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Subungual Acantholytic Dyskeratotic Acanthoma: A Case Report and Literature Review 舌下棘层溶解性角化异常棘皮瘤:病例报告和文献综述
IF 1 Q2 Medicine Pub Date : 2024-05-16 DOI: 10.1159/000538624
Ankit Gupta, Sara Lee de Menezes, Matthew David Howard, Rod O’Keefe, Saurabh Prakash, Johannes Steffen Kern
Introduction: Subungual acantholytic dyskeratotic acanthoma is a rare benign tumor of epidermal keratinocytes characterized by acantholysis and dyskeratosis. Only 7 other cases have been published in the literature. Case Presentation: A 29-year-old male presented with painful erythronychia and onycholysis of the left thumbnail. He worked as an electrician and was ambidextrous. Two months prior to the onset, he reported completing a mechanical task which led to repeated and sustained pressure to his left thumb. The clinical diagnosis was onychopapilloma, and a longitudinal excision was performed to remove the tumor. However, on histopathological examination, the primary features were hyperkeratosis, acantholysis, and dyskeratosis, consistent with a final diagnosis of subungual acantholytic dyskeratotic acanthoma. Conclusion: Nail trauma was reported by our case as a preceding feature, and this has not been described previously. Pain may accompany nail changes in the presentation of this tumor. Although subungual acantholytic dyskeratotic acanthoma is a benign tumor, it caused disruption in productivity, and our case highlights the need for timely access to specialist nail services.
导言表皮下棘层溶解性角化不良棘皮瘤是一种罕见的表皮角质细胞良性肿瘤,其特征是棘层溶解和角化不良。文献中仅发表过 7 个病例。病例介绍:一名 29 岁的男性因左手拇指甲出现疼痛性红斑和角化不全而就诊。他是一名电工,双手灵活。发病前两个月,他报告说在完成一项机械任务时,左手拇指受到反复持续的压力。临床诊断为趾甲状软骨瘤,并进行了纵向切除术以切除肿瘤。然而,在组织病理学检查中,主要特征是角化过度、棘层溶解和角化不良,这与最终诊断一致,即舌下棘层溶解性角化不良棘皮瘤。结论我们的病例将指甲外伤作为发病前的一个特征,这在以前的病例中从未有过描述。在这种肿瘤的发病过程中,疼痛可能会伴随指甲的变化。虽然舌下棘层溶解性角化异常棘皮瘤是一种良性肿瘤,但它会影响患者的工作效率,我们的病例强调了及时获得专科指甲服务的必要性。
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引用次数: 0
Scalp Rosacea Treated with Topical Ivermectin 使用局部伊维菌素治疗头皮红斑痤疮
IF 1 Q2 Medicine Pub Date : 2024-05-15 DOI: 10.1159/000537807
F. Dall'Oglio, M. Nasca, Giulia Guglielmi, G. Micali
Introduction: Scalp rosacea is often misdiagnosed or overlooked, and few reports deal with this peculiar localization. Furthermore, the pharmacological approach to scalp rosacea remains a therapeutic challenge, as no topical and/or systemic drugs have been approved for this specific area so far. Case Presentation: A series of 5 adult patients affected by inflammatory rosacea and concurrent scalp involvement, confirmed by dermoscopy and histopathology with negative microbiologic swabs, and effectively treated with ivermectin 1% cream once daily for 12 weeks is presented. Conclusion: Our experience, although limited, suggests that evaluation of rosacea subjects should also include the scalp and that the treatment with ivermectin 1% cream may be effective on scalp rosacea.
