1
|
Melo RR, Cortez de Almeida RF, Lemes LR, Frattini Junior S, Müller Ramos P, Melo DF. Low-dose oral minoxidil for persistent chemotherapy and radiotherapy-induced alopecia in a pediatric female patient. An Bras Dermatol 2024:S0365-0596(24)00067-9. [PMID: 38653611 DOI: 10.1016/j.abd.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 07/05/2023] [Indexed: 04/25/2024] Open
Affiliation(s)
- Raíssa Rodriguez Melo
- Dermatology Department, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | | | - Luciana Rodino Lemes
- Dermatology Department, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | - Paulo Müller Ramos
- Department of Infectious Diseases, Dermatology, Imaging Diagnosis and Radiotherapy, Faculty of Medicine, Universidade Estadual Paulista, Botucatu, SP, Brazil
| | - Daniel Fernandes Melo
- Dermatology Department, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| |
Collapse
|
2
|
Buzatto BC, Lemes LR, Cortez de Almeida RF, Machado CJ, Starace M, Piraccini BM, Alessandrini A, Quadrelli F, Marti M, Rudnicka L, Wáskiel Burnat A, Doroshkevich A, Silyuk T, Iorizzo M, Rigatti M, Tosti A, Vincenzi C, Mercau S, Sánchez-Dueñas LE, Asz Sigall D, Dos Santos Lima C, Baptista E, de Carvalho R, Faro GBDA, Doche I, Melo DF. Diffuse pattern of alopecia areata in children: A multicentre retrospective study with 67 patients. J Eur Acad Dermatol Venereol 2024. [PMID: 38407450 DOI: 10.1111/jdv.19915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 02/13/2024] [Indexed: 02/27/2024]
Affiliation(s)
- Brenda Costa Buzatto
- Department of Dermatology, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Luciana Rodino Lemes
- Department of Dermatology, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | - Carla Jorge Machado
- Preventive and Social Medicine Department, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Michela Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Aurora Alessandrini
- Dermatology Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Federico Quadrelli
- Dermatology Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Miguel Marti
- Centro de Tricologia y Transplante Capilar Dr Miguel Marti, Buenos Aires, Argentina
| | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warszawa, Poland
| | | | - Andrei Doroshkevich
- Private Practice, Hair Treatment and Transplantation Center, Saint Petersburg, Russia
| | - Tatiana Silyuk
- Private Practice, Hair Treatment and Transplantation Center, Saint Petersburg, Russia
| | - Matilde Iorizzo
- Private Dermatology Practice, Bellinzona, Lugano, Switzerland
| | - Marcelo Rigatti
- Department of Dermatology, Hair, and Nail Clinic, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Antonella Tosti
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, Miami, Florida, USA
| | | | - Sebastian Mercau
- Dermatology Department, Trichology Unit, Hospital Centenario, and Clínica de la Piel, Rosario, Argentina
| | | | - Daniel Asz Sigall
- Trichology Clinic, Department of Dermatology, Dr. Manuel Gea Gonzalez General Hospital, Mexico City, Mexico
| | - Caren Dos Santos Lima
- Department of Dermatology, University of State of Pará - UEPA, Belém, Brazil
- Department of Dermatology, University Center of Pará - CESUPA, Belém, Brazil
| | - Erica Baptista
- Department of Dermatology, University of State of Pará - UEPA, Belém, Brazil
| | | | - Gustavo Baptista de Almeida Faro
- Department of Dermatology, Hospital of the Public Servants of São Paulo - HSPM, São Paulo, Brazil
- Federal University of Sergipe - UFS, Aracaju, Brazil
| | - Isabella Doche
- Department of Dermatology, Universidade de São Paulo, Sao Paulo, Brazil
| | - Daniel Fernandes Melo
- Department of Dermatology, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| |
Collapse
|
3
|
Melo DF, Donda ALV, Cortez de Almeida RF, Antelo DAP, Muller-Ramos P, Machado CJ, Frattini S, Tosti A, Barcaui CB. Hair-to-Hair Trichoscopy: An Objective Method to Assess Effectiveness of Botulinum Toxin in a Clinical Trial for Androgenetic Alopecia. Skin Appendage Disord 2024; 10:41-45. [PMID: 38313570 PMCID: PMC10836916 DOI: 10.1159/000533796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/17/2023] [Indexed: 02/06/2024] Open
Abstract
Introduction Androgenetic alopecia (AGA) is the most common alopecia affecting both genders leading to a potential decrease in quality of life and self-esteem. A current concern in trichology is how to accurately measure clinical response in both daily medical practice and academic research. Hair-to-hair (H2H)-matching technology™ has recently emerged as a technique to evaluate variations in follicular units, hair shaft number, and thickness. This study aimed to describe the methodology employed in a clinical trial using this technology to test the efficacy of botulinum toxin (BT) for male AGA. Methods This pilot study is a triple-blind, randomized, split scalp, placebo-controlled clinical trial. Patients enrolled were submitted to injections half of the scalp with 50 IU of BT and the other half with 1 mL of normal saline as a control. The trial involved three visits (weeks 0, 12, and 24) and 8 global clinical photographs followed by H2H-matching trichoscopy were captured before the injections at each visit. Paired t test analysis was employed for matched pairs of the following parameters: total hair count, the total number of terminal hair strands, average shaft thickness, and the number of hairs lost or gained during each visit. Then, the software compared the differences between the two sides (BT vs. placebo) per scalp zone and a long time. Conclusion The combination of manually corrected image processing, follicular map, and H2H-matching technology™ appears to be the most precise way to evaluate changes in hair count and thickness over time. The design is reproducible and can help other researchers and dermatologists in their clinical practice to obtain reliable results in similar scientific research.
Collapse
Affiliation(s)
- Daniel Fernandes Melo
- Dermatology Department, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | | | | | | | - Paulo Muller-Ramos
- Dermatology Department, São Paulo State University (UNESP), Botucatu, Brazil
| | - Carla Jorge Machado
- Preventive and Social Medicine Department, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | | | - Antonella Tosti
- Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, Miami, FL, USA
| | | |
Collapse
|
4
|
Jimenez-Cauhe J, Pirmez R, Müller-Ramos P, Melo DF, Ortega-Quijano D, Moreno-Arrones OM, Saceda-Corralo D, Gil-Redondo R, Hermosa-Gelbard A, Dias-Sanabria B, Restom D, Porriño-Bustamante ML, Pindado-Ortega C, Berna-Rico E, Fernandez-Nieto D, Ramos M, Jaen-Olasolo P, Vaño-Galvan S. Safety of Low-Dose Oral Minoxidil in Patients With Hypertension and Arrhythmia: A Multicenter Study of 264 Patients. Actas Dermosifiliogr 2024; 115:T28-T35. [PMID: 37923070 DOI: 10.1016/j.ad.2023.10.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 07/20/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Systemic adverse effects (AE) are a major concern of low-dose oral minoxidil (LDOM) treatment, especially in patients with arterial hypertension or arrhythmia. The objective of this study was to evaluate the safety of LDOM in patients with hypertension or arrhythmia. PATIENTS AND METHODS Retrospective multicenter study of patients with hypertension or arrhythmia treated with LDOM for any type of alopecia. RESULTS A total of 254 patients with hypertension [176 women (69.3%) and 78 men (30.7%)] with a mean age of 56.9 years (range 19-82) were included. From them, the dose of LDOM was titrated in 128 patients, allowing the analysis of 382 doses. Patients were receiving a mean of 1.45 (range 0-5) antihypertensive drugs. Systemic AE were detected in 26 cases (6.8%) and included lightheadedness (3.1%), fluid retention (2.6%), general malaise (0.8%), tachycardia (0.8%) and headache (0.5%), leading to LDOM discontinuation in 6 cases (1.5%). Prior treatment with doxazosin (P<0.001), or with three or more antihypertensive drugs (P=0.012) was associated with a higher risk of discontinuation of LDOM. CONCLUSIONS LDOM treatment showed a favorable safety profile in patients with hypertension or arrhythmia, similar to general population.
Collapse
Affiliation(s)
- J Jimenez-Cauhe
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - R Pirmez
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - P Müller-Ramos
- Universidade Estadual Paulista - UNESP, Botucatu, São Paulo, Brazil
| | - D F Melo
- Dermatology Department, University of State of Rio de Janeiro (UERJ), Spain
| | - D Ortega-Quijano
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - O M Moreno-Arrones
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - D Saceda-Corralo
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain.
