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Melián-Olivera A, Moreno-Arrones Ó, Burgos-Blasco P, Hermosa-Gelbard Á, Jaén-Olasolo P, Vañó-Galván S, Saceda-Corralo D. Clinical Characterization and Treatment Response of Folliculitis Decalvans Lichen Planopilaris Phenotypic Spectrum: A Unicentre Retrospective Series of 31 Patients. Acta Derm Venereol 2024; 104:adv12373. [PMID: 38372472 PMCID: PMC10896096 DOI: 10.2340/actadv.v104.12373] [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: 04/23/2023] [Accepted: 01/10/2024] [Indexed: 02/20/2024] Open
Abstract
Folliculitis decalvans and lichen planopilaris phenotypic spectrum has been described as a form of cicatricial alopecia. The aim of this study is to describe the clinical and trichoscopic features and therapeutic management of this condition in a series of patients. A retrospective observational unicentre study was designed including patients with folliculitis decalvans and lichen planopilaris phenotypic spectrum confirmed with biopsy. A total of 31 patients (20 females) were included. The most common presentation was an isolated plaque of alopecia (61.3%) in the vertex. Trichoscopy revealed hair tufting with perifollicular white scaling in all cases. The duration of the condition was the only factor associated with large plaques (grade III) of alopecia (p = 0.026). The mean time to transition from the classic presentation of folliculitis decalvans to folliculitis decalvans and lichen planopilaris phenotypic spectrum was 5.2 years. The most frequently used treatments were topical steroids (80.6%), intralesional steroids (64.5%) and topical antibiotics (32.3%). Nine clinical relapses were detected after a mean time of 18 months (range 12-23 months). Folliculitis decalvans and lichen planopilaris phenotypic spectrum is an infrequent, but probably underdiagnosed, cicatricial alopecia. Treatment with anti-inflammatory drugs used for lichen planopilaris may be an adequate approach.
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Affiliation(s)
- Ana Melián-Olivera
- Department of Dermatology, University Hospital Ramón y Cajal, Madrid, Spain; Trichology Unit, Grupo de Dermatología Pedro Jaén, Madrid, Spainm
| | - Óscar Moreno-Arrones
- Department of Dermatology, University Hospital Ramón y Cajal, Madrid, Spain; Trichology Unit, Grupo de Dermatología Pedro Jaén, Madrid, Spain
| | - Patricia Burgos-Blasco
- Department of Dermatology, University Hospital Ramón y Cajal, Madrid, Spain; Trichology Unit, Grupo de Dermatología Pedro Jaén, Madrid, Spain
| | - Ángela Hermosa-Gelbard
- Department of Dermatology, University Hospital Ramón y Cajal, Madrid, Spain; Trichology Unit, Grupo de Dermatología Pedro Jaén, Madrid, Spain
| | - Pedro Jaén-Olasolo
- Department of Dermatology, University Hospital Ramón y Cajal, Madrid, Spain; Trichology Unit, Grupo de Dermatología Pedro Jaén, Madrid, Spain
| | - Sergio Vañó-Galván
- Department of Dermatology, University Hospital Ramón y Cajal, Madrid, Spain; Trichology Unit, Grupo de Dermatología Pedro Jaén, Madrid, Spain.
