Skin Appendage Disorders最新文献

Introduction: Eruptive syringomas (ES) are a rare variant of syringomas, benign adnexal tumors of eccrine sweat glands' ducts. They mostly affect young-to middle-aged women, but rarely they may also occur in the elderly, requiring generally no specific treatment.

Case presentation: We present the case of a 76-year-old woman with sudden onset of ES. Clinical examination evidenced brown-to-orange papules and plaques on the anterior neck, corresponding dermatoscopically to orange-brownish structureless areas, with barely hinted peripheral incomplete network, superimposed on areas of light pink. Histology showed dermal proliferation of epithelial cells forming cords and ductules, confirming the clinical-dermoscopic suspect of ES. The lesions remained stable at 12-month follow-up without treatment.

Discussion: This case highlights the role of dermoscopy to help differentiate ES from other clinically similar but more serious entities, such as histiocytosis, mastocytosis, and lichen planus, and to schedule the required confirmatory biopsy in due time without haste.

Introduction: Teledermatology has been shown to improve efficiency and reduce barriers to care for patients. However, teledermatology is limited by the inability to perform diagnostic tests. With proper planning, teletrichoscopy can be utilized with teledermatology to evaluate patients with hair loss.

Case presentation: Diagnosis of this patient was made using images taken during the televisit, including scalp images taken by the patient using a handheld microscope and images of the hair roots taken by her referring doctor.

Conclusion: Hair tests that can be conducted during teledermatology visits include a self-performed pull test, measurement of the thickness of the ponytail, measurement of the distance from the hairline to the glabella, and evaluation of the shedding scale. These tests, in addition to mobile applications for imaging or low-cost handheld microscopes, can be utilized to virtually evaluate patients with hair loss.

Introduction: Ingrown toenails are one of the common nail problems generally occurs in the big toe area and most often occurs during productive ages. Treatment of ingrowing toenail can be chosen based on the clinical condition of the patient. Nonoperative therapy is not effective in advanced cases in terms of the severity. Improper handling will cause recurrence in this case.

Case presentation: Six of 8 patients had the ingrown toenail recurrence previously treated using the nail avulsion (onychectomy) without matricectomy. One patient was reported to have hemophilia as comorbidity. The other one had pincer nail associated with inflammatory and degenerative processes. Most patients were at modified Mozena grades III and IV ingrown toenail. Post therapy evaluation revealed no recurrence in all patients.

Conclusions: Combination of wedge resection with matricectomy using electrocautery can be applied as therapy for recurrent ingrown toenail.

Scalp microinfusion is a promising novel drug delivery technique for hair loss treatment. We discuss the MMP® technique and review its possible use in alopecias. MMP® technique provides a small amount of drugs delivered homogeneously into the skin combined with micro-needling and can, therefore, provide optimal delivery. However, literature on this technique is limited to a few case reports despite its wide use in some countries. Further studies are needed to standardize protocols.

Introduction: Although Hutchinson's sign can appear associated with benign conditions, dermoscopic findings of non-melanoma eponychium pigmentation have not yet been described in the literature. We report for the first time to our knowledge the dermoscopic findings of an acral nevus located in the proximal nail fold as well as its clinical-dermoscopic-histologic correlation.

Case report: A twenty-year-old patient presented with a homogeneous longitudinal melanonychia on the left-hand thumb, with benign dermoscopic pattern, and an irregular, 6-mm, dark-brown hyperpigmented macule on the adjacent eponychium (Hutchinson's sign). The eponychium lesion showed on dermoscopy two irregular brown-black pigmented blotches, with superimposed parallel brown lines on a brushy distribution, with a thicker terminal end. The histopathologic examination of the proximal nail fold was performed, revealing scattered nevus cells in the epidermal basal layer and dermal-epidermal junction thecae, without any atypia or mitosis. These features were consistent with nevus of the proximal nail fold.

Discussion: Previous descriptions of benign hyponychium's pigmentations, despite the malignant appearance of the overlying melanonychia, were reported to have a similar dermoscopic pattern, known as longitudinal brushy pigmentation. This newly described dermoscopic sign on the eponychium may help distinguish Hutchinson's sign related to subungual melanoma to non-melanoma Hutchinson's sign.

Introduction: We analyzed randomized clinical trials (RCTs) evaluating the efficacy of combined therapy with low-level light therapy (LLLT) and topical minoxidil for treatment of androgenetic alopecia (AGA).

Methods: A literature search within PubMed identified RCTs evaluating hair regrowth following LLLT and minoxidil. Selection criteria were 600-1,100 nm wavelengths, treatment time ≥16 weeks, and objective evaluation for hair regrowth.

Results: Five RCTs compared LLLT with minoxidil (2% or 5%) to 5% minoxidil treatment or LLLT treatment. One study showed combination therapy of LLLT, and 5% minoxidil improved hair density more than monotherapy. Another found combination LLLT with 2% minoxidil induced hair regrowth equivalent to 5% minoxidil. Similarly, another study described LLLT with 5% minoxidil versus minoxidil monotherapy to increase the number of hairs with no statistical difference between groups. One trial found that combination group increased hair regrowth in the first 2 months. The last study found a statistically significant increase in hair density with combined therapy compared to monotherapy.

Conclusion: The studies describe either superiority or equivalence of combination therapy to minoxidil monotherapy for AGA. Early outcomes appear to support the superiority of combination therapy, but this advantage wanes at the end of the study periods.

Introduction: Alopecia areata (AA) is a common autoimmune disease characterized by non-scarring hair loss. New onsets of AA have been associated with coronavirus disease 2019 (COVID-19). Various skin diseases have already been reported because of the vaccines (the Pfizer-BioNTech COVID-19 vaccine, the Moderna COVID-19 vaccine, the AstraZeneca vaccine) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Case presentation: We report 5 cases of AA after COVID-19 vaccination. The trend shown by patients in this study is an initial worsening after the first dose of the vaccine with the stability of the disease even with subsequent doses. However, it is worth highlighting the case reported by one of our patients who suffered a "booster effect" of the disease with progressive and worsening alopecia with each vaccine booster.

Discussion: The possible mechanism of action lies in the ability of COVID-19 vaccines to induce spike protein, which can lead to molecular mimicry phenomena. In an organism predisposed to autoimmunity, the mRNA vaccine acts as a trigger. Furthermore, we would like to point out how even cytokine storm and simple oxidative stress from SARS-CoV-2 infection can induce not only AA but also other types of hair loss such as telogen effluvium. Thus, this highlights how complex and multifaceted the phenomenon is.