Pseudo-Fringe sign in frontal fibrosing alopecia-like cutaneous lupus erythematosus.

BACKGROUND: Marginal alopecia presents itself frequently in dermatological practice. For patients who present peripheral scalp hair loss, cicatricial and non-cicatricial alopecia should be considered, such as ophiasis, traction alopecia and frontal fibrosing alopecia. In spite of the several types of hair loss that have been described in cutaneous lupus erythematosus, the 'pseudo-fringe sign' had never been observed in such patents. OBJECTIVE: This study aims at including the 'pseudo-fringe sign' as another possibility of clinical manifestation in patients with cutaneous lupus erythematosus. METHODS: A case report of a 67-year-old lady with the diagnosis of lupus erythematosus and peripheral hair loss is shown in this study; the respective differential diagnosis have also been discussed. RESULTS: The diagnosis of a scarring alopecia caused by lupus erythematosus was established with dermoscopy and histopathology. CONCLUSION: Cutaneous lupus erythematosus is another diagnostic possibility for patients who display the 'pseudo-fringe sign'.

Erosive pustular dermatosis of the scalp: a multicentre study.

BACKGROUND: Erosive pustular dermatosis of the scalp (EPDS) is characterized by crusted erosions or superficial ulcerations that lead to scarring alopecia. OBJECTIVES AND METHODS: We performed a multicentre retrospective clinical study including 56 patients (29 females and 27 males, mean age 62.7) with a confirmed EPDS in order to describe epidemiology, clinical findings and therapeutic choices of this disease. RESULTS: Mechanical/chemical trauma was reported in 28.6%, a previous infection in 10.7%, a previous cryotherapy in 5.4% androgenetic alopecia in 48.2% and severe actinic damage in 25%. Trichoscopy showed absence of follicular ostia, tufted and broken hair, crusts, serous exudate, dilated vessels, pustules and hyperkeratosis. Histopathology revealed three different features, depending on the disease duration. The most prescribed therapy was topical steroids (62.5%), followed by the combination of topical steroids and topical tacrolimus (8.9%), systemic steroids (7.1%) and topical tacrolimus (5.4%). A reduction of inflammatory signs was observed in 28 patients (50%) treated with topical steroids and in all three patients treated with topical tacrolimus. CONCLUSION: The relatively high number of patients collected allowed us to identify a better diagnostic approach, using trichoscopy and a more effective therapeutic strategy, with high-potency steroids or tacrolimus, which should be considered as first-line treatment.

European S1 guidelines on the management of lichen planus: a cooperation of the European Dermatology Forum with the European Academy of Dermatology and Venereology.

Lichen planus (LP) is a chronic inflammatory and immune-mediated disease that affects the skin, hair, nails and mucous membranes. Although there is a broad clinical spectrum of lichen planus manifestations, the skin and oral cavity remain the major sites of involvement. A group of European dermatologists with a long-standing interest and expertise in lichen planus has sought to define therapeutic guidelines for the management of patients with LP. The clinical features, diagnosis and possible medications that clinicians can use, in order to control the disease, will be reviewed in this manuscript. The revised final version of the lichen planus guideline was passed on to the European Dermatology Forum (EDF) for a final consensus with the European Academy of Dermatology and Venereology (EADV).