| | - David Saceda-Corralo
- Department of Dermatology, University Hospital Ramón y Cajal, Madrid, Spain; Trichology Unit, Grupo de Dermatología Pedro Jaén, Madrid, Spain
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2
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Karrakchou B, Fliti A, El Fiboumi A, Kettani F, Senouci K, Meziane M. Folliculitis Decalvans with Frontal Fibrosing Alopecia in a Dark Phototype: Presentation of Folliculitis Decalvans and Lichen Planopilaris Phenotypic Spectrum. Dermatol Pract Concept 2023; 13:dpc.1304a229. [PMID: 37992391 PMCID: PMC10656122 DOI: 10.5826/dpc.1304a229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2023] [Indexed: 11/24/2023] Open
Affiliation(s)
- Basma Karrakchou
- Dermatology and Venereology Department, Ibn Sina Hospital, Mohammed V University of Rabat, Morocco
| | - Amani Fliti
- Dermatology and Venereology Department, Ibn Sina Hospital, Mohammed V University of Rabat, Morocco
| | - Amal El Fiboumi
- Department of medicine, Moulay Youssef Hospital, Mohammed V University of Rabat, Morocco
| | - Fouad Kettani
- Histopathology Center of the United Nations, Rabat, Morocco
| | - Karima Senouci
- Dermatology and Venereology Department, Ibn Sina Hospital, Mohammed V University of Rabat, Morocco
| | - Mariame Meziane
- Dermatology and Venereology Department, Ibn Sina Hospital, Mohammed V University of Rabat, Morocco
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3
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Neves Souza E, Martins Diniz L, Amaral de Moura L, Dos Anjos Bortolini B. Folliculitis Decalvans and Lichen Planopilaris Phenotypic Spectrum With Pityriasis Amiantacea: A Challenging Diagnosis. ACTAS DERMO-SIFILIOGRAFICAS 2023:S0001-7310(23)00692-0. [PMID: 37683802 DOI: 10.1016/j.ad.2023.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 11/21/2022] [Accepted: 01/28/2023] [Indexed: 09/10/2023] Open
Affiliation(s)
- E Neves Souza
- Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil; Hospital Universitário Cassiano Antônio Moraes (HUCAM), Vitória, ES, Brazil.
| | - L Martins Diniz
- Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil
| | - L Amaral de Moura
- Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil; Hospital Universitário Cassiano Antônio Moraes (HUCAM), Vitória, ES, Brazil
| | - B Dos Anjos Bortolini
- Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil; Hospital Universitário Cassiano Antônio Moraes (HUCAM), Vitória, ES, Brazil
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4
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Umar S, Waterman A, Ton D, Shitabata P. Refractory Folliculitis Decalvans Treatment Success with a Novel Surgical Excision Approach Using Guarded High-Tension Sutures. Clin Cosmet Investig Dermatol 2023; 16:2381-2390. [PMID: 37675182 PMCID: PMC10478779 DOI: 10.2147/ccid.s422077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 08/20/2023] [Indexed: 09/08/2023]
Abstract
Purpose Folliculitis decalvans (FD) is a difficult-to-treat, localized scarring alopecia characterized by an expanding area of chronically inflamed purulent plaques or masses. Current treatment modalities vary and often result in only temporary remission. There are no reports of surgical therapies for FD. Here, we describe FD treatment using surgical excision and second-intention healing aided by guarded high-tension sutures. Methods Five patients (one woman and four men) with histologically confirmed FD were treated by surgical lesion excision. All wounds were allowed to heal via second-intention. Guarded high-tension sutures were employed to minimize tissue tears while aiding and guiding wound contraction. Results All wounds healed with a 47-83% spatial contraction of the maximum wound diameters. Three patients healed entirely by second-intention, while two required a minor skin graft to close the wound completely. No disease recurrence was noted at 10-24 months. Conclusion Surgical excision with second-intention healing aided by guarded high-tension sutures effectively treated small and extensive FD lesions with no recurrence at long-term follow-up. To our knowledge, this is the first report of successful surgical treatment of FD.
