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George MN, Seervai RN, Chon SY. Erosive pustular dermatosis-like eruption of the scalp secondary to amivantamab: A case series. JAAD Case Rep 2024; 47:72-79. [PMID: 38659476 PMCID: PMC11039775 DOI: 10.1016/j.jdcr.2023.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024] Open
Affiliation(s)
- Mariya N. George
- Department of Dermatology, University of Texas Health Science Center, McGovern Medical School at UTHealth Houston, Houston, Texas
| | - Riyad N.H. Seervai
- Department of Internal Medicine, Providence Portland Medical Center, Portland, Oregon
- Department of Dermatology, Oregon Health and Science University, Portland, Oregon
| | - Susan Y. Chon
- Department of Dermatology, University of Texas Health Science Center, McGovern Medical School at UTHealth Houston, Houston, Texas
- Department of Dermatology, MD Anderson Cancer Center, Houston, Texas
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2
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Kim JS, Chae SW, Lee GY, Choi YJ. Erosive Pustular Dermatosis of the Scalp Arising on Long-Standing Burn Scars: A Report of Three Cases and Brief Review of Literature. Skin Appendage Disord 2024; 10:69-73. [PMID: 38313567 PMCID: PMC10836929 DOI: 10.1159/000533965] [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: 04/13/2023] [Accepted: 08/18/2023] [Indexed: 02/06/2024] Open
Abstract
Introduction Erosive pustular dermatosis of the scalp (EPDS) is a rare and recalcitrant condition in which chronic scalp pustules and erosive patches are diagnosed by nondiagnostic laboratory tests and histopathological tests. Although various precipitating factors including trauma have been reported, erosive pustular dermatosis arising on the long-standing burn scars is rare. Case Presentation We report three cases of EPDS arising on long-standing burn scars. Based on clinical and histological findings, erosive pustular dermatosis was diagnosed and successfully treated with topical steroid ointment. Conclusion We propose that chronic burn scar is another precipitating factors for EPDS and clinicians should consider EPDS in differential diagnoses of erosive pustular dermatosis in long-standing burn scars on the scalp.
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Affiliation(s)
- Jin Seop Kim
- Department of Dermatology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Seoung Wan Chae
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ga-Young Lee
- Department of Dermatology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Young-Jun Choi
- Department of Dermatology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
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3
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Shamloul N, Kamrani P, Shamloul G, Kunselman A, Thiboutot D, Billingsley E, Lam C. Incidence and time to development of malignancies arising on the scalp of patients with erosive pustular dermatosis based on sex: A retrospective analysis. J Am Acad Dermatol 2023; 89:1038-1039. [PMID: 37321482 DOI: 10.1016/j.jaad.2023.05.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/22/2023] [Accepted: 05/28/2023] [Indexed: 06/17/2023]
Affiliation(s)
- Norhan Shamloul
- Department of Dermatology, Penn State Hershey Medical Center, Hershey, Pennsylvania
| | - Payvand Kamrani
- Department of Dermatology, Penn State Hershey Medical Center, Hershey, Pennsylvania
| | - Gelan Shamloul
- Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania
| | - Allen Kunselman
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania
| | - Diane Thiboutot
- Department of Dermatology, Penn State Hershey Medical Center, Hershey, Pennsylvania
| | | | - Charlene Lam
- Department of Dermatology, Penn State Hershey Medical Center, Hershey, Pennsylvania.
