scholarly journals Pili Torti: A Feature of Numerous Congenital and Acquired Conditions

2021 ◽  
Vol 10 (17) ◽  
pp. 3901
Author(s):  
Aleksandra Hoffmann ◽  
Anna Waśkiel-Burnat ◽  
Jakub Żółkiewicz ◽  
Leszek Blicharz ◽  
Adriana Rakowska ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Cleft Lip ◽  
Genetic Diseases ◽  
Growth Factor Receptor ◽  
Rare Condition ◽  
Hair Shaft ◽  
Discoid Lupus Erythematosus ◽  
Lichen Planopilaris ◽  
Netherton Syndrome ◽  
Pili Torti

Pili torti is a rare condition characterized by the presence of the hair shaft, which is flattened at irregular intervals and twisted 180° along its long axis. It is a form of hair shaft disorder with increased fragility. The condition is classified into inherited and acquired. Inherited forms may be either isolated or associated with numerous genetic diseases or syndromes (e.g., Menkes disease, Björnstad syndrome, Netherton syndrome, and Bazex–Dupré–Christol syndrome). Moreover, pili torti may be a feature of various ectodermal dysplasias (such as Rapp–Hodgkin syndrome and Ankyloblepharon-ectodermal defects-cleft lip/palate syndrome). Acquired pili torti was described in numerous forms of alopecia (e.g., lichen planopilaris, discoid lupus erythematosus, dissecting cellulitis, folliculitis decalvans, alopecia areata) as well as neoplastic and systemic diseases (such as cutaneous T-cell lymphoma, scalp metastasis of breast cancer, anorexia nervosa, malnutrition, cataracts, and chronic graft-vs-host disease). The condition may also be induced by several drugs (epidermal growth factor receptor inhibitors, oral retinoids, sodium valproate, and carbamide perhydrate). The diagnosis of pili torti is based on trichoscopic or microscopic examination. As pili torti is a marker of numerous congenital and acquired disorders, in every case, the search for the signs of underlying conditions is recommended.

scholarly journals Trichoscopic findings in cicatricial alopecias and hair shaft disorders and its application in histopathology

2017 ◽  
Vol 5 (12) ◽  
pp. 5254 ◽  
Author(s):  
Ashwini S. Khadatkar ◽  
Nishant B. Ghodake
Keyword(s):  
Characteristic Feature ◽  
Hair Follicle ◽  
Lupus Erythematosus ◽  
Hair Shaft ◽  
Discoid Lupus Erythematosus ◽  
Pathological Findings ◽  
Diagnostic Features ◽  
The Past ◽  
Type Iv ◽  
Folliculitis Decalvans

Background: Many studies have been published on dermoscopy of hair and scalp disorders in the past few years, but these have been mainly carried out in western countries. Indian skin is mainly type IV and V and has its own unique set of problems and pathological findings. Hence, we conducted a study at our institute to study the dermoscopic patterns of various cicatricial alopecias.Methods: This was a descriptive study conducted in the Dermatology outpatient department, Skinaccess clinics, Nashik, between August 2014 to June 2016. The most common and characteristic feature seen in patients with cicatricial alopecia was hair follicle effacement seen in all 24 patients (100%). Hair follicle plugging was seen in 6 (25%) patients with DLE, and one patient with idiopathic scarring. Hyperkeratotic perifollicular scaling was seen in 2 patients with lichen plano pilaris. Perifollicular hyperpigmentation was seen in one patient of discoid lupus erythematosus (DLE) and 2 patients with idiopathic scarring. Hair casts were seen in 2 patients with lichen plano pilaris, and in one patient with idiopathic scarring. Patchy depigmentation was seen in 4 patients with discoid lupus erythematosus, 3 patients with idiopathic scarring, and one patient with lichen plano pilaris.Results: The most common and characteristic feature seen in patients with cicatricial alopecia was hair follicle effacement seen in all 24 patients (100%). Hair follicle plugging was seen in 6 (25%) patients with DLE, and one patient with idiopathic scarring. Hyperkeratotic perifollicular scaling was seen in 2 patients with lichen plano pilaris. Perifollicular hyperpigmentation was seen in one patient of discoid lupus erythematosus (DLE) and 2 patients with idiopathic scarring. Hair casts were seen in 2 patients with lichen plano pilaris, and in one patient with idiopathic scarring. Patchy depigmentation was seen in 4 patients with discoid lupus erythematosus, 3 patients with idiopathic scarring, and one patient with lichen plano pilaris.Conclusions: Hair follicle effacement is a characteristic dermoscopic feature of cicatricial alopecia. Hair follicle plugging, patchy depigmentation and red dots are seen in DLE. In lichen plano pilaris the dermoscopic findings of blue dots, white dots and perifollicular scaling were found to be useful for making an accurate diagnosis. Perifollicular scaling and tufting of hair is characteristically seen in patients with folliculitis decalvans. Dermoscopy is very useful in differentiating cicatricial from non-cicatricial alopecias. A biopsy obtained from the peripheral edge of the patch is more likely to show diagnostic features than the central portion. Dermoscopic guided biopsies were shown to yield definitive pathological diagnosis in 95% of the cases. Hair shaft disorders can be easily diagnosed by dermoscopy, without the need for hair.