| | - R Gil-Redondo
- Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain; Dermatology Department, Hospital Universitario La Paz, Madrid, Spain
| | - A Hermosa-Gelbard
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - B Dias-Sanabria
- Universidade Federal do Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - D Restom
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - C Pindado-Ortega
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - E Berna-Rico
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain
| | - D Fernandez-Nieto
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - M Ramos
- Cardiology Department, Hospital Universitario de la Cruz Roja San Jose y Santa Adela, Universidad Alfonso X El Sabio, Madrid, Spain
| | - P Jaen-Olasolo
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - S Vaño-Galvan
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| |
Collapse
|
5
|
de Brito FOX, de Almeida RFC, Frattini S, Barcaui CB, Starace M, Melo DF. Is there a Rationale for the Use of Lymecycline for Frontal Fibrosing Alopecia? Dermatol Pract Concept 2024; 14:dpc.1401a18. [PMID: 38364412 PMCID: PMC10868803 DOI: 10.5826/dpc.1401a18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2023] [Indexed: 02/18/2024] Open
Affiliation(s)
| | | | - Sidney Frattini
- The Mole Clinic, Private Practice, Ancaster, Ontario, Canada
| | - Carlos Baptista Barcaui
- Department of Dermatology, State University of Rio de Janeiro, UERJ, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Michela Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Daniel Fernandes Melo
- Department of Dermatology, State University of Rio de Janeiro, UERJ, Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
6
|
Sarkis A, Cortez de Almeida RF, Lemes LR, Obadia DL, Machado CJ, Müller-Ramos P, Pedretti M, Starace M, Quadrelli F, Piraccini BM, Alessandrini A, Rossi A, Saceda-Corralo D, Khobzei K, Iorizzo M, Vañó-Galván S, Silyuk T, Tosti A, Vincenzi C, Fechine COC, Anzai A, Rigatti M, Minotto R, D'Atri G, Kakizaki P, Mercau S, Oliveira-Soares R, Navarro Tuculet C, Cappetta ME, Alves LD, Pinto GM, Lima CDS, Frattini S, Melo DF. Folliculitis decalvans in women: A retrospective multicentre study of 150 patients. J Eur Acad Dermatol Venereol 2024; 38:e66-e70. [PMID: 37594799 DOI: 10.1111/jdv.19434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 08/09/2023] [Indexed: 08/19/2023]
Affiliation(s)
- Aline Sarkis
- Department of Dermatology, State University of Rio de Janeiro - UERJ, Rio de Janeiro, Brazil
| | | | - Luciana Rodino Lemes
- Department of Dermatology, State University of Rio de Janeiro - UERJ, Rio de Janeiro, Brazil
| | - Daniel Lago Obadia
- Department of Dermatology, State University of Rio de Janeiro - UERJ, Rio de Janeiro, Brazil
| | - Carla Jorge Machado
- Preventive and Social Medicine Department, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Paulo Müller-Ramos
- Department of Dermatology and Radiotherapy, Universidade Estadual Paulista - UNESP, Botucatu, Brazil
| | - Manuela Pedretti
- Department of Dermatology, State University of Rio de Janeiro - UERJ, Rio de Janeiro, Brazil
| | - Michela Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Federico Quadrelli
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Aurora Alessandrini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Alfredo Rossi
- Department of Internal Medicine and Medical Specialties, University of Rome "La Sapienza", Rome, Italy
| | - David Saceda-Corralo
- Dermatology Department, Trichology Unit, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria, University of Alcalá, Madrid, Spain
| | | | - Matilde Iorizzo
- Private Dermatology Practice, Bellinzona/Lugano, Switzerland
| | - Sergio Vañó-Galván
- Dermatology Department, Trichology Unit, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria, University of Alcalá, Madrid, Spain
| | - Tatiana Silyuk
- Private Practice, Hair Treatment and Transplantation Center, Saint Petersburg, Russian Federation
| | - Antonella Tosti
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, Miami, Florida, USA
| | | | | | - Alessandra Anzai
- Department of Dermatology, Universidade de São Paulo - USP, São Paulo, Brazil
| | - Marcelo Rigatti
- Department of Dermatology, Hair and Nail Clinic - Federal University of Santa Catarina, Florianópolis, Brazil
| | - Renan Minotto
- Department of Dermatology, Hospital Santa Casa de Porto Alegre, Porto Alegre, Brazil
| | - Gisela D'Atri
- Grupo MCI (Integral Hair Medicine), Private Dermatology Practice, Buenos Aires, Argentina
| | - Priscila Kakizaki
- Department of Dermatology, Hospital do Servidor Público Municipal de São Paulo, São Paulo, Brazil
| | - Sebastian Mercau
- Dermatology Department, Trichology Unit, Hospital Centenario, and Clínica de la Piel, Rosario, Argentina
| | | | | | | | - Lorena Dourado Alves
- Department of Tropical Medicine and Dermatology, Federal University of Goiás, Goiânia, Brazil
| | | | - Caren Dos Santos Lima
- Department of Dermatology, University of State of Pará - UEPA, Belém, Brazil
- Department of Dermatology, University Center of Pará - CESUPA, Belém, Brazil
| | - Simone Frattini
- Public Health Services, The City of Hamilton, Hamilton, Ontario, Canada
| | - Daniel Fernandes Melo
- Department of Dermatology, State University of Rio de Janeiro - UERJ, Rio de Janeiro, Brazil
| |
Collapse
|
7
|
Jimenez-Cauhe J, Pirmez R, Müller-Ramos P, Melo DF, Ortega-Quijano D, Moreno-Arrones OM, Saceda-Corralo D, Gil-Redondo R, Hermosa-Gelbard A, Dias-Sanabria B, Restom D, Porriño-Bustamante ML, Pindado-Ortega C, Berna-Rico E, Fernandez-Nieto D, Ramos M, Jaen-Olasolo P, Vaño-Galvan S. Safety of Low-Dose Oral Minoxidil in Patients With Hypertension and Arrhythmia: A Multicenter Study of 264 Patients. Actas Dermosifiliogr 2024; 115:28-35. [PMID: 37652097 DOI: 10.1016/j.ad.2023.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/16/2023] [Accepted: 07/20/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Systemic adverse effects (AE) are a major concern of low-dose oral minoxidil (LDOM) treatment, especially in patients with arterial hypertension or arrhythmia. The objective of this study was to evaluate the safety of LDOM in patients with hypertension or arrhythmia. PATIENTS AND METHODS Retrospective multicenter study of patients with hypertension or arrhythmia treated with LDOM for any type of alopecia. RESULTS A total of 254 patients with hypertension [176 women (69.3%) and 78 men (30.7%)] with a mean age of 56.9 years (range 19-82) were included. From them, the dose of LDOM was titrated in 128 patients, allowing the analysis of 382 doses. Patients were receiving a mean of 1.45 (range 0-5) antihypertensive drugs. Systemic AE were detected in 26 cases (6.8%) and included lightheadedness (3.1%), fluid retention (2.6%), general malaise (0.8%), tachycardia (0.8%) and headache (0.5%), leading to LDOM discontinuation in 6 cases (1.5%). Prior treatment with doxazosin (P<0.001), or with three or more antihypertensive drugs (P=0.012) was associated with a higher risk of discontinuation of LDOM. CONCLUSIONS LDOM treatment showed a favorable safety profile in patients with hypertension or arrhythmia, similar to general population.
Collapse
Affiliation(s)
- J Jimenez-Cauhe
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - R Pirmez
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - P Müller-Ramos
- Universidade Estadual Paulista - UNESP, Botucatu, São Paulo, Brazil
| | - D F Melo
- Dermatology Department, University of State of Rio de Janeiro (UERJ), Spain
| | - D Ortega-Quijano
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - O M Moreno-Arrones
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - D Saceda-Corralo
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain.
| | - R Gil-Redondo
- Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain; Dermatology Department, Hospital Universitario La Paz, Madrid, Spain
| | - A Hermosa-Gelbard
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - B Dias-Sanabria
- Universidade Federal do Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - D Restom
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - C Pindado-Ortega
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - E Berna-Rico
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain
| | - D Fernandez-Nieto
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - M Ramos
- Cardiology Department, Hospital Universitario de la Cruz Roja San Jose y Santa Adela, Universidad Alfonso X El Sabio, Madrid, Spain
| | - P Jaen-Olasolo
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - S Vaño-Galvan
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| |
Collapse
|
8
|
Rodriguez Melo R, Cortez de Almeida RF, Starace MVR, Melo DF. Positive Anagen Pull Test Predicting Lichen Planopilaris Activity. Dermatol Pract Concept 2023; 13:e2023140. [PMID: 37557158 PMCID: PMC10412071 DOI: 10.5826/dpc.1303a140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2022] [Indexed: 08/11/2023] Open
Affiliation(s)
- Raíssa Rodriguez Melo
- Department of Dermatology, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | | | - Michela Valeria Rita Starace
- Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Daniel Fernandes Melo
- Department of Dermatology, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| |
Collapse
|
9
|
Starace M, Yamagata JP, Cortez de Almeida RF, Frattini S, Bruni F, Alessandrini A, Iorizzo M, Melo DF, Neri I, Piraccini BM. A Practical Algorithm for the Management of Superficial Folliculitis of the Scalp: 10 Years of Clinical and Dermoscopy Experience. Dermatol Pract Concept 2023; 13:e2023131. [PMID: 37557142 PMCID: PMC10412046 DOI: 10.5826/dpc.1303a131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2023] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION Superficial folliculitis of the scalp (SFS) is a common complaint in clinical practice, and initial presentation may be difficult to differentiate as they may appear very similar to each other. OBJECTIVES The aim of this thesis is to describe the pathologies that occur clinically as folliculitis of the scalp, identify their causes and characteristics and create a standardized classification. METHODS This is a retrospective clinical, dermoscopic and histopathological study over 10 years of dermatologic consultations. Only individuals with a confirmed diagnosis of SFS (updated diagnostic criteria or biopsy) were included. RESULTS In this review, we describe the various clinical features of different causes of SFS in ninety-nine cases and divided into infectious due to fungus, bacteria, or virus and inflammatory conditions such as rosacea, acneiform eruption and Ofuji syndrome. CONCLUSIONS The clinician must differentiate SFS from other underlying scarring disorders to prevent poorer outcomes. We created an algorithm to help the clinician reach a proper diagnosis.