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Affiliation(s)
- Sanusi Umar
- Department of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
- Division of Dermatology, Department of Medicine, Harbor-UCLA Medical Center, Torrance, CA, USA
- Dr. U Hair and Skin Clinic, Manhattan Beach, CA, USA
| | - Ade Waterman
- Dr. U Hair and Skin Clinic, Manhattan Beach, CA, USA
| | - Donna Ton
- Dr. U Hair and Skin Clinic, Manhattan Beach, CA, USA
| | - Paul Shitabata
- Department of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
- Division of Dermatology, Department of Medicine, Harbor-UCLA Medical Center, Torrance, CA, USA
- Dermatopathology Institute, Torrance, CA, USA
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5
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Umar S, Ton D, Carter MJ, Shitabata P. Unveiling a Shared Precursor Condition for Acne Keloidalis Nuchae and Primary Cicatricial Alopecias. Clin Cosmet Investig Dermatol 2023; 16:2315-2327. [PMID: 37649568 PMCID: PMC10464825 DOI: 10.2147/ccid.s422310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/18/2023] [Indexed: 09/01/2023]
Abstract
Purpose Small observational studies suggest subclinical disease occurrence in the normal-appearing scalp zones of several primary cicatricial alopecias. To aid patient management, we began routinely evaluating the entire scalp of patients with acne keloidalis nuchae (AKN), including trichoscopy-guided biopsies. Patients and Methods This retrospective study evaluated 41 patients sequentially presenting with AKN at a single clinic between June and December 2022. Primary lesions and normal-appearing scalp in the superior parietal scalp at least 5 cm away from AKN-affected zones were clinically evaluated, and areas showing perifollicular erythema or scales/casts on trichoscopy were biopsied and histologically analyzed. Results Forty-one men with AKN, including 20 men of African descent, 17 Hispanic, and 4 European-descended Whites, were evaluated. All patients, including 22% with associated folliculitis decalvans, showed scalp-wide trichoscopy signs of perifollicular erythema or scaling in normal-appearing scalp areas. All patients showed histologic evidence of perifollicular infundibulo-isthmic lymphocytoplasmic infiltrates and fibrosis (PIILIF), with 96% showing Vellus or miniaturized hair absence. PIILIF was often clinically mistaken for seborrheic dermatitis (44-51%). All White patients had mild papular acne keloidalis nuchae lesions mistaken for seborrheic dermatitis. Conclusion PIILIF may be a precursor to a wide spectrum of primary cicatricial alopecias, including AKN and folliculitis decalvans. This finding carries implications for the early diagnosis and management of AKN and other primary cicatricial alopecias.
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Affiliation(s)
- Sanusi Umar
- Department of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
- Division of Dermatology, Department of Medicine, Harbor-UCLA Medical Center, Torrance, CA, USA
- Dr. U Hair and Skin Clinic, Manhattan Beach, CA, USA
| | - Donna Ton
- Dr. U Hair and Skin Clinic, Manhattan Beach, CA, USA
| | | | - Paul Shitabata
- Department of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
- Division of Dermatology, Department of Medicine, Harbor-UCLA Medical Center, Torrance, CA, USA
- Dermatopathology Institute, Torrance, CA, USA
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6
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Kinoshita-Ise M, Fukuyama M, Ohyama M. Recent Advances in Understanding of the Etiopathogenesis, Diagnosis, and Management of Hair Loss Diseases. J Clin Med 2023; 12:jcm12093259. [PMID: 37176700 PMCID: PMC10179687 DOI: 10.3390/jcm12093259] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 04/26/2023] [Accepted: 04/29/2023] [Indexed: 05/15/2023] Open
Abstract
Hair-loss diseases comprise heterogenous conditions with respective pathophysiology and clinicopathological characteristics. Major breakthroughs in hair follicle biology and immunology have led to the elucidation of etiopathogenesis of non-scarring alopecia (e.g., alopecia areata, AA) and cicatricial alopecia (e.g., lichen planopilaris, LPP). High-throughput genetic analyses revealed molecular mechanism underlying the disease susceptibility of hair loss conditions, such as androgenetic alopecia (AGA) and female pattern hair loss (FPHL). Hair loss attracted public interest during the COVID-19 pandemic. The knowledge of hair loss diseases is robustly expanding and thus requires timely updates. In this review, the diagnostic and measurement methodologies applied to hair loss diseases are updated. Of note, novel criteria and classification/scoring systems published in the last decade are reviewed, highlighting their advantages over conventional ones. Emerging diagnostic techniques are itemized with clinical pearls enabling efficient utilization. Recent advances in understanding the etiopathogenesis and management for representative hair diseases, namely AGA, FPHL, AA, and major primary cicatricial alopecia, including LPP, are comprehensively summarized, focusing on causative factors, genetic predisposition, new disease entity, and novel therapeutic options. Lastly, the association between COVID-19 and hair loss is discussed to delineate telogen effluvium as the predominating pathomechanism accounting for this sequela.