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4
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Ma X, Ma DL. An 81-Year-Old Woman With Erosions and Pustules Affecting Her Scalp. Clin Infect Dis 2023; 77:460-463. [PMID: 37579722 DOI: 10.1093/cid/ciac906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2023] Open
Affiliation(s)
- Xiao Ma
- Department of Dermatology, Peking Union Medical College Hospital, State Key Laboratory of Complex Severe and Rare Diseases, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, PR China
| | - Dong-Lai Ma
- Department of Dermatology, Peking Union Medical College Hospital, State Key Laboratory of Complex Severe and Rare Diseases, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, PR China
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5
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Yamashita C, Arase N, Fukushima K, Ueda-Hayakawa I, Tonomura K, Tanemura A, Sakai H, Fujimoto M. A case of erosive pustular dermatosis of the scalp following bullous pemphigoid in a hematopoietic stem cell transplant recipient. J Dermatol 2023; 50:e218-e219. [PMID: 36794550 DOI: 10.1111/1346-8138.16743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 01/20/2023] [Accepted: 01/24/2023] [Indexed: 02/17/2023]
Affiliation(s)
- Chigusa Yamashita
- Department of Dermatology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Noriko Arase
- Department of Dermatology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kentaro Fukushima
- Department of Hematology and Oncology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Ikuko Ueda-Hayakawa
- Department of Dermatology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kyoko Tonomura
- Department of Dermatology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Atsushi Tanemura
- Department of Dermatology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hiroshi Sakai
- Department of Dermatology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Manabu Fujimoto
- Department of Dermatology, Osaka University Graduate School of Medicine, Osaka, Japan
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6
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Salah NB, Aounallah A, Douh L, Trimeche K, Sriha B, Denguesli M. Erosive pustular dermatosis of the scalp in the COVID-19 era. J Cosmet Dermatol 2023; 22:42-44. [PMID: 36374803 DOI: 10.1111/jocd.15495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 09/28/2022] [Accepted: 10/23/2022] [Indexed: 11/15/2022]
Affiliation(s)
- Nesrine Ben Salah
- Dermatology Department, Farhat Hached University Hospital, University of Sousse, Sousse, Tunisia
| | - Amina Aounallah
- Dermatology Department, Farhat Hached University Hospital, University of Sousse, Sousse, Tunisia
| | - Lella Douh
- Dermatology Department, Farhat Hached University Hospital, University of Sousse, Sousse, Tunisia
| | - Khaoula Trimeche
- Dermatology Department, Farhat Hached University Hospital, University of Sousse, Sousse, Tunisia
| | - Badreddine Sriha
- Anatomopathology Department, Farhat Hached University Hospital, University of Sousse, Sousse, Tunisia
| | - Mohamed Denguesli
- Dermatology Department, Farhat Hached University Hospital, University of Sousse, Sousse, Tunisia
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7
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Erosive Pustular Dermatosis: Delving into Etiopathogenesis and Management. LIFE (BASEL, SWITZERLAND) 2022; 12:life12122097. [PMID: 36556462 PMCID: PMC9784138 DOI: 10.3390/life12122097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/04/2022] [Accepted: 12/08/2022] [Indexed: 12/15/2022]
Abstract
Erosive pustular dermatosis (EPD) is a chronic inflammatory skin disorder that usually affects mature individuals. It predominantly affects the scalp and can lead to scarring alopecia. Risk factors include actinic damage and androgenetic alopecia. A traumatic insult to the skin is considered a vital trigger of the condition. EPD is a diagnosis of exclusion; thus, several neoplastic, infectious, vesiculobullous, and inflammatory conditions should be ruled out. Biopsy and clinicopathologic correlation are required to differentiate between EPD and these entities. A dysregulated, chronic immune response is considered central to the etiopathogenesis of EPD. We performed an evidence-based systematic review of the management options. There were predominantly studies with level IV and V evidence and only two with level III. Despite the responsiveness of EPD to potent topical steroids, such as clobetasol propionate, recurrence occurs after treatment withdrawal. With the available data, tacrolimus 0.1%, curettage-assisted aminolevulinic acid-photodynamic therapy, and systemic retinoids can be considered second-line options for EPD with a role in maintenance regimens. However, controlled data and more powerful studies are needed to make solid recommendations.
