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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. [PMID: 38622785 DOI: 10.1111/ijd.17184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [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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Pinedo-Moraleda F, Tristán-Martín B, Dradi GG. Alopecias: Practical Tips for the Management of Biopsies and Main Diagnostic Clues for General Pathologists and Dermatopathologists. J Clin Med 2023; 12:5004. [PMID: 37568407 PMCID: PMC10419566 DOI: 10.3390/jcm12155004] [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: 07/06/2023] [Revised: 07/21/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
Accurately diagnosing specific variants of alopecia remains challenging for pathologists, potentially delaying appropriate therapeutic decisions by dermatologists. Issues such as limited knowledge on optimal biopsy types and processing methods add complexity. Understanding the normal histology of hair follicles and their changes throughout the follicular cycle further complicates microscopic evaluation. This paper aims to summarize these characteristics and highlight essential diagnostic clues for pathologists to confidently suggest a diagnosis, therefore playing a key role in alopecia diagnosis. Ongoing education, collaboration with dermatologists, and staying up to date on advancements is crucial for the accurate diagnosis and effective management of different types of alopecia.
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Affiliation(s)
| | - Belén Tristán-Martín
- Department of Pathology, Hospital Nuestra Señora de Sonsoles, 05004 Avila, Spain;
| | - Giulia Greta Dradi
- Department of Dermatology, Hospital Universitario Fundacion Alcorcon, 28922 Alcorcon, Spain;
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Brown-Korsah JB, McKenzie S, Omar D, Syder NC, Elbuluk N, Taylor SC. Variations in genetics, biology, and phenotype of cutaneous disorders in skin of color - Part I: Genetic, biologic, and structural differences in skin of color. J Am Acad Dermatol 2022; 87:1239-1258. [PMID: 35809800 DOI: 10.1016/j.jaad.2022.06.1193] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 05/27/2022] [Accepted: 06/13/2022] [Indexed: 11/18/2022]
Abstract
Skin of color (SOC) populations include those who identify as Black/African, Hispanic/Latinx, Asian/Pacific Islander, American Indian/Native Alaskan, Indigenous Australian, Middle Eastern, biracial/multiracial, or non-White; this list is far from exhaustive and may vary between and within cultures. Recent genetic and immunological studies have suggested that cutaneous inflammatory disorders (atopic dermatitis, psoriasis, and hidradenitis suppurativa) and malignancies (melanoma, basal cell carcinoma, and cutaneous T-cell lymphoma) may have variations in their immunophenotype among SOC. Additionally, there is growing recognition of the substantial role social determinants of health play in driving health inequalities in SOC communities. It is critically important to understand that social determinants of health often play a larger role than biologic or genetic factors attributed to "race" in health care outcomes. Herein, we describe the structural, genetic, and immunological variations and the potential implications of these variations in populations with SOC. This article underscores the importance of increasing the number of large, robust genetic studies of cutaneous disorders in SOC to create more targeted, effective therapies for this often underserved and understudied population. Part II of this CME will highlight the clinical differences in the phenotypic presentation of and the health disparities associated with the aforementioned cutaneous disorders in SOC.
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Affiliation(s)
- Jessica B Brown-Korsah
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; Case Western Reserve University, School of Medicine, Cleveland, Ohio
| | - Shanice McKenzie
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Deega Omar
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; George Washington University, School of Medicine and Health Sciences, Washington, District of Columbia
| | - Nicole C Syder
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Nada Elbuluk
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Susan C Taylor
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
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Mbussuh Nzeng LF, Nguefack‐Tsague G, Kotto R, Tounouga DN, Sigha OB, Nkoro GA, Nida M, Kouotou EA. Hair care and epidemiological-clinical profile of traction alopecia among women in hair salons in Yaoundé, Cameroon. SKIN HEALTH AND DISEASE 2022; 3:e158. [PMID: 36751322 PMCID: PMC9892458 DOI: 10.1002/ski2.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 08/04/2022] [Accepted: 08/10/2022] [Indexed: 11/10/2022]
Abstract
Background Hair is valued by all individuals especially women. The perception of beauty is specific to everyone. In order to fulfil their ideal beauty, women use various methods to modify their hair's appearance. Afro hair is particularly fragile, so using these methods can be particularly deleterious for black women's hair. Objectives Describe hair care practices of women living in Yaoundé, determine the prevalence of traction alopecia (TA) and describe its clinical profile. Methods We carried out a cross-sectional study in hairdressing saloon in Yaoundé. A questionnaire was administered and scalp exams were performed to determine Marginal TA severity score. Results We included 223 women with a mean age of 24.9 ± 7 years. The prevalence of TA was 34.5%. Mild and moderate stages were most represented. As far as haircare is concerned, extensions were regularly used by 95.1% of participants. Wigs were regularly worn by 58.7% of participants. Chemical hair straightening was done by 87.9% of women and was performed twice to thrice a year by 43.9%. Almost 76% of women used hair straightener and hair dryer. Hair washing was done monthly by 43.8% of participants and the main cosmetic used was shampoo (75.3%). Conclusion Traction alopecia is a very common disease in women living in Yaoundé. Extensions, wigs and shampooing are their main hair care practices.