scholarly journals Focal alopecia in parietal area in adult women — assessment of usefulness of trichoscopy in making a proper diagnosis

2020 ◽  
Vol 3 (2) ◽  
pp. 86-96
Author(s):  
Dominik Mikiel ◽  
Adriana Polańska ◽  
Aleksandra Dańczak‑Pazdrowska ◽  
Ryszard Żaba ◽  
Zygmunt Adamski
Keyword(s):  
Hair Loss ◽  
Lupus Erythematosus ◽  
Diagnostic Method ◽  
Skin Surface ◽  
Control Group ◽  
Discoid Lupus Erythematosus ◽  
Adult Women ◽  
Lichen Planopilaris ◽  
Non Invasive ◽  
Parietal Area

Introduction. Focal alopecia in the parietal area is one of the types of hair loss that can be found in dermatological practice. Trichoscopy is a non-invasive and easily accessible diagnostic method widely used in scalp disorders.Aim. The aim of this study was to assess the usefulness of trichoscopy in the non-invasive diagnosis of focal hair loss in adult women.Material and Methods. The study included 40 adult women. The study group consisted of 30 patients including 10 patients with alopecia areata (AA), 10 patients with discoid lupus erythematosus (DLE) and 10 with classical form of lichen planopilaris (LPP). The control group consisted of 10 healthy volunteers. Four groups of structures observed in trichoscopic examination were evaluated: hair follicle openings, hair shafts, vessels, perifollicular and interfollicular skin surface. Results. Among patients with AA the most frequently observed trichoscopic structures were: yellow dots in 100% (10/10), broken hairs in 90% (9/10), hairs resembling exclamation marks in 90% (9/10). DLE patients most often presented white / white-pink structureless areas and prominent, interfollicular scaling in 100% (10/10) and 90% (9/10) of cases, respectively. On the other hand, in the group of patients with LPP, the most frequent findings were: fine perifollicular scaling in 100% (10/10) and linear, slightly branched vessels arranged concentrically around the follicular openings - both features observed also in 100% (10/10) of cases.Conclusion. Trichoscopy as a non-invasive diagnostic method may be helpful in differentiating non-scarring and scarring alopecia in the parietal area in women. Moreover, there are some trichoscopic features typical for AA, DLE and LPP, which allow for differentiation and facilitate the diagnosis of these entities.

scholarly journals Trichoscopy in common scalp alopecia: an observational study

2020 ◽  
Vol 6 (3) ◽  
pp. 361
Author(s):  
Krishnendra Varma ◽  
Ujjwal Singh ◽  
Manu Kataria
Keyword(s):  
Observational Study ◽  
Lupus Erythematosus ◽  
Seborrheic Dermatitis ◽  
Daily Practice ◽  
Common Finding ◽  
Discoid Lupus Erythematosus ◽  
Diagnostic Dilemma ◽  
Lichen Planopilaris ◽  
Medical College ◽  
One Year