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8
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Negbenebor NA, Shayegan LH, Cohen LM, Kroumpouzos G. Nonmelanoma Skin Cancer in the Setting of Erosive Pustular Dermatosis of the Scalp: A Case Series and Comment on Management Implications. Dermatol Ther 2022; 35:e15584. [DOI: 10.1111/dth.15584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 03/28/2022] [Accepted: 05/13/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Nicole A. Negbenebor
- Department of Dermatology Warren Alpert Medical School at Brown University Providence Rhode Island USA
| | - Leila H. Shayegan
- Department of Dermatology Warren Alpert Medical School at Brown University Providence Rhode Island USA
| | - Lisa M. Cohen
- Dermatopathology Section, StrataDx Lexington Massachusetts USA
| | - George Kroumpouzos
- Department of Dermatology Warren Alpert Medical School at Brown University Providence Rhode Island USA
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9
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Okuno S, Hashimoto T, Matsuo S, Satoh T. Erosive pustular dermatosis of the scalp‐like eruption from panitumumab. Australas J Dermatol 2022; 63:271-272. [DOI: 10.1111/ajd.13791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 12/14/2021] [Accepted: 01/04/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Satoshi Okuno
- Department of Dermatology National Defense Medical College Tokorozawa Japan
| | - Takashi Hashimoto
- Department of Dermatology National Defense Medical College Tokorozawa Japan
| | - Shinsuke Matsuo
- Department of Dermatology National Defense Medical College Tokorozawa Japan
| | - Takahiro Satoh
- Department of Dermatology National Defense Medical College Tokorozawa Japan
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10
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Starace M, Vezzoni R, Alessandrini A, Bruni F, Carpanese M, Melo DF, Piraccini BM. Tufted hairs: A bouquet of flowers in different hair diseases. J Cosmet Dermatol 2022; 21:3741-3746. [PMID: 35001495 DOI: 10.1111/jocd.14712] [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: 11/03/2021] [Accepted: 12/20/2021] [Indexed: 02/01/2023]
Abstract
Tufted hairs, an unusual hair follicle dysplasia, are characterized by several hair shafts grouped together, emerging from a single hair follicle-like "doll's hair". This clinical picture is considered characteristic of folliculitis decalvans (FD). However, the emergence of grouped hair shafts from a single follicle can also be observed in other hair disorders, even if not as a distinctive diagnostic sign. This paper aims to collect and analyze all clinical and trichoscopic features of different hair diseases with tufted hairs to find distinctive features, helping the clinician with the diagnosis.
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Affiliation(s)
- Michela Starace
- Dermatology- IRCCS, Policlinico Sant'Orsola, Department of Specialized, Experimental and Diagnostic Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Roberta Vezzoni
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Aurora Alessandrini
- Dermatology- IRCCS, Policlinico Sant'Orsola, Department of Specialized, Experimental and Diagnostic Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Francesca Bruni
- Dermatology- IRCCS, Policlinico Sant'Orsola, Department of Specialized, Experimental and Diagnostic Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Miriam Carpanese
- Dermatology- IRCCS, Policlinico Sant'Orsola, Department of Specialized, Experimental and Diagnostic Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | | | - Bianca Maria Piraccini
- Dermatology- IRCCS, Policlinico Sant'Orsola, Department of Specialized, Experimental and Diagnostic Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
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11
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Erosive Pustular Dermatosis of the Scalp: A Clinicopathologic Study of Fifty Cases. Dermatopathology (Basel) 2021; 8:450-462. [PMID: 34698128 PMCID: PMC8544368 DOI: 10.3390/dermatopathology8040048] [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: 08/30/2021] [Revised: 09/16/2021] [Accepted: 09/19/2021] [Indexed: 12/25/2022] Open
Abstract
Erosive pustular dermatosis of the scalp (EPDS) is an uncommon, pustular, idiopathic disorder typically occurring on the scalp of the elderly, whose diagnosis requires close clinicopathologic correlations. Recently, the primary histopathologic characteristic of EPDS has been identified in some biopsies from hair-bearing scalp lesions as a sterile, vesiculo-pustule involving the infundibulum of hair follicles. To further delineate the clinicopathologic spectrum of the disease, we led a retrospective study of 50 patients (36 males and 14 females) with a diagnosis of EPDS between 2011 and 2021, reviewing clinical and histopathological data. Androgenetic alopecia was present in 32 patients. Triggering factors were present in 21 patients. The vertex was the most common location; one patient also had leg involvement. Two cases were familial. Disease presentation varied markedly from tiny, erosive, scaly lesions to crusted and hemorrhagic plaques, mimicking pustular pyoderma gangrenosum (PPG). Biopsies of patients with severe androgenetic or total baldness produced specimens showing nonspecific pathologic changes (39/50), while in 11 patients with a hair-bearing scalp histopathologic examination, changes were specific. The clinicopathologic similarities between EPDS and PPG suggest that EPDS should be included in the spectrum of autoinflammatory dermatoses. Clinicians could consider the possibility of associated disorders rather than managing EPDS as a sui generis skin disorder.
