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Annunziata MC, Tosti A, Fattore D, Potestio L, Maddy AJ, Fabbrocini G. Trichoscopic Patterns and Confocal Microscopy Features of Chemotherapy-Induced Alopecia. Skin Appendage Disord 2023; 9:346-350. [PMID: 37900779 PMCID: PMC10601955 DOI: 10.1159/000531183] [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: 02/19/2023] [Accepted: 04/24/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction Chemotherapy-induced alopecia (CIA) can seriously affect the quality of life of cancer patients. Trichoscopic patterns and confocal microscopy (RCM) features of CIA have been scarcely studied. This study aimed to investigate the dermoscopic and RCM features of CIA in 19 females and 5 males, with CIA due to current or recent chemotherapy. Methods Patients with CIA and current or recent (within 2 months) history of chemotherapy treatment were enrolled. After clinical examination, standard pictures were taken by digital camera (SLR Canon PowerShot G10) and trichoscopic images were captured by the Handyscope device (20x). Images of RCM were acquired by VivaScope 3000 with the VivaStack option. The trichoscopic and confocal images were acquired by three independent observers after central parting on three areas: vertex, middle, and frontal scalp. Results A total of 24 patients were enrolled. CIA has features of anagen effluvium at trichoscopy but with low frequency of yellow dots and prominence of black dots. The simultaneous presence of pseudo-monilethrix and black dots at trichoscopy confirms the hypothesis that chemotherapy insults the hair follicle intermittently. At RCM, the presence of abnormal hair shaft morphology highlights that the insults affect hair shaft production. Conclusion These are the first data in this field, so further studies with a higher number of patients analyzed are needed to confirm these findings.
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Affiliation(s)
- Maria Carmela Annunziata
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Antonella Tosti
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Davide Fattore
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Luca Potestio
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Austin John Maddy
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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Paun M, Tiplica GS. Non-Invasive Techniques for Evaluating Alopecia Areata. MAEDICA 2023; 18:333-341. [PMID: 37588838 PMCID: PMC10427099 DOI: 10.26574/maedica.2023.18.2.333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
Alopecia areata (AA) is a disease affecting mostly young patients, being the second most prevalent cause of alopecia. For the assessment of AA patients, numerous non-invasive techniques are available. For diagnosing and treating AA, non-invasive hair follicle exploration is crucial. Trichoscopy, videodermoscopy, pull test, global scalp photography and scalp imaging techniques (reflectance confocal microscopy (RCM), multiphoton microscopy (MPM), and high-frequency ultrasonography (HF-USG) are non-invasive methods used to assess the hair loss. Short vellus hairs and yellow dots were the most commonly reported and sensitive trichoscopy signs of AA. Additionally, it was observed that AA activity was associated with black dots, micro-exclamation mark hairs and tapering hairs. A good prognosis of AA includes the transformation of vellus into terminal hairs. Reflectance confocal microscopy is a non-invasive imaging technique for in vivo evaluation of the skin and observation of cell morphology with a nearly histological resolution, which is helpful in diagnosis and management of AA. Additionally, MPM delivers information on hair follicles and scalp inflammation and can be utilized to assess hair growth while undergoing treatment. High-frequency ultrasonography allows distinguishing between hair cycle phases, which is undoubtedly important from the prognostic of AA. The current review aims to discuss the non-invasive methods of diagnosis of AA.