Collapse
Affiliation(s)
- Michela Starace
- Dermatology - IRCCS Azianda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - João Paulo Yamagata
- Department of Dermatology, State University of Rio de Janeiro – UERJ, Rio de Janeiro – RJ, Brazil
| | | | - Simone Frattini
- Mental Health Department, Guelph General Hospital, Guelph, ON, Canada
| | - Francesca Bruni
- Dermatology - IRCCS Azianda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Aurora Alessandrini
- Dermatology - IRCCS Azianda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Matilde Iorizzo
- Private Dermatology Practice, Bellinzona/Lugano, Switzerland
| | - Daniel Fernandes Melo
- Department of Dermatology, State University of Rio de Janeiro – UERJ, Rio de Janeiro – RJ, Brazil
| | - Iria Neri
- Dermatology - IRCCS Azianda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology - IRCCS Azianda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| |
Collapse
|
10
|
Leroy AK, Cortez de Almeida RF, Obadia DL, Frattini S, Melo DF. Scalp Seborrheic Dermatitis: What We Know So Far. Skin Appendage Disord 2023. [DOI: 10.1159/000529854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
Abstract
Scalp seborrheic dermatitis (SSD) is a prevalent chronic, relapsing inflammatory skin disease. The etiology is related to sebum production, bacterial proliferation – <i>Staphylococcus</i> sp., <i>Streptococcus</i>, and <i>M. restricta</i> – and host immunity factors – NK1+, CD16+ cells, IL-1, and IL-8. Trichoscopy features include mostly arborizing vessels and yellowish scales. New trichoscopic findings were described to guide the diagnosis as dandelion vascular conglomerate, “cherry blossom” vascular pattern, and intrafollicular oily material. Antifungals and corticosteroids constitute the essential therapy, but new treatments have been described. This article aims to review and discuss the etiology, pathophysiology, trichoscopy, histopathologic findings, main differential diagnoses, and therapeutic options of SSD.
Collapse
|
11
|
de Brito FOX, de Almeida RFC, Machado CJ, Lemes LR, Donda ALV, Blanco A, Silveira ALG, Munck A, Dos Santos Lima C, Canela CPC, Fechine COC, Obadia DL, Pinto GM, Alves LD, Dias MFRG, Benez M, Rigatti M, Paiva NTEKM, Kakizaki P, Minotto R, Frattini S, Ramos PM, Melo DF. Frontal Fibrosing Alopecia associated with Lichen Planus Pigmentosus: a multicenter retrospective descriptive analytical study of 104 patients. J Eur Acad Dermatol Venereol 2023. [PMID: 37016987 DOI: 10.1111/jdv.19093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 03/27/2023] [Indexed: 04/06/2023]
Affiliation(s)
| | | | - Carla Jorge Machado
- Preventive and Social Medicine Department, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Luciana Rodino Lemes
- Department of Dermatology, State University of Rio de Janeiro - UERJ, Rio de Janeiro, RJ, Brazil
| | - Andre Luiz Vairo Donda
- Department of Dermatology, State University of Rio de Janeiro - UERJ, Rio de Janeiro, RJ, Brazil
| | - Aline Blanco
- Department of Dermatology, Hospital Universitário Maria Aparecida Pedrossian, Campo Grande, MS, Brazil
| | | | - Andreia Munck
- Department of Dermatology - Mogi das Cruzes University - UMC, Mogi das Cruzes, SP, Brazil
| | - Caren Dos Santos Lima
- Department of Dermatology, University of State of Pará - UEPA, Belém, PA, Brazil
- Department of Dermatology, University Center of Pará - CESUPA, Belém, PA, Brazil
| | | | | | - Daniel Lago Obadia
- Department of Dermatology, State University of Rio de Janeiro - UERJ, Rio de Janeiro, RJ, Brazil
| | | | - Lorena Dourado Alves
- Department of Tropical Medicine and Dermatology, Federal University of Goias - UFG, Goiânia, GO, Brazil
| | | | - Marcela Benez
- Department of Dermatology, State University of Rio de Janeiro - UERJ, Rio de Janeiro, RJ, Brazil
| | - Marcelo Rigatti
- Department of Dermatology, Federal University of Santa Catarina - UFSC, Florianópolis, SC, Brazil
| | | | - Priscila Kakizaki
- Department of Dermatology, Hospital do Servidor Público Municipal de São Paulo, São Paulo, SP, Brazil
| | - Renan Minotto
- Department of Dermatology, Hospital Santa Casa de Porto Alegre, Porto Alegre, RS, Brazil
| | | | - Paulo Müller Ramos
- Department of Dermatology, São Paulo State University - UNESP, Botucatu, SP, Brazil
| | - Daniel Fernandes Melo
- Department of Dermatology, State University of Rio de Janeiro - UERJ, Rio de Janeiro, RJ, Brazil
| |
Collapse
|
12
|
Müller Ramos P, Melo DF, Radwanski H, de Almeida RFC, Miot HA. Female pattern hair loss: therapeutic update. An Bras Dermatol 2023:S0365-0596(23)00053-3. [PMID: 37003900 DOI: 10.1016/j.abd.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 04/03/2023] Open
Abstract
Female androgenetic alopecia or female-pattern hair loss (FPHL) is highly prevalent and has a great impact on the quality of life. The treatment is a routine challenge in dermatological practice, as many therapeutic options have a limited level of evidence and often do not meet patients expectations. Lack of knowledge of the pathogenesis of the hair miniaturization process and the factors that regulate follicular morphogenesis restricts the prospect of innovative therapies. There is also a lack of randomized, controlled studies with longitudinal follow-up, using objective outcomes and exploring the performance of the available treatments and their combinations. Topical minoxidil, which has been used to treat female pattern hair loss since the 1990s, is the only medication that has a high level of evidence and remains the first choice. However, about 40% of patients do not show improvement with this treatment. In this article, the authors critically discuss the main clinical and surgical therapeutic alternatives for FPHL, as well as present camouflage methods that can be used in more extensive or unresponsive cases.
Collapse
Affiliation(s)
- Paulo Müller Ramos
- Department of Dermatology, Faculty of Medicine, Universidade Estadual Paulista, Botucatu, SP, Brazil.
| | - Daniel Fernandes Melo
- Department of Dermatology, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | | | - Hélio Amante Miot
- Department of Dermatology, Faculty of Medicine, Universidade Estadual Paulista, Botucatu, SP, Brazil
| |
Collapse
|
13
|
Massiot P, Pinto PC, Leclerc-Mercier S, Rasmont V, Piraccini BM, Rudnicka L, Reygagne P, Melo DF, Vano-Galvan S, Wu WY, Kerob D. Clinical benefit and tolerance profile of a keratolytic and hydrating shampoo in subjects with mild to moderate psoriasis. Results from a double-blind, randomized, vehicle-controlled study. J Cosmet Dermatol 2023. [PMID: 36942745 DOI: 10.1111/jocd.15693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/12/2023] [Accepted: 02/14/2023] [Indexed: 03/23/2023]
Abstract
INTRODUCTION Scalp psoriasis frequently goes with other disease location and may lead to a significant burden and impairment of quality of life (QoL). Adherence to local treatments is a frequent problem. A keratolytic and hydrating shampoo containing 2% salicylic acid, 5% urea, and 1% glycerin (active shampoo) has been developed for psoriasis-prone scalp. OBJECTIVE To assess the efficacy and tolerability of an active shampoo in subjects with mild to moderate scalp psoriasis. MATERIALS AND METHODS A single-center, randomized, double-blind, vehicle-controlled study was conducted on 67 adults with mild to moderate psoriasis. The active shampoo or its vehicle were applied daily for 14 days and 3 times/week for another 14 days. Assessments included the Psoriasis Scalp Severity Index (PSSI), Investigator Global Assessment (IGA), calculated total surface affected hair, scalp greasiness, irritation, and assessed scalp dermatitis-specific quality-of-life issues using SCALPDEX and product acceptability. RESULTS The active shampoo significantly (p < 0.05) reduced the PSSI by 39.0%, 37.2%, 63.0%, and 69.0% immediately after washing compared to a 22.8%, 5.5%, 19.6%, and 13.0% with the vehicle at Days 1, 8, 15, and 30, respectively. SCALPDEX items, IGA, and irritation significantly (p < 0.05) reduced with the active shampoo. Hair and scalp greasiness improved continuously with both products until Day 21. Subject-reported symptom scores paralleled the positive evolution of clinical signs. The active shampoo was well tolerated, subjects were highly satisfied and had an improved QoL. CONCLUSION The active shampoo significantly improved clinical signs, symptoms, and QoL of mild-to-moderate scalp psoriasis compared to the vehicle. It was very well tolerated and highly appreciated by the subjects.
Collapse
Affiliation(s)
| | | | | | | | - Bianca Maria Piraccini
- Division of Dermatology, Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Bologna, Italy
| | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | | | - Daniel Fernandes Melo
- Department of Dermatology, University of State of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Sergio Vano-Galvan
- Ramon y Cajal University Hospital, TricoHRC, IRYCIS, University of Alcala, Madrid, Spain
| | - Wen-Yu Wu
- Department of Dermatology, Huashan Hospital Fudan University, Shanghai, China
| | | |
Collapse
|
14
|
Cortez de Almeida RF, Melo DF, Tosti A. Scalp Microinfusion: A Novel Drug Delivery Technique for Hair Loss Treatment. Skin Appendage Disord 2023; 9:81-83. [PMID: 36937154 PMCID: PMC10015642 DOI: 10.1159/000528446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 11/23/2022] [Indexed: 01/06/2023] Open
Abstract
Scalp microinfusion is a promising novel drug delivery technique for hair loss treatment. We discuss the MMP® technique and review its possible use in alopecias. MMP® technique provides a small amount of drugs delivered homogeneously into the skin combined with micro-needling and can, therefore, provide optimal delivery. However, literature on this technique is limited to a few case reports despite its wide use in some countries. Further studies are needed to standardize protocols.
