Skin Appendage Disorders最新文献

Introduction: Paronychia can be both acute and chronic dependent on the chronicity of disease, with different etiologies linked to each. Acute paronychia is commonly secondary to bacterial infections, while chronic paronychia can be multifactorial and include inflammatory causes.

Case presentation: We present a case of chronic paronychia that developed into osteomyelitis of the affected finger.

Conclusion: Because nail folds are anatomically close to the phalanges, it is important to monitor for worsening disease, as paronychia can develop into more serious infections.

Introduction: Red scalp disease or scalp rosacea, an inflammatory dermatosis, is frequently misdiagnosed as scarring alopecia due to nonspecific trichoscopic findings and limited case reports. While facial rosacea is well-documented, rosacea affecting extrafacial sites, such as the scalp, remains underrecognized. Accurate diagnosis is crucial to avoid unnecessary treatments and to establish an appropriate prognosis.

Case report: A 70-year-old male with an asymptomatic red scalp for 1 year, unresponsive to topical treatments, presented to our clinic. Examination revealed diffuse erythema with papules and pustules. Trichoscopy showed vascular polygons, "caterpillar hair" vessels, linear arterial branching, and hairpin vessels. Diagnosis of scalp rosacea was made, and significant improvement was observed after 2 months of oral tetracycline therapy.

Discussion/conclusion: Red scalp disease is characterized by diffuse erythema, inflammatory lesions, and vascular changes. Patients often exhibit mild facial photosensitivity but may not show prominent facial rosacea symptoms. Distinct trichoscopic patterns can assist in accurate diagnosis. Early recognition and treatment with systemic antibiotics, such as tetracyclines, are crucial to prevent progression to more severe inflammation. Increased awareness among dermatologists and trichologists is essential to enhance the diagnosis and management of this condition.

Introduction: Lichen planopilaris (LPP) is a rare scarring alopecia with poorly understood etiology, leading to challenges in both diagnosis and management. With an increasing number of studies focused on its clinical presentation, histopathology, and trichoscopic features, a comprehensive bibliometric analysis of high-impact LPP research is necessary to assess current trends and identify gaps in the literature.

Methods: The objective of this study was to analyze trends in LPP research using the top 100 most-cited articles from Web of Science.

Results: The average number of citations per article was 80.4 (range: 37-289), with publication dates ranging from 1990 to 2021. The most-cited article was Kossard's "Progressive Frontal Scarring Alopecia in Postmenopausal Women" with 289 citations. The USA (n = 47) had the most publications, followed by England (n = 18) and Spain (n = 14). Most articles were LOE 3 (n = 34) focusing on the "clinical and histopathological presentation" (n = 33). Key reported trichoscopic features included perifollicular erythema, perifollicular scaling, and loss of follicular ostia.

Conclusion: This bibliometric analysis highlights foundational LPP studies, emphasizing key trichoscopic features while revealing gaps in high-level evidence. It underscores the need for more rigorous research and expanded geographic diversity to enhance diagnostic markers, refine trichoscopic criteria, and improve therapeutic approaches.

Introduction: Nowadays, the impact of acne on the psyche of patients is evident to physicians and patients themselves. Studies concerned with the relation between acne and quality of life (QOL) are scarce in the Middle East.

Methods: This prospective cross-sectional study included 247 patients. The severity of acne was evaluated using the Global Acne Grading System (GAGS). Then, patients were asked to fill in the Arabic versions of the Dermatology Life Quality Index (DLQI) and the Cardiff Acne Disability Index (CADI).

Results: The mean CADI and DLQI scores were 6 ± 3.2 and 9.8 ± 5.5, respectively. There was a weakly significant positive correlation between CADI and GAGS, gender, cheek, chin, chest, and upper back localization of lesions (p ≤ 0.05). Moreover, there was a weakly significant positive correlation between only GAGS and DLQI (r = 0.125, p = 0.000).