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Affiliation(s)
- Monica Paun
- Dermatology PhD Student, Dermatology Research Unit, Colentina Clinical Hospital, Bucharest, Romania
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - George Sorin Tiplica
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- Second Department of Dermatology, Colentina Clinical Hospital, Bucharest, Romania
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3
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Ekelem C, Feil N, Csuka E, Juhasz M, Lin J, Choi F, Asghari A, Heydarlou D, Mesinkovska NA. Optical Coherence Tomography in the Evaluation of the Scalp and Hair: Common Features and Clinical Utility. Lasers Surg Med 2020; 53:129-140. [PMID: 32253781 DOI: 10.1002/lsm.23243] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 03/22/2020] [Accepted: 03/23/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVE Early diagnosis and treatment of hair loss disorders is vital in providing patients with improved psychological outcomes. Non-invasive imaging with optical coherence tomography (OCT) may be useful in characterizing and managing alopecia. Despite expanding clinical applications of OCT in dermatology, guidelines demonstrating in vivo features of normal and alopecic scalp images remain scant. This pilot study aims to provide an atlas of OCT findings of healthy and alopecia subjects, explore diagnostic quantitative endpoints of alopecia, and compare epidermal thickness and follicular density between scalp regions. STUDY DESIGN/MATERIALS AND METHODS A total of 32 patients (19-76 years old) were enrolled in the study, including healthy patients (n = 6), and patients with scarring alopecia (n = 12) or non-scarring alopecia (n = 14). An in-line fiber-based swept source OCT was used to image five scalp locations at baseline and 6-month visits. Three investigators evaluated each image for gross features, epidermal thickness, and follicular density. RESULTS Only data from baseline imaging analysis is discussed in this manuscript. Qualitative differences of OCT images are identified in sample images from healthy scalp and each subtype of alopecia studied. Scarring alopecia is characterized by significantly increased epidermal thickness (average Image J pixel units 32 ± 2 compared with non-scarring alopecia [average 28 ± 3] and control [average 27 ± 3]) (P = 0.022) and decreased follicle count (average 35 ± 5 in a 5 × 7 mm2 area compared with control (50 ± 3) and non-scarring patients (47 ± 6)) (P = 0.0052). Scalp location had no impact on epidermal thickness (P = 0.861) or follicular density (P = 0.15). CONCLUSION OCT holds promise as a non-invasive technique to further characterize and objectively measure alopecia. Larger sample sizes and longitudinal data are needed to improve reliability and determine if additional distinction between alopecia subtypes and treatment monitoring is possible. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.
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Affiliation(s)
- Chloe Ekelem
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697
| | - Nate Feil
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697
| | - Ella Csuka
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697
| | - Margit Juhasz
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697
| | - Jessica Lin
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697
| | - Franchesca Choi
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697.,School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, 807
| | - Arya Asghari
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697
| | - Dorsa Heydarlou
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697
| | - Natasha A Mesinkovska
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697
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Melo DF, De Carvalho N, Ardigò M, Pellacani G, Mota ANCDM, Barreto TDM, Jorge Machado C, Pineiro‐Maceira JM, Barcaui CB. Concordance among in vivo reflectance confocal microscopy, trichoscopy, and histopathology in the evaluation of scalp discoid lupus. Skin Res Technol 2020; 26:675-682. [DOI: 10.1111/srt.12852] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 03/02/2020] [Indexed: 12/22/2022]
Affiliation(s)
- Daniel Fernandes Melo
- Dermatology Department University of State of Rio de Janeiro (UERJ) Rio de Janeiro Brazil
- Dermatology Department Marcílio Dias Naval Hospital Rio de Janeiro Brazil
| | | | - Marco Ardigò
- Clinical Dermatology San Galicano Dermatology Institute‐IRCCS Rome Italy
| | - Giovanni Pellacani
- Dermatology Department University of Modena and Reggio Emilia Modena Italy
| | - Amanda Nascimento Cavalleiro de Mac Mota