Collapse
Affiliation(s)
| | - Daniel Fernandes Melo
- Department of Dermatology, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Antonella Tosti
- Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, Miami, Florida, USA
| |
Collapse
|
15
|
Cajas-Garcia MS, Cortez de Almeida RF, Medaglia CRM, Saceda-Corralo D, Araújo Fonte Boa M, Frattini S, Müller Ramos P, Melo DF. Distinct presentations of scalp dissecting cellulitis manifesting with furrows and gyri. J Eur Acad Dermatol Venereol 2023; 37:e786-e788. [PMID: 36734209 DOI: 10.1111/jdv.18933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 02/01/2023] [Indexed: 02/04/2023]
Affiliation(s)
- Maria Salomé Cajas-Garcia
- Department of Dermatology, Rio de Janeiro State University (UERJ), Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - David Saceda-Corralo
- Trichology Unit, Dermatology Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria, University of Alcalá, Madrid, Spain
| | - Marina Araújo Fonte Boa
- Department of Dermatology, Rio de Janeiro State University (UERJ), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sidney Frattini
- The Mole Clinic, Private Practice, Ancaster, Ontario, Canada
| | - Paulo Müller Ramos
- Department of Dermatology and Radiotherapy, São Paulo State University, Botucatu, São Paulo, Brazil
| | - Daniel Fernandes Melo
- Department of Dermatology, Rio de Janeiro State University (UERJ), Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
16
|
Melo DF, Tagliolatto S, Studart AC, Gallo BF, Machado CJ, Frattini SC, Weffort F, Cortez de Almeida RF. Is There a Rationale for the Use of an Alpha-Melanocyte-Stimulating Hormone Analog to Improve Gray Hair Repigmentation? Skin Appendage Disord 2023; 9:50-53. [PMID: 36643199 PMCID: PMC9833004 DOI: 10.1159/000527605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 10/12/2022] [Indexed: 11/27/2022] Open
Affiliation(s)
- Daniel Fernandes Melo
- Department of Dermatology, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | | | - Carla Jorge Machado
- Preventive and Social Medicine Department, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | - Flavia Weffort
- Department of Dermatology, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | |
Collapse
|
17
|
de Andrade Lima MMD, Benez M, Gamonal SBL, Melo DF, Tortelly VD, Frattini S, de Andrade Lima EV. Percutaneous collagen induction (microneedling) for scarring alopecia in discoid lupus erythematosus of the scalp. J Cosmet Dermatol 2022; 21:6479-6481. [PMID: 35676760 DOI: 10.1111/jocd.15149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/30/2022] [Accepted: 06/06/2022] [Indexed: 12/27/2022]
Affiliation(s)
| | - Marcela Benez
- Department of Dermatology, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Shirley B L Gamonal
- Department of Dermatology, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil.,Department of Dermatology, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, Brazil.,Department of Dermatology, Faculdade de Ciências Médicas e da Saúde de Juiz de Fora (SUPREMA), Juiz de Fora, Brazil
| | - Daniel Fernandes Melo
- Department of Dermatology, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Violeta Duarte Tortelly
- Department of Dermatology, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Simone Frattini
- Department of Mental health, Guelph General Hospital, Guelph, Canada
| | | |
Collapse
|
18
|
Melo DF, Cortez de Almeida RF, Frattini SC, Santos LDN, Ramos PM. Minimally invasive procedures for the management of female pattern hair loss. J Cosmet Dermatol 2022; 21:5405-5408. [PMID: 35713007 DOI: 10.1111/jocd.15160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/25/2022] [Accepted: 06/13/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Female Pattern Hair Loss (FPHL) is one of the most common types of hair loss in women. It is characterized by progressive follicular miniaturization leading to diffuse hair thinning over the midfrontal scalp with a negative impact on quality of life. Pharmacological treatments are commonly used, and hair follicle transplantation is an option for those cases with adequate donor area. Minimally invasive procedures, such as microneedling, mesotherapy, microinfusion of drugs into the scalp with tattoo machines (MMP®), and platelet-rich plasma (PRP) have been reported as adjuvant treatments. AIMS This study aims to summarize and discuss the efficacy of minimally invasive procedures described for the management of FPHL. METHODS Published articles indexed on the Pubmed database and Scopus that described minimally invasive procedures for the management of FPHL in humans were considered. Citations were reviewed and added for completeness. The search was for articles in English only. After excluding duplicate titles, 23 relevant articles were considered. CONCLUSION Minimally invasive procedures are promising options and may play a role in FPHL treatment. They can be used as adjunctive therapy for FPHL, in case of poor response to clinical therapy, or when patients prefer other care than the standard. We reinforce that these methods should be performed by an experienced medical professional following strict aseptic techniques. However, microneedling, mesotherapy, MMP, and PRP lack standardization and are supported by a low level of evidence yet. For the future, larger randomized clinical trials are essential to determine the efficacy and optimal protocols for these treatments.
Collapse
Affiliation(s)
- Daniel Fernandes Melo
- Department of Dermatology, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | | | | | | | - Paulo Müller Ramos
- Department of Dermatology and Radiotherapy, São Paulo State University (UNESP), Botucatu, Brazil
| |
Collapse
|
19
|
Carvalho RDM, Santos LDN, Ramos PM, Machado CJ, Acioly P, Frattini SC, Barcaui CB, Donda ALV, Melo DF. Bicalutamide and the new perspectives for female pattern hair loss treatment: What dermatologists should know. J Cosmet Dermatol 2022; 21:4171-4175. [PMID: 35032336 DOI: 10.1111/jocd.14773] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 01/09/2022] [Accepted: 01/10/2022] [Indexed: 01/06/2023]
Abstract
Female pattern hair loss (FPHL) is the most common form of alopecia in women. FPHL may compromise body image and strongly affect self-esteem, negatively impacting quality of life. Currently, the only Food and Drug Administration (FDA) approved drug for its treatment is topical minoxidil, with a variable response rate. Recently, a few studies in FPHL have pointed out bicalutamide as an emergent selective androgen receptor antagonist with a favorable safety and tolerability profile. This review aimed to summarize and discuss the key information on this new therapy for FPHL. Bicalutamide has no diuretic effect. It does not cross the blood-brain barrier, and it has little effect on serum luteinizing hormone. Additionally, bicalutamide was found to be effective on women presenting with other features of hyperandrogenism such as seborrhea, acne, and hirsutism with mild and well-tolerated adverse effects. Despite the high prevalence and psychosocial impairment, FPHL treatment remains challenging. Therefore, although future prospective, comparative, randomized clinical trials are essential to establish the ideal dose and efficacy of the drug, oral bicalutamide appears to be a promising option to expand the arsenal of FPHL treatment.
Collapse
Affiliation(s)
| | | | - Paulo Müller Ramos
- Department of Dermatology and Radiotherapy, São Paulo State University (UNESP), Botucatu, Brazil
| | - Carla Jorge Machado
- Preventive and Social Medicine Department, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Patricia Acioly
- Dermatology Department, University of State of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | | | - Carlos Baptista Barcaui
- Dermatology Department, University of State of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - André Luiz Vairo Donda
- Dermatology Department, University of State of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Daniel Fernandes Melo
- Dermatology Department, University of State of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| |
Collapse
|
20
|
Cortez de Almeida RF, Ferreira BDFM, Melo DF, Benez M, Vincenzi C, Starace M, Tosti A. Dermoscopic Findings of Discoid Lupus Erythematosus Involving the Eyelids. Skin Appendage Disord 2022; 8:424-426. [PMID: 36161083 PMCID: PMC9485923 DOI: 10.1159/000524239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 03/16/2022] [Indexed: 09/03/2023] Open
Abstract
Introduction Although facial involvement in discoid lupus erythematosus (DLE) is common, eyelid involvement is atypical. Identifying this condition is challenging due to misdiagnosis, and it is essential to avoid potential deformities of the eyelid margin. Case Presentation We, herein, report the dermoscopic findings in 2 female patients with a confirmed diagnosis of DLE who presented eyelids involvement. Discussion/Conclusion This study highlights the importance of performing a dermoscopy examination to help physicians obtain an early diagnosis of DLE.
Collapse
Affiliation(s)
| | | | - Daniel Fernandes Melo
- Department of Dermatology, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Marcela Benez
- Department of Dermatology, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | | | - Michela Starace
- Dermatology-IRCCS, Policlinico Sant'Orsola, Department of Specialized, Experimental and Diagnostic Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Antonella Tosti
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, Miami, Florida, USA
| |
Collapse
|
21
|
Machado JLR, Cortez de Almeida RF, Frattini SC, Melo DF. Perinevoid alopecia: an unusual presentation of alopecia areata. Dermatol Pract Concept 2022; 12:e2022112. [PMID: 36159147 PMCID: PMC9464527 DOI: 10.5826/dpc.1203a112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2021] [Indexed: 11/26/2022] Open
Affiliation(s)
| | | | | | - Daniel Fernandes Melo
- Dermatology Department, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
22
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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
| |
Collapse
|
23
|
Martinez DDAES, Sodré JL, Regis JR, de Mattos Barreto T, Santos LDN, Ramos PM, Frattini S, Weffort F, Melo DF. Hair transplantation in uncommon secondary cicatricial alopecias. Dermatol Ther 2022; 35:e15592. [PMID: 35604795 DOI: 10.1111/dth.15592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/18/2022] [Accepted: 05/19/2022] [Indexed: 11/30/2022]
Abstract
Secondary cicatricial alopecia is the follicular destruction caused by infections, neoplastic conditions, burns, or trauma to the dermis. Hair restoration surgery has been used successfully as an option for androgenetic alopecia and stable primary cicatricial alopecia with favorable outcomes. However, little is known about hair restoration surgery for secondary cicatricial alopecia, especially to affected areas other than the scalp. A good surgical outcome may bring a remarkable psychosocial impact to patients with cicatricial alopecia. This paper presents three uncommon cases of secondary cicatricial alopecia successfully treated with hair restoration surgery.
