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Geisler AN, Taye M, Larrondo J, Mayo TT, Aguh C, McMichael A, MacKelfresh JB, Krueger L. Updates on disorders in curly hair. Int J Dermatol 2024; 63:1145-1154. [PMID: 38622785 DOI: 10.1111/ijd.17184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 03/22/2024] [Accepted: 03/23/2024] [Indexed: 04/17/2024]
Abstract
Hair disorders, including central centrifugal cicatricial alopecia (CCCA), traction alopecia (TA), and acquired trichorrhexis nodosa (ATN), commonly occur in individuals with curly textured hair. Curly textured hair in individuals of African descent has unique properties and can present diagnostic and therapeutic challenges. CCCA has been linked to uterine leiomyoma and type 2 diabetes mellitus, as well as fibroproliferation. TA often presents with a fringe sign and can arise from high-tension hairstyles presumed to be protective. Trichoscopy is useful in establishing a diagnosis; perifollicular halos are more commonly seen than perifollicular erythema or scale in CCCA. In TA, miniaturized follicles, hair casts, and "flambeau sign" can be seen. Hairstyling practices likely contribute to TA and ATN; however, the data are mixed on the role of chemical relaxers and heat styling in CCCA. Unique considerations in the presentation of frontal fibrosing alopecia in curly textured hair have also been published recently. This review provides a comprehensive, up-to-date summary of these disorders with an emphasis on their unique properties, as well as considerations in hair care for curly textured hair.
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Affiliation(s)
- Amaris N Geisler
- Department of Dermatology, Emory University School of Medicine, Atlanta, USA
| | - Marta Taye
- Department of Dermatology, Emory University School of Medicine, Atlanta, USA
| | - Jorge Larrondo
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, USA
| | - Tiffany T Mayo
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, USA
| | - Crystal Aguh
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, USA
| | - Amy McMichael
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, USA
| | - Jamie B MacKelfresh
- Department of Dermatology, Emory University School of Medicine, Atlanta, USA
| | - Loren Krueger
- Department of Dermatology, Emory University School of Medicine, Atlanta, USA
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Jasińska M, Czuwara J, Lortkipanidze N, Michalczyk A, Borkowska B, Gajda-Mróz P, Kurzeja M, Olszewska M, Rudnicka L, Rakowska A. Hair Shaft Abnormalities as a Dermoscopic Feature of Mycosis Fungoides: Pilot Results. Dermatol Ther (Heidelb) 2024; 14:2119-2126. [PMID: 38961037 PMCID: PMC11333686 DOI: 10.1007/s13555-024-01206-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 06/03/2024] [Indexed: 07/05/2024] Open
Abstract
INTRODUCTION Diagnosis of persistent erythematous, scaly patches, or plaques can be complex since psoriasis (Ps), eczematous dermatitis (ED), and mycosis fungoides (MF) can be considered. Dermoscopy, which is a noninvasive diagnostic tool, is commonly used to examine blood vessels, scales, and background color; however, research on hair shaft evaluation in inflammatory dermatoses remains scarce. The aim of the study was dermoscopic evaluation of hair shafts in skin lesions localized on the non-scalp skin areas in patients diagnosed with MF, Ps, and ED. METHODS This was a retrospective evaluation of 55 patients diagnosed with MF, Ps, and ED. Photographic and dermoscopic documentation of these patients and detailed medical history were evaluated. RESULTS A total of 21 patients with MF, 21 patients with Ps, and 13 patients with ED were evaluated. The examination revealed the presence of various abnormalities of hair shafts (e.g., numerous pili torti, single pili torti, 8-shaped hairs, pigtail hairs, broken hairs, hair shafts rapidly tapered over long sections, hair shafts irregular in thickness, angulated hairs, branched hairs, the presence of trichorrhexis nodosa, and monilethrix-like hairs), yellow dots, and black dots. The presence of pili torti was found in 80% of patients with MF, compared with 16% of patients with Ps and 8% of patients with ED (p < 0.005), with multiple pili torti found only in MF patients (67%) (p < 0.005). Statistically significant differences also applied to hair shafts rapidly tapering over long sections and 8-shaped hairs, which occurred only in MF patients (p < 0.005 and p = 0.035, respectively). CONCLUSIONS The presence of hair shaft abnormalities such as numerous pili torti, 8-shaped hairs, and hair shafts rapidly tapering over long sections is an important criterion that should be considered in the dermoscopic differentiation of the patchy/plaque mycosis fungoides and inflammatory dermatoses, such as psoriasis and eczematous dermatitis localized on the non-scalp skin areas.
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Affiliation(s)
- Magdalena Jasińska
- Department of Dermatology, Medical University of Warsaw, Koszykowa 82a Street, 02-008, Warsaw, Poland
| | - Joanna Czuwara
- Department of Dermatology, Medical University of Warsaw, Koszykowa 82a Street, 02-008, Warsaw, Poland
| | | | - Agnieszka Michalczyk
- Department of Dermatology, Medical University of Warsaw, Koszykowa 82a Street, 02-008, Warsaw, Poland
| | | | - Patrycja Gajda-Mróz
- Department of Dermatology, Medical University of Warsaw, Koszykowa 82a Street, 02-008, Warsaw, Poland
| | - Marta Kurzeja
- Department of Dermatology, Medical University of Warsaw, Koszykowa 82a Street, 02-008, Warsaw, Poland
| | - Małgorzata Olszewska
- Department of Dermatology, Medical University of Warsaw, Koszykowa 82a Street, 02-008, Warsaw, Poland
| | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Koszykowa 82a Street, 02-008, Warsaw, Poland
| | - Adriana Rakowska
- Department of Dermatology, Medical University of Warsaw, Koszykowa 82a Street, 02-008, Warsaw, Poland.