- Dermatology Department University of State of Rio de Janeiro (UERJ) Rio de Janeiro Brazil
- Dermatology Department Central Aeronautics Hospital Rio de Janeiro Brazil
| | | | - Carla Jorge Machado
- Preventive and Social Medicine Department Federal University of Minas Gerais Belo Horizonte Brazil
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Rossi A, Muscianese M, Piraccini BM, Starace M, Carlesimo M, Mandel VD, Alessandrini A, Calvieri S, Caro G, D'arino A, Federico A, Magri F, Pigliacelli F, Amendolagine G, Annunziata MC, Arisi MC, Astorino S, Babino G, Bardazzi F, Barruscotti S, Belloni Fortina A, Borghi A, Bruni F, Caccavale S, Calzavara-Pinton P, Cameli N, Cardone M, Carugno A, Coppola R, Dattola A, De Felici Del Giudice MB, Di Cesare A, Dika E, Di Nunno D, D'ovidio R, Fabbrocini G, Feliciani C, Fulgione E, Galluzzo M, Garcovich S, Garelli V, Guerriero C, Hansel K, La Placa M, Lacarrubba F, Lora V, Marinello E, Megna M, Micali G, Misciali C, Monari P, Monfrecola G, Neri I, Offidani A, Orlando G, Papini M, Patrizi A, Piaserico S, Rivetti N, Simonetti O, Stan TR, Stingeni L, Talamonti M, Tassone F, Villa L, Vincenzi C, Fortuna MC. Italian Guidelines in diagnosis and treatment of alopecia areata. GIORN ITAL DERMAT V 2019; 154:609-623. [PMID: 31578836 DOI: 10.23736/s0392-0488.19.06458-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Alopecia areata (AA) is an organ-specific autoimmune disorder that targets anagen phase hair follicles. The course is unpredictable and current available treatments have variable efficacy. Nowadays, there is relatively little evidence on treatment of AA from well-designed clinical trials. Moreover, none of the treatments or devices commonly used to treat AA are specifically approved by the Food and Drug Administration. The Italian Study Group for Cutaneous Annexial Disease of the Italian Society of dermatology proposes these Italian guidelines for diagnosis and treatment of Alopecia Areata deeming useful for the daily management of the disease. This article summarizes evidence-based treatment associated with expert-based recommendations.
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Affiliation(s)
- Alfredo Rossi
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy -
| | - Marta Muscianese
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Bianca M Piraccini
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Michela Starace
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Marta Carlesimo
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Victor D Mandel
- Unit of Dermatology, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Aurora Alessandrini
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Stefano Calvieri
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Gemma Caro
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Andrea D'arino
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Alessandro Federico
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Francesca Magri
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Flavia Pigliacelli
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Graziana Amendolagine
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Maria C Annunziata
- Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Maria C Arisi
- Department of Dermatology, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy
| | - Stefano Astorino
- Unit of Dermatology and Venereology, Celio Military Hospital, Rome, Italy
| | - Graziella Babino
- Unit of Dermatology, Nuovo Policlinico, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Federico Bardazzi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Stefania Barruscotti
- Unit of Dermatology, S. Matteo University Polyclinic, IRCCS and Foundation, Pavia, Italy
| | - Anna Belloni Fortina
- Unit of Dermatology, Department of Medicine - DIMED, University of Padua, Padua, Italy
| | - Alessandro Borghi
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Francesca Bruni
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Stefano Caccavale
- Unit of Dermatology, Nuovo Policlinico, Luigi Vanvitelli University of Campania, Naples, Italy
| | | | - Norma Cameli
- San Gallicano Dermatological Institute (IRCCS), Rome, Italy
| | - Michele Cardone
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Andrea Carugno
- Unit of Dermatology, S. Matteo University Polyclinic, IRCCS and Foundation, Pavia, Italy
| | - Rosa Coppola
- Campus Bio-Medico University (Hospital), Rome, Italy
| | - Annunziata Dattola
- Department of Dermatology, Tor Vergata Polyclinic and University, Rome, Italy
| | | | - Antonella Di Cesare
- Section of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - Emi Dika
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Donato Di Nunno