Collapse
Affiliation(s)
| | - João Luz Sodré
- Department of Dermatology, State University of Rio de Janeiro - UERJ, Rio de Janeiro, RJ, Brazil
| | - José Rogerio Regis
- Departament of Dermatology, Santa de Misericórdia de Belo Horizonte, Belo Horizonte, MG, Brazil
| | | | | | - Paulo Müller Ramos
- Department of Dermatology, São Paulo State University - UNESP, Botucatu, São Paulo - SP, Brazil
| | - Simone Frattini
- Mental Health Department, Guelph General Hospital, Guelph, Canada
| | - Flávia Weffort
- Department of Dermatology, State University of Rio de Janeiro - UERJ, Rio de Janeiro, RJ, Brazil
| | - Daniel Fernandes Melo
- Department of Dermatology, State University of Rio de Janeiro - UERJ, Rio de Janeiro, RJ, Brazil
| |
Collapse
|
24
|
Melo DF, Ramos PM, Machado CJ, Anzai A, Blanco A, Mulinari‐Brenner F, Pinto GM, Abraham LS, Alves LD, Rigatti M, Rivitti‐Machado MC, Kakizaki P, Minotto R, Macedo TB, Santos TS, Doche I. Dissecting cellulitis in women: a retrospective multicenter study with 17 patients. Int J Dermatol 2022; 61:e427-e430. [DOI: 10.1111/ijd.16271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 02/22/2022] [Accepted: 04/26/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Daniel Fernandes Melo
- Department of Dermatology Universidade do Estado do Rio de Janeiro Rio de Janeiro Brazil
| | - Paulo Müller Ramos
- Department of Dermatology Universidade Estadual Paulista Botucatu Brazil
| | - Carla Jorge Machado
- Preventive and Social Medicine Department Universidade Federal de Minas Gerais Belo Horizonte Brazil
| | - Alessandra Anzai
- Department of Dermatology Universidade de São Paulo Sao Paulo Brazil
| | - Aline Blanco
- Department of Dermatology Universidade Federal de São Paulo Soa Paulo Brazil
- Department of Dermatology Universidade Federal do Mato Grosso do Sul Campo Grande Brazil
| | | | | | | | - Lorena Dourado Alves
- Department of Tropical Medicine and Dermatology Universidade Federal de Goias Goiania Brazil
| | - Marcelo Rigatti
- Department of Dermatology Universidade Federal de Santa Catarina Florianopolis Brazil
| | | | - Priscila Kakizaki
- Department of Dermatology State Civil Servant Hospital of Sao Paulo Sao Paulo Brazil
| | - Renan Minotto
- Department of Dermatology Santa Casa Hospital Federal University of Health Sciences Porto Alegre Brazil
| | | | | | - Isabella Doche
- Department of Dermatology Universidade de São Paulo Sao Paulo Brazil
| |
Collapse
|
25
|
Melo DF, Müller Ramos P, Iorizzo M, Lima CDS, Pinto EB, Cortez de Almeida RF, Machado CJ, Starace M. Epidemiological, Clinical, Trichoscopic, and Histopathological Features of Lupus Erythematous Mimicking Alopecia Areata: A Multicenter Retrospective Study. Skin Appendage Disord 2022; 8:236-240. [PMID: 35707286 PMCID: PMC9149462 DOI: 10.1159/000520825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 11/03/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction All types of lupus erythematosus (LE) may cause hair loss. Nonscarring alopecia was correlated with systemic LE, based on its high specificity. Discoid LE can also appear as nonscarring patches in early stages. Patchy alopecia LE-specific may also mimic alopecia areata (AA) - which can co-occur with LE. The distinction is fundamental to early diagnosis and effective treatment. This study aims to analyze clinical, epidemiological, trichoscopic, and histopathological features of patients with patchy LE-specific alopecia, nonscarring type, mimicking AA. Methods This is a multicentric retrospective study. We reviewed the medical records of patients with a confirmed diagnosis of LE mimicking AA. Results Ten patients were included (90% female) with a mean age of 45.9 years. Clinically, 60% showed erythema and 70% presented incomplete hair loss. The most common trichoscopic findings were interfollicular arborizing vessels (90%) and scattered brown discoloration (80%). On histopathology, perivascular inflammation (85.7%), peribulbar lymphocytes (85.7%), and dermal pigment incontinence (71.4%) were present in most cases. Discussion/Conclusion Trichoscopy was found as an essential first step for the patchy alopecia diagnosis, enabling to differentiate LE from AA. Putting it mildly, trichoscopy raises the suspicion that leads to a biopsy, increasing the diagnostic accuracy with better outcome for patients.
Collapse
Affiliation(s)
- Daniel Fernandes Melo
- Department of Dermatology, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Paulo Müller Ramos
- Department of Dermatology and Radiotherapy, São Paulo State University (UNESP), Botucatu, Brazil
| | | | - Caren dos Santos Lima
- Department of Dermatology, State University of Pará (UEPA), Belém, Brazil
- Department of Dermatology, University Center of Pará (CESUPA), Belém, Brazil
| | | | | | - Carla Jorge Machado
- Preventive and Social Medicine Department, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Michela Starace
- Department of Specialized, Experimental and Diagnostic Medicine, Dermatology − IRCCS, Policlinico Sant'Orsola, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| |
Collapse
|
26
|
de Mattos Barreto T, Xavier de Brito EO, Medina Vilela G, Melo DF. Atypical Frontal Fibrosing Alopecia presentation in a male patient associated with spontaneous reversal of canities. J Eur Acad Dermatol Venereol 2022; 36:e568-e570. [DOI: 10.1111/jdv.18064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 02/02/2022] [Accepted: 03/02/2022] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | - Daniel Fernandes Melo
- Dermatology Department Universidade do Estado do Rio de Janeiro Rio de Janeiro Brazil
| |
Collapse
|
27
|
Barreto TDM, Cortez de Almeida RF, Ramos PM, Jeunon T, Melo DF. The watch sign: an atypical clinical finding of frontal fibrosing alopecia in two male patients. J Eur Acad Dermatol Venereol 2022; 36:e437-e439. [PMID: 35034396 DOI: 10.1111/jdv.17934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/04/2021] [Accepted: 01/07/2022] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Paulo Müller Ramos
- Department of Dermatology and Radiotherapy, Universidade Estadual Paulista - UNESP, Botucatu, SP, Brazil
| | - Thiago Jeunon
- ID- Investigação em Dermatologia, Rio de Janeiro, RJ, Brazil
| | - Daniel Fernandes Melo
- Department of Dermatology, State University of Rio de Janeiro - UERJ, Rio de Janeiro, RJ, Brazil
| |
Collapse
|
28
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
29
|
Melo DF, Lima CDS, Piraccini BM, Tosti A. Trichotillomania: What Do We Know So Far? Skin Appendage Disord 2022; 8:1-7. [PMID: 35118122 PMCID: PMC8787581 DOI: 10.1159/000518191] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 06/25/2021] [Indexed: 01/03/2023] Open
Abstract
Trichotillomania is defined as an obsessive-compulsive or related disorder in which patients recurrently pull out hair from any region of their body. The disease affects mainly female patients, who often deny the habit, and it usually presents with a bizarre pattern nonscarring patchy alopecia with short hair and a negative pull test. Trichoscopy can reveal the abnormalities resulting from the stretching and fracture of hair shafts, and biopsy can be necessary if the patient or parents have difficulties in accepting the self-inflicted nature of a trichotillomania diagnosis. Trichotillomania requires a comprehensive treatment plan and interdisciplinary approach. Physicians should always have a nonjudgmental, empathic, and inviting attitude toward the patient. Behavioral therapy has been used with success in the treatment of trichotillomania, but not all patients are willing or able to comply with this treatment strategy. Pharmacotherapy can be necessary, especially in adolescents and adult patients. Options include tricyclic antidepressants, selective serotonin reuptake inhibitors, and glutamate-modulating agents. Glutamate-modulating agents such as N-acetylcysteine are a good first-line option due to significant benefits and low risk of side effects. Physicians must emphasize that the role of psychiatry-dermatology liaison is extremely necessary with concurrent support services for the patient and parents, in case of pediatric patients. In pediatric cases, parents should be advised and thoroughly educated that negative feedback and punishment for hair pulling are not going to produce positive results. Social support is a significant pillar to successful habit reversal training; therefore, physicians must convey the importance of familial support to achieving remission. This is a review article that aims to discuss the literature on trichotillomania, addressing etiology, historical aspects, clinical and trichoscopic features, main variants, differential diagnosis, diagnostic clues, and psychological and pharmacological management.
Collapse
Affiliation(s)
- Daniel Fernandes Melo
- Dermatology Department, University of State of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil,*Daniel Fernandes Melo,
| | - Caren dos Santos Lima
- Dermatology Department, University of State of Pará (UEPA), Belém, Brazil,Dermatology Department, University Center of Pará (CESUPA), Belém, Brazil
| | - Bianca Maria Piraccini
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, Bologna, Italy,IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Antonella Tosti
- Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, Miami, Florida, USA
| |
Collapse
|
30
|
Melo DF, Saceda-Corralo D, Tosti A, Weffort F, Carla Jorge M, de Barros CC, de Melo Carvalho R, Starace M. Frontal edema due to mesotherapy for androgenetic alopecia: A case series. Dermatol Ther 2021; 35:e15247. [PMID: 34877759 DOI: 10.1111/dth.15247] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/27/2021] [Accepted: 12/02/2021] [Indexed: 11/29/2022]
Abstract
Androgenetic alopecia (AGA) is the most common form of non-cicatricial alopecia in both genders. Currently approved drugs for the treatment of AGA include topical minoxidil in women and topical minoxidil and oral finasteride in men. Other routes of administration of approved drugs have been proposed to enhance therapeutic results for AGA, including intradermal injections, known as mesotherapy. Mesotherapy-or intradermotherapy-is a non-surgical procedure, consisting of multiple intradermal injections of pharmacological substances diluted in small doses. Although minimally invasive, mesotherapy may be related to mild side effects like burning, erythema and headaches, as a few reports indicate. Among the most serious adverse events, subcutaneous necrosis, scalp abscesses, and angioedema have been described. This multicenter retrospective, descriptive study aims to report 14 cases of frontal edema resulting from mesotherapy for AGA treatment. In our patients, the edema mostly arose in the first two sessions and lasted between 1 and 4 days, with a favorable outcome after a local cold compress. In all our cases of edema, lidocaine was the anesthetic used. Minoxidil and dutasteride might also play a role as causative agents. To the best of our knowledge, this is the largest case series focused on frontal edema after mesotherapy for AGA and gives clinicians helpful information for when performing this technique. Dermatologists should already consider and be conscious of this possible mesotherapy side effect, as it can be remarkably disruptive to affected patients.