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Roumi Jamal B, Breim F, Zakour J, Marachli B, Abubakir M, Abdul Rahman N, Ishkhanian S. Coexisting trichorrhexis nodosa and pili annulati: a case report of hair shaft abnormalities in a Syrian family. Ann Med Surg (Lond) 2024; 86:4887-4890. [PMID: 39118738 PMCID: PMC11305761 DOI: 10.1097/ms9.0000000000002295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Accepted: 06/08/2024] [Indexed: 08/10/2024] Open
Abstract
Introduction Pili annulati (PA) and trichorrhexis nodosa (TN) are rare genetic hair disorders. PA presents with sparkly, spotted hair due to air-filled cavities in the cortex, mainly affecting the scalp. TN causes brittle, breakable hair shafts, often due to physical or chemical damage. Case Presentation A 23-year-old Syrian woman presented with glistening, brittle hair and whitish nodules since puberty, reminiscent of TN. Trichoscopy confirmed TN alongside PA, displaying characteristic dark-light bands. Interestingly, TN breakage occurred within the PA bands. Her aunt displayed similar TN patterns. Microscopy revealed ring-like structures and a 'thrust paint brush' appearance, indicative of TN, within PA-affected regions. Management included avoidance of hair treatments and prescription of vitamins and minoxidil to enhance hair strength and density. Discussion PA is usually congenital and autosomal dominant, often without causing hair fragility. However, some cases report fragility, particularly in light bands. While PA is typically benign, its combination with TN underscores the complexity of hair shaft disorders. Only five such cases exist. Proposed causes for PA and TN include genetic factors and hair shaft abnormalities. PA's fragility may stem from band stiffness differences and lower cysteine content. Treatment is typically unnecessary, but avoiding excessive heat styling is advised. Conclusion This case highlights the rare co-occurrence of PA and TN, emphasizing the need for further research into their relationship and potential systemic associations. Understanding the underlying mechanisms is crucial for informing treatment and counseling patients effectively, especially considering the rarity of this association.
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Affiliation(s)
| | | | - Joud Zakour
- Department of Dermatology and Venereology, Aleppo University Hospital, University of Aleppo, Aleppo, Syrian Arab Republic
| | | | | | - Noura Abdul Rahman
- Department of Dermatology and Venereology, Aleppo University Hospital, University of Aleppo, Aleppo, Syrian Arab Republic
| | - Silva Ishkhanian
- Department of Dermatology and Venereology, Aleppo University Hospital, University of Aleppo, Aleppo, Syrian Arab Republic
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Watanabe TM, Ueda S, Ishida S, Shioi G, Kaneshiro J, Magari M. Optical evaluation of internal damage to human hair based on second near-infrared window polarization microscopy. Int J Cosmet Sci 2024. [PMID: 38802700 DOI: 10.1111/ics.12970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/08/2024] [Accepted: 04/10/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVE Hair beauty treatments glorify human life. As a side effect, there is a risk of deteriorating the health of the hair. Optically polarized microscopy has been used for many decades to evaluate hair conditions owing to its ease of use and low operating costs. However, the low biopermeability of light hinders the observation of detailed structures inside hair. The aim of this study is to establish an evaluation technique of internal damages in a hair by utilizing a near-infrared (NIR) light with a wavelength of 1000-1600 nm, called "second NIR window". METHODS We built a laser scanning transmission microscope system with an indium gallium arsenide detector, a 1064 nm laser source, and optical circular polarization to visualize the anisotropy characterization of keratin fibres in hair. Samples of Asian black hair before and after bleaching, after permanent-waving, after lithium bromide (LiBr) treatment, and after heating was observed. Some parameters reflecting intra-hair damage were quantitatively compared with the parameters in digitally recorded images with analytical developments. RESULTS The light transmittance of black hair was dramatically improved by utilizing the second NIR window. Numerical analysis of circular polarization in hair quantified the internal damage in chemically or thermally treated hair and found two different types of damage. The present method enabled quantitative evaluation of the condition changes in the cortex; for example, a decrease in circular polarizability by LiBr treatment and restoration by replacing the LiBr solution with water. In addition, black speckles were observed after the heat treatment. Longer heating and wetting times increased the appearance probability and size of the speckles. According to quantitative analyses, the emergence of black spots was independent of polarizability changes, indicating that they were not pores. CONCLUSION Circular polarization microscopy based on near-infrared optics in the second NIR window provides an effective evaluation method for quantifying intra-hair damage caused by cosmetic treatments. The present method provides noninvasive, easy, and inexpensive hair evaluation and has potential as a gold standard in hair care research/medical fields.
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Affiliation(s)
- Tomonobu M Watanabe
- Laboratory for Comprehensive Bioimaging, RIKEN Center for Biosystems Dynamics Research (BDR), Kobe, Japan
- Department of Stem Cell Biology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Seiko Ueda
- Health & Beauty R&D, Sunstar Inc., Asia One Center, Kobe, Hyogo, Japan
| | - Saki Ishida
- Health & Beauty R&D, Sunstar Inc., Asia One Center, Kobe, Hyogo, Japan
| | - Go Shioi
- Laboratory for Comprehensive Bioimaging, RIKEN Center for Biosystems Dynamics Research (BDR), Kobe, Japan
| | - Junichi Kaneshiro
- Laboratory for Comprehensive Bioimaging, RIKEN Center for Biosystems Dynamics Research (BDR), Kobe, Japan
| | - Michi Magari
- Health & Beauty R&D, Sunstar Inc., Asia One Center, Kobe, Hyogo, Japan
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Meghwal L, Mehta S, Gupta LK, Balai M, Mittal A. Trichoscopic and Clinico-Morphological Evaluation of Tinea Capitis. Indian Dermatol Online J 2024; 15:437-442. [PMID: 38845633 PMCID: PMC11152477 DOI: 10.4103/idoj.idoj_439_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 01/01/2024] [Accepted: 01/21/2024] [Indexed: 06/09/2024] Open
Abstract
Introduction Tinea capitis (TC) is a common fungal infection of the scalp, especially in children. Trichoscopy is a noninvasive technique that allows rapid and magnified in vivo observation of the hair with the visualization of morphologic features that are often imperceptible to the naked eye. Aim This study aimed to evaluate the usefulness of trichoscopy in clinical diagnosis and to study various clinico-morphological patterns of TC. Materials and Methods This cross-sectional, observational study included 140 clinically diagnosed cases of TC seen during a period of 1 year (April 2021 to March 2022). All patients were evaluated using a dermoscope (DermLite DL4 Multispectral 3 Gen, San Juan Capistrano, CA, USA,10×). Results The prevalence rate of TC in this study was 2.69 per thousand population. The most common clinical variant was gray patch followed by kerion and black dot, and the most common etiological agent was Trichophyton tonsurans. The characteristic trichoscopic features were as follows: comma hairs (80%), followed by corkscrew hairs (68.6%), bent hairs (54.2%), zigzag hairs (35.7%), and morse code-like hairs (15%). Other findings included scaling (89.2%), followed by black dot (67.1%), broken hairs (42.8%), and crusting and pustules (32.1% each). Comma and corkscrew-shaped hairs were most common in the black dot type, whereas zigzag, bent hairs, and morse code hairs were common in the gray patch type of TC. There was a significant association between trichoscopic findings and type of TC. Conclusion Trichoscopy can be considered a novel tool for rapid diagnosis and selection of the appropriate therapy and in the monitoring of treatment efficacy in TC.