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Affiliation(s)
- Misaki Kinoshita-Ise
- Department of Dermatology, Kyorin University Faculty of Medicine, Tokyo 181-8611, Japan
| | - Masahiro Fukuyama
- Department of Dermatology, Kyorin University Faculty of Medicine, Tokyo 181-8611, Japan
| | - Manabu Ohyama
- Department of Dermatology, Kyorin University Faculty of Medicine, Tokyo 181-8611, Japan
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7
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Case for diagnosis. Cicatricial alopecia on the vertex - Folliculitis decalvans and lichen planopilaris phenotypic spectrum. An Bras Dermatol 2023:S0365-0596(23)00047-8. [PMID: 36894349 DOI: 10.1016/j.abd.2021.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 03/09/2023] Open
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8
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[Translated article] Chronic Lichenoid Folliculitis Decalvans. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:T968-T969. [DOI: 10.1016/j.ad.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 07/18/2021] [Indexed: 11/05/2022] Open
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9
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Zhang X, Zhu M, Zhou J, Wu S, Liu J, Qin Q. Folliculitis Decalvans and Lichen Planopilaris Phenotypic Spectrum: A Case Report. Clin Cosmet Investig Dermatol 2022; 15:993-996. [PMID: 35677221 PMCID: PMC9167836 DOI: 10.2147/ccid.s365566] [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: 03/08/2022] [Accepted: 05/26/2022] [Indexed: 11/23/2022]
Abstract
The folliculitis decalvans (FD) and lichen planopilaris (LPP) phenotypic spectrum combines biphasic features of FD and LPP. It is characterized by successive or concomitant occurrence of pustules, crusts, follicular tufts, perifollicular erythema, perifollicular scales, and cicatricial alopecia and includes mixed histologic features of both FD and LPP. Here, we report the case of a 33-year-old female patient with a 30-year history of FD-LPP phenotypic spectrum lesions.
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Affiliation(s)
- Xi Zhang
- Department of Dermatology, The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, People's Republic of China
| | - Mingfang Zhu
- Department of Dermatology, The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, People's Republic of China
| | - Jia Zhou
- Department of Dermatology, The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, People's Republic of China
| | - Shuhui Wu
- Department of Dermatology, The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, People's Republic of China
| | - Juan Liu
- Department of Dermatology, The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, People's Republic of China
| | - Qiuyan Qin
- Department of Dermatology, The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, People's Republic of China
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10
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López Mateos A, Plata Clemente S, Guerrero Ramírez C, Azaña Defez J. Foliculitis decalvante liquenoide crónica. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:968-969. [DOI: 10.1016/j.ad.2021.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 07/18/2021] [Indexed: 10/18/2022] Open
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11
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Uchiyama M. Primary cicatricial alopecia: Recent advances in evaluation and diagnosis based on trichoscopic and histopathological observation, including overlapping and specific features. J Dermatol 2021; 49:37-54. [PMID: 34866229 DOI: 10.1111/1346-8138.16252] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 11/04/2021] [Accepted: 11/09/2021] [Indexed: 12/27/2022]
Abstract
Primary cicatricial alopecia (PCA) is a form of alopecia in which inflammatory cells target follicles, including the bulge region containing follicular stem cells, leading to permanent alopecia. New classifications of PCA subtypes have recently been proposed, including those that account for novel trichoscopic and histopathological features of PCA, enabling greater precision in the evaluation and diagnosis of this condition. Nonetheless, diagnosis remains challenging clinically and histopathologically because the etiology of PCA is multifactorial. Inconsistent use of terminology, overlapping disease concepts, and changes in the clinical or histopathological severity of inflammation in the disease course in the same patient also make diagnosis quite challenging. The present study comprehensively reviews recent progress in diagnostic techniques, including the use of clinical, trichoscopic, and histopathological features, in evaluating each PCA subtype, containing overlapping and specific features. Elucidating the features of PCA, including those that are common to multiple subtypes as well as specific to each in both early and advanced-stage lesions, is important for accurate diagnosis. Improving the evaluation and treatment of this disease depends on having a broader clinical understanding that takes into account not only the features of the disease at a given point in time, but also the changes that occur during the entire disease course.
