Subject(s)
Alopecia/etiology , Adult , Age Factors , Age of Onset , Aged , Aged, 80 and over , Alopecia/drug therapy , Body Mass Index , Cross-Sectional Studies , Educational Status , Female , Fibrosis , Humans , Middle Aged , Risk Factors , Severity of Illness IndexABSTRACT
BACKGROUND: Frontal fibrosing alopecia (FFA) is a chronic cicatricial alopecia with an increasing incidence and unknown aetiology. AIM: To identify possible environmental and hormonal factors related to FFA. METHODS: We conducted a multicentre case-control study paired by sex and age, and recruited 664 women (335 cases and 329 controls) and 106 men (20 cases and 86 controls). Study subjects completed an exhaustive questionnaire enquiring about pharmacological, environmental, hormonal, social, job exposure, lifestyle, drugs and diet factors to which they were exposed at least 5 years prior to the onset of the disease. RESULTS: For women, there was a statistical association between alopecia and history of pregnancy (OR = 1.6; 95% CI 1.06-2.41), use of facial sunscreen (OR = 1.6; 95% CI 1.06-2.41) and hormone replacement therapy (HRT) (OR = 1.76; 95% CI 1.11-2.8) or raloxifene (no controls exposed therefore OR was not calculated), exposure to alkylphenolic compounds (OR = 1.48; 95% CI 1.05-2.08), and presence of rosacea (OR = 1.91; 95% CI 1.07-3.39), lichen planus pigmentosus (LPP) (OR = 5.14; 95% CI 1.11-23.6) or hypothyroidism (OR = 1.73; 95% CI 1.11-2.69). For men, there was a statistical association between alopecia and use of facial sunscreens (OR = 11.6; 95% CI 1.7-80.9) or antiageing creams (OR = 1.84; 95% CI 1.04-3.23). CONCLUSIONS: FFA seems to be associated with hormonal exposure (pregnancy, HRT and raloxifene), comorbidities (hypothyroidism, LPP and rosacea) and environmental factors (facial sunscreens, antiageing creams and occupational exposure). Further research is required to analyse the exact mechanism in which these environmental factors participate in the development of this alopecia.
Subject(s)
Alopecia/pathology , Fibrosis/pathology , Forehead/pathology , Sunscreening Agents/adverse effects , Adult , Aged , Aged, 80 and over , Alopecia/chemically induced , Alopecia/etiology , Case-Control Studies , Comorbidity , Estrogen Antagonists/adverse effects , Female , Fibrosis/etiology , Hormone Replacement Therapy/adverse effects , Humans , Lichen Planus/complications , Male , Middle Aged , Occupational Exposure/adverse effects , Raloxifene Hydrochloride/adverse effects , Risk FactorsABSTRACT
Las neoplasias anexiales cutáneas malignas constituyen un grupo de carcinomas poco frecuentes, habitualmente de bajo grado de malignidad, que muestran diferenciación folicular, sebácea, apocrina o ecrina o una combinación de las 3 primeras. Clínicamente suelen ser neoplasias con características poco distintivas, siendo necesaria una biopsia que permitirá establecer el tipo de diferenciación y el diagnóstico definitivo. Al tratarse de una enfermedad poco frecuente, no existe un claro consenso sobre el tratamiento más eficaz. En la mayoría de casos se considera la microcirugía de Mohs como la opción más efectiva para prevenir recidivas. La radioterapia y quimioterapia han sido escasamente estudiadas y solo se han mostrado eficaces en escasas ocasiones
Malignant cutaneous adnexal neoplasms form a group of rare, typically low-grade-malignancy carcinomas with follicular, sebaceous, apocrine, or eccrine differentiation or a combination of the first 3 subtypes. Their clinical presentation is usually unremarkable, and biopsy is required to establish the differentiation subtype and the definitive diagnosis. Due to their rarity, no clear consensus has been reached on which treatment is most effective. Mohs micrographic surgery is considered to be the best option to prevent recurrence in the majority of patients. Radiotherapy and chemotherapy have been studied in very few cases and have rarely been shown to be effective
Subject(s)
Humans , Neoplasms, Adnexal and Skin Appendage/surgery , Mohs Surgery , Neoplasms, Adnexal and Skin Appendage/pathology , Skin Neoplasms/classification , Skin Neoplasms/surgeryABSTRACT
Malignant cutaneous adnexal neoplasms form a group of rare, typically low-grade-malignancy carcinomas with follicular, sebaceous, apocrine, or eccrine differentiation or a combination of the first 3 subtypes. Their clinical presentation is usually unremarkable, and biopsy is required to establish the differentiation subtype and the definitive diagnosis. Due to their rarity, no clear consensus has been reached on which treatment is most effective. Mohs micrographic surgery is considered to be the best option to prevent recurrence in the majority of patients. Radiotherapy and chemotherapy have been studied in very few cases and have rarely been shown to be effective.