Collapse
Affiliation(s)
- Daniel Fernandes Melo
- Department of Dermatology, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - David Saceda-Corralo
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Departamento de Medicina, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Madrid, Spain
| | - Antonella Tosti
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, School of Medicine, University of Miami, Miami, Florida, USA
| | - Flavia Weffort
- Department of Dermatology, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Machado Carla Jorge
- Department of Preventive and Social Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Claudia Carreira de Barros
- Department of Dermatology, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.,Department of Dermatology, Santa Casa de Misericórdia of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Raquel de Melo Carvalho
- Department of Dermatology, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Michela Starace
- Dermatology - IRCCS, Policlinico Sant'Orsola, Department of Specialized, Experimental and Diagnostic Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| |
Collapse
|
31
|
Starace M, Iorizzo M, Sechi A, Alessandrini AM, Carpanese M, Bruni F, Vara G, Apalla Z, Asz-Sigall D, Barruscotti S, Camacho F, Doche I, Estrada BD, Dhurat R, Gavazzoni MF, Grimalt R, Harries M, Ioannidis D, McMichael A, Melo DF, Oliveira R, Ovcharenko Y, Pirmez R, Ramot Y, Rudnicka L, Shapiro J, Silyuk T, Sinclair R, Tosti A, Vano-Galvan S, Piraccini BM. Trichodynia and telogen effluvium in COVID-19 patients: Results of an international expert opinion survey on diagnosis and management. JAAD Int 2021; 5:11-18. [PMID: 34368790 PMCID: PMC8328568 DOI: 10.1016/j.jdin.2021.07.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The cutaneous manifestations of COVID-19 may be useful disease markers and prognostic indicators. Recently, postinfectious telogen effluvium and trichodynia have also been reported. OBJECTIVE To evaluate the presence of trichodynia and telogen effluvium in patients with COVID-19 and describe their characteristics in relation to the other signs and symptoms of the disease. METHODS Patients with a history of COVID-19 presenting to the clinics of a group of hair experts because of telogen effluvium and/or scalp symptoms were questioned about their hair signs and symptoms in relation to the severity of COVID-19 and associated symptoms. RESULTS Data from 128 patients were collected. Telogen effluvium was observed in 66.3% of the patients and trichodynia in 58.4%. Trichodynia was associated with telogen effluvium in 42.4% of the cases and anosmia and ageusia in 66.1% and 44.1% of the cases, respectively. In majority (62.5%) of the patients, the hair signs and symptoms started within the first month after COVID-19 diagnosis, and in 47.8% of the patients, these started after 12 weeks or more. LIMITATIONS The recruitment of patients in specialized hair clinics, lack of a control group, and lack of recording of patient comorbidities. CONCLUSION The severity of postviral telogen effluvium observed in patients with a history of COVID-19 infection may be influenced by COVID-19 severity. We identified early-onset (<4 weeks) and late-onset (>12 weeks) telogen effluvium.
Collapse
Affiliation(s)
- Michela Starace
- Dermatology-IRCCS Policlinico Sant'Orsola, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Matilde Iorizzo
- Private Dermatology Practice, Lugano/Bellinzona, Switzerland
| | - Andrea Sechi
- Dermatology-IRCCS Policlinico Sant'Orsola, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Aurora Maria Alessandrini
- Dermatology-IRCCS Policlinico Sant'Orsola, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Miriam Carpanese
- Dermatology-IRCCS Policlinico Sant'Orsola, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Francesca Bruni
- Dermatology-IRCCS Policlinico Sant'Orsola, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Giulio Vara
- Radiology Unit, Policlinico Sant'Orsola, University of Bologna, Bologna, Italy
| | - Zoe Apalla
- Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Stefania Barruscotti
- Department of Clinical-Surgical, Diagnostic and Pediatric Science, Institute of Dermatology, IRCCS Fondazione Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Francisco Camacho
- University of Seville, Medical-Surgical Dermatology Department, University Hospital, Seville, Spain
| | - Isabella Doche
- Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil
| | - Bruna Duque Estrada
- Centro de Estudos dos Cabelos, Instituto de Dermatologia Prof. Rubem D Azulay, Rio de Janeiro, Brazil
| | - Rachita Dhurat
- Department of Dermatology, LTM Medical College & Hospital Sion, Mumbai, India
| | | | - Ramon Grimalt
- Facultat de Medicina i Ciencies de la Salut, UIC-Barcelona, Universitat Internacional de Catalunya, Sant Cugat del `Valles, Barcelona, Spain
| | - Matthew Harries
- Department of Dermatology, Salford Royal NHS Foundation Trust, Manchester, United Kingdom
| | - Dimitrios Ioannidis
- Department of Dermatology-Venereology, Aristotle University Medical School, Hospital for Skin and Venereal Diseases, Thessaloniki, Greece
| | - Amy McMichael
- Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Daniel Fernandes Melo
- Department of Dermatology, University of State of Rio de Janeiro - UERJ, Rio de Janeiro, Brazil
| | - Rui Oliveira
- Trichology Unit, Dermatology Center CUF Descobertas Hospital, Lisbon, Portugal
| | - Yuliya Ovcharenko
- Department of General and Clinical Immunology and Allergology, V.N. Karazin Kharkiv National University Medical School, Kharkiv, Ukraine
| | - Rodrigo Pirmez
- Centro de Estudos dos Cabelos, Instituto de Dermatologia Prof. Rubem D Azulay, Rio de Janeiro, Brazil
| | - Yuval Ramot
- Department of Dermatology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - Jerry Shapiro
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York City, New York
| | - Tatiana Silyuk
- Hair Treatment and Transplantation Center, Private Practice, Saint Petersburg, Russia
| | | | - Antonella Tosti
- Fredric Brandt Endowed Professor of Dermatology, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, Florida
| | - Sergio Vano-Galvan
- Dermatology Department, Ramon y Cajal Hospital, IRYCIS, University of Alcala, Madrid, Spain
| | - Bianca Maria Piraccini
- Dermatology-IRCCS Policlinico Sant'Orsola, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| |
Collapse
|
32
|
Melo DF, Lemes LR, Alves AL, Frattini SC, Obadia DL, Tortelly VD. Low-dose oral isotretinoin in a young female with dissecting cellulitis. Pediatr Dermatol 2021; 38:1573-1574. [PMID: 34647351 DOI: 10.1111/pde.14829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 09/13/2021] [Accepted: 09/18/2021] [Indexed: 11/30/2022]
Abstract
Dissecting cellulitis (DC) is a chronic inflammatory primary neutrophilic scarring alopecia. It predominantly affects the vertex and occipital regions of Afro-descendent men. Female DC is uncommon, and little is known about this condition in childhood. This paper reports a pediatric female case of DC with an excellent therapeutic response to low-dose oral isotretinoin.
Collapse
Affiliation(s)
- Daniel Fernandes Melo
- Dermatology Department, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Luciana Rodino Lemes
- Dermatology Department, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Ana Luisa Alves
- Dermatology Department, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | | | - Daniel Lago Obadia
- Dermatology Department, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | | |
Collapse
|
33
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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
| |
Collapse
|
34
|
Melo DF, Ramos PM, Antelo DAP, Machado CJ, Barcaui CB. Is there a rationale for the use of botulinum toxin in the treatment of Androgenetic Alopecia? J Cosmet Dermatol 2021; 20:2093-2095. [PMID: 33894053 DOI: 10.1111/jocd.14177] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 04/15/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Daniel Fernandes Melo
- Dermatology Department, University of State of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Paulo Muller Ramos
- Dermatology Department, São Paulo State University (UNESP), Botucatu, Brazil
| | | | - Carla Jorge Machado
- Preventive and Social Medicine Department, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Carlos Baptista Barcaui
- Dermatology Department, University of State of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| |
Collapse
|
35
|
Fernandes MRDN, Melo DF, Vincenzi C, Lima CDS, Tosti A. Trichotillomania Incognito: Two Case Reports and Literature Review. Skin Appendage Disord 2020; 7:131-134. [PMID: 33796560 DOI: 10.1159/000512038] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 10/01/2020] [Indexed: 11/19/2022] Open
Abstract
Trichotillomania is a compulsive disorder characterized by repetitive hairpulling. It is an important cause of patchy alopecia, especially in children between 9 and 13 years of age. The aim of this paper is to report 2 pediatric cases presenting with trichotillomania without patches. This condition may be extremely distressful, impacting psychosocial development of children. In these case reports, we reinforce the relevance of trichoscopy in hair disorder evaluation, which allowed early recognition to better advise and conduct these unique pediatric cases.