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Affiliation(s)
- Masaki Uchiyama
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
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12
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Doche I, Hordinsky MK, Valente NS, Sotto MN, Miotto I, Rebeis M, Rivitti-Machado MC. Evidence for lymphocytic inflammation in non-lesional scalp of folliculitis decalvans: an observational study of 25 patients. J Eur Acad Dermatol Venereol 2021; 36:e109-e111. [PMID: 34510547 DOI: 10.1111/jdv.17649] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 09/02/2021] [Indexed: 02/04/2023]
Affiliation(s)
- I Doche
- Department of Dermatology, University of Sao Paulo Medical School, São Paulo, Brazil
| | - M K Hordinsky
- Department of Dermatology, University of Minnesota Medical School, São Paulo, Brazil
| | - N S Valente
- Department of Dermatology, University of Sao Paulo Medical School, São Paulo, Brazil
| | - M N Sotto
- Department of Pathology, University of Sao Paulo Medical School, São Paulo, Brazil
| | - I Miotto
- Department of Dermatology, University of Sao Paulo Medical School, São Paulo, Brazil
| | - M Rebeis
- Department of Dermatology, University of Sao Paulo Medical School, São Paulo, Brazil
| | - M C Rivitti-Machado
- Department of Dermatology, University of Sao Paulo Medical School, São Paulo, Brazil
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13
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Trüeb RM. Comment on: folliculitis decalvans and lichen planopilaris phenotypic spectrum: a case report of two paediatric cases. J Eur Acad Dermatol Venereol 2021; 35:e888-e889. [PMID: 34310760 DOI: 10.1111/jdv.17537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/21/2021] [Indexed: 12/01/2022]
Affiliation(s)
- R M Trüeb
- Center for Dermatology and Hair Diseases Professor Trüeb, Wallisellen-Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
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14
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Ramos PM, Melo DF, Lemes LR, Alcantara G, Miot HA, Lyra MR, Vargas TJDS. Folliculitis decalvans and lichen planopilaris phenotypic spectrum: case report of two paediatric cases. J Eur Acad Dermatol Venereol 2021; 35:e674-e676. [PMID: 34014598 DOI: 10.1111/jdv.17379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/26/2021] [Accepted: 04/28/2021] [Indexed: 01/05/2023]
Affiliation(s)
- P M Ramos
- Department of Dermatology and Radiotherapy, São Paulo State University (UNESP), Botucatu, Brazil
| | - D F Melo
- Department of Dermatology, University of State of Rio de Janeiro - UERJ, Brazil
| | - L R Lemes
- Department of Dermatology, University of State of Rio de Janeiro - UERJ, Brazil
| | - G Alcantara
- Department of Dermatology and Radiotherapy, São Paulo State University (UNESP), Botucatu, Brazil
| | - H A Miot
- Department of Dermatology and Radiotherapy, São Paulo State University (UNESP), Botucatu, Brazil
| | - M R Lyra
- Oswaldo Cruz Foundation - Infectious Disease in Dermatology, Rio de Janeiro, Brazil
| | - T J de S Vargas
- Department of Dermatology, Federal Hospital of Bonsucesso, Rio de Janeiro, Brazil
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15
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A Cell Membrane-Level Approach to Cicatricial Alopecia Management: Is Caveolin-1 a Viable Therapeutic Target in Frontal Fibrosing Alopecia? Biomedicines 2021; 9:biomedicines9050572. [PMID: 34069454 PMCID: PMC8159142 DOI: 10.3390/biomedicines9050572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/05/2021] [Accepted: 05/17/2021] [Indexed: 12/12/2022] Open
Abstract
