China
Africa
Explore chapters and articles related to this topic
Trichoscopy II: Cicatricial Alopecia
Published in Rubina Alves, Ramon Grimalt, Techniques in the Evaluation and Management of Hair Diseases, 2021
Bruna Duque-Estrada, Rodrigo Pirmez
One of the big advances of trichoscopy was to allow quick and easy differentiation between non-scarring and scarring forms of hair loss. Destruction of hair follicles is perceived by the dermatologist as loss of follicular openings, the trichoscopic hallmark of cicatricial alopecias (Figure 6.1) [1, 2]. Additionally, most of the trichoscopic findings have good correlation with pathology. For such, specific features will enable a trichoscopic diagnosis between the different types of cicatricial alopecia. This chapter will focus on trichoscopy of primary cicatricial alopecias [3, 4].
Trichoscopy
Published in Aimilios Lallas, Zoe Apalla, Elizabeth Lazaridou, Dimitrios Ioannides, Theodosia Gkentsidi, Christina Fotiadou, Theocharis-Nektarios Kirtsios, Eirini Kyrmanidou, Konstantinos Lallas, Chryssoula Papageorgiou, Dermatoscopy A–Z, 2019
Aimilios Lallas, Zoe Apalla, Elizabeth Lazaridou, Dimitrios Ioannides, Theodosia Gkentsidi, Christina Fotiadou, Theocharis-Nektarios Kirtsios, Eirini Kyrmanidou, Konstantinos Lallas, Chryssoula Papageorgiou
The most frequent finding in trichoscopy is the presence of alopecia plaques that lack hair shafts and follicular openings (“empty areas”) (Figure 8.52). The latter feature is generally considered the hallmark of cicatricial alopecia. Tufting of follicular units is found in a high percentage (∼80%) and is recognized as numerous hair shafts (up to 20) emerging from the same follicular orifice (polytrichia or “dolly” hair) (Figures 8.52 and 8.53). Yellow scales and crusts in a perifollicular arrangement are common (Figures 8.53 and 8.54). The use of a dermatoscope facilitates recognition of pustules that are seen as yellow areas around follicular units, with vessels and foci of hemorrhage (Figure 8.54). Perifollicular erythema arranged in a starburst pattern represents an additional trichoscopic feature. In late-phase disease, ivory-white and milky-red structureless areas, without follicular orifices, predominate in dermatoscopy.
Management of definitive hair alopecia in Asians
Published in Pierre Bouhanna, Eric Bouhanna, The Alopecias, 2015
Healthy scalp hair is a human characteristic that conveys aspects of self-image, identity, and perceptions of health. Hair loss from disease or other conditions may result in distorted self-perception and psychological conflicts. Cicatricial alopecia (CA) encompasses a diverse group of disorders characterized by permanent destruction of the hair follicle and irreversible hair loss. It is classified into primary (the hair follicle is the main target) and secondary (nonfollicular) disease. Dermatological disorders causing permanent hair loss such as cicatricial alopecia make immediate diagnosis and therapeutic intervention imperative. Location of biopsy is very important; it should include good hair at the border of the lesion and inside the lesion that contains the hair follicle. At least two specimens 4 mm each should be sent for horizontal and vertical sectioning and direct immunofluorescence.
A comprehensive review of platelet-rich plasma for the treatment of dermatologic disorders
Published in Journal of Dermatological Treatment, 2023
Jessica N. Pixley, Madison K. Cook, Rohan Singh, Jorge Larrondo, Amy J. McMichael
Cicatricial alopecia comprises a group of disorders in which peribulbar lymphocytic inflammation leads to destruction of the hair follicle and replacement by fibrous tissue that prevents hair regrowth (20). One multicenter study found the scarring alopecias together comprise approximately 26.8% of total alopecias, of which the most common was frontal fibrosing alopecia (FFA) with a prevalence of 40.1% of cicatricial alopecias (21,22). Treatment of scarring alopecia is challenging, with treatments utilized including oral finasteride, dutasteride, topical, intralesional, and systemic steroids, minoxidil, topical tacrolimus, and oral hydroxychloroquine. Several subtypes including central centrifugal cicatricial alopecia (CCCA), lichen planopilaris (LPP), and FFA have been successfully treated with PRP, although current literature is limited to a few case reports. Of the four case reports available, 2 described a subjective improvement in hair density, 1 described improved perifollicular erythema and scaling, and the last described complete regression of scalp erythema and scaling (Table 1).
An international expert consensus statement focusing on pre and post hair transplantation care
Published in Journal of Dermatological Treatment, 2023
S. Vañó-Galván, C. N. Bisanga, P. Bouhanna, B. Farjo, V. Gambino, T. Meyer-González, T. Silyuk
Although increasingly popular amongst patients seeking treatment for hair loss, hair transplantation is not an appropriate option for all candidates. The correct selection of patients for hair transplant is an essential part of the procedure’s success, with important ethical and even legal implications (6,7). Physicians should ensure that patients have realistic expectations regarding results, and must inform patients of possible complications, eliciting written informed consent before the procedure. While the role of hair restoration surgery as a successful treatment for patients with androgenetic alopecia has been confirmed by multiple studies (8,9), patients with forms of primary cicatricial alopecia have traditionally been considered as poor candidates for hair transplantation. However, several case reports of successful hair transplant in patients with these conditions (10–13) and advances in surgical technique and physician expertise support consideration of these patients for hair transplant on a case-by-case basis, after ruling out the presence of inflammatory activity.
Comedonic discoid lupus erythematous
Published in Scandinavian Journal of Rheumatology, 2019
A 54-year-old Chinese male had had a patch of hair loss with comedones on the scalp for 2 years. According to the patient’s report, an erythematous plaque had arisen before the comedones developed. Conventional treatments for acne did not help. He denied any history of malar erythema, oral ulceration, or arthralgia. His medication was non-contributory. Skin examination revealed a patch of cicatricial alopecia on the scalp with an erythematous and telangiectatic setting. In the lesion, there were conspicuous cribriform openings and comedones. The comedones were whitish to brown, of different tones, with diameter ranging from 2 to 3 mm. There were no pustules, nodulocystic lesions, or scars (Figure 1). A skin biopsy showed hyperkeratosis, follicular plugging, and epidermal inclusion cysts. There was an extensive vacuolar degeneration of the basal cells. Additional features noted included heavy perivascular and periadnexal mononuclear cell infiltration (Figure 2). Routine laboratory tests found a normal full blood count. Antinuclear antibody, anti-Sm antibody, and anti-double-stranded DNA antibody screens were all normal. Urinalysis and complement were within normal limits. These clinical and pathological findings were consistent with the diagnosis of discoid lupus erythematous (DLE). He was commenced on oral hydroxychloroquine and was topically treated with tretinoin 0.01% cream for 3 months. The number of comedones reduced, with no improvement of the alopecia patch.