Risk factors associated with frontal fibrosing alopecia: a multicentre case-control study.

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.

Evaluación del pelo y cuero cabelludo: tricograma / Hair and Scalp Evaluation: The Trichogram

Los métodos de exploración en tricología se pueden clasificar en 3 categorías: métodos no invasivos (historia clínica, exploración general, inspección y palpación del cabello y cuero cabelludo, fotografía, dermoscopia, etc.), métodos semi-invasivos (tricograma) e invasivos (biopsia). En este artículo se repasa de forma práctica el abordaje de los motivos de consulta en tricología en la consulta del dermatólogo (AU)

Hair and scalp evaluation techniques can be classified into 3 categories: noninvasive methods (clinical history, general examination, inspection and palpation of the hair and scalp, photography, dermoscopy, etc.); semi-invasive methods (the trichogram); and invasive methods (biopsy). In this article, we provide a practical guide on how to evaluate hair and scalp conditions in the dermatology office (AU)

Exploración de las uñas con dermoscopia: onicoscopia / Nail digital dermoscopy: onychoscopy

La dermoscopia es un procedimiento diagnóstico que ha demostrado su utilidad en tumores pigmentados. En la actualidad sus aplicaciones se han extendido a otras enfermedades de la piel y de los anejos como el pelo (tricoscopia) y uñas (onicoscopia).La aplicación de la dermoscopia en la exploración de las alteraciones ungueales es una técnica no invasiva que nos permite valorar diferentes características de las uñas: anomalías en la lámina ungueal (pigmentaciones de origen melanocítico y no melanocítico), y el lecho ungueal y nos ayuda adetectar anomalías en el patrón vascular del hiponiquio y del pliegue proximal (en las enfermedades del tejido conectivo).A continuación se exponen los signos más característicos de la exploración con esta técnica y se establecen los patrones de las pigmentacione sungueales de origen melanocítico y no melanocítico, enfermedades ungueales como el psoriasis ungueal y afectación de enfermedades del tejidoconectivo (AU)

Dermoscopy has proven to be a useful diagnostic procedure in pigmented tumours. More recently its application has been extended to other skin diseases, and diseases of the cutaneous annexes such as the hair (trichoscopy) and nails (onichoscopy).The application of dermoscopy in the evaluation of nails disorders is a noninvasive technique that enables the assessment of specific characteristics ofthe nails: dermoscopy permits better visualization of abnormalities in the nail plate (pigmentation produced by melanocytic and non melanocyticlesions) and bed, and aids detection of the vascular abnormalities in the hyponychium and proximal nail fold (in connective tissue diseases).The most characteristic signs observed with this technique are reported below, describing the patterns of nail pigment of melanocytic and nonmelanocycit origin, nail diseases like ungueal psoriasis and connective tissue diseases (AU)

Hair and scalp evaluation: the trichogram.

Hair and scalp evaluation techniques can be classified into 3 categories: noninvasive methods (clinical history, general examination, inspection and palpation of the hair and scalp, photography, dermoscopy, etc.); semi-invasive methods (the trichogram); and invasive methods (biopsy). In this article, we provide a practical guide on how to evaluate hair and scalp conditions in the dermatology office.

Síndrome papular purpúrico en guante y calcetín asociado a infección por Parvovirus B19 / Papular purpuric syndrome glove and sock associated with Parvovirus B19 infection

El síndrome papular purpúrico en “guante y calcetín” (SPPGC) es una dermatosis rara, aguda, caracterizada por lesiones eritematosas, pruriginosas y papulares en manos y pies, con una distribución en “guante y calcetín”, asociadas a lesiones orales y fiebre. Parvovirus B19 es en la mayoría de los casos el agente causante del síndrome. Presentamos el caso de un paciente adulto con síndrome papular purpúrico con lesiones poco frecuentes, asociado a Parvovirus B19 que fue confirmado mediante estudio serológico (AU)

Papular-purpuric “gloves and socks” syndrome (PPGSS) is a rare acute dermatosis characterized by pruritic erythematous and papular lesions on the hands and feet in a “gloves and socks” distribution associated with oral lesions and fever. Parvovirus B19 has been implicated in most cases as thecause of this syndrome. We present the case of an adult patient with papular purpuric syndrome with uncommon lesions, associated with parvovirusB19. He was confirmed by serology (AU)

Dermoscopia en tricología: tricoscopia / Scalp dermoscopy: trichoscopy

La dermoscopia es un procedimiento diagnóstico que ha demostrado su utilidad en tumores pigmentados y otras enfermedades cutáneas. En la actualidad sus aplicaciones se han extendido más allá y han invadido el campo de la tricología. En tricología disponemos de métodos no invasivos para el diagnóstico y seguimiento del paciente como el tricograma y el fototricograma a los que se añade la tricoscopia como una técnica más de exploración tricológica que mejora el diagnóstico de diferentes patologías del pelo. Mediante esta técnica es más fácil observar algunas características del pelo y del cuero cabelludo y aporta unos signos diagnósticos sencillos de obtener con videodermoscopia o con dermatoscopio manual, que ya forman parte del instrumental habitual en la consulta del dermatólogo. A continuación se exponen los signos más característicos de la exploración con esta técnica y se establecen los patrones característicos de la alopecia androgenética (AGA), la alopecia areata (AA) y la alopecia cicatricial (AC (AU)

Dermoscopy has proven to be a useful diagnostic procedure in pigmented tumours and other skin diseases, and its application has been extended to other fields, including trichology. Thus, trichoscopy has now been added to available non-invasive diagnostic and follow-up techniques in trichology, such as the trichogram and phototrichogram, as a further trichological examination to improve the diagnosis of different hair diseases. Trichoscopy facilitates the observation of certain hair and scalp features and contributes diagnostic signs that are readily detected with video or manual dermatoscopes, which already form part of the usual equipment in the dermatology office. The most characteristic signs observed with this technique are reported below, describing the patterns of androgenetic alopecia (AGA), alopecia areata (AA) and cicatricial alopecia (CA) (AU)

Annular erythematous papules in the neckline.

A 45-year-old woman with personal history of hypertension presented with an erythematous lesion in the neckline for a year and with a progressive growth. A physical examination revealed an annular lesion with erythematous papules in the edge. Histological exam showed phagocytosis of elastic fibers by multinucleated cells compatible with annular elastolytic giant-cell granuloma. The patient did not present any other associated systemic manifestation. Treatment with tacrolimus 0.1 percent ointment was prescribed with a very good response after two months.

Lesiones hiperqueratósicas en paciente con síndrome de Down / Hyperkeratotic lesions in a patiens with Down syndrome

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A new case of extensive congenital erosions and vesicles healing with reticulate scarring.

Congenital erosions and vesicles that heal with reticulate scarring comprise a new entity first described in 1985 in 3 girls aged 3, 5 and 6 years. Two years later, an 8-year-old boy in whom the skin lesions were accompanied by neurological disorders was described, as in one of the patients described in the 1985 study. In 1990, similar findings were reported in a neonate, and recently the 7th case has been reported in the American literature. We describe an 8-month-old infant born with cutaneous lesions that subsequently formed reticulate scars peculiar to this clinical entity, which is characterized by variable clinical and histological expression.