- Unit of Dermatology and Venereology, Celio Military Hospital, Rome, Italy
| | | | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Claudio Feliciani
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - Elisabetta Fulgione
- Unit of Dermatology, Nuovo Policlinico, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Marco Galluzzo
- Department of Dermatology, Tor Vergata Polyclinic and University, Rome, Italy
| | - Simone Garcovich
- Institute of Dermatology, A. Gemelli University Polyclinic, IRCCS and Foundation, Sacred Heart Carholic University, Rome, Italy
| | - Valentina Garelli
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Cristina Guerriero
- Institute of Dermatology, A. Gemelli University Polyclinic, IRCCS and Foundation, Sacred Heart Carholic University, Rome, Italy
| | - Katharina Hansel
- Section of Dermatology, Department of Medicine, University of Perugia, Perugia, Italy
| | - Michelangelo La Placa
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | | | - Viviana Lora
- Institute of Dermatology, A. Gemelli University Polyclinic, IRCCS and Foundation, Sacred Heart Carholic University, Rome, Italy
| | - Elena Marinello
- Unit of Dermatology, Department of Medicine - DIMED, University of Padua, Padua, Italy
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Giuseppe Micali
- Department of Dermatology, University of Catania, Catania, Italy
| | - Cosimo Misciali
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Paola Monari
- Department of Dermatology, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy
| | - Giuseppe Monfrecola
- Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Iria Neri
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Annamaria Offidani
- Unit of Dermatology, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Gloria Orlando
- Unit of Dermatology, Department of Medicine - DIMED, University of Padua, Padua, Italy
| | - Manuela Papini
- Section of Dermatology, Department of Medicine, University of Perugia, Perugia, Italy
| | - Annalisa Patrizi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Stefano Piaserico
- Unit of Dermatology, Department of Medicine - DIMED, University of Padua, Padua, Italy
| | - Niccolò Rivetti
- Unit of Dermatology, S. Matteo University Polyclinic, IRCCS and Foundation, Pavia, Italy
| | - Oriana Simonetti
- Unit of Dermatology, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Teodora R Stan
- Unit of Dermatology, Department of Medicine - DIMED, University of Padua, Padua, Italy
| | - Luca Stingeni
- Section of Dermatology, Department of Medicine, University of Perugia, Perugia, Italy
| | - Marina Talamonti
- Department of Dermatology, Tor Vergata Polyclinic and University, Rome, Italy
| | - Francesco Tassone
- Institute of Dermatology, A. Gemelli University Polyclinic, IRCCS and Foundation, Sacred Heart Carholic University, Rome, Italy
| | | | - Colombina Vincenzi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Maria C Fortuna
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
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Ionescu AM, Ilie MA, Chitu V, Razvan A, Lixandru D, Tanase C, Boda D, Caruntu C, Zurac S. In vivo Diagnosis of Primary Cutaneous Amyloidosis -the Role of Reflectance Confocal Microscopy. Diagnostics (Basel) 2019; 9:diagnostics9030066. [PMID: 31252549 PMCID: PMC6787715 DOI: 10.3390/diagnostics9030066] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 06/20/2019] [Accepted: 06/24/2019] [Indexed: 12/12/2022] Open
Abstract
Primary cutaneous amyloidosis (PCA) is a form of localized amyloidosis. It is characterized by the deposition of a fibrillar material in the superficial dermis, without affecting other systems or organs. The diagnosis can be made clinically, but usually a skin biopsy is performed in order to exclude other skin diseases with similar appearance. Reflectance confocal microscopy (RCM) is a novel imaging tool that enables in vivo characterization of various skin changes with a high, quasi-microscopic resolution. This technique might have an important role in the differential diagnosis of cutaneous amyloidosis, by the in vivo assessment of epidermal changes and dermal amyloid deposition. Moreover, it is completely non-invasive and can be safely repeated on the same skin area. However, to date, there is only one published paper presenting the confocal features of primary cutaneous amyloidosis. Hereby, we describe the in vivo RCM features of PCA lesions from a patient with diabetes and correlate them with histologic findings. This strengthens the clinical usefulness of in vivo RCM examination for the non-invasive diagnosis of cutaneous amyloidosis, especially in patients that might associate diseases with impaired wound healing.