简介头皮红斑痤疮经常被误诊或忽视,很少有报道涉及这一特殊的局部症状。此外,头皮红斑痤疮的药物治疗方法仍然是一项挑战,因为迄今为止还没有针对这一特殊部位的外用药和/或全身用药获得批准。病例介绍:该系列病例涉及 5 名患有炎性红斑痤疮并同时累及头皮的成年患者,经皮肤镜检查和组织病理学检查确认,微生物拭子阴性,使用 1%伊维菌素乳膏治疗 12 周,每天一次,疗效显著。结论:我们的经验虽然有限,但表明对酒渣鼻患者的评估也应包括头皮,而且使用 1%伊维菌素乳膏治疗头皮酒渣鼻可能有效。
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引用次数: 0
Dermoscopic Nail Changes in Psoriasis, Lichen Planus, and Lichen Striatus 皮肤镜下银屑病、扁平苔藓和条纹状苔藓的指甲变化
IF 1 Q2 Medicine Pub Date : 2024-05-08 DOI: 10.1159/000538581
M. Sar-Pomian, M. Starace, André Lencastre, B. Piraccini, Bertrand Richert, Lidia Rudnicka, M. Trakatelli, M. Iorizzo
Background: Onychoscopy is a noninvasive method helpful in diagnosing nail disorders. The aim of the study was to review literature on the usability of onychoscopy in nail psoriasis, nail lichen planus, and nail lichen striatus. Summary: Onychoscopic features of nail psoriasis are pitting, onycholysis with erythematous border, salmon patches, splinter hemorrhages, dotted vessels in lateral and proximal folds, and hyponychium. Onychoscopic features of nail lichen planus are onychorrhexis, onycholysis, longitudinal melanonychia, and red lunula. The literature on the usability of onychoscopy in nail lichen striatus is scarce. Keynotes: Onychoscopy facilitates evaluation of nail abnormalities compared to the clinical examination. Lunular alterations, salmon patches, erythematous border of onycholysis as well as splinter hemorrhages in nail psoriasis are better visualized with onychoscopy compared to the naked eye. Onychoscopy enhances detection of melanonychia, dyschromia, and lunular changes in nail lichen planus. Onychoscopic features are different in fingernails and toenails.
背景:甲镜检查是一种无创方法,有助于诊断指甲疾病。本研究旨在回顾有关甲沟炎镜在甲银屑病、甲扁平苔藓和甲条纹状苔藓中可用性的文献。摘要:甲银屑病的甲内镜特征是点状凹陷、带红斑边界的甲癣、鲑鱼斑、劈裂出血、外侧和近端皱褶中的点状血管以及甲下。甲沟炎的甲镜特征为甲沟炎、甲沟炎、纵向黑斑和红色月牙。有关甲沟炎的甲沟镜检查可用性的文献很少。要点:与临床检查相比,甲内镜检查有助于评估指甲异常。与肉眼相比,甲状银屑病的月牙状改变、鲑鱼斑、甲癣红斑边界以及劈裂出血在甲内镜下更容易观察到。甲沟镜检查能更好地发现甲沟炎中的黑斑、色素沉着和月牙状变化。指甲和脚趾甲的甲内镜特征有所不同。
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引用次数: 0
Corticosteroid Atrophy Plaque on the Scalp Treated with 5-Fluourouracil and Bleomycin Infusion in the MMP Technique 采用 MMP 技术注入 5-氟尿嘧啶和博莱霉素治疗头皮上的皮质类固醇萎缩斑块
IF 1 Q2 Medicine Pub Date : 2024-05-03 DOI: 10.1159/000538405
Luciana Gasques, Fernanda Freitas de Brito, Raissa Zobiole, Letícia Bortolini, Vanessa Catalá Casteli Assumpção, Caio Leal Carvalho
Alopecia areata (AA) is a disease with a great impact on quality of life of patients. Among several treatment modalities, intralesional injectable corticosteroid therapy is the first option, with corticosteroid-induced cutaneous atrophy as a common adverse event. We describe a case of plaque AA in the frontal region of the scalp that evolved with cutaneous atrophy induced by the application of intralesional corticosteroids but presented complete and sustained repilation after being treated with 5-Fluorouracil and Bleomycin using the technique of MMP (Microinfusion of Medicines into the Skin).