Subject(s)
Carcinoma/therapy , Mohs Surgery , Skin Neoplasms/therapy , Antineoplastic Agents/therapeutic use , Biopsy , Carcinoma/classification , Carcinoma/diagnosis , Carcinoma/pathology , Cell Differentiation , Humans , Paget Disease, Extramammary/therapy , Pilomatrixoma/therapy , Radiotherapy, Adjuvant , Skin Neoplasms/classification , Skin Neoplasms/diagnosis , Skin Neoplasms/pathologyABSTRACT
INTRODUCTION: Spider naevi (SN) are considered a subtype of telangiectasias, currently classified as low-flow vascular malformations. OBJECTIVE: To describe the videodermoscopy and Doppler-ultrasound (US) features of a large group of SN. MATERIAL AND METHODS: A retrospective study of cases of SN collected at our Dermatology department during the period between June 2015 and June 2017 was performed. Clinical images, dermoscopic, videodermoscopic and Doppler-US files were reviewed. For each case, the age of the patient, time since onset, size and dermoscopic pattern of the lesions were recorded. The presence of pulsatility was also evaluated visually on the videodermoscopy. RESULTS: Two hundred and thirty-three SN in 189 patients were included. The mean age was 39.5 years (range: 10-76 years). Mean size of the lesions was 4.1 ± 2.0 mm. We described three dermoscopic patterns: network, star and looping. Older age, longer time since onset and larger size were found associated with higher frequency of the looping and star patterns compared to that of network pattern (P < 0.01). Pulsatility during videodermoscopy was found in 88 patients (37%). This pulsatility phenomenon was more commonly associated with the looping pattern (64.7%) than star- (40.3%) or network-like patterns (29.9%) (P < 0.001). In Doppler-US studies, a high-flow with arterial biphasic waveform was found. CONCLUSIONS: In the light of the results, we support that SN could be reconsidered in upcoming classifications as lesions closer to the group of high-flow arteriovenous malformations.
Subject(s)
Dermoscopy , Telangiectasis/classification , Telangiectasis/diagnostic imaging , Ultrasonography, Doppler , Adolescent , Adult , Age Factors , Aged , Child , Humans , Middle Aged , Pulsatile Flow , Retrospective Studies , Video Recording , Young AdultABSTRACT
BACKGROUND: Alopecia areata on the beard area (BAA) is a common clinical manifestation, but there are no studies about its characteristics. OBJECTIVE: To describe the epidemiology, comorbidities, clinical presentation, evolution, diagnostic findings and therapeutic choices in a series of patients with BAA. METHODS: This retrospective multicentre review included patients diagnosed with BAA as the first and unique clinical manifestation with at least 12 months of follow-up. Diagnosis was performed based on the typical clinical features. Extra-beard involvement was monitored in all cases. RESULTS: Overall, 55 male patients with a mean age of 39.1 years (range 20-74) were included. Twenty-five patients (45.5%) developed alopecia of the scalp during follow-up and more than 80% of cases appeared in the first 12.4 months. Clinical presentation of AA on the scalp was patchy AA (less than 5 patches) (52%), multifocal AA (28%), AA totalis (12%) and AA universalis (8%). Multivariate analysis revealed a trend of association between scalp involvement and family history of AA without statistical significance. CONCLUSIONS: According to this study, BAA may progress to scalp AA in a significant number of patients (45.5% of the patients with a follow-up interval of at least 12 months). In the group of patients who developed scalp AA, 80% of them did it within the first 12 months, so follow-up of patients with BAA is highly encouraged.
