diagnosis during the considered period. A diagnostic delay of more than 5 years was significantly associated with an earlier onset of symptoms, location on breasts and thighs, follicular phenotype, and with cardiovascular and psychiatric comorbidities. Smoking and body mass index ≥25 kg/m2 were also associated with a longer diagnostic delay. A personal history of acne and a greater disease severity were associated with an earlier diagnosis. Conclusions: This study reveals the lack of improvement in the diagnostic delay in HS and highlights its association with atypical clinical manifestations and systemic comorbidities, scarcely reported in literature.","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":"1 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139265799","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}
Maria Rubi Losoya-Jaquez, Arturo Lopez Yañez-Blanco, Yonatan Armendariz-Barragan, Nidia Gabriela Aguilar-Figueroa, Lidia Rudnicka, L. E. Sánchez-Dueñas
Introduction: Pediatric androgenetic alopecia is a product of hormonal and genetic factors. The diagnosis depends on recognizing the hair loss pattern in the context of a positive family history and a typical trichoscopy. Methods: A multicenter retrospective study assessing medical data from January 2008 to January 2023 of two reference centers – one public and one private in west Mexico. Patients under 18 years old were included. The clinical features, trichoscopic findings, associated conditions, and treatment received were documented and analyzed. Results: We found 145 patients, with a mean age of 16.08 ± 1.30 years, predominantly comprising males (72%). Trichoscopy was performed on 33 patients. The main trichoscopic findings were hair shaft thickness variability in 100% of the cases, vellus hair in 85%, and single-hair units in 79%. Vitamin D deficiency was found in 84% of the cases with laboratory determination, insulin resistance in 33%, and hyperandrogenemia in 12.5%. Topical minoxidil emerged as the main treatment modality in 24% of cases, demonstrating both efficacy and tolerability. Conclusion: Pediatric androgenetic alopecia could be more prevalent than commonly perceived, potentially explained by the lower level of suspicion among medical practitioners. Distinctive trichoscopic findings offer valuable guidance for therapeutic strategies and ongoing management.
{"title":"Androgenetic Alopecia in Children and Adolescents: From Trichoscopy to Therapy","authors":"Maria Rubi Losoya-Jaquez, Arturo Lopez Yañez-Blanco, Yonatan Armendariz-Barragan, Nidia Gabriela Aguilar-Figueroa, Lidia Rudnicka, L. E. Sánchez-Dueñas","doi":"10.1159/000534844","DOIUrl":"https://doi.org/10.1159/000534844","url":null,"abstract":"Introduction: Pediatric androgenetic alopecia is a product of hormonal and genetic factors. The diagnosis depends on recognizing the hair loss pattern in the context of a positive family history and a typical trichoscopy. Methods: A multicenter retrospective study assessing medical data from January 2008 to January 2023 of two reference centers – one public and one private in west Mexico. Patients under 18 years old were included. The clinical features, trichoscopic findings, associated conditions, and treatment received were documented and analyzed. Results: We found 145 patients, with a mean age of 16.08 ± 1.30 years, predominantly comprising males (72%). Trichoscopy was performed on 33 patients. The main trichoscopic findings were hair shaft thickness variability in 100% of the cases, vellus hair in 85%, and single-hair units in 79%. Vitamin D deficiency was found in 84% of the cases with laboratory determination, insulin resistance in 33%, and hyperandrogenemia in 12.5%. Topical minoxidil emerged as the main treatment modality in 24% of cases, demonstrating both efficacy and tolerability. Conclusion: Pediatric androgenetic alopecia could be more prevalent than commonly perceived, potentially explained by the lower level of suspicion among medical practitioners. Distinctive trichoscopic findings offer valuable guidance for therapeutic strategies and ongoing management.","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":"10 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139268731","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}
Introduction: Treatment of nail psoriasis is challenging. Systemic therapies may be difficult to justify, while topical therapies may be sup-optimal. Triamcinolone acetonide (TA) injections are recommended as first-line therapy in cases with less than 3 nails involved; however, limited studies are available. This study was conducted to evaluate the reduction in NAPSI (Nail Psoriasis Severity Index) with TA injections in patients with isolated nail psoriasis. Methods: A retrospective case record analysis of efficacy and safety of TA (5 mg/mL) nail injections (4-weekly for fingernails, 8-weekly for toenails) was done in 10 patients. NAPSI was evaluated at each visit and treatment endpoint (75% reduction or 10 injections, whichever was earlier). Dropouts and adverse effects were recorded. Results: Among 10 patients (94 involved nails, 61 fingernails, and 33 toenails), 3 patients (30%) dropped out (2, 4, and 5 sessions, respectively), citing procedural pain. Three patients achieved NAPSI-75 (3, 6, and 7 sessions, respectively). Baseline mean NAPSI of 5.03 (4.63 fingernails and 5.78 toenails) dropped to 3.67 (3.13 fingernails and 4.42 toenails) by the 5th injection; and 2.35 (2.13 fingernails and 2.59 toenails) by the 10th injection. Adverse effects included pain (30%), subungual haematoma (1.7%), and proximal nail fold hypopigmentation with mild atrophy (1.1%). Conclusions: TA (5 mg/mL) injections are effective in nail psoriasis and associated with minimal adverse effects.