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12
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Di Altobrando A, Tabanelli M. Topical zinc oxide: breaking the vicious cycle of erosive pustular dermatosis of the scalp. Int J Dermatol 2021; 61:e216-e217. [PMID: 34403492 DOI: 10.1111/ijd.15867] [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: 06/13/2021] [Accepted: 07/30/2021] [Indexed: 01/19/2023]
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13
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Siskou S, Lallas A, Theodoropoulos K, Sgouros D, Trakatelli M, Patsatsi A, Trigoni A, Manoli M, Papageorgiou C, Liopyris K, Katoulis A, Stratigos A, Ioannides D, Lazaridou E, Apalla Z. Diagnostic and management challenges of erosive pustular dermatosis of the scalp: a retrospective study in Greek population. J Eur Acad Dermatol Venereol 2021; 35:e776-e779. [PMID: 34143550 DOI: 10.1111/jdv.17455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- S Siskou
- Second Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - A Lallas
- Dermomedica, Dermatology Unit, Thessaloniki, Greece.,First Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - K Theodoropoulos
- Second Dermatology Department, Kapodistrian University of Athens, Attikon Hospital, Athens, Greece
| | - D Sgouros
- Second Dermatology Department, Kapodistrian University of Athens, Attikon Hospital, Athens, Greece
| | - M Trakatelli
- Second Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A Patsatsi
- Second Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A Trigoni
- Second Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - M Manoli
- Dermomedica, Dermatology Unit, Thessaloniki, Greece.,First Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - C Papageorgiou
- Second Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Dermomedica, Dermatology Unit, Thessaloniki, Greece
| | - K Liopyris
- First Dermatology Department, Kapodistrian University of Athens, A. Syggros Hospital, Athens, Greece
| | - A Katoulis
- Second Dermatology Department, Kapodistrian University of Athens, Attikon Hospital, Athens, Greece
| | - A Stratigos
- First Dermatology Department, Kapodistrian University of Athens, A. Syggros Hospital, Athens, Greece
| | - D Ioannides
- First Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Lazaridou
- Second Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Z Apalla
- Second Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Dermomedica, Dermatology Unit, Thessaloniki, Greece
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14
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Cutaneous T-cell lymphoma in erythrodermic cases may be suspected on the basis of scalp examination with dermoscopy. Sci Rep 2021; 11:282. [PMID: 33431905 PMCID: PMC7801426 DOI: 10.1038/s41598-020-78233-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 11/17/2020] [Indexed: 02/08/2023] Open
Abstract
Erythrodermic variants of cutaneous T-cell lymphoma (CTLC) are one of the case of erythroderma. The aim of the study was to assess the value of scalp dermoscopy in differentiation between erythrodermic CTCL, psoriasis, and atopic dermatitis. A total of 76 patients were included into the study (16 patients with erythrodermic CTCL, 20 patients with psoriatic erythroderma, 20 with erythrodermic atopic dermatitis, and 20 healthy volunteers). The most common trichoscopic features of erythrodermic CTCL were: numerous pili torti, numerous broken hairs, white thick interfollicular bands, and patchy hyperpigmentation of the background. They were observed in 81% (13/16), 75% (12/16), 56% (9/16), and 37.5% (6/16) of patients with CTCL, respectively (p < 0.001). Other specific features of erythrodermic CTCL were 8-shaped hairs (19%; 3/16) and visible anagen bulbs (12.5%; 2/16) (p < 0.05 and p = 0.052, respectively). The most common vascular pattern of erythrodermic CTCL was perifollicular arrangement of glomerular (50%; 8/16; p < 0.001) or linear vessels (31%; 5/16; p < 0.05). Follicular spicules-like scaling was pathognomonic for erythrodermic CTCL (12%, 2/16) although its presence did not reach statistical significance (p = 0.052). In conclusion, the characteristic trichoscopic findings of erythrodermic CTCL are numerous pili torti, eight-shaped hairs, thick white interfollicular bands, color heterogeneity of the background and perifollicular arrangement of vessels.
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15
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Gallo G, Ribero S, Conti L, Baglioni E, Fierro MT, Quaglino P. Erosive pustular dermatosis: not only scalp. J Eur Acad Dermatol Venereol 2020; 34:e399-e402. [PMID: 32107801 DOI: 10.1111/jdv.16314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- G Gallo
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - S Ribero
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - L Conti
- Division of Pathology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - E Baglioni
- Department of General and Specialized Surgery, Città della Salute e della Scienza di Torino, Turin, Italy
| | - M T Fierro
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - P Quaglino
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
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