Irreversible destruction of the hair follicle (HF) in primary cicatricial alopecia and its most common variant, frontal fibrosing alopecia (FFA), results from apoptosis and pathological epithelial-mesenchymal transition (EMT) of epithelial HF stem cells (eHFSCs), in conjunction with the collapse of bulge immune privilege (IP) and interferon-gamma-mediated chronic inflammation. The scaffolding protein caveolin-1 (Cav1) is a key component of specialized cell membrane microdomains (caveolae) that regulates multiple signaling events, and even though Cav1 is most prominently expressed in the bulge area of human scalp HFs, it has not been investigated in any cicatricial alopecia context. Interestingly, in mice, Cav1 is involved in the regulation of (1) key HF IP guardians (TGF-β and α-MSH signaling), (2) IP collapse inducers/markers (IFNγ, substance P and MICA), and (3) EMT. Therefore, we hypothesize that Cav1 may be an unrecognized, important player in the pathobiology of cicatricial alopecias, and particularly, in FFA, which is currently considered as the most common type of primary lymphocytic scarring alopecia in the world. We envision that localized therapeutic inhibition of Cav1 in management of FFA (by cholesterol depleting agents, i.e., cyclodextrins/statins), could inhibit and potentially reverse bulge IP collapse and pathological EMT. Moreover, manipulation of HF Cav1 expression/localization would not only be relevant for management of cicatricial alopecia, but FFA could also serve as a model disease for elucidating the role of Cav1 in other stem cell- and/or IP collapse-related pathologies.
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16
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Matard B, Cavelier Balloy B, Assouly P, Reygagne P. It has the Erythema of a Lichen Planopilaris, it has the Hyperkeratosis of a Lichen Planopilaris, but it is Not a Lichen Planopilaris: About the "Lichen Planopilaris-Like" Form of Folliculitis Decalvans. Am J Dermatopathol 2021; 43:235-236. [PMID: 32769552 DOI: 10.1097/dad.0000000000001758] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Bruno Matard
- Centre Sabouraud, Hôpital Saint-Louis, Paris, France ; and
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17
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Bohnett MC, Kolivras A, Thompson AA, Thompson CT. Epidermal thickness is useful in distinguishing lichen planopilaris from neutrophil-poor/lymphocyte-predominant folliculitis decalvans. J Cutan Pathol 2021; 48:816-818. [PMID: 33382483 DOI: 10.1111/cup.13950] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/09/2020] [Accepted: 12/13/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Mary Clare Bohnett
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | - Athanassios Kolivras
- Department of Dermatology and Dermatopathology, Saint-Pierre, Brugmann and Queen Fabiola Children's University Hospitals, Université Libre de Bruxelles, Brussels, Belgium
| | - Abigail A Thompson
- Department of Chemistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Curtis T Thompson
- CTA Pathology, Portland, Oregon, USA.,Department of Dermatology and Pathology, Oregon Health and Science University, Portland, Oregon, USA
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18
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Moreno-Arrones OM, Campo RD, Saceda-Corralo D, Jimenez-Cauhe J, Ponce-Alonso M, Serrano-Villar S, Jaén P, Paoli J, Vañó-Galván S. Folliculitis decalvans microbiological signature is specific for disease clinical phenotype. J Am Acad Dermatol 2020; 85:1355-1357. [PMID: 33144151 DOI: 10.1016/j.jaad.2020.10.073] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/20/2020] [Accepted: 10/25/2020] [Indexed: 10/23/2022]
Affiliation(s)
- O M Moreno-Arrones
- Dermatology Department, Trichology Unit, Ramon y Cajal University Hospital, University of Alcala, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; Trichology and Hair Transplantation Unit, Grupo Pedro Jaen Clinic, Madrid, Spain.