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Affiliation(s)
- Lavina Meghwal
- Department of Dermatology, R.N.T. Medical College, Udaipur, Rajasthan, India
| | - Sharad Mehta
- Department of Dermatology, R.N.T. Medical College, Udaipur, Rajasthan, India
| | - Lalit Kumar Gupta
- Department of Dermatology, R.N.T. Medical College, Udaipur, Rajasthan, India
| | - Manisha Balai
- Department of Dermatology, R.N.T. Medical College, Udaipur, Rajasthan, India
| | - Asit Mittal
- Department of Dermatology, R.N.T. Medical College, Udaipur, Rajasthan, India
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Zadurska M, Rakowska A, Czochrowska E, Laskowska M, Perkowski K, Strużycka I, Rudnicka L, Jurek A. Hair Evaluation in Orthodontic Patients with Oligodontia. Diagnostics (Basel) 2024; 14:945. [PMID: 38732359 PMCID: PMC11083739 DOI: 10.3390/diagnostics14090945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 03/03/2024] [Accepted: 04/28/2024] [Indexed: 05/13/2024] Open
Abstract
Oligodontia can be isolated or syndromic, associated with other ectodermal abnormalities. The aim of the study was to perform hair examination in orthodontic patients diagnosed with oligodontia with a low clinical expression of symptoms of ectodermal origin. All available orthodontic patients diagnosed with oligodontia in the permanent dentition were enrolled. Hair examination included clinical evaluation of the patients' hair, trichoscopy, trichogram and evaluation of the hair shafts under a polarized light microscope. In total, 25 patients, 18 males and 7 females, aged 6 to 24 years were evaluated for the presence of dental and hair abnormalities. The number of congenitally absent teeth ranged from 6 to 24 teeth and diastemas, microdontia, taurodontism and altered tooth shape were found in 23 patients. Hair disorders were found in 68% of the subjects. Hypotrichosis, the heterogeneity of shaft color and loss of pigment, androgenetic alopecia, telogen effluvium, trichoschisis, pili canaliculi, trichorrhexis nodosa and pseudomoniletrix were observed. Trichoscopy and trichogram are valid non-invasive diagnostic tests which could be used to differentiate between isolated and syndromic oligodontia in patients with a low clinical expression of ectodermal symptoms.
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Affiliation(s)
- Małgorzata Zadurska
- Department of Orthodontics, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.Z.); (E.C.); (M.L.); (K.P.)
| | - Adriana Rakowska
- Department of Dermatology, Medical University of Warsaw, 02-097 Warsaw, Poland (L.R.)
| | - Ewa Czochrowska
- Department of Orthodontics, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.Z.); (E.C.); (M.L.); (K.P.)
| | - Małgorzata Laskowska
- Department of Orthodontics, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.Z.); (E.C.); (M.L.); (K.P.)
| | - Konrad Perkowski
- Department of Orthodontics, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.Z.); (E.C.); (M.L.); (K.P.)
| | - Izabela Strużycka
- Department of Comprehensive Dentistry, Medical University of Warsaw, 02-097 Warsaw, Poland;
| | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, 02-097 Warsaw, Poland (L.R.)
| | - Agnieszka Jurek
- Department of Orthodontics, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.Z.); (E.C.); (M.L.); (K.P.)
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Zanna G, Abramo F, Contiero B, Zini E, Albanese F, Borio E, Godizzi F, Necci F, Luciani L, Roccabianca P. Dermoscopic findings and comparison of usefulness of longitudinal versus transversal sections in the histological diagnosis of alopecia X. Vet Dermatol 2024; 35:126-137. [PMID: 37867253 DOI: 10.1111/vde.13212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 07/05/2023] [Accepted: 10/10/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND A combination of dermoscopic and histological findings may provide useful information for the diagnosis of hair follicle diseases. However, there are no studies on dermoscopic-histopathological correlations in dogs affected by alopecia X, and comparison of longitudinal versus transversal sectioning of skin biopsy specimens in the assessment of this hair loss disorder has not been thoroughly investigated. HYPOTHESIS/OBJECTIVES The aim of this study was to correlate dermoscopic and histological features using both longitudinal and transversal sectioning of skin biopsy samples to gain additional information for the diagnosis of alopecia X. ANIMALS Nineteen Pomeranian dogs affected by alopecia X and five healthy Pomeranians as controls. MATERIALS AND METHODS Dermoscopic-histological correlation was performed within the diseased group, whereas histological comparisons against controls. The demographic and clinical characteristics also were related to the histological findings. RESULTS The dermoscopic findings revealed scattered, thinned, short hairs mixed with amorphous keratoseborrhoeic-like material (follicular plugging), perifollicular and intrafollicular scaling, and hyperpigmentation varying from pinpoint black spots to a diffuse texture. Dermoscopic findings correlated with histological findings for selected qualitative and quantitative findings. The usefulness of transversal sections was demonstrated in accurately determining the hair follicular density and counts, growth arrest phases and in identifying mineralisation of hair follicle basement membrane when compared to the longitudinal. Conversely, no correlations between histological findings and demographic and clinical characteristics were detected. CONCLUSIONS AND CLINICAL RELEVANCE These data provide evidence of the usefulness of dermoscopic evaluation as an accessory diagnostic tool and of transversal sections of skin biopsies as complementary to the diagnosis of alopecia X.