斑秃(AA)是一种严重影响患者生活质量的疾病。在多种治疗方法中,局部注射皮质类固醇疗法是首选,但皮质类固醇引起的皮肤萎缩是常见的不良反应。我们描述了一例头皮额部的斑块状 AA 病例,该病例在应用皮质类固醇激素治疗后出现了皮肤萎缩,但在使用 5-氟尿嘧啶和博莱霉素(MMP,将药物微量注入皮肤)治疗后,病情得到了完全和持续的控制。
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引用次数: 0
Rogue Hairs: A Mixed-Method Characterization of a Previously Unreported Entity 流氓毛:用混合方法描述以前从未报道过的实体
IF 1 Q2 Medicine Pub Date : 2024-05-02 DOI: 10.1159/000538622
Anise Marshall, Andrea Kalus, April Schachtel
Introduction: We define rogue hairs as unusually long hairs on the face outside of the typical hormone-driven hair-bearing areas. These represent a common and previously undocumented phenomenon. This mixed-method study describes the frequency and clinical features of rogue hairs using a case series, patient survey, and social media analysis. Methods: Clinical cases were identified by dermatologists, and social media platforms were searched for additional cases. Social media comments were reviewed using qualitative thematic analysis. Surveys were administered to patients at an academic dermatology clinic. Results: The case series revealed these hairs are seen in children and adults, men and women, and across races. Of the surveyed patients, 18% reported rogue hairs. Social media analysis highlighted common experiences of sudden appearance, frequent removal attempts, and minimal interaction with dermatologists. Conclusion: This mixed-method study defines rogue hairs on the face, underscoring their prevalence despite their benign nature. While the biological explanation for these hairs remains unknown, the study highlights the potential of social media as a tool for clinical inquiry and enhanced understanding of the patient experience. The study provides evidence-based information for individuals experiencing rogue hairs and prompts future research into the biologic mechanisms underlying this common phenomenon.
简介我们将 "杂毛 "定义为脸部典型的激素驱动生发区以外的异常长毛。这代表了一种常见的、以前未被记录的现象。这项混合方法研究通过病例系列、患者调查和社交媒体分析,描述了 "乱发 "的发生频率和临床特征。研究方法由皮肤科医生确定临床病例,并在社交媒体平台上搜索其他病例。采用定性主题分析法对社交媒体评论进行审查。对一家皮肤病学术诊所的患者进行调查。结果系列病例显示,这些毛发可见于儿童和成人、男性和女性以及不同种族。在接受调查的患者中,有 18% 的人报告了 "乱发"。社交媒体分析强调了突然出现、频繁尝试拔除以及与皮肤科医生互动极少等共同经历。结论:这项混合方法研究定义了脸部的 "坏毛发",强调了它们的普遍性,尽管它们是良性的。虽然这些毛发的生物学解释仍然未知,但该研究强调了社交媒体作为临床探究工具的潜力,并增强了对患者体验的理解。该研究为遭遇 "乱发 "的患者提供了循证信息,并促进了未来对这一常见现象的生物机制的研究。
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引用次数: 0
The Effects of Environmental Pollutants and Exposures on Hair Follicle Pathophysiology 环境污染物和暴露对毛囊病理生理学的影响
IF 1 Q2 Medicine Pub Date : 2024-04-17 DOI: 10.1159/000537745
Tara Samra, Rachel R. Lin, Andrea D. Maderal
Background: Environmental exposures profoundly impact cutaneous physiology, with hair follicles (HFs) being particularly vulnerable due to their high levels of proliferation and perfusion. HFs are exposed directly to contaminants that are absorbed transcutaneously and exposed indirectly to ingested and inhaled pollutants via the bloodstream. Summary: Some pollutants, such as particulate matter, trigger inflammatory responses and have been associated with alopecia areata. Others, like tobacco smoke and phthalates, exert endocrine effects with unclear ramifications for HF function. Pesticides and heavy metals have both been linked to alopecia areata and acute anagen effluvium, while polyaromatic hydrocarbons – ligands of aryl hydrocarbon receptors – are linked to androgenetic alopecia. Finally, UV exposure, which has increased due to anthropogenic ozone depletion, causes oxidative damage and perifollicular mast cell degranulation. Key Messages: Pollutants have far-reaching consequences for hair pathology, which remain incompletely characterized. The effects of environmental exposures on HFs are an active area of research that deserve further attention.