| | - R Del Campo
- Microbiology Department, Ramon y Cajal University Hospital, University of Alcala, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain. Red Española de Investigación en Patología Infecciosa (REIPI), Madrid, Spain
| | - D Saceda-Corralo
- Dermatology Department, Trichology Unit, Ramon y Cajal University Hospital, University of Alcala, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; Trichology and Hair Transplantation Unit, Grupo Pedro Jaen Clinic, Madrid, Spain
| | - J Jimenez-Cauhe
- Dermatology Department, Trichology Unit, Ramon y Cajal University Hospital, University of Alcala, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - M Ponce-Alonso
- Microbiology Department, Ramon y Cajal University Hospital, University of Alcala, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain. Red Española de Investigación en Patología Infecciosa (REIPI), Madrid, Spain
| | - S Serrano-Villar
- Department of Infectious Diseases Ramon y Cajal University Hospital, University of Alcala, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - P Jaén
- Dermatology Department, Trichology Unit, Ramon y Cajal University Hospital, University of Alcala, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; Trichology and Hair Transplantation Unit, Grupo Pedro Jaen Clinic, Madrid, Spain
| | - John Paoli
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Region Västra Götaland, Sahlgrenska University Hospital, Department of Dermatology and Venereology, Gothenburg, Sweden
| | - S Vañó-Galván
- Dermatology Department, Trichology Unit, Ramon y Cajal University Hospital, University of Alcala, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; Trichology and Hair Transplantation Unit, Grupo Pedro Jaen Clinic, Madrid, Spain
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19
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Fernandez-Flores A, Hermosa-Gelbard A, Novo-Lens R. Lichen-planopilaris-like scarring pattern in a patient with alopecia and pityriasis rubra pilaris. J Cutan Pathol 2020; 48:133-139. [PMID: 32949041 DOI: 10.1111/cup.13879] [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: 03/16/2020] [Revised: 08/25/2020] [Accepted: 09/01/2020] [Indexed: 11/27/2022]
Abstract
Pityriasis rubra pilaris (PRP) is an erythematous-desquamative dermatitis that is sometimes associated with non-scarring alopecia. Despite the fact that the disease can be disfiguring, scarring alopecia has rarely been described in this disease. Here, we present a 69-year-old woman who developed an erythrodermic episode of PRP associated with telogen effluvium that left an area of persistent alopecia of the scalp and resulted in hair loss in the eyebrows. The biopsy of that area of the scalp demonstrated a scarring alopecia with lichen-planopilaris-like features. Despite this histopathology, the alopecia responded well to treatment. This finding expands the context in which lichen planopilaris features can be found and demonstrates their good prognosis under early treatment.
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Affiliation(s)
- Angel Fernandez-Flores
- Department of Cellular Pathology, Hospital El Bierzo, Ponferrada, Spain.,Department of Cellular Pathology, Hospital de la Reina, Ponferrada, Spain.,Research Department, Institute for Biomedical Research of A Coruña (INIBIC), University of A Coruña (UDC), A Coruña, Spain
| | - Angela Hermosa-Gelbard
- Dermatology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain.,Dermatology Department, Hospital Universitario Quirón San José, Madrid, Spain.,Dermatology Department, Hospital Universitario HM Montepríncipe, Madrid, Spain
| | - Raquel Novo-Lens
- Dermatology Department, Hospital Universitario HM Montepríncipe, Madrid, Spain
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Mazzilli S, Vollono L, Tassone F, Cappilli S, Peris K, Bianchi L. Reflectance Confocal Microscopy Applied to Folliculitis Decalvans: Preliminary Results of a Multicenter Study. Skin Appendage Disord 2020; 6:202-206. [DOI: 10.1159/000507655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 04/01/2020] [Indexed: 11/19/2022] Open
Abstract
Although trichoscopic criteria indicative of disease severity and inflammatory activity have been recently proposed, the potential use of reflectance confocal microscopy (RCM) in the evaluation of the inflammatory stage of FD has never been published to date. Our study investigated RCM features of 14 patients with a histopathological diagnosis of FD, evaluating clinical and trichoscopic findings. RCM findings were divided into 2 main patterns: “follicular” and “interfollicular.” Our results suggest a potential role for RCM as a noninvasive, fast technique for a complementary investigation in the diagnostic process, as well as in the therapeutic management decision.
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