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Affiliation(s)
- Giordana Zanna
- Anicura-Istituto Veterinario di Novara, Granozzo con Monticello, Italy
| | - Francesca Abramo
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - Barbara Contiero
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Italy
| | - Eric Zini
- Anicura-Istituto Veterinario di Novara, Granozzo con Monticello, Italy
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Italy
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | | | - Elena Borio
- Clinica Veterinaria San Martino, Novara, Italy
| | | | - Fabiano Necci
- CDVet- Laboratorio Analisi Veterinarie Roma, Rho, Italy
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Wal P, Wal A. CBD: A Potential Lead against Hair Loss, Alopecia, and its Potential Mechanisms. Curr Drug Discov Technol 2024; 21:e200723218949. [PMID: 37475557 DOI: 10.2174/1570163820666230720153607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/24/2023] [Accepted: 05/12/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Nowadays, the majority of the population suffers from the problem of hair loss. It leads to disturbed mental health, lower self-confidence, and a lot more problems. A lot of the hair loss therapies available are not reliable and lead to recurrence and side effects after some time. Cannabinoids (CBD) have recently become quite popular for their benefits against hair loss. CBD oil preparations have been used both internally and externally for oral and topical use, respectively. Due to the presence of the endocannabinoid system (ECS) in the body, which naturally targets CB1 and CB2 receptors, the control of hair fall is possible. CBD is used topically for hair loss, whereas it is administered orally for the treatment and management of a medical condition, i.e., alopecia. AIM/OBJECTIVE The present review aimed to provide an in-depth study on hair loss and its management using CBD and its associated mechanisms. METHODS Electronic databases, such as ScienceDirect, Google Scholar, PubMed, Wiley, Springer, and Scopus, were thoroughly searched for information about how CBD is used, how it works, and what role it plays in treating alopecia and hair loss. RESULTS This review has highlighted the use of CBD-based hair loss therapy, and described various types of hair loss and their treatments. This review also details the phytocannabinoids and the potential mechanisms of CBD's activity against hair loss and alopecia. CONCLUSION The data obtained from the literature regarding CBD and hair loss provide a scientific basis for CBD use in alopecia. Additionally, a more precise and comprehensive study concerning CBD needs to be carried out at the pre-clinical and clinical levels.
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Affiliation(s)
- Pranay Wal
- Department of Pharmacy, Pranveer Singh Institute of Technology (Pharmacy) NH19 Bhaunti Kanpur, India
| | - Ankita Wal
- Department of Pharmacy, Pranveer Singh Institute of Technology (Pharmacy) NH19 Bhaunti Kanpur, India
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Kurzeja M, Rakowska A, Jasinska M, Warszawik-Hendzel O, Olszewska M, Rudnicka L. Dermoscopy as a Noninvasive Diagnostic Tool for Hailey-Hailey Disease and Darier Disease. Dermatol Ther (Heidelb) 2023; 13:2345-2355. [PMID: 37668900 PMCID: PMC10539227 DOI: 10.1007/s13555-023-01009-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/08/2023] [Indexed: 09/06/2023] Open
Abstract
INTRODUCTION Hailey-Hailey disease (HHD) and Darier disease (DD) are rare genetic disorders for which differential diagnosis, especially in less obvious cases, can be difficult. The diagnosis is based on the clinical picture and family history, and is confirmed by histopathologic examination. Dermoscopy is a noninvasive technique that is primarily used at the present time to diagnose skin cancers. However, in the past few years this technique has also been increasingly used as a noninvasive diagnostic tool of inflammatory skin diseases. The aim of the study was to evaluate whether dermoscopy is a useful noninvasive diagnostic tool for HHD and DD. METHODS We performed an observational retrospective case series study involving 13 patients with HHD (n = 8) and DD (n = 5). The presence or absence of standardized dermoscopic features of inflammatory diseases (according to International Dermoscopy Society [IDS] guidelines) was assessed in these patients. RESULTS The most distinctive feature of HHD was white clouds separated by pink furrows, visible in all cases (8/8; 100.0%). Another distinctive clue of HHD was the crumbled fabric pattern seen in six patients with HHD (6/8; 75.0%). These dermoscopic findings were not present in patients with DD. The most typical features of DD in the dermoscopic examination was star-like or oval-shaped yellow areas surrounded by whitish halo, visible in all patients (5/5; 100.0%). Another distinctive dermoscopic clue of DD was pinkish homogeneous structureless background, which was present in all patients (5/5, 100.0%). These latter two features were not observed in patients with HHD. CONCLUSION Dermoscopy reveals distinctive features of HHD and DD, respectively. Therefore, we conclude that dermoscopy can be an excellent complementary noninvasive tool in the diagnostic process of patients with HHD and DD.
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Affiliation(s)
- Marta Kurzeja
- Department of Dermatology, Medical University of Warsaw, ul. Koszykowa 82a, 02-005, Warsaw, Poland
| | - Adriana Rakowska
- Department of Dermatology, Medical University of Warsaw, ul. Koszykowa 82a, 02-005, Warsaw, Poland.
| | - Magdalena Jasinska
- Department of Dermatology, Medical University of Warsaw, ul. Koszykowa 82a, 02-005, Warsaw, Poland
| | - Olga Warszawik-Hendzel
- Department of Dermatology, Medical University of Warsaw, ul. Koszykowa 82a, 02-005, Warsaw, Poland
| | - Małgorzata Olszewska
- Department of Dermatology, Medical University of Warsaw, ul. Koszykowa 82a, 02-005, Warsaw, Poland
| | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, ul. Koszykowa 82a, 02-005, Warsaw, Poland
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Salve VJ, Viswanath V, Joshi P, Dhakne M. A Potpourri of Trichoscopic Findings: Unique Presentation of Hyperthyroidism-Induced Hair Changes. Int J Trichology 2023; 15:160-162. [PMID: 38765722 PMCID: PMC11098137 DOI: 10.4103/ijt.ijt_98_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 06/14/2022] [Indexed: 05/22/2024] Open
Abstract
Hyperthyroidism is known to cause thin, brittle hair, and premature graying. Hair shaft abnormalities in hyperthyroidism have not been described in the literature. A visible and microscopic change in the hair shaft due to cosmetic procedures and environmental factors is known as hair weathering. Herein, we report a case of hair weathering in an adult female with hyperthyroidism with unique dermoscopic features.