背景:环境暴露会对皮肤生理产生深远影响,而毛囊(HF)因其高度增殖和灌注而尤其脆弱。毛囊直接接触经皮吸收的污染物,并通过血液间接接触摄入和吸入的污染物。摘要:一些污染物(如颗粒物质)会引发炎症反应,并与斑秃有关。其他污染物,如烟草烟雾和邻苯二甲酸盐,会对内分泌产生影响,但对高频功能的影响尚不明确。杀虫剂和重金属都与斑秃和急性脱发有关,而芳香烃受体的配体--多芳香烃则与雄激素性脱发有关。最后,由于人为臭氧消耗而增加的紫外线照射会导致氧化损伤和毛囊周围肥大细胞脱颗粒。关键信息:污染物对毛发病理具有深远影响,但其特征仍不完全清楚。环境暴露对高频的影响是一个活跃的研究领域,值得进一步关注。
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引用次数: 0
Tick Bite Alopecia: A Report of Five Cases and Review of the Literature 蜱咬脱发症:五例病例报告及文献综述
IF 1 Q2 Medicine Pub Date : 2024-04-16 DOI: 10.1159/000538402
Stefano Veraldi, Giulia Murgia, G. Nazzaro, M. Barbareschi
Introduction: Although well-known, tick bite alopecia is rarely reported in the literature. Case Presentations: We present five cases of alopecia of the scalp caused by tick bites. All patients were Caucasians, 2 males and 3 females, with an age ranging from 4 to 9 years (mean age: 6.3 years). Discussion: The mechanisms by which ticks cause alopecia are unknown. The saliva of ticks contains anticoagulants (heparins, heparinoids, and coumarins). The release of these anticoagulants would induce an inflammatory reaction on the scalp, with alopecia as the final clinical result.
简介:蜱虫咬伤脱发虽然广为人知,但文献中却鲜有报道。病例介绍:我们介绍了五例由蜱虫叮咬引起的头皮脱发病例。所有患者均为白种人,2 男 3 女,年龄从 4 岁到 9 岁不等(平均年龄:6.3 岁)。讨论:蜱虫导致脱发的机制尚不清楚。蜱虫的唾液中含有抗凝血剂(肝素、类肝素和香豆素)。这些抗凝血剂的释放会诱发头皮炎症反应,最终导致脱发。
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引用次数: 0
Leukonychia Totalis: An Underreported Sign of Chronic Arsenicosis 总白斑病:被低估的慢性砷中毒征兆
IF 1 Q2 Medicine Pub Date : 2024-04-12 DOI: 10.1159/000538450
Anil Kumar Bhoi, Vishal Gaurav, Sunil Kushwaha
Introduction: Arsenic poisoning results from exposure to arsenic through ingestion, inhalation, or skin contact. Cutaneous and neurological symptoms enable early diagnosis. Diagnostic tests include hair, nail, and urine arsenic levels. Leukonychia can be true, apparent, or pseudoleukonychia, depending on the underlying cause. Case Report: A 27-year-old male on herbal supplement for bodybuilding, presented with whitish discolouration of nails for 2 years and tingling sensation in extremities for 6 months. Electrophysiological tests indicated symmetric sensorimotor polyneuropathy. Arsenic levels were significantly elevated in hair, nails, and herbal supplements. A diagnosis of chronic arsenicosis with leukonychia totalis and early peripheral neuropathy was made. Discussion: Chronic arsenicosis may feature skin changes including pigmentary alterations, palmoplantar keratosis, and the characteristic “raindrops on a dusty road” appearance. Hair loss and nail alterations, such as Mees’ lines, are also noted. Arsenic-related neuropathy can be mild or subclinical initially and primarily affects sensory nerve fibres. Total leukonychia due to chronic arsenic exposure has not been reported previously.
简介:砷中毒是由于摄入、吸入或皮肤接触砷而引起的。皮肤和神经症状有助于早期诊断。诊断检查包括头发、指甲和尿液中的砷含量。白斑病可分为真性白斑病、显性白斑病或假性白斑病,这取决于潜在的病因。病例报告:一名 27 岁的男性,因健美而服用草药,出现指甲变白 2 年,四肢刺痛 6 个月。电生理测试显示他患有对称性感觉运动多发性神经病。头发、指甲和草药中的砷含量明显升高。诊断结果为慢性砷中毒伴全甲白斑和早期周围神经病变。讨论:慢性砷中毒可导致皮肤改变,包括色素改变、掌跖角化病和特有的 "尘土飞扬的道路上的雨滴 "外观。脱发和指甲改变(如梅斯纹)也会出现。砷相关神经病最初可能是轻微或亚临床的,主要影响感觉神经纤维。因长期接触砷而导致的全白斑病以前从未报道过。
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引用次数: 0
Serial Excision Technique to Reduce Cicatricial Alopecia 减少斑秃的连续切除技术
IF 1 Q2 Medicine Pub Date : 2024-04-09 DOI: 10.1159/000538397
M. Benez, Ana Luísa Alves, Lucas Emmels, Adriana Dornelas, Guillermo Loda
Introduction: Cicatricial alopecia (CA) poses a challenge for dermatologists due to irreversible hair follicle damage. While pharmacological treatments offer limited efficacy, surgical interventions aim to improve aesthetic outcomes. This article explores the serial excision technique (SET) as a viable option for stable cases of inflammatory CA. Case Report/Case Presentation: Three adult females with different forms of CA underwent staged surgeries to correct CA patches. Procedures included different incision and closure methods based on individual characteristics such as age, type and extent of alopecia, location, and tissue mobility in the scarred area. Discussion: CA significantly impacts patients’ quality of life, demanding comprehensive treatment approaches. SET emerges as an encouraging possibility for stable cases, providing notable cosmetic improvements and enhancing patients’ well-being. This technique offers cost-effective benefits with potential standalone efficacy or in combination with hair transplantation, providing promising outcomes for individuals with CA.