Collapse
Affiliation(s)
| | - Daniel Fernandes Melo
- Dermatology Department, University of State of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | | | - Caren Dos Santos Lima
- Dermatology Department, University of State of Pará (UEPA), Belém, Brazil.,Dermatology Department, University Center of Pará (CESUPA), Belém, Brazil
| | - Antonella Tosti
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery University of Miami School of Medicine, Miami, Florida, USA
| |
Collapse
|
36
|
Pedrosa LR, Melo DF, Tortelly VD, Ribeiro NCR, Mann D, Machado CJ. A Matched Case-Control Study of Zinc Levels in Androgenetic Alopecia and Alopecia Areata: Is There a Need to Do Routine Screening? Skinmed 2020; 18:398-400. [PMID: 33397578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
| | - Daniel Fernandes Melo
- Dermatology Department, Marcílio Dias Naval Hospital, Rio de Janeiro, RJ, Brazil
- Dermatology Department, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - Violeta Duarte Tortelly
- Dermatology Department, Marcílio Dias Naval Hospital, Rio de Janeiro, RJ, Brazil
- Dermatology Department, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | | | - Danielle Mann
- Dermatology Department, Marcílio Dias Naval Hospital, Rio de Janeiro, RJ, Brazil
| | - Carla Jorge Machado
- Preventive and Social Medicine Department, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| |
Collapse
|
37
|
Ramos PM, Anzai A, Duque-Estrada B, Farias DC, Melo DF, Mulinari-Brenner F, Pinto GM, Abraham LS, Nogueira Santos LD, Pirmez R, Miot HA. Regarding methodologic concerns in clinical studies on frontal fibrosing alopecia. J Am Acad Dermatol 2020; 84:e207-e208. [PMID: 33253845 DOI: 10.1016/j.jaad.2020.11.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 11/21/2020] [Indexed: 10/22/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Rodrigo Pirmez
- Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro
| | | |
Collapse
|
38
|
Melo DF, Jorge Machado C, Bordignon NL, Silva LL, Ramos PM. Lymecycline as a treatment option for dissecting cellulitis and folliculitis decalvans. Dermatol Ther 2020; 33:e14051. [DOI: 10.1111/dth.14051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/28/2020] [Accepted: 07/17/2020] [Indexed: 11/28/2022]
Affiliation(s)
| | - Carla Jorge Machado
- Department of Preventive and Social Medicine Federal University of Minas Gerais, Medical School Belo Horizonte Brazil
| | | | - Letícia Liberino Silva
- Department of Dermatology Federal Hospital of Servidores do Estado Rio de Janeiro Brazil
| | - Paulo Müller Ramos
- Dermatology Department São Paulo State University – UNESP Botucatu Brazil
| |
Collapse
|
39
|
Melo DF, Trüeb RM, Dutra H, Lima MMDA, Machado CJ, Dias MFRG. Low-dose isotretinoin as a therapeutic option for dissecting cellulitis. Dermatol Ther 2020; 33:e14273. [PMID: 32890448 DOI: 10.1111/dth.14273] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/17/2020] [Accepted: 08/24/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Daniel Fernandes Melo
- Department of Dermatology, University of State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ralph Michel Trüeb
- Center for Dermatology and Hair Diseases, Zurich, Wallisellen, Switzerland
| | - Hudson Dutra
- Department of Dermatology, Fluminense Federal University, University Hospital Antonio Pedro, Niteroi, Brazil
| | | | - Carla Jorge Machado
- Department of Preventive and Social Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | |
Collapse
|
40
|
Ramos PM, Anzai A, Duque-Estrada B, Melo DF, Sternberg F, Santos LDN, Alves LD, Mulinari-Brenner F. Consensus on the treatment of alopecia areata - Brazilian Society of Dermatology. An Bras Dermatol 2020; 95 Suppl 1:39-52. [PMID: 33183894 PMCID: PMC7772599 DOI: 10.1016/j.abd.2020.05.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 05/15/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Alopecia areata is a highly frequent disease with an impact on quality of life and several treatment options with little clinical confirmatory evidence. OBJECTIVE To disseminate the recommendations of Brazilian dermatologists with expertise in the treatment of alopecia areata. METHODS Eight specialists with expertise in alopecia areata from different university centers were appointed by the Brazilian Society of Dermatology to reach a consensus on its treatment. Based on the adapted DELPHI methodology, the relevant elements were considered; then, an analysis of recent literature was carried out and the consensus was written down. Consensus on the management of alopecia areata was defined with the approval of at least 70% of the panel. RESULTS/CONCLUSIONS Intralesional injectable corticotherapy was considered the first option for localized disease in adults. In extensive cases with signs of activity, systemic corticosteroid therapy should be considered and can be used together with immunosuppressants (corticosteroid-sparing agents). The use of an immunosensitizer (diphencyprone) is an option for stable long-term cases. Evaluation of side effects is as important as the rate of hair regrowth.
Collapse
Affiliation(s)
- Paulo Müller Ramos
- Department of Dermatology and Radiotherapy, Universidade Estadual Paulista, Botucatu, SP, Brazil.
| | - Alessandra Anzai
- Department of Dermatology, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Bruna Duque-Estrada
- Centro de Estudos dos Cabelos, Instituto de Dermatologia Prof. Rubem David Azulay, Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Daniel Fernandes Melo
- Department of Dermatology, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Flavia Sternberg
- Department of Dermatology, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Leopoldo Duailibe Nogueira Santos
- Department of Medicine, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil; Department of Dermatology and Allergology, Hospital do Servidor Público Municipal, São Paulo, SP, Brazil
| | - Lorena Dourado Alves
- Department of Tropical Medicine and Dermatology, Universidade Federal de Goiás, Goiânia, GO, Brazil
| | | |
Collapse
|
41
|
Barreto TDM, Weffort F, Frattini SC, Martins Pinto G, Dos Santos Damasco P, Melo DF. Permanent hair wavings: What dermatologists should know? J Cosmet Dermatol 2020; 20:1204-1207. [PMID: 32813907 DOI: 10.1111/jocd.13687] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 08/10/2020] [Accepted: 08/14/2020] [Indexed: 11/26/2022]
Abstract
Hair represents an important aspect of human individuality. The possibility of having an easy to handle hairstyle and changing it from time to time promoted an increasing search for chemical hair transformations, including permanent wavings (PW). PW is the chemical process used to convert straight into curly hair. Significant findings have been made in this field within the last three decades. In the past few years, PW has come back up to date, helping to define curls in wavy and curly hair and to create waves in straight hair. "Afro permanent" and "Beach waves" are some popular names for these new uses of PW. The primary safety concerns for PW generally arise from misuse or failure to comply with the product's usage instructions. Skin irritation, hair breakage, oral toxicity, sensitization, and scarring alopecia have been reported in the literature. Therefore, dermatologists need to understand well this matter to properly advise patients on how to get the best outcome without hazards. This review aims to discuss the main types of reducing agents used, the different techniques, the consequences to hair shafts, and the most important patients' recommendations on this topic.
Collapse
Affiliation(s)
| | - Flavia Weffort
- Dermatology Department, University of State of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Giselle Martins Pinto
- Dermatology Department, Santa Casa Hospital of Porto Alegre, Porto Alegre, Brazil.,Department of Department of Dermatology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | | | - Daniel Fernandes Melo
- Dermatology Department, University of State of Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
42
|
Ramos PM, Anzai A, Duque-Estrada B, Farias DC, Melo DF, Mulinari-Brenner F, Pinto GM, Abraham LS, Santos LDN, Pirmez R, Miot HA. Risk factors for frontal fibrosing alopecia: A case-control study in a multiracial population. J Am Acad Dermatol 2020; 84:712-718. [PMID: 32835739 DOI: 10.1016/j.jaad.2020.08.076] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/11/2020] [Accepted: 08/14/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Frontal fibrosing alopecia (FFA) is a chronic cicatricial alopecia with unknown etiology and a worldwide rising incidence. OBJECTIVE The objective of this study was to evaluate the association of FFA with demographic and exposure factors in a Brazilian multiracial population. METHODS A multicenter case-control study was conducted in 11 referral centers throughout Brazil. The study was a case-control study that prospectively recruited 902 participants (451 patients with FFA and 451 sex-matched control individuals). Study participants completed a thorough questionnaire comprising variables grouped as baseline demographics, environmental exposure, diet, hormonal factors, allergies, and hair and skin care. RESULTS When adjusted by sex, age, menopause, and skin color, FFA was associated with hair straightening with formalin (odds ratio [OR], 3.18), use of ordinary (nondermatologic) facial soap (OR, 2.09) and facial moisturizer (OR, 1.99), thyroid disorders (OR, 1.69), and rosacea (OR, 2.08). Smokers (OR, 0.33) and users of antiresidue/clarifying shampoo (OR, 0.35) presented a negative association with FFA. There was no association with the use of sunscreen. LIMITATIONS Recall bias. CONCLUSIONS The association with moisturizers, ordinary facial soap, and hair straightening with formalin and the negative association with antiresidue/clarifying shampoo reinforce the possibility of an exogenous particle triggering FFA.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Rodrigo Pirmez
- Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | | |
Collapse
|
43
|
Weffort F, Sales Martins S, Plata GT, Duraes CT, Melo DF. Do you know how to recommend a wig to your patient? J Cosmet Dermatol 2020; 20:724-728. [PMID: 32706926 DOI: 10.1111/jocd.13602] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 06/15/2020] [Accepted: 06/30/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Throughout history, wigs have often had a relevant cultural and social importance with correlations to wealth and position of power. Wigs help minimize the psychological consequences of different types of hair loss. They may reduce potential experiences of stigmatization, and improve social confidence and quality of life, besides enhancing self-esteem and social adjustment. In dermatology, wigs may have a positive impact on the global treatment of patients suffering from alopecia as they offer an immediate and efficient cosmetic result. However, the medical literature on wigs is not extensive. AIMS This review aims to discuss synthetic wigs and nonsynthetic custom-made hair systems, highlighting different hair fibers, foundations, various types of prosthesis, and the most common methods of attachments used to make wigs. METHODS The terms "wigs", "hair" AND "camouflage", "alopecia" AND "camouflage", and "hair prosthesis" were used to perform a literature search in MEDLINE through PubMed until April 8th, 2020. The search was limited to English-language peer-reviewed journal articles about humans, and it included only nonsurgical alternatives to camouflage alopecia. CONCLUSIONS This article will help physicians, especially those who care for patients with hair loss, to provide appropriate advice for their patients about the wide variety and peculiarities of wigs and hairpieces currently available.