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Affiliation(s)
| | | | - Rose Kotto
- Faculty of Medicine and Pharmaceutic SciencesUniversité of DoualaDoualaCameroon
| | | | | | - Grace Anita Nkoro
- Faculty of Medicine and Biomedical SciencesUniversité of Yaoundé 1YaoundeCameroon
| | - Martine Nida
- Faculty of Medicine and Pharmaceutic SciencesUniversité of DoualaDoualaCameroon
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Mitchell KN, Tay YK, Heath CR, Trachtman R, Silverberg NB. Review article: Emerging issues in pediatric skin of color, part 1. Pediatr Dermatol 2021; 38 Suppl 2:20-29. [PMID: 34664330 DOI: 10.1111/pde.14775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Dermatology for the pediatric skin of color population is the application of dermatology to the genetically diverse and distinctive segment of the pediatric population that includes children of non-White racial and ethnic groups with increased pigmentation including individuals of Asian, LatinX, African, Native American, Pacific Island descent, Indigenous Peoples, among others, with overlap in particular individuals, and mixtures thereof. Treating children of color is a unique skill set within the field of pediatric dermatology, requiring knowledge and sensitivity. The discipline of pediatric skin of color can be challenging. Difficulty in diagnosis of common conditions stems from underlying pigmentation, variations in common hairstyling practices, and differences in demographics of cutaneous disease, whereas some conditions are more common in children of color, other conditions have nuances in clinical appearance and/or therapeutics with regard to skin color. This article is the first in a series of two articles looking at recently published skin-related issues of high concern in children of color. Conditions reviewed in Part 1 include (1) hairstyling hair-related concerns (traction alopecia, central centrifugal cicatricial alopecia, endocrine disruption), (2) autoimmune concerns (cutaneous lupus, vitiligo), and (3) infections (tinea capitis, progressive macular hypomelanosis).
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Affiliation(s)
- Krystal N Mitchell
- Department of Dermatology, Icahn School of Medicine at Mt Sinai, New York, New York, USA
| | - Yong Kwang Tay
- Department of Dermatology, Changi General Hospital, Singapore, Singapore
| | - Candrice R Heath
- Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA
| | - Rebecca Trachtman
- Department of Pediatrics, Division of Pediatric Rheumatology, Icahn School of Medicine at Mt Sinai, New York, New York, USA
| | - Nanette B Silverberg
- Department of Dermatology, Icahn School of Medicine at Mt Sinai, New York, New York, USA
- Department of Pediatrics, Icahn School of Medicine at Mt Sinai, New York, New York, USA
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Afifi L, Oparaugo NC, Hogeling M. Review of traction alopecia in the pediatric patient: Diagnosis, prevention, and management. Pediatr Dermatol 2021; 38 Suppl 2:42-48. [PMID: 34467569 DOI: 10.1111/pde.14773] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/28/2021] [Accepted: 08/08/2021] [Indexed: 02/01/2023]
Abstract
Hairstyles and practices that frequently apply tension to the hair follicle can result in traction alopecia (TA). Many of the hairstyles and hair practices associated with a higher risk of TA begin at a young age, making early intervention and education advantageous in the pediatric population. Recognizing TA at its reversible stage in the pediatric population is critical as early interventions, and counseling will prevent permanent scarring alopecia. While TA can affect any pediatric patient, this review highlights the reported literature on specific populations with a higher reported prevalence of TA.
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Affiliation(s)
- Ladan Afifi
- Division of Dermatology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | | | - Marcia Hogeling
- Division of Dermatology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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