Conclusion: Acne has an evident negative impact on the QOL of the participants. Assessing the QOL of acne patients and psychiatric consultation are advised to be standard measures of any management approach for acne patients for their well-being.

Introduction: Lichen planopilaris (LPP) is an inflammatory disease, leading to permanent hair loss, which significantly affects the psychosocial and self-image of patients with this condition; however, the impact of this condition on patients' quality of life (QoL), their perception of disease, and their knowledge about it have rarely been studied. This study aimed to investigate patients' knowledge and perspective on their disease and its association with their QoL and the extent of skin involvement.

Methods: Patients diagnosed with LPP and confirmed through a biopsy from 2022 to 2023 completed a questionnaire covering demographic characteristics, the Illness Perception Questionnaire, disease and therapy knowledge, and the Dermatology Life Quality Index. Additionally, a dermatologist (S.D.) examined the Lichen Planopilaris Activity Index (LPPAI).

Results: This study enrolled 42 LPP patients, with 81% being female and 73.8% under 60 years old. The LPPAI did not correlate with knowledge (r = 0.04, p = 0.783), illness perception (r = 0.097, p = 0.543), or QoL scores (r = 0.119, p = 0.452). However, QoL was positively linked to knowledge (r = 0.382, p = 0.013) and illness perception scores (r = 0.398, p = 0.009). Patients with a longer disease duration had higher knowledge scores (r = 0.400, p = 0.009).

Conclusion: Dermatologists should note that enhancing patients' knowledge of their disease and assessing their illness perceptions can help identify and correct misconceptions, improving treatment outcomes and their QoL.

Background: Silicones are unique polymers characterized by their repeating siloxane bonds, which have become essential in the hair care industry due to their protective and conditioning properties. Widely incorporated into various hair products, silicones form a film over the hair shaft, reducing friction, preventing moisture loss, and enhancing shine. However, concerns regarding product buildup from water-insoluble silicones and the environmental implications of certain cyclic silicones have emerged. Recent advancements in silicone technology, including water-dispersible and nano-encapsulated systems, aim to mitigate these issues while preserving the benefits of enhanced hair texture and protection against thermal and chemical damage.

Summary: This article provides a comprehensive review of the classification, advantages, and controversies surrounding silicones in hair care. It emphasizes practical guidance for selecting appropriate products tailored to individual hair types and the importance of preventing excessive buildup. The discussion highlights the need for education on the benefits and proper use of silicones, addressing common misconceptions. Ultimately, while silicones offer significant advantages in hair care, a balanced approach combining efficacy with environmental responsibility is essential for their continued use as a viable solution in the industry.

Key messages: Silicones provide numerous advantages, including enhanced hair texture, improved appearance, and increased moisture retention in hair care formulations. Water-insoluble silicones can accumulate on the hair, requiring the use of stronger surfactants for removal, which may lead to dryness associated with the excessive application of clarifying products. Fourth-generation silicones and innovative surfactant systems are designed to minimize environmental impact while optimizing the targeted delivery of active ingredients.

Background: Psoriatic alopecia is a distinct but underrecognized manifestation of psoriasis, leading to both non-scarring and scarring hair loss. While scalp involvement is common in psoriasis, the mechanisms underlying follicular damage and hair loss remain poorly understood. Diagnosis is challenging due to clinical and histopathological overlap with other alopecias, and treatment responses are often variable.

Summary: This review examines the clinical presentation, pathogenesis, and management of psoriatic alopecia. The inflammatory process, primarily driven by the Th17/IL-23 axis, contributes to hair follicle disruption, sebaceous gland atrophy, and in severe cases, permanent alopecia. Trichoscopy and histopathology aid in diagnosis, but standardized criteria are lacking. Treatment strategies include topical corticosteroids, vitamin D analogs, and systemic biologics, but some patients remain refractory to conventional therapies. Paradoxical psoriatic alopecia induced by TNF inhibitors further complicates management, necessitating individualized treatment approaches.