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Affiliation(s)
- Ana-Maria Ionescu
- First Department of Dermatology, Colentina Clinical Hospital, 020125 Bucharest, Romania
- Dermatology Research Laboratory, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Mihaela-Adriana Ilie
- Dermatology Research Laboratory, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Biochemistry, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Virginia Chitu
- First Department of Dermatology, Colentina Clinical Hospital, 020125 Bucharest, Romania
- Department of Dermatology, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Andrei Razvan
- Department of Pathology, Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Daniela Lixandru
- Department of Biochemistry, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Cristiana Tanase
- Department of Biochemistry-Proteomics, "Victor Babes" National Institute of Pathology, 050096 Bucharest, Romania
| | - Daniel Boda
- Dermatology Research Laboratory, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Dermatology, "Prof. N. Paulescu" National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
| | - Constantin Caruntu
- Department of Dermatology, "Prof. N. Paulescu" National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania.
- Department of Physiology, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
| | - Sabina Zurac
- Department of Dermatology, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Pathology, Colentina Clinical Hospital, 020125 Bucharest, Romania
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7
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Ilie MA, Caruntu C, Lixandru D, Tampa M, Georgescu SR, Constantin MM, Constantin C, Neagu M, Zurac SA, Boda D. In vivo confocal laser scanning microscopy imaging of skin inflammation: Clinical applications and research directions. Exp Ther Med 2018; 17:1004-1011. [PMID: 30679966 PMCID: PMC6327452 DOI: 10.3892/etm.2018.6981] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 10/05/2018] [Indexed: 11/18/2022] Open
Abstract
In vivo confocal laser scanning microscopy (CLSM) is a novel imaging technique that provides noninvasive, morphological characterization of skin structures with a resolution that is very close to that of light microscopy. Moreover, as it allows repeated imaging of the same skin area at different time-points, it is an excellent method for monitoring disease course, response to treatment or specific stimuli and a path to study dynamic phenomena in real-time. To date, two different variants of in vivo CLSM have been authorized in dermatological field, namely the reflectance confocal microscopy predominantly for clinical diagnosis and the fluorescence confocal microscopy mainly for research purposes. This study describes the principles of in vivo CLSM technique, its role in the diagnosis and monitoring of inflammatory skin diseases, as well as some promising research directions to study the dynamics of skin inflammation using this method. In vivo CLSM evaluation of inflammatory dermatoses and of the skin inflammatory component in various diseases has an undoubted potential with broad applications ranging from clinical, morphological to experimental, functional studies involving the skin.
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Affiliation(s)
- Mihaela Adriana Ilie
- Dermatology Research Laboratory, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Department of Biochemistry, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Constantin Caruntu
- Department of Physiology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Department of Dermatology, 'Prof. N. Paulescu' National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
| | - Daniela Lixandru
- Department of Biochemistry, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Mircea Tampa
- Department of Dermatology, 'Victor Babes' Hospital, 'Carol Davila' University of Medicine and Pharmacy, 030303 Bucharest, Romania
| | - Simona-Roxana Georgescu
- Department of Dermatology, 'Victor Babes' Hospital, 'Carol Davila' University of Medicine and Pharmacy, 030303 Bucharest, Romania
| | | | - Carolina Constantin
- Department of Immunology, 'Victor Babes' National Institute of Pathology, 050096 Bucharest, Romania.,Department of Pathology, Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Monica Neagu
- Department of Immunology, 'Victor Babes' National Institute of Pathology, 050096 Bucharest, Romania.,Department of Pathology, Colentina Clinical Hospital, 020125 Bucharest, Romania.,Faculty of Biology, University of Bucharest, 050095 Bucharest, Romania
| | - Sabina Andrada Zurac
- Department of Pathology, Colentina Clinical Hospital, 020125 Bucharest, Romania.,Department of Pathology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Daniel Boda
- Dermatology Research Laboratory, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Department of Dermatology, 'Prof. N. Paulescu' National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
