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Rodríguez-Tamez G, Herz-Ruelas ME, Gómez-Flores M, Ocampo-Candiani J, Chavez-Alvarez S. Hair Disorders in Autoimmune Diseases. Skin Appendage Disord 2023; 9:84-93. [PMID: 36937160 PMCID: PMC10015649 DOI: 10.1159/000527933] [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: 08/16/2022] [Accepted: 10/25/2022] [Indexed: 01/25/2023] Open
Abstract
Alopecia is a common feature in several autoimmune diseases. With a wide spectrum of clinical presentations, it may manifest with a scarring or non-scarring nature, in a diffuse, patchy, or localized pattern. We as dermatologists have the opportunity of assessing patients with hair loss who may have an underlying undiagnosed autoimmune disorder. This review aimed to describe the main clinical, trichoscopic, and histopathological features of hair disorders associated with autoimmune diseases.
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Affiliation(s)
| | | | | | | | - Sonia Chavez-Alvarez
- Dermatology Department, Facultad de Medicina, “Dr. José E. González” University Hospital, Universidad Autónoma de Nuevo León, Monterrey, Mexico
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de Marsillac PF, Cortez de Almeida RF, Machado CJ, Piraccini BM, Starace M, Tosti A, Vincenzi C, Kobzei K, Iorizzo M, Alves LD, Blanco A, Coelho C, Saceda-Corralo D, D'Atri G, Benez M, Ramos PM, Baja S, Tortelly VD, Frattini S, Melo DF. Clinical, epidemiological, trichoscopic and histopathological features of linear morphea on the scalp. J Eur Acad Dermatol Venereol 2022; 36:e892-e895. [PMID: 35694874 DOI: 10.1111/jdv.18323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/03/2022] [Indexed: 11/29/2022]
Affiliation(s)
- P F de Marsillac
- Department of Dermatology, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - R F Cortez de Almeida
- Department of Dermatology, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - C J Machado
- Preventive and Social Medicine Department, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - B M Piraccini
- Dermatology - IRCCS Policlinico di Sant'Orsola - Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - M Starace
- Dermatology - IRCCS Policlinico di Sant'Orsola - Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - A Tosti
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, Miami, Florida, USA
| | - C Vincenzi
- Department of Dermatology, Private Hospital Nigrisoli, Bologna, Italy
| | - K Kobzei
- Kyiv Medical University, Kyiv, Ukraine
| | - M Iorizzo
- Private Dermatology Practice, Bellinzona, Lugano, Switzerland
| | - L D Alves
- Department of Tropical Medicine and Dermatology, Federal University of Goiás, Goiânia, GO, Brazil
| | - A Blanco
- Department of Dermatology, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - C Coelho
- Department of Dermatology, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - D Saceda-Corralo
- Dermatology Department, Trichology Unit, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria, University of Alcalá, Madrid, Spain
| | - G D'Atri
- GrupoMCI (Integral Hair Medicine), Private Dermatology Practice, Buenos Aires, Argentina
| | - M Benez
- Department of Dermatology, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - P M Ramos
- Department of Dermatology and Radiotherapy, São Paulo State University, Botucatu, SP, Brazil
| | - S Baja
- Private Dermatology Practice, Resende, RJ, Brazil
| | - V D Tortelly
- Department of Dermatology, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - S Frattini
- Mental Health Department, Guelph General Hospital, Guelph, Ontario, Canada
| | - D F Melo
- Department of Dermatology, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Mazzilli S, Vollono L, Cosio T, Donati M, Piccolo A, Di Raimondo C, Campione E, Bianchi L. Reflectance Confocal Microscopy Applied to Linear (en Coup de Sabre) Morphea. Skin Appendage Disord 2020; 6:171-174. [PMID: 32656238 DOI: 10.1159/000506748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 02/22/2020] [Indexed: 11/19/2022] Open
Abstract
En coup de sabre morphea is a clinical variant of morphea, presenting as a linear depressed, atrophic area in the paramedian forehead or the frontoparietal scalp, resembling a stroke from a sword. It affects the skin and subcutaneous connective tissues, with possible extension to the underlying musculature, cartilage, and bone and variable association with neurologic symptoms. A 50-year-old woman presented to our clinic for evaluation of an atrophic lesion on her forehead and scalp appearing 1 year before, progressively extending over time. An alopecic atrophic area involving the skin and subcutaneous tissues of her right forehead and scalp arranged in a linear fashion with an "en coup de sabre" appearance was observed in relation with hair loss in the affected area. Reflectance confocal microscopy showed marked hyperreflective areas with severe eccrine gland atrophy. All sebaceous glands had disappeared, with sporadic follicular persistence reduction. Histopathological examination of a punch biopsy specimen taken from a central parietal alopecic area was consistent with a diagnosis of morphea. To our knowledge, this is the first report regarding the use of reflectance confocal microscopy as an ancillary diagnostic technique in linear localized morphea of the scalp and face. This noninvasive technique may represent a useful tool in distinguishing between early stages of the disease, with prevalence of inflammatory lymphocytic infiltrate, and late stages characterized by more prominent sclerosis with mild or absent signs of inflammation.
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Affiliation(s)
- Sara Mazzilli
- Dermatology Unit, Department of "Medicina dei Sistemi," Tor Vergata University, Rome, Italy
| | - Laura Vollono
- Dermatology Unit, Department of "Medicina dei Sistemi," Tor Vergata University, Rome, Italy
| | - Terenzio Cosio
- Dermatology Unit, Department of "Medicina dei Sistemi," Tor Vergata University, Rome, Italy
| | - Michele Donati
- Department of Surgical Pathology, Campus Biomedico, Rome, Italy
| | - Arianna Piccolo
- Dermatology Unit, Department of "Medicina dei Sistemi," Tor Vergata University, Rome, Italy
| | - Cosimo Di Raimondo
- Dermatology Unit, Department of "Medicina dei Sistemi," Tor Vergata University, Rome, Italy
| | - Elena Campione
- Dermatology Unit, Department of "Medicina dei Sistemi," Tor Vergata University, Rome, Italy
| | - Luca Bianchi
- Dermatology Unit, Department of "Medicina dei Sistemi," Tor Vergata University, Rome, Italy
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