导言:由于毛囊损伤不可逆,毛囊角化性脱发(CA)给皮肤科医生带来了挑战。药物治疗的疗效有限,而手术干预则旨在改善美学效果。本文探讨了序列切除技术(SET),将其作为炎症性秃发稳定期病例的一种可行选择。病例报告/病例介绍:三名患有不同形式 CA 的成年女性接受了分期手术,以矫正 CA 斑块。手术方法包括根据个体特征(如年龄、脱发类型和程度、位置以及瘢痕区域组织的流动性)采用不同的切口和闭合方法。讨论CA 严重影响了患者的生活质量,需要采取综合治疗方法。对于病情稳定的病例,SET 是一种令人鼓舞的治疗方法,它能明显改善外观,提高患者的生活质量。这项技术具有成本效益,可单独使用,也可与毛发移植手术结合使用,为 CA 患者带来良好的治疗效果。
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引用次数: 0
Body-Focused Repetitive Behaviors in Patients with FOXP1 Syndrome: An International Cross-Sectional Survey-Based Study FOXP1 综合征患者的身体重复行为:一项基于横断面调查的国际研究
IF 1 Q2 Medicine Pub Date : 2024-04-02 DOI: 10.1159/000537906
Kaya L Curtis, Shari R. Lipner
Introduction: FOXP1 syndrome is a rare neurodevelopmental disorder due to forkhead box protein 1 (FOXP1) gene mutations and is associated with intellectual disability, dysmorphic features, and autism spectrum disorder. We aimed to assess body-focused repetitive behavior (BFRB) prevalence in this patient population using a cross-sectional survey-based study. Methods: A validated survey assessing for BFRBs was administered to parents attending the International FOXP1 Foundation conference on June 21, 2023, and was sent to a FOXP1 syndrome listserv. Results: Excoriation disorder, onychophagia, onychotillomania, and trichotillomania were reported by 58.6%, 38.6%, 29.7%, and 10.0% of subjects, with 63.4%, 59.3%, 54.5%, and 14.3% having moderate to severe disease, respectively. Overall, 28.6%, 30.0%, and 10.0% had one, two, and three BFRBs, respectively. Conclusion: Prevalence of BFRBs is high among FOXP1 syndrome patients surveyed, affecting quality of life for patients and their families and causing significant sequelae.
简介FOXP1 综合征是一种罕见的神经发育障碍,由叉头盒蛋白 1(FOXP1)基因突变引起,与智力障碍、畸形特征和自闭症谱系障碍有关。我们旨在通过一项基于横断面调查的研究,评估该患者群体中身体聚焦重复行为(BFRB)的患病率。研究方法我们向参加 2023 年 6 月 21 日国际 FOXP1 基金会会议的家长发放了一份评估 BFRB 的有效调查表,并将其发送至 FOXP1 综合征列表服务器。结果显示58.6%、38.6%、29.7%和10.0%的受试者报告了秽语障碍、秽语嗜食症、秽语躁狂症和秽语躁狂症,分别有63.4%、59.3%、54.5%和14.3%的受试者患有中度至重度疾病。总体而言,28.6%、30.0% 和 10.0% 的受试者分别患有一种、两种和三种 BFRB。结论在接受调查的 FOXP1 综合征患者中,BFRB 的发病率很高,影响了患者及其家人的生活质量,并造成了严重的后遗症。
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引用次数: 0
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Skin Appendage Disorders
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