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8
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Leite MGA, Maia Campos PMBG. Photoprotective Effects of a Multifunctional Hair Care Formulation Containing Botanical Extracts, Vitamins, and UV Filters. Photochem Photobiol 2018; 94:1010-1016. [DOI: 10.1111/php.12932] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 04/11/2018] [Indexed: 11/27/2022]
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9
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Agozzino M, Gonzalez S, Ardigò M. Reflectance Confocal Microscopy for Inflammatory Skin Diseases. ACTAS DERMO-SIFILIOGRAFICAS 2016. [DOI: 10.1016/j.adengl.2016.01.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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10
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Reflectance Confocal Microscopy for Inflammatory Skin Diseases. ACTAS DERMO-SIFILIOGRAFICAS 2016; 107:631-9. [DOI: 10.1016/j.ad.2016.01.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 01/10/2016] [Accepted: 01/28/2016] [Indexed: 11/23/2022] Open
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Hoogedoorn L, Peppelman M, van de Kerkhof P, van Erp P, Gerritsen M. The value ofin vivoreflectance confocal microscopy in the diagnosis and monitoring of inflammatory and infectious skin diseases: a systematic review. Br J Dermatol 2015; 172:1222-48. [DOI: 10.1111/bjd.13499] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2014] [Indexed: 11/27/2022]
Affiliation(s)
- L. Hoogedoorn
- Department of Dermatology; Radboud University Medical Center; PO Box 9101 NL 6500 HB Nijmegen the Netherlands
| | - M. Peppelman
- Department of Dermatology; Radboud University Medical Center; PO Box 9101 NL 6500 HB Nijmegen the Netherlands
| | - P.C.M. van de Kerkhof
- Department of Dermatology; Radboud University Medical Center; PO Box 9101 NL 6500 HB Nijmegen the Netherlands
| | - P.E.J. van Erp
- Department of Dermatology; Radboud University Medical Center; PO Box 9101 NL 6500 HB Nijmegen the Netherlands
| | - M.J.P. Gerritsen
- Department of Dermatology; Radboud University Medical Center; PO Box 9101 NL 6500 HB Nijmegen the Netherlands
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Assessment of the usefulness of dihydrotestosterone in the diagnostics of patients with androgenetic alopecia. Postepy Dermatol Alergol 2014; 31:207-15. [PMID: 25254005 PMCID: PMC4171668 DOI: 10.5114/pdia.2014.40925] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 07/26/2013] [Accepted: 08/20/2013] [Indexed: 11/17/2022] Open
Abstract
Introduction Androgenetic alopecia (AGA) is the most common form of hair loss. Clinically observed hair loss is due to the continuous miniaturization of affected hair follicles. Genetic factors and androgenic factors especially dihydrotestosterone (DHT), which is a testosterone tissue metabolite, play major roles in the pathogenesis of AGA. However, expert opinions about the usefulness of DHT in the diagnosis of this type of alopecia are divided. Aim To evaluate the usefulness of DHT level in patients with androgenetic alopecia compared with the control group. Material and methods The study comprised 49 subjects: 19 women and 9 men with androgenetic alopecia. The control group consisted of 17 healthy women and 4 men without hair loss. Results Increased serum concentrations of DHT were observed in patients with androgenetic alopecia (17 women, 5 men), but also in the control group. The differences in mean values of DHT were not significant according to the types of alopecia and the control group. Increased serum concentrations of DHT were not correlated with the advance of alopecia. Conclusions Dihydrotestosterone is the most influential androgen and seems to play a very important role in the pathogenesis of androgenetic alopecia. Based on the results of our study and others, the most important factors would appear to be the genetically-determined sensitivity of the follicles to DHT and their different reactions to androgen concentration.
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Kubanova AA, Chikin VV, Shtirshneider YUYU, Katunina OR. Confocal laser scanning microscopy in vivo for diagnosing melanocytic skin neoplasms. VESTNIK DERMATOLOGII I VENEROLOGII 2014. [DOI: 10.25208/0042-4609-2014-90-3-85-94] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
The authors discuss the use of confocal laser scanning microscopy in vivo (CLSM) for diagnosing melanocytic skin neoplasms and its value for early diagnostics of melanoma. CLSM is an innovation noninvasive visual examination method for real-time multiple and painless examinations of the patient’s skin without injuring the skin integument. The method ensures early diagnostics of skin melanomas with high sensitivity and specificity, which makes it possible to use CLSM for screening melanocytic skin neoplasms for the sake of the early onset of treatment to save patient life and health.