{"title":"Triamcinolone Acetonide Injections in Nail Psoriasis: A Pragmatic Analysis","authors":"Chander Grover, Geetali Kharghoria, Shikha Bansal","doi":"10.1159/000534699","DOIUrl":"https://doi.org/10.1159/000534699","url":null,"abstract":"<b><i>Introduction:</i></b> Treatment of nail psoriasis is challenging. Systemic therapies may be difficult to justify, while topical therapies may be sup-optimal. Triamcinolone acetonide (TA) injections are recommended as first-line therapy in cases with less than 3 nails involved; however, limited studies are available. This study was conducted to evaluate the reduction in NAPSI (Nail Psoriasis Severity Index) with TA injections in patients with isolated nail psoriasis. <b><i>Methods:</i></b> A retrospective case record analysis of efficacy and safety of TA (5 mg/mL) nail injections (4-weekly for fingernails, 8-weekly for toenails) was done in 10 patients. NAPSI was evaluated at each visit and treatment endpoint (75% reduction or 10 injections, whichever was earlier). Dropouts and adverse effects were recorded. <b><i>Results:</i></b> Among 10 patients (94 involved nails, 61 fingernails, and 33 toenails), 3 patients (30%) dropped out (2, 4, and 5 sessions, respectively), citing procedural pain. Three patients achieved NAPSI-75 (3, 6, and 7 sessions, respectively). Baseline mean NAPSI of 5.03 (4.63 fingernails and 5.78 toenails) dropped to 3.67 (3.13 fingernails and 4.42 toenails) by the 5th injection; and 2.35 (2.13 fingernails and 2.59 toenails) by the 10th injection. Adverse effects included pain (30%), subungual haematoma (1.7%), and proximal nail fold hypopigmentation with mild atrophy (1.1%). <b><i>Conclusions:</i></b> TA (5 mg/mL) injections are effective in nail psoriasis and associated with minimal adverse effects.","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":"14 11","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134955345","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}
Yonatan Armendariz-Barragan, Daniel Jimenez-Zaragoza, Luis Enrique Sánchez-Dueñas
Introduction: Eczema-like psoriasiform dermatitis has been described as a complication after Brazilian keratin treatment, with the presence of perifollicular scale resembling the outer skin of an onion bulb reported as a characteristic trichoscopic feature. To date, no treatment for this condition has been communicated. Methods: A retrospective study was conducted on patients diagnosed with eczema-like psoriasiform dermatitis. Clinical and trichoscopic images were analyzed, and the improvement in the scale and the vascular component of patients treated with oral isotretinoin was described. Results: A total of 132 patients were included. The most frequent trichoscopic findings were perifollicular scale, peripilar desquamation, and interfollicular scale. Most of the 7 patients treated with oral isotretinoin showed a partial improvement in the scale and the vascular component. Conclusion: The peripilar scale resembling the outer skin of an onion bulb could be used as a marker for this disease. We observed partial response to oral isotretinoin, probably due to the chronic character of this condition secondary to continuous release of formaldehyde, suboptimal doses, or a short treatment time.
{"title":"Eczema-Like Psoriasiform Dermatitis due to Hair Straighteners: Trichoscopic Findings and Clinical Experience in Its Management","authors":"Yonatan Armendariz-Barragan, Daniel Jimenez-Zaragoza, Luis Enrique Sánchez-Dueñas","doi":"10.1159/000534695","DOIUrl":"https://doi.org/10.1159/000534695","url":null,"abstract":"<b><i>Introduction:</i></b> Eczema-like psoriasiform dermatitis has been described as a complication after Brazilian keratin treatment, with the presence of perifollicular scale resembling the outer skin of an onion bulb reported as a characteristic trichoscopic feature. To date, no treatment for this condition has been communicated. <b><i>Methods:</i></b> A retrospective study was conducted on patients diagnosed with eczema-like psoriasiform dermatitis. Clinical and trichoscopic images were analyzed, and the improvement in the scale and the vascular component of patients treated with oral isotretinoin was described. <b><i>Results:</i></b> A total of 132 patients were included. The most frequent trichoscopic findings were perifollicular scale, peripilar desquamation, and interfollicular scale. Most of the 7 patients treated with oral isotretinoin showed a partial improvement in the scale and the vascular component. <b><i>Conclusion:</i></b> The peripilar scale resembling the outer skin of an onion bulb could be used as a marker for this disease. We observed partial response to oral isotretinoin, probably due to the chronic character of this condition secondary to continuous release of formaldehyde, suboptimal doses, or a short treatment time.","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":"85 18","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135092416","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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