<p class="abstract"><strong>Background:</strong> Many patients of alopecia are encountered in daily practice with diagnostic dilemma. Trichoscopy is a sensitive, non-invasive tool which aids in clinical diagnosis.</p><p class="abstract"><strong>Methods:</strong> An observational study performed in adult patients with alopecia attending R.D. Gardi Medical College, Ujjain, over a period of one year. Trichoscopy was performed using a Dinolite digital microscope with both polarized and non polarized modes.<strong></strong></p><p class="abstract"><strong>Results:</strong> 269 patients of alopecia (257 non cicatricial, 12 cicatricial) aged 18-50 years were enrolled. The diagnosis was made after detailed history and clinical examination. 173 (64.3%) males and 96 (35.7%) females. 45.4% patients were diagnosed to have alopecia areata in which yellow dots were the most common trichoscopic finding observed in 88.5% patients. 37.2% patients were diagnosed with androgenetic alopecia with hair diameter diversity &gt;20% observed in all the patients. 9.3% patients were diagnosed to have telogen effluvium with short vellus hair seen in 64% patients. 3.7% of the patients were diagnosed to have seborrheic dermatitis with arborizing vessels being the most common finding seen in 90% patients. 2.9% patients were diagnosed with lichen planopilaris in which loss of follicles and peritubular white casts were seen in all the cases. 0.9% patients were diagnosed to have discoid lupus erythematosus with hyperkeratotic follicular plugging seen in all the cases. Overall yellow dots were the most common trichoscopic findings seen in 61% cases.</p><p class="abstract"><strong>Conclusions:</strong> Trichoscopy is a reliable diagnostic tool in hair and scalp disorders. Hence trichoscopic evaluation should be done in every case of alopecia.  </p><p class="abstract"> </p>

scholarly journals Successional occurrence of two papulosquamous disorders in HIV positive patient: a rare case report

2021 ◽  
Vol 7 (6) ◽  
pp. 869
Author(s):  
Nitika Sanjay Deshmukh ◽  
Ravindranath Brahmadeo Chavan ◽  
Anil Prakash Gosavi ◽  
Supriya Ashok Kachare
Keyword(s):  
Case Report ◽  
Lichen Planus ◽  
Lupus Erythematosus ◽  
Rare Condition ◽  
Discoid Lupus Erythematosus ◽  
Rare Presentation ◽  
Rare Case Report ◽  
Autoimmune Conditions ◽  
Atypical Presentations ◽  
High Index Of Suspicion

<p class="abstract">Presentation of two papulosquamous disorders in a same individual is rare condition till date. Independently, psoriasis and Lichen planus (LP) are common inflammatory skin conditions affecting around 2-3% and 1% of HIV (Human immune deficiency) positive population respectively. As reviewed in the literature, psoriasis may be independently associated with other autoimmune conditions like vitiligo, alopecia areata, lichen planus, and discoid lupus erythematosus. In this article, we presented a case report of a HIV seropositive patient who suffered from psoriasis and lichen planus. The coexistence of psoriasis and lichen planus in one individual is rare and underreported in literature. Psoriasis or lichen planus may be the presenting feature of HIV infection and tends to be more severe, to have atypical presentations. Psoriasis and lichen planus can be coexistent or successionally appear one after other in one individual though rare presentation. High index of suspicion is always required while dealing with papulosquamous lesions in PLHIV.</p><p> </p>

scholarly journals Rowell syndrome – a clinical entity that must not be forgotten

2016 ◽  
Vol 63 (4) ◽  
pp. 331-333
Author(s):  
Maria Daniela Tănăsescu ◽  
◽  
Mihai Ovidiu Comşa ◽  
Alexandru Mincă ◽  
Alexandru Cristian Diaconescu ◽  
...  
Keyword(s):  
Erythema Multiforme ◽  
Lupus Erythematosus ◽  
Rare Condition ◽  
Skin Lesions ◽  
Pulse Therapy ◽  
Therapeutic Regimen ◽  
Discoid Lupus Erythematosus ◽  
Cutaneous Lesions ◽  
High Doses ◽  
Minor Criteria