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14
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Cinotti E, Perrot J, Labeille B, Raberin H, Flori P, Cambazard F. Hair dermatophytosis diagnosed by reflectance confocal microscopy: six cases. J Eur Acad Dermatol Venereol 2014; 29:2257-9. [DOI: 10.1111/jdv.12557] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- E. Cinotti
- Department of Dermatology; University Hospital of Saint-Etienne; Saint Etienne France
| | - J.L. Perrot
- Department of Dermatology; University Hospital of Saint-Etienne; Saint Etienne France
| | - B. Labeille
- Department of Dermatology; University Hospital of Saint-Etienne; Saint Etienne France
| | - H. Raberin
- Department of Parasitology; University Hospital of Saint-Etienne; Saint Etienne France
| | - P. Flori
- Department of Parasitology; University Hospital of Saint-Etienne; Saint Etienne France
| | - F. Cambazard
- Department of Dermatology; University Hospital of Saint-Etienne; Saint Etienne France
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15
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Kurzeja M, Czuwara J, Rakowska A, Sicińska J, Maj M, Nasierowska-Guttmejer A, Rudnicka L, Olszewska M. Reflectance confocal microscopy as a non-invasive diagnostic tool for Hailey-Hailey disease. Skin Res Technol 2014; 20:503-9. [DOI: 10.1111/srt.12146] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2014] [Indexed: 11/30/2022]
Affiliation(s)
- M. Kurzeja
- Department of Dermatology; CSK MSW; Warsaw Poland
| | - J. Czuwara
- Department of Dermatology; CSK MSW; Warsaw Poland
| | - A. Rakowska
- Department of Dermatology; CSK MSW; Warsaw Poland
| | - J. Sicińska
- Department of Dermatology; CSK MSW; Warsaw Poland
| | - M. Maj
- Department of Dermatology; CSK MSW; Warsaw Poland
| | | | - L. Rudnicka
- Department of Dermatology; CSK MSW; Warsaw Poland
- Faculty of Health Sciences; Medical University of Warsaw; Warsaw Poland
- Department of Neuropeptides; Mossakowski Medical Research Centre Polish Academy of Sciences; Warsaw Poland
| | - M. Olszewska
- Department of Dermatology; Medical University of Warsaw; Warsaw Poland
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16
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Cinotti E, Fouilloux B, Perrot JL, Labeille B, Douchet C, Cambazard F. Confocal microscopy for healthy and pathological nail. J Eur Acad Dermatol Venereol 2013; 28:853-8. [DOI: 10.1111/jdv.12330] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Accepted: 11/06/2013] [Indexed: 11/28/2022]
Affiliation(s)
- E. Cinotti
- Dermatology Department; University Hospital of Saint-Etienne; Saint-Etienne France
| | - B. Fouilloux
- Dermatology Department; University Hospital of Saint-Etienne; Saint-Etienne France
| | - J. L. Perrot
- Dermatology Department; University Hospital of Saint-Etienne; Saint-Etienne France
| | - B. Labeille
- Dermatology Department; University Hospital of Saint-Etienne; Saint-Etienne France
| | - C. Douchet
- Pathology Department; University Hospital of Saint-Etienne; Saint-Etienne France
| | - F. Cambazard
- Dermatology Department; University Hospital of Saint-Etienne; Saint-Etienne France
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17
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Böhling A, Bielfeldt S, Himmelmann A, Keskin M, Wilhelm KP. Comparison of the stratum corneum thickness measuredin vivowith confocal Raman spectroscopy and confocal reflectance microscopy. Skin Res Technol 2013; 20:50-7. [DOI: 10.1111/srt.12082] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2013] [Indexed: 11/29/2022]
Affiliation(s)
- A. Böhling
- proDERM Institute for Applied Dermatological Research GmbH; Schenefeld/Hamburg Germany
| | - S. Bielfeldt
- proDERM Institute for Applied Dermatological Research GmbH; Schenefeld/Hamburg Germany
| | - A. Himmelmann
- proDERM Institute for Applied Dermatological Research GmbH; Schenefeld/Hamburg Germany
