Skin Appendage Disorders最新文献

Introduction: Onychomatricoma is a fibroepithelial tumor derived from the nail matrix and onychodermis. Many clinical and histological variants have been described. Pigmented onychomatricoma is a rare variant which presents as longitudinal pachymelanonychia.

Case presentation: We report the details of a 41-year-old female who presented with blackening and thickening involving more than half of the left middle fingernail for the past 10 years. Dorsal plate onychoscopy revealed longitudinal parallel white, gray, and black bands, while onychoscopy of the distal free edge demonstrated a thickened nail plate with "wood worm" cavities. The histopathological examination of the excised tumor revealed a pigmented onychomatricoma.

Conclusions: Onychomatricoma is one of the nail tumors presenting as pachyonychia striata apart from onychocytic matricoma and onychocytic carcinoma. A pigmented onychomatricoma may closely mimic fungal melanonychia, pigmented onychopapilloma, pigmented ungual Bowen's disease, and ungual melanoma. Noninvasive techniques like onychoscopy and imaging studies like ultrasonography and magnetic resonance imaging are helpful in differentiating it from pigmented ungual Bowen's disease and ungual melanoma, even though diagnostic confirmation requires an excisional biopsy.

Introduction: Chemotherapy-induced alopecia (CIA) can seriously affect the quality of life of cancer patients. Trichoscopic patterns and confocal microscopy (RCM) features of CIA have been scarcely studied. This study aimed to investigate the dermoscopic and RCM features of CIA in 19 females and 5 males, with CIA due to current or recent chemotherapy.

Methods: Patients with CIA and current or recent (within 2 months) history of chemotherapy treatment were enrolled. After clinical examination, standard pictures were taken by digital camera (SLR Canon PowerShot G10) and trichoscopic images were captured by the Handyscope device (20x). Images of RCM were acquired by VivaScope 3000 with the VivaStack option. The trichoscopic and confocal images were acquired by three independent observers after central parting on three areas: vertex, middle, and frontal scalp.

Results: A total of 24 patients were enrolled. CIA has features of anagen effluvium at trichoscopy but with low frequency of yellow dots and prominence of black dots. The simultaneous presence of pseudo-monilethrix and black dots at trichoscopy confirms the hypothesis that chemotherapy insults the hair follicle intermittently. At RCM, the presence of abnormal hair shaft morphology highlights that the insults affect hair shaft production.

Conclusion: These are the first data in this field, so further studies with a higher number of patients analyzed are needed to confirm these findings.

Introduction: Telogen effluvium is a form of non-scarring alopecia characterized by an increased hair shedding rate induced by mechanical or inflammatory factors.

Case report: A 27-year-old healthy male patient presented with several itchy alopecic patches in the occipital region. The patient had undergone a follicular unit extraction 6 weeks before with complete recovery after 1 week. Upon trichoscopy, we found empty follicular openings, short regrowing hairs, and coudability hairs. A diagnosis of acute telogen effluvium was made, and the patient was started on betamethasone lotion for daily use as a means to treat pruritus. After 1 month, the patient presented an almost complete response.

Conclusion: While acute telogen effluvium is commonly seen in the receptor area after a hair transplant, the incidence of the donor region as a presentation is unknown. Common trichoscopic findings in telogen effluvium include empty follicular openings, short regrowing hairs, and lack of other signs usually seen in other types of alopecia. This description was consistent with what we found in our patient. Trichoscopic findings can help in the diagnosis, and understanding its natural course, physicians can reassure the patient about the self-resolutive outcome of this condition.