Subject(s)
Alopecia Areata/epidemiology , Adult , Aged , Alopecia Areata/diagnosis , Humans , Male , Middle Aged , Retrospective Studies , Young AdultABSTRACT
No disponible
Subject(s)
Humans , Female , Adult , Nevus, Pigmented/diagnosis , Histiocytoma, Benign Fibrous/diagnosis , Skin Neoplasms/diagnosis , Dermatofibrosarcoma/diagnosis , Diagnosis, Differential , Diagnostic ImagingABSTRACT
Elastosis perforans serpiginosa (EPS) is a rare skin disorder characterized by transepidermal elimination of abnormal elastic fibres. We present a new case of D-penicillamine (DPA)-induced EPS, and describe the clinical, dermoscopic, histopathological and direct immunofluorescence (DIF) findings. A 33-year-old woman receiving treatment with DPA presented with annular skin lesions. Digital dermoscopy of the lesions showed a central area of pink and yellowish discolouration with keratotic papules in the periphery, surrounded by a white halo, disposed in a way that resembled the islands of an archipelago. Other lesions showed a white to yellow central colouration and 'chrysalides' surrounding the keratotic plugs. Linear and granular deposits of IgG attached to the abnormal elastic fibres were seen with DIF. Dermoscopy can be helpful in the diagnosis of EPS. Moreover, DIF findings in skin biopsies of this case support the immune-mediated pathogenesis of EPS.
Subject(s)
Dermoscopy/methods , Fluorescent Antibody Technique, Direct/methods , Penicillamine/adverse effects , Skin Diseases/chemically induced , Adult , Chelating Agents/adverse effects , Chelating Agents/therapeutic use , Elastic Tissue/pathology , Female , Hepatolenticular Degeneration/complications , Hepatolenticular Degeneration/drug therapy , Hepatolenticular Degeneration/pathology , Humans , Penicillamine/administration & dosage , Penicillamine/therapeutic use , Rare Diseases , Skin/pathology , Skin Diseases/pathologyABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Adult , Sweet Syndrome/diagnosis , Sweet Syndrome/immunology , Skin Diseases/complications , Skin Diseases/diagnosis , Skin Diseases/immunology , Autoimmunity , Autoimmunity/immunology , Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/diagnosis , Lupus Erythematosus, Systemic/immunology , Lupus Erythematosus, Cutaneous/complications , Adrenal Cortex Hormones/therapeutic use , Prednisone/therapeutic use , Immunosuppressive Agents/therapeutic use , Azathioprine/therapeutic useSubject(s)
Fibroma/complications , Hyaline Fibromatosis Syndrome/complications , Adult , Humans , MaleABSTRACT
Patients with autoimmune disorders are predisposed to develop a second immunologic disease, frequently with systemic involvement. We present a patient who developed lesions of discoid lupus erythematosus (DLE) limited to the face, and, concurrently, a linear morphoea involving her right axilla. No criteria for systemic lupus erythematosus or systemic scleroderma were present in the patient. To our knowledge, no patients with concomitant DLE and linear morphoea, without systemic involvement, have been previously reported in the literature.
Subject(s)
Lupus Erythematosus, Discoid/pathology , Scleroderma, Localized/pathology , Skin Diseases/pathology , Arm/pathology , Face/pathology , Female , Humans , Middle Aged , Mixed Connective Tissue Disease/pathologyABSTRACT
No disponible