Objective. Rowell Syndrome represents a rare condition, characterised by the existence of erythema multiforme with lupus erythematosus. The diagnosis is made in patients which present both the major criteria (coexistence of discoid lupus erythematosus with erythema multiforme lesions and positivity for speckled - pattern antinuclear antibodies) and at least one of the minor criteria (frostbites-like lesions, positive anti-La or anti-Ro antibodies and reactive rheumatoid factor). The main objective of this article is to evidence a rare case of Rowell Syndrome and the optimal diagnostic and therapeutic management involved for resolving this case. Material and method. This article presents the case of a 47-year-old patient diagnosed with Rowell Syndrome, which met the diagnostic criteria. In her case, we used a therapeutic regimen comprising Hydroxychloroquine 400 mg/day and pulse-therapy with methylprednisolone 1 gram/day, for 3 days. Results. The decremental titration of prednisone resulted in reoccurrence of cutaneous lesions, prompting the return to the high doses, with normalisation of skin lesions. Conclusions. The presented case highlights the importance of keeping in mind the diagnosis of Rowell Syndrome in all the situations of patients with serologic profile of lupus and erythema multiforme lesions. Discussion. The therapeutic regimen and evolution under treatment may have a variable course, imposing the monitoring of patients a course for preventing the disease relapse.

scholarly journals Pseudopelade of Brocq: a clinico-therapeutic challenge!

2014 ◽  
Vol 11 (3) ◽  
pp. 273-275
Author(s):  
S Jain
Keyword(s):  
Lupus Erythematosus ◽  
Scalp Hair ◽  
Young Male ◽  
Clinical Syndrome ◽  
Definitive Diagnosis ◽  
Discoid Lupus Erythematosus ◽  
Pathological Features ◽  
Therapeutic Challenge ◽  
Lichen Planopilaris ◽  
Specific Disease

Pseudopelade of Brocq is a clinical syndrome comprising of scarring alopecia and fibrosis in which distinct pathological features are absent. It is not a specific disease, rather a pattern of cicatricial alopecia. However, if a definitive diagnosis of DLE (discoid lupus erythematosus), LPP (Lichen planopilaris) or any other condition can be made on the basis of clinical, histopathological or immunofluorescent features, then this term cannot be used. Here we report the case of a 20 year old young male who presented to us with complaints of loss of scalp hair for 2 years which were associated with mild itching. The condition is as such rare in prevalence and hence we report the same in view of its unique presentation. DOI: http://dx.doi.org/10.3126/hren.v11i3.9652 Health Renaissance 2013;11(3):273-275

scholarly journals Lichen planopilaris versus discoid lupus erythematosus: A trichoscopic perspective

2013 ◽  
Vol 5 (4) ◽  
pp. 204 ◽  
Author(s):  
BalachandraS Ankad ◽  
SavithaL Beergouder ◽  
VishnuM Moodalgiri
Keyword(s):  
Lupus Erythematosus ◽  
Discoid Lupus Erythematosus ◽  
Lichen Planopilaris

scholarly journals Value of CD123 immunohistochemistry and elastic staining in differentiating discoid lupus erythematosus from lichen planopilaris

2020 ◽  
Vol 12 (2) ◽  
pp. 62
Author(s):  
Mojgan Akbarzadeh-Jahromi ◽  
FatemehSari Aslani ◽  
Mozhdeh Sepaskhah ◽  
Zahra Bagheri
Keyword(s):  
Lupus Erythematosus ◽  
Discoid Lupus Erythematosus ◽  
Lichen Planopilaris

scholarly journals A Rare Case of Plasma Cell Gingivitis with Cheilitis

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Yashodeep Chauhan ◽  
Shaleen Khetarpal ◽  
Madhu Singh Ratre ◽  
Manish Varma
Keyword(s):  
Plasma Cell ◽  
Lupus Erythematosus ◽  
Plasma Cells ◽  
Rare Condition ◽  
Discoid Lupus Erythematosus ◽  
Gradual Reduction ◽  
Case Presentation ◽  
Gingival Enlargement ◽  
Hematologic Examination

Background. Plasma cell gingivitis (PCG) is a rare condition of the gingiva, characterized histopathologically by infiltration of plasma cells in connective tissue. Hypersensitivity reaction due to antigen is considered as primary etiological factor. Case Presentation. The present case is of an 18-year-old male patient suffering from gingival enlargement along with cheilitis. Histopathological and immunohistochemistry of tissue revealed lesion as plasma cell gingivitis. After gingivectomy, the follow up of the patient was done for 8 months. Gradual reduction of lip swelling was observed after gingivectomy during subsequent visits. Conclusion. Early diagnosis is essential as plasma cell gingivitis has similar pathologic changes seen clinically as in leukemia, multiple myeloma, discoid lupus erythematosus, atrophic lichen planus, desquamative gingivitis, or cicatricial pemphigoid which must be differentiated through hematologic examination.

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