Collapse
Affiliation(s)
- Flávia Weffort
- University of State of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Sofia Sales Martins
- Campus Universitário Darcy Ribeiro, University of Brasília (UnB), Brasília, Brazil
| | | | | | | |
Collapse
|
44
|
Carvalho RDM, Barreto TDM, Weffort F, Machado CJ, Melo DF. Use of vibrating anesthetic device reduces the pain of mesotherapy injections: A randomized split-scalp study. J Cosmet Dermatol 2020; 20:425-428. [PMID: 32640097 DOI: 10.1111/jocd.13554] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 06/09/2020] [Indexed: 11/29/2022]
Abstract
Pain evaluation during local injections is a complex process. Injections cause patient's distress, especially when the target is a sensitive area such as scalp. Nonpharmacological methods as vibration before and during the procedure have been used to reduce pain. Mesotherapy has become a popular nonsurgical procedure for nonscarring alopecia, such as androgenetic alopecia (AGA) and alopecia areata (AA). Vibration has been successfully used in dermatological procedures, pediatrics, and dentistry. No study was found on vibration anesthesia during scalp mesotherapy. To analyze the effect of a vibration anesthetic device (VAD) during scalp mesotherapy on the patients' comfort.This is a randomized split-scalp study; thirty patients received mesotherapy with or without VAD on half of their scalp. Numerical rating scale (NRS) was used to measure self-reported pain. To test difference in means and medians in comparing device use and by treatment (AGA or AA), Student's t tests and Wilcoxon signed rank tests were used. Overall mean pain score on the no vibration-assisted side was 8.0 ± 1.0 while pain score for the vibration side was 2.3 ± 1.5, for AGA (P < .001) and 7.4 ± 1.2 and 2.1 ± 1.3, respectively, for AA (P < .001). Findings were similar for medians. No complications were found following procedure. To the best of our knowledge, this is the first study analyzing the effect of VAD in patients undergoing scalp mesotherapy. The VAD technique was found to be safe, effective, simple, and suitable for scalp procedures.
Collapse
Affiliation(s)
| | | | - Flavia Weffort
- University of State of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Carla Jorge Machado
- Preventive and Social Medicine Department, Federal University of Minas Gerais, Minas Gerais, Brazil
| | | |
Collapse
|
45
|
Lemes LR, Melo DF, de Oliveira DS, de La-Rocque M, Zompero C, Ramos PM. Topical and oral minoxidil for hair disorders in pediatric patients: What do we know so far? Dermatol Ther 2020; 33:e13950. [PMID: 32614119 DOI: 10.1111/dth.13950] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 06/26/2020] [Indexed: 12/11/2022]
Abstract
Minoxidil is a strong arterial vasodilator, first introduced as an antihypertensive medication. In dermatology, topical minoxidil (TMX) has been used for many types of alopecia. TMX is not FDA-approved in patients under 18 years old and there are no guidelines for its pediatric use. Low-dose oral minoxidil (OMX) has been used off-label for hair loss treatment in adults expecting to achieve better therapeutic compliance and greater clinical efficacy. However, little is known about TMX and OMX in pediatric population. the literature presented on TMX and OMX in children to date was reviewed. The terms "minoxidil", "child", "children", "childhood", and "infant" were used to perform a literature search in MEDLINE through PubMed. The search was limited to articles about humans and available in English. While 25 relevant articles were selected, duplicate titles were excluded. This article pointed out the use of minoxidil in several pediatric hair diseases. Even when used topically, dermatologists should be aware of potential risks of systemic absorption. In particular situations, OMX in very low doses may be considered. To date, there are no guidelines regarding the ideal dose or minimum age for using the drug topically or systemically.
Collapse
Affiliation(s)
- Luciana Rodino Lemes
- Department of Dermatology, University of State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Daniel Fernandes Melo
- Department of Dermatology, University of State of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | | | - Paulo Müller Ramos
- Department of Dermatology, São Paulo State University-UNESP, Botucatu, Brazil
| |
Collapse
|
46
|
Barreto TDM, Melo DF, Alves TDBC, Lima MMDDA, Lima CDS. Dodging Pitfalls in Trichoscopy: How to Nail the Right Diagnosis. Int J Trichology 2020; 12:195-196. [PMID: 33376292 PMCID: PMC7759058 DOI: 10.4103/ijt.ijt_9_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/20/2020] [Accepted: 07/23/2020] [Indexed: 11/04/2022] Open
|
47
|
Mota ANCM, De Carvalho N, Pellacani G, de Faria PCP, Melo DF, Pineiro-Maceira JM, Barcaui CB. Reflectance confocal microscopy in actinic keratosis-Comparison of efficacy between cryotherapy protocols. Skin Res Technol 2020; 26:876-882. [PMID: 32592215 DOI: 10.1111/srt.12889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 05/30/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Actinic keratosis (AK) incidence is increasing. Due to the risk of progression to squamous cell carcinoma, early detection and treatment are essential. The method stated in the European Consensus is cryotherapy, but there is no standard protocol defined for better results. OBJECTIVES To compare two different cryotherapy protocols for AK using reflectance confocal microscopy (RCM) as a noninvasive imaging method for evaluation. METHODS A self-controlled clinical trial was proposed to compare the efficacy of cryotherapy in two different application protocols. Grade II AKs in the forearms were submitted to freezing and thawing time of 10 seconds for 1 cycle (group A) or 2 cycles (group B). At baseline and 4 weeks after treatment, the same dermatologists assessed RCM evaluation (thickness of horny layer, parakeratosis, dyskeratosis, atypia in spinous layer, fibrosis, and presence of inflammatory cells in epidermis and dermis). RESULTS We examined 24 AK lesions in each group. Statistical evaluation of the results evidenced superior response after 2 cycles of cryotherapy in parakeratosis and number of inflammatory cells in epidermis. CONCLUSION Both protocols are effective in clearing clinical AK. Two cycles are not generating more side effects (fibrosis) and could reduce the risk of recurrence (better "clearance" of parakeratosis).
Collapse
Affiliation(s)
- Amanda Nascimento Cavalleiro Macedo Mota
- Dermatology Department, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil.,Dermatology Departament, Central Aeronautics Hospital (HCA), Rio de Janeiro, Brazil
| | - Nathalie De Carvalho
- Dermatology Department, University of Modena and Reggio Emilia (UNIMORE), Modena, Italy.,Dermatology Department, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | - Giovanni Pellacani
- Dermatology Department, University of Modena and Reggio Emilia (UNIMORE), Modena, Italy
| | | | - Daniel Fernandes Melo
- Dermatology Department, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | | | | |
Collapse
|
48
|
Melo DF, Lemes LR, Pirmez R, Duque-Estrada B. Trichoscopic stages of dissecting cellulitis: a potential complementary tool to clinical assessment. An Bras Dermatol 2020; 95:514-517. [PMID: 32522451 PMCID: PMC7335869 DOI: 10.1016/j.abd.2019.10.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 10/29/2019] [Indexed: 01/08/2023] Open
Abstract
Dissecting cellulitis is a chronic, progressive, and relapsing inflammatory disease that predominantly affects the vertex and occiput of young Afro-descendent men. It starts with papules and pustules that evolve to nodules, abscesses, and cicatricial alopecia. This article illustrates the evolutive trichoscopy of dissecting cellulitis, from its early phase, through the abscess phase, to the fibrotic cicatricial phase. Trichoscopy complements clinical-pathological classification, representing a complementary tool useful in early diagnosis and monitoring of the patient during treatment.
Collapse
Affiliation(s)
- Daniel Fernandes Melo
- Center for Trichology Studies, Hospital Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Luciana Rodino Lemes
- Center for Trichology Studies, Hospital Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | - Rodrigo Pirmez
- Outpatient Clinic of Capillary Disorders, Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Bruna Duque-Estrada
- Outpatient Clinic of Capillary Disorders, Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| |
Collapse
|
49
|
Melo DF, de Mattos Barreto T, Saceda-Corralo D, Machado CJ, Xavier de Brito F, Tebet M, Tortelly VD, Moreno-Arrones OM, Vañó-Galván S. Epidemiologic and clinical features of pattern III frontal fibrosing alopecia (pseudo fringe type): A multicenter series of 38 patients. J Am Acad Dermatol 2020; 84:797-798. [PMID: 32497694 DOI: 10.1016/j.jaad.2020.05.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 04/18/2020] [Accepted: 05/22/2020] [Indexed: 11/16/2022]
Affiliation(s)
- Daniel Fernandes Melo
- Dermatology Department, University of the State of Rio de Janeiro, Rio de Janeiro, Brazil.
| | | | | | - Carla Jorge Machado
- Preventive and Social Medicine Department, Federal University of Minas Gerais, Minas Gerais, Brazil
| | | | | | | | | | - Sérgio Vañó-Galván
- Dermatology Department, Hospital Universitario Ramon y Cajal, Madrid, Spain
| |
Collapse
|
50
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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
| | | | | |
Collapse
|