| | - M. Keskin
- proDERM Institute for Applied Dermatological Research GmbH; Schenefeld/Hamburg Germany
| | - K.-P. Wilhelm
- proDERM Institute for Applied Dermatological Research GmbH; Schenefeld/Hamburg Germany
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Słowińska M, Kardynal A, Warszawik O, Czuwara J, Rudnicka L. Alopecia areata developing paralell to improvement of psoriasis during ustekinumab therapy. J Dermatol Case Rep 2011; 4:15-7. [PMID: 21886740 DOI: 10.3315/jdcr.2010.1041] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2010] [Accepted: 03/05/2010] [Indexed: 11/11/2022]
Abstract
BACKGROUND Ustekinumab is a new immunosuppressive anti-psoriasis agent. The drug targets the p40 subunit of IL-12 and IL-23 and indirectly inhibits cytokine production by Th17 cells. MAIN OBSERVATIONS We present a case of a 36-year-old male patient with psoriasis, who received ustekinumab therapy, applied in 45mg subcutaneous injections at week 0, 4 and than every 12 weeks. After 7 months of therapy PASI decreased from 10,1 to 0,9. At this phase of therapy he developed two patches of alopecia areata on the scalp. The diagnosis was made based on clinical appearance and was confirmed by trichoscopy (hair and scalp dermoscopy) and reflectance confocal microscopy. The development of alopecia areata was preceded by emotional stress and dental infection. CONCLUSIONS Ustekinumab seems an unlikely cause of alopecia areata in this patient. However, lack of efficacy is preventing hair loss may indicate that interleukin- 12 cytokine family is not a key player in pathogenesis of alopecia areata.
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Kurzeja M, Rakowska A, Rudnicka L, Olszewska M. Criteria for diagnosing pemphigus vulgaris and pemphigus foliaceus by reflectance confocal microscopy. Skin Res Technol 2011; 18:339-46. [DOI: 10.1111/j.1600-0846.2011.00574.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2011] [Indexed: 12/01/2022]
Affiliation(s)
- Marta Kurzeja
- Department of Dermatology; CSK MSWiA; Warsaw; Poland
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Adya KA, Inamadar AC, Palit A, Shivanna R, Deshmukh NS. Light microscopy of the hair: a simple tool to "untangle" hair disorders. Int J Trichology 2011; 3:46-56. [PMID: 21769242 PMCID: PMC3129130 DOI: 10.4103/0974-7753.82124] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Light microscopy of the hair forms an important bedside clinical tool for the diagnosis of various disorders affecting the hair. Hair abnormalities can be seen in the primary diseases affecting the hair or as a secondary involvement of hair in diseases affecting the scalp. Hair abnormalities also form a part of various genodermatoses and syndromes. In this review, we have briefly highlighted the light microscopic appearance of various infectious and non-infectious conditions affecting the hair.
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Affiliation(s)
- Keshavmurthy A Adya
- Department of Dermatology, Venereology and Leprosy, Shri BM Patil Medical College, Hospital and Research Center, BLDE University, Bijapur, Karnataka, India
| | - Arun C Inamadar
- Department of Dermatology, Venereology and Leprosy, Shri BM Patil Medical College, Hospital and Research Center, BLDE University, Bijapur, Karnataka, India
| | - Aparna Palit
- Department of Dermatology, Venereology and Leprosy, Shri BM Patil Medical College, Hospital and Research Center, BLDE University, Bijapur, Karnataka, India
| | - Ragunatha Shivanna
- Department of Dermatology, Venereology and Leprosy, Shri BM Patil Medical College, Hospital and Research Center, BLDE University, Bijapur, Karnataka, India
| | - Niranjan S Deshmukh
- Department of Dermatology, Venereology and Leprosy, Shri BM Patil Medical College, Hospital and Research Center, BLDE University, Bijapur, Karnataka, India
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