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Affiliation(s)
- Vrushali Jaysing Salve
- Department of Dermatology, Rajiv Gandhi Medical College and Chhatrapati Shivaji Maharaj Hospital, Thane, Maharashtra, India
| | - Vishalakshi Viswanath
- Department of Dermatology, Rajiv Gandhi Medical College and Chhatrapati Shivaji Maharaj Hospital, Thane, Maharashtra, India
| | - Pradnya Joshi
- Department of Dermatology, Rajiv Gandhi Medical College and Chhatrapati Shivaji Maharaj Hospital, Thane, Maharashtra, India
| | - Mayuri Dhakne
- Department of Dermatology, Rajiv Gandhi Medical College and Chhatrapati Shivaji Maharaj Hospital, Thane, Maharashtra, India
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Bhat Y, Trumboo T, Krishan K. Hair shaft disorders in children – An update. Indian Dermatol Online J 2023; 14:163-171. [PMID: 37089857 PMCID: PMC10115339 DOI: 10.4103/idoj.idoj_7_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 05/18/2022] [Accepted: 06/30/2022] [Indexed: 03/12/2023] Open
Abstract
Disorders of hair shaft are a diverse group of congenital and acquired abnormalities of the hair that can pose a diagnostic and therapeutic challenge to the dermatologists. Hair shaft abnormalities can occur as an isolated phenomenon or can be associated with an underlying genetic syndrome. Any change in the texture, appearance, and growth of the hair should prompt evaluation of the patient for the presence of any hair shaft anomaly. The diagnosis can be suggested by a complete history and physical examination of the hair-bearing areas as well as other ectodermal structures (nails and teeth). A key feature in the evaluation of hair shaft defects is to determine the fragility of the hair shaft that can be elucidated by performing the "tug test." Trichoscopy and light microscopy serve as valuable tools in establishing the specific type of hair shaft disorder. An update of the approach for the diagnosis and management is included in this review.
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Das A, Madke B, Jakhar D, Neema S, Kaur I, Kumar P, Pradhan S. Named signs and metaphoric terminologies in dermoscopy: A compilation. Indian J Dermatol Venereol Leprol 2022; 88:855-866. [PMID: 35146985 DOI: 10.25259/ijdvl_1047_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 06/01/2021] [Indexed: 02/03/2023]
Affiliation(s)
- Anupam Das
- Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India
| | - Bhushan Madke
- Department of Dermatology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Sawangi, Wardha, Maharashtra, India
| | - Deepak Jakhar
- Department of Dermatology, North DMC Medical College and Hindu Rao Hospital, New Delhi, India
| | - Shekhar Neema
- Department of Dermatology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Ishmeet Kaur
- Department of Dermatology, North DMC Medical College and Hindu Rao Hospital, New Delhi, India
| | - Piyush Kumar
- Department of Dermatology, Katihar Medical College, Katihar, Bihar, India
| | - Swetalina Pradhan
- Department of Dermatology, All India Institute of Medical Sciences, Patna, Bihar, India
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13
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Mittal A, Singh M, Singh S, Jain A, Barman KD. Monilethrix: A Cytologist's Perspective. J Cytol 2022; 39:188-189. [PMID: 36605870 PMCID: PMC9809428 DOI: 10.4103/joc.joc_25_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 08/02/2022] [Accepted: 10/14/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Anjali Mittal
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Meeta Singh
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Shabnam Singh
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Ashish Jain
- Department of Paediatrics, Maulana Azad Medical College, New Delhi, India
| | - Krishna D. Barman
- Department of Dermatology, Maulana Azad Medical College, New Delhi, India
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14
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Essendoubi M, Andre N, Granger B, Clave C, Manfait M, Thuillier I, Piot O, Ginestar J. New approach for hair keratin characterization: use of the confocal Raman spectroscopy to assess the effect of a thermal stress on human hair fiber. Int J Cosmet Sci 2022; 44:588-601. [PMID: 35916243 PMCID: PMC9546255 DOI: 10.1111/ics.12808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 07/19/2022] [Accepted: 07/31/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The objective of our research was to investigate the heat-protecting effect of a product ex vivo and in vivo on human hair fibers. METHODS A preparatory study was carried out in order to determine an optimal threshold of thermal stress. For this, the structure of cross-sections of the hair fiber was observed by optical microscopy. Then, Scanning Electron Microscopy (SEM) and Confocal Raman Spectroscopy (CRS) were applied to analyze ex vivo and in vivo morphological and molecular damage in hair structure after heat stress. Finally, in vivo tests were used to collect consumer perception. RESULTS The preparatory study enabled us to determine an optimal stress threshold of 10 heating cycle for SEM and 5 heating cycle for CRS. Based on spectral hierarchical classification using Ward's clustering algorithm, the ex vivo Raman results show that the spectral signature of the hair treated and heated is very close to the negative control. This shows that the product preserves the keratin structure after thermal stress. These results were also confirmed by an in vivo Raman analysis performed on hair samples from 5 donors. In concordance with Raman results, SEM show that treated hair present lesser "bubbles" and "crackling" on the hair surface. Finally, the in vivo studies proved that hair was more protected from the heat. CONCLUSION The authors concluded that the product shows protective properties with respect to morphological and molecular heat damage. We also demonstrate that the product promotes the α-helix keratin conformation and preserves the S-S disulfide bands.