Key messages: Psoriatic alopecia requires greater clinical recognition and research to improve diagnosis and treatment. A deeper understanding of its pathogenesis, particularly immune-mediated follicular damage, could lead to more effective therapies. Personalized treatment approaches, including novel biologics, hold promise for improving patient outcomes, but further studies are needed to optimize long-term management strategies.

Introduction: Patchy scarring alopecia in the fronto-temporal areas presents a diagnostic challenge, requiring accurate recognition for proper management. Cicatricial marginal alopecia (CMA) and frontal fibrosing alopecia (FFA) are key differential diagnoses, distinguishable through histopathology. FFA has variable prognosis, depending on typical or atypical patterns. Literature on hair transplantation (HT) in CMA and FFA is limited, with inconsistent outcomes and little data on FFA subtypes. This study aimed to describe HT outcomes in patients with atypical FFA patterns.

Case presentation: Patients were followed at the Municipal Public Servant Hospital of São Paulo, Brazil, from 2016 to 2023. Three postmenopausal women with patchy FFA confirmed by clinical and histological criteria underwent HT using the follicular unit transplantation technique. Over 5 to 6 years of follow-up, two patients had mild graft loss, and one experienced more significant loss. No clinical signs of disease reactivation were observed.

Conclusion: Despite the small sample size and retrospective design, this study offers valuable insight into long-term graft survival in atypical FFA. Mild hair density reduction occurred after more than 5 years, with all patients reporting high satisfaction with aesthetic results. Larger prospective studies are needed to confirm long-term HT efficacy in this population.

Introduction: Yellow nail syndrome (YNS) is a rare disorder characterized by a triad of thickened yellow nails, primary lymphedema, and chronic respiratory manifestations. A key feature of the condition is diminished nail growth which contributes to the development of the characteristic yellow nails. Although its underlying etiology is unclear, it is postulated that microvasculopathy, lymphatic dysfunction, and protein leakage are involved. Current treatment options are limited and do not demonstrate consistent efficacy.

Case reports: We report 2 cases of YNS which improved with treatment using oral minoxidil for 3-6 months.

Conclusion: Oral minoxidil therapy was well tolerated and resulted in visible improvement in nail changes. To our knowledge, oral minoxidil therapy for YNS has not previously been reported and may represent a promising new treatment.

Introduction: Folliculitis decalvans (FD) is a neutrophilic scarring alopecia characterized by follicular pustules, crusts, and tufted hair. Its etiology remains unclear, though Staphylococcus aureus infection and immune dysfunction are implicated. This study investigates the clinical, dermoscopic, and therapeutic aspects of FD in a skin of color population. The objective of our study was to analyze the epidemiological profile, clinical diversity, diagnostic features, and treatment strategies for FD patients.

Methods: A retrospective, descriptive study of 17 FD patients was conducted at Ibn Sina University Hospital, Rabat, over 4 years. Diagnosis was based on clinical, dermoscopic, and histological findings. Data collected included demographics, disease onset, comorbidities, symptoms, severity grading, and therapeutic responses.

Results: The cohort comprised 17 patients (8 men, 9 women) with a median age of 37.2 years. Phototype IV was predominant (47.1%). The vertex was the most affected site (82.4%). Scarring alopecia was present in all cases, with perifollicular erythema (100%) and tufted hair (88.2%) being the most common dermoscopic findings. Grade 3 severity was observed in 55.5% of female patients. Topical and oral antibiotics, including doxycycline, were the most prescribed treatments. Resistance to treatment was more common in women.

Conclusions: FD in skin of color patients exhibits clinical, dermoscopic, and therapeutic patterns comparable to global data, though higher severity and pustule prevalence were noted. Doxycycline and topical agents remain key therapeutic options. Larger studies are needed to elucidate pathogenesis and optimize management strategies.