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Affiliation(s)
- M Essendoubi
- EA 7506 Biospectroscopie Translationnelle (BioSpectT), Faculty of Pharmacy, University of Reims Champagne-Ardenne, Reims, France.,Biophysic Laboratory, Faculty of Medicine and Pharmacy of Tangier, AbdelMalek Essâdi University, Tangier, Morocco
| | - N Andre
- CFEB SISLEY 3-5 avenue de Friedland, Paris
| | - B Granger
- CFEB SISLEY 3-5 avenue de Friedland, Paris
| | - C Clave
- CFEB SISLEY 3-5 avenue de Friedland, Paris
| | - M Manfait
- EA 7506 Biospectroscopie Translationnelle (BioSpectT), Faculty of Pharmacy, University of Reims Champagne-Ardenne, Reims, France
| | | | - O Piot
- EA 7506 Biospectroscopie Translationnelle (BioSpectT), Faculty of Pharmacy, University of Reims Champagne-Ardenne, Reims, France
| | - J Ginestar
- CFEB SISLEY 3-5 avenue de Friedland, Paris
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15
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Karunakar P, Munisamy M, Maya M, Sahadevan G, Chandrasekaran V. A 7-month-old boy with global developmental delay, hypotonia, and abnormal hair. Pediatr Dermatol 2022; 39:634-636. [PMID: 36000941 DOI: 10.1111/pde.15008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/06/2022] [Accepted: 03/29/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Pediredla Karunakar
- Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
| | - Malathi Munisamy
- Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
| | - Malini Maya
- Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
| | - Geethanjali Sahadevan
- Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
| | - Venkatesh Chandrasekaran
- Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
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16
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Phillipps J, Raval NS, Musiek A. SnapshotDx Quiz: May 2022. J Invest Dermatol 2022; 142:e43-e49. [DOI: 10.1016/j.jid.2022.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 03/07/2022] [Indexed: 10/18/2022]
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17
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Sun HY, Wong XL, Chen MKY, Sebaratnam DF. Trichoscopy of syphilitic alopecia: a systematic review. Sex Transm Infect 2022; 98:539-540. [PMID: 35135846 DOI: 10.1136/sextrans-2021-055302] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 11/20/2021] [Indexed: 12/29/2022] Open
Affiliation(s)
- Helen Yiling Sun
- Department of Dermatology, Liverpool Hospital, Liverpool, New South Wales, Australia .,Faculty of Medicine and Health, University of New South Wales, Kensington, New South Wales, Australia
| | - Xin Lin Wong
- Faculty of Medicine and Health, University of New South Wales, Kensington, New South Wales, Australia
| | - Michelle K Y Chen
- Department of Dermatology, Liverpool Hospital, Liverpool, New South Wales, Australia.,Faculty of Medicine and Health, University of New South Wales, Kensington, New South Wales, Australia
| | - Deshan Frank Sebaratnam
- Department of Dermatology, Liverpool Hospital, Liverpool, New South Wales, Australia.,Faculty of Medicine and Health, University of New South Wales, Kensington, New South Wales, Australia
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18
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Claves diagnósticas en displasias pilosas I. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:141-149. [DOI: 10.1016/j.ad.2021.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 06/01/2021] [Accepted: 06/06/2021] [Indexed: 11/19/2022] Open
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19
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Claves diagnósticas en displasias pilosas II. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:150-156. [DOI: 10.1016/j.ad.2021.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/31/2021] [Accepted: 06/06/2021] [Indexed: 11/21/2022] Open
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20
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Giacaman A, Ferrando J. [Translated article] Keys to the Diagnosis of Hair Shaft Disorders: Part I. ACTAS DERMO-SIFILIOGRAFICAS 2022. [DOI: 10.1016/j.ad.2022.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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21
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[Translated article] Keys to the Diagnosis of Hair Shaft Disorders: Part II. ACTAS DERMO-SIFILIOGRAFICAS 2022. [DOI: 10.1016/j.ad.2022.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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22
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Sáez-de-Ocariz M, Aguilar-Sarmiento AS, Garcés-Abad MA, Vázquez-Arroyo P, García-Romero MT, Durán-McKinster C. Usefulness of Trichoscopy over Hair Light Microscopy in Menkes Disease. Skin Appendage Disord 2022; 8:57-60. [PMID: 35118132 PMCID: PMC8787585 DOI: 10.1159/000518368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 07/07/2021] [Indexed: 01/03/2023] Open
Abstract
Menkes disease (MD) is a rare X-linked recessive neurodegenerative disorder caused by mutations in the ATP7A gene, with a high mortality rate within the first 3 years of life. It typically affects males and is characterized by impaired copper distribution and malfunction of several copper-dependent enzymes. Patients develop progressive muscle hypotonia associated with neurological damage and hair shaft dysplasia - particularly pili torti. Pili torti is usually very subtle in the first 3 months of life and gradually increases during the first year. Light microscopy examination in search for pili torti requires the observation of more than 50 hair shafts. In contrast, trichoscopy with a hand-held dermatoscope allows to easily identify the hair shaft defect. We report a case of a Hispanic male infant with MD in whom we show that trichoscopy is superior to hair light microscopy in revealing pili torti.
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Affiliation(s)
| | | | | | - Paulina Vázquez-Arroyo
- Servicio de Dermatología, Hospital de Especialidades, Centro Médico Nacional, Mexico City, Mexico
| | | | - Carola Durán-McKinster
- Dermatology Department, Instituto Nacional de Pediatría, Mexico City, Mexico,*Carola Durán-McKinster,
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23
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Bhattarai D, Banday AZ, Sadanand R, Arora K, Kaur G, Sharma S, Rawat A. Hair microscopy: an easy adjunct to diagnosis of systemic diseases in children. Appl Microsc 2021; 51:18. [PMID: 34843009 PMCID: PMC8630179 DOI: 10.1186/s42649-021-00067-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 11/17/2021] [Indexed: 12/11/2022] Open
Abstract
Hair, having distinct stages of growth, is a dynamic component of the integumentary system. Nonetheless, derangement in its structure and growth pattern often provides vital clues for the diagnosis of systemic diseases. Assessment of the hair structure by various microscopy techniques is, hence, a valuable tool for the diagnosis of several systemic and cutaneous disorders. Systemic illnesses like Comel-Netherton syndrome, Griscelli syndrome, Chediak Higashi syndrome, and Menkes disease display pathognomonic findings on hair microscopy which, consequently, provide crucial evidence for disease diagnosis. With minimal training, light microscopy of the hair can easily be performed even by clinicians and other health care providers which can, thus, serve as a useful tool for disease diagnosis at the patient's bedside. This is especially true for resource-constrained settings where access and availability of advanced investigations (like molecular diagnostics) is a major constraint. Despite its immense clinical utility and non-invasive nature, hair microscopy seems to be an underutilized diagnostic modality. Lack of awareness regarding the important findings on hair microscopy may be one of the crucial reasons for its underutilization. Herein, we, therefore, present a comprehensive overview of the available methods for hair microscopy and the pertinent findings that can be observed in various diseases.
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Affiliation(s)
- Dharmagat Bhattarai
- Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Aaqib Zaffar Banday
- Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
| | - Rohit Sadanand
- Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Kanika Arora
- Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Gurjit Kaur
- Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Satish Sharma
- Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Amit Rawat
- Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
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24
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Kinoshita-Ise M, Sachdeva M. Update on trichoscopy: Integration of the terminology by systematic approach and a proposal of a diagnostic flowchart. J Dermatol 2021; 49:4-18. [PMID: 34806223 DOI: 10.1111/1346-8138.16233] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 10/28/2021] [Accepted: 11/01/2021] [Indexed: 01/18/2023]
Abstract
Trichoscopy represents a non-invasive diagnostic modality widely used in daily practice. Despite the common perception that this technique has been fairly established, some key issues remain to be addressed. Complexity and inconsistency in terminology in past literature are likely to confuse investigators when they are recording, reporting, and retrieving the findings. In addition, a diagnostic algorithm adopting sufficiently integrated and updated findings is not readily available. By adopting a systematic review approach, this review attempted to redefine major trichoscopic findings and integrate their synonyms individually into the most frequently used terms besides identifying and discussing terms which potentially cause confusion. The findings are categorized into five subgroups: hair shaft, follicular, perifollicular, scalp findings, and hair distribution pattern abnormalities. The calculation of sensitivities and positive predictive values of such redefined findings was conducted by reviewing the descriptions in the past literature on major hair diseases, including alopecia areata, androgenetic alopecia/female pattern hair loss, telogen effluvium, trichotillomania, lichen planopilaris, frontal fibrosing alopecia, central centrifugal cicatricial alopecia, discoid lupus erythematosus, folliculitis decalvans, tinea capitis, and dissecting cellulitis, to confirm the diagnostically meaningful findings for representative diseases. This attempt redefined, for instance, yellow dots, short vellus hairs, exclamation mark hairs, black dots, and broken hairs as the findings of diagnostic significance for alopecia areata and hair diameter diversity, peripilar sign, and focal atrichia for androgenetic alopecia/female pattern hair loss. An updated diagnostic flowchart is proposed with the instructions to maximize its usefulness. Current limitations and future perspectives of trichoscopy as well as other emerging non-invasive diagnostic modalities for hair diseases are also discussed.
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Affiliation(s)
| | - Muskaan Sachdeva
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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25
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Giacaman A, Ferrando J. WITHDRAWN: Keys to the Diagnosis of Hair Shaft Disorders: Part I. ACTAS DERMO-SIFILIOGRAFICAS 2021. [DOI: 10.1016/j.adengl.2021.11.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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26
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Giacaman A, Ferrando J. WITHDRAWN: Keys to the Diagnosis of Hair Shaft Disorders: Part II. ACTAS DERMO-SIFILIOGRAFICAS 2021. [DOI: 10.1016/j.adengl.2021.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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27
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Pili Torti: A Feature of Numerous Congenital and Acquired Conditions. J Clin Med 2021; 10:jcm10173901. [PMID: 34501349 PMCID: PMC8432236 DOI: 10.3390/jcm10173901] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/20/2021] [Accepted: 08/25/2021] [Indexed: 02/06/2023] Open
Abstract
Pili torti is a rare condition characterized by the presence of the hair shaft, which is flattened at irregular intervals and twisted 180° along its long axis. It is a form of hair shaft disorder with increased fragility. The condition is classified into inherited and acquired. Inherited forms may be either isolated or associated with numerous genetic diseases or syndromes (e.g., Menkes disease, Björnstad syndrome, Netherton syndrome, and Bazex-Dupré-Christol syndrome). Moreover, pili torti may be a feature of various ectodermal dysplasias (such as Rapp-Hodgkin syndrome and Ankyloblepharon-ectodermal defects-cleft lip/palate syndrome). Acquired pili torti was described in numerous forms of alopecia (e.g., lichen planopilaris, discoid lupus erythematosus, dissecting cellulitis, folliculitis decalvans, alopecia areata) as well as neoplastic and systemic diseases (such as cutaneous T-cell lymphoma, scalp metastasis of breast cancer, anorexia nervosa, malnutrition, cataracts, and chronic graft-vs.-host disease). The condition may also be induced by several drugs (epidermal growth factor receptor inhibitors, oral retinoids, sodium valproate, and carbamide perhydrate). The diagnosis of pili torti is based on trichoscopic or microscopic examination. As pili torti is a marker of numerous congenital and acquired disorders, in every case, the search for the signs of underlying conditions is recommended.
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Kaczorowska A, Rudnicka L, Stefanato CM, Waskiel-Burnat A, Warszawik-Hendzel O, Olszewska M, Rakowska A. Diagnostic Accuracy of Trichoscopy in Trichotillomania: A Systematic Review. Acta Derm Venereol 2021; 101:adv00565. [PMID: 34184065 PMCID: PMC9425589 DOI: 10.2340/00015555-3859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Trichotillomania is formally classified as a mental health disorder, but it is commonly diagnosed by dermatologists. The aim of this systematic review is to assess the diagnostic value of trichoscopy in diagnosing trichotillomania. The analysis identified the 7 most specific trichoscopic features in trichotillomania. These features had the following prevalence and specificity: trichoptilosis (57.5%; 73/127 and 97.5%, respectively), v-sign (50.4%; 63/125 and 99%), hook hairs (43.1%; 28/65 and 100%), flame hairs (37.1%; 52/140 and 96.5%), coiled hairs (36.8%; 46/125 and 99.6%), tulip hairs (36.4%; 28/77 and 89.6%), and hair powder (35.6%; 42/118 and 97.9%). The 2 most common, but least specific, features were broken hairs and black dots. In conclusion, trichoscopy is a reliable new diagnostic method for hair loss caused by hair pulling. Trichoscopy should be included as a standard procedure in the differential diagnosis of trichotillomania in clinical practice.
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Yılmaz MA, Nasirov V, Kaya TI. Glomerular hair sign: New trichoscopic finding in a patient with trichothiodystrophy. Dermatol Ther 2020; 34:e14676. [PMID: 33320978 DOI: 10.1111/dth.14676] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/19/2020] [Accepted: 12/10/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Mustafa Anıl Yılmaz
- Department of Dermatology, Mersin University School of Medicine, Mersin, Turkey
| | - Vali Nasirov
- Department of Pathology, Mersin University School of Medicine, Mersin, Turkey
| | - Tamer Irfan Kaya
- Department of Dermatology, Mersin University School of Medicine, Mersin, Turkey
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30
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Kremer N, Martinez H, Leshem YA, Hodak E, Zer A, Brenner B, Amitay-Laish I. The trichoscopic features of hair shaft anomalies induced by epidermal growth factor receptor inhibitors: A case series. J Am Acad Dermatol 2020; 85:1178-1184. [PMID: 32244022 DOI: 10.1016/j.jaad.2020.03.055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 02/14/2020] [Accepted: 03/22/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Although the clinical hair changes that occur under treatment with epidermal growth factor receptor inhibitors (EGFRIs) are documented, their trichoscopic features have not been reported. OBJECTIVE To evaluate the trichoscopic findings in scalp and facial hair, induced by EGFRI treatment. METHODS Patients treated with EGFRIs at a tertiary oncodermatology clinic in 2015 through 2017 were evaluated for macroscopic and trichoscopic changes. RESULTS The cohort included 23 patients (13 women; median age, 68 years) treated with EGFRIs for an average of 13 months (range, 2-40 months). Macroscopically, 18 patients (78%) had dry, lusterless, coarse, kinky, brittle scalp hair, and 17 (74%) had trichomegaly of the eyebrows/eyelashes. Trichoscopic findings were of hair shaft anomalies including pili torti, affecting scalp hair in 20 patients (87%), eyebrows in 6 (26%), and eyelashes in 8 (50%), and asymmetric hyperpigmented fusiform widening of hair scalp in 3 (13%), eyebrows in 10 (43%), and eyelashes in 4 (25%). Dermoscopic findings of the peri- and interfollicular skin were scale, whitish erythematous structureless areas, and branching vessels. LIMITATIONS Lack of trichoscopic-histologic correlation, lack of baseline examination. CONCLUSION The trichoscopic correlates of the macroscopic hair changes under EFGRI treatment include pili torti, and asymmetric hyperpigmented fusiform widening, with dermoscopic cutaneous manifestations of scale, whitish erythematous structureless areas, and branching vessels.
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Affiliation(s)
- Noa Kremer
- Division of Dermatology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
| | - Helena Martinez
- Division of Dermatology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Anne Leshem
- Division of Dermatology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Emmilia Hodak
- Division of Dermatology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alona Zer
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Institute of Oncology, Davidoff Cancer Center, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
| | - Baruch Brenner
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Institute of Oncology, Davidoff Cancer Center, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
| | - Iris Amitay-Laish
- Division of Dermatology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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31
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Waśkiel-Burnat A, Rakowska A, Sikora M, Ciechanowicz P, Olszewska M, Rudnicka L. Trichoscopy of Tinea Capitis: A Systematic Review. Dermatol Ther (Heidelb) 2020; 10:43-52. [PMID: 31907867 PMCID: PMC6994564 DOI: 10.1007/s13555-019-00350-1] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION An increased incidence of tinea capitis has been observed over the last few decades. Trichoscopy is a non-invasive, in-office method helpful in establishing the correct diagnosis in patients with hair loss and inflammatory hair disorders. The objective was to review and analyze current data on the trichoscopy of tinea capitis. METHODS A systematic review of the literature was conducted using the PubMed, EBSCO and Scopus databases. The search terms included 'tinea capitis' combined with 'trichoscopy', 'dermatoscopy', 'dermoscopy', 'videodermatoscopy' or 'videodermoscopy'. RESULTS Of 326 articles, 37 were considered eligible for the quantitative analysis. The most characteristic (with a high predictive value) trichoscopic findings of tinea capitis included comma hairs (51%), corkscrew hairs (32%), Morse code-like hairs (22%), zigzag hairs (21%), bent hairs (27%), block hairs (10%) and i-hairs (10%). Other common, but not characteristic, trichoscopic features were broken hairs (57%), black dots (34%), perifollicular scaling (59%) and diffuse scaling (89%). Morse code-like hairs, zigzag hairs, bent hairs and diffuse scaling were only observed in Microsporum tinea capitis (8/29, 28%; 6/29, 21%; 4/29, 14% and 4/29, 14%, respectively). In Trichophyton tinea capitis, corkscrew hairs were more commonly detected compared to Microsporum tinea capitis (21/38, 55% vs 3/29, 10%). CONCLUSION The presence of characteristic trichoscopic features of tinea capitis is sufficient to establish the initial diagnosis and introduce treatment before culture results are available. Trichoscopy may be useful in distinguishing between Microsporum and Trichophyton tinea capitis.
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Affiliation(s)
| | - Adriana Rakowska
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland.
| | - Mariusz Sikora
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | | | | | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
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Ahmed A, Almohanna H, Griggs J, Tosti A. Genetic Hair Disorders: A Review. Dermatol Ther (Heidelb) 2019; 9:421-448. [PMID: 31332722 PMCID: PMC6704196 DOI: 10.1007/s13555-019-0313-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Indexed: 12/23/2022] Open
Abstract
Hair loss in early childhood represents a broad differential diagnosis which can be a diagnostic and therapeutic challenge for a physician. It is important to consider the diagnosis of a genetic hair disorder. Genetic hair disorders are a large group of inherited disorders, many of which are rare. Genetic hair abnormalities in children can be an isolated phenomenon or part of genetic syndromes. Hair changes may be a significant finding or even the initial presentation of a syndrome giving a clue to the diagnosis, such as Netherton syndrome and trichothiodystrophy. Detailed history including family history and physical examination of hair and other ectodermal structures such as nails, sweat glands, and sebaceous glands with the use of dermoscopic devices and biopsy all provide important clues to establish the correct diagnosis. Understanding the pathophysiology of genetic hair defects will allow for better comprehension of their treatment and prognosis. For example, in patients with an isolated hair defect, the main problem is aesthetic. In contrast, when the hair defect is associated with a syndrome, the prognosis will depend mainly on the associated condition. Treatment of many genetic hair disorders is focused on treating the primary cause and minimizing trauma to the hair.
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Affiliation(s)
- Azhar Ahmed
- Department of Dermatology, King Fahad General Hospital, Medina, Saudi Arabia.
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, University of Miami Hospital, Miami, FL, USA.
| | - Hind Almohanna
- Department of Dermatology and Dermatologic Surgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Jacob Griggs
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, University of Miami Hospital, Miami, FL, USA
| | - Antonella Tosti
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, University of Miami Hospital, Miami, FL, USA
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Ferrari B, Vincenzi C, Tosti A. Pili Torti as a Sign of Eyebrow Involvement in Frontal Fibrosing Alopecia. Skin Appendage Disord 2019; 5:393-395. [PMID: 31799271 DOI: 10.1159/000502059] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 07/11/2019] [Indexed: 12/19/2022] Open
Abstract
Frontal fibrosing alopecia (FFA) is a disease characterized by progressive band-like scarring alopecia involving the frontotemporal hairline and eyebrow hair loss. It affects mainly postmenopausal women. Trichoscopy features of FFA include absence of vellus hair, perifollicular erythema and scaling (peri-pilar casts), and absence of follicular openings. Trichoscopy of eyebrows in FFA patients shows tapered and broken hair, absence of follicular openings, black dots, and hair growing in different directions. We report a case of FFA with numerous pili torti in the eyebrows.
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Affiliation(s)
- Bruno Ferrari
- Dermatology Service, Hospital Ramos Mejía, Universidad de Buenos Aires, Buenos Aires, Argentina
| | | | - Antonella Tosti
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
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