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

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.

Relationship between BMI and the severity of facial wrinkles — preliminary study

Introduction. The severity of facial wrinkles is related to many factors, such as: endogenic skin aging (innate mechanisms), the influence of external factors (photoaging) and lifestyle factors such as smoking or body weight.Aim. The aim of the study is to determine the relationship between BMI and the occurrence of various types of facial wrinkles.Material and Methods. 50 people participated in the study, including 9 men and 41 women. The criteria for participation in the study were: age over 18, no visible facial hair, no makeup. Each volunteer had their weight and height examined — BMI was determined and 6 extraoral photographs were taken. The severity of wrinkles in 9 facial areas was analyzed, and their severity was assessed on the basis of a photographic scale by three independent researchers. The obtained data were analyzed statistically. The adopted limit of statistical significance was p <0.05.Results. There was a statistically significant correlation between BMI and the severity of mouth angle wrinkles.Conclusions. The relationship between BMI and the severity of the wrinkles of the mouth angle may be determined by the weight of the subcutaneous tissue around the mouth angle, however, it requires more detailed research.

En coup de sabre — a case report of therapeutic difficulties

En coup de sabre (ECDS) is a rare linear form of localized scleroderma that occurs more frequently in children than in adults. The involvement of the scalp leads to cicatricial alopecia. The aim of this paper is to present a problematic case of ECDS in young female patient. Many terapeutical methods were introduced, based on guidelines described in diagnostic and therapeutic recommendations of the Polish Dermatological Society (e.g. methotrexate, oral and intravenous glucocorticoids, subcutaneous triamcinolone injections and topical high potent steroids as well as kalcineurin inhibitor (tacrolimus). The lasting improvement was not achieved. The remission was finally induced after the implementation of mycophenolate mofetil.

Morphea en coup de sabre and hemifacial atrophy in an interdisciplinary approach

The increase in the degree of fluctuation asymmetry is accompanied, among others, by diseases such as morphea en coup de sabre (morphea ECDS) or Parry‑Romberg syndrome (PHA). Patients suffering from them struggle not only with dermatological defects, but also with neurological, rheumatological, orthopedic, ophthalmological and dental symptoms. Morphological and functional disorders and craniofacial deformities related to them often generate psychosocial problems. The complexity of the issues to be solved proves the necessity of undertaking interdisciplinary actions aimed at developing objective diagnostic and therapeutic protocols, restoring (especially in pediatric patients) as close as possible to the correct developmental patterns, inhibiting the active phase of the disease and undertaking effective and aesthetically satisfying measures.

Demodicosis in humans as a current problem in dermatology and ophthalmology

Introduction. Human Demodex mites (Demodex folliculorum and Demodex brevis) are ectoparasites living inside the sebaceous glands and hair follicles. In most people, their presence is of no consequence. However, several conditions or various external factors might contribute to pathological Demodex infestation resulting in demodicosis. Many different cutaneous diseases can resemble demodicosis leading to misdiagnosis.Aim. This paper aims to present information about demodicosis and provides a clear clinical portrait of demodicosis in order to distinguish it from other mimicking inflammatory dermatoses. Material and Methods. The literature search was conducted in the English and Polish language via the PubMed database and Main Medical Library. The articles regarding Demodex infestation were selected. Results. There is some evidence about the role of Demodex in the development of rosacea, blepharitis and clinical correlation between them.Conclusions. More attention should be drawn to Demodex as it plays a significant role in the development of various clinical entities in both dermatology and ophthalmology.

Botulinum toxin in the treatment of gummy smile

A gummy smile is an excessive exposure of the gums while smiling. There are four types: anterior- excessive gum exposure from canine to canine, posterior — excessive gum exposure in the lateral segment, mixed — combining the anterior and posterior components, and asymmetrical — with a disproportion between the right and left side. The causes of gingival smile include: skeletal defect, delayed passive tooth eruption, nasal septal dysplasia, and excessive muscle activity. A simple, fast and minimally invasive method of gummy smile therapy caused by excessive muscle activity is the supply of botulinum toxin type A to the muscles responsible for a given type of smile. A favorable aesthetic effect can be achieved with a good knowledge of application sites and individually selected doses. When determining the dose, which is described in the literature between 2 IU and 10 IU onabotulin per page, researchers take into account not only the type of corrected smile, the number of puncture points, but also gender and age of the patient.

Instrumental possibilities of skin parameters assessment — literature review

The authors reviewed the literature on the most commonly used devices for measuring skin parameters. The instruments were selected to measure: skin elasticity Cutometer® (Courage-Khazaka, Koln, Germany), Reviscometer® RVM600; hydration while using skin properties such as resistance, capacity, conductivity and impedance, the Corneometer CM 820 and CM 825 (Courage & Khazaka, Koln, Germany), Nova DPM 9003 (Nova Technology Corporation, Gloucester, MA, USA), DermaLab® USB Moisture Module (Cortex Technology, Hadsund, Denmark) and Scalar Moisture Checker MY-808S (Scalar Corporation, Japan), to test percutaneous water loss (TEWL) with Tewameter® TM 300 (Courage-Khazaka, Koln, Germany); high-frequency ultrasound scanners Dub®SkinScanner 75 (TPM Company, Lueneburg, Germany), DermaScan® C USB (Cortex Technology, Hadsund, Denmark); for pH measurement Skin-pH-Meter PH 905 (Courage-Khazaka, Koln, Germany), Skin-pH-Meter PH 900 (Courage-Khazaka, Koln, Germany, pH-Meter 1140 (Mettler Toledo, Urdorf, Switzerland); skin sebum is tested by Sebumeter® SM 815 (Courage-Khazaka, Koln, Germany); the Mexameter® MX 18 (Courage-Khazaka, Koln, Germany), CM-2600d Spectrophotometer (Konica Minolta, Tokyo, Japan) and Minolta Chromameter CR-200 (Konica Minolta, Tokyo, Japan. The analysis of measuring devices available on the market introduces the mechanism of their operation and application.

Aesthetic medicine treatments in terms of patient rights

Treatments in the field of facial aesthetic medicine are largely related to the discontinuity of the skin and are performed by both doctors and dentists. In the dentist's office, where such procedures are performed, as in any other therapeutic entity, the patient's rights apply, which are a guarantee of subjective treatment of the patient. They enable the patient in the situation of violation of patient's rights, dissatisfaction with the effects or occurrence of a complication or adverse event to refer the case to the appropriate authorities. The paper presents the basic rights of the patient, expressing the protection of his autonomy (freedom of will, awareness and knowledge) in terms of his own health.

Botulinum toxin and hyaluronic acid — the most common facial aesthetic medicine treatments — the economic aspect in terms of price in 2019 in Poland

Introduction. The observed intensive quantitative growth of aesthetic medicine clinics on the market may lead to a lowering of the general price level, although nowadays the high quality of services is a factor that determines the choice of a surgery more often than a low price.Aim. Estimate of average prices of selected facial aesthetic medicine’s procedures in Poland in 2019.Material and Methods. 7 types of facial aesthetic medicine treatments with the use of botulinum toxin or fillers that were used in 112 clinics located in Poland in 2019 were taken for the analysis.Results. The highest prices for wrinkle reduction with botulinum toxin were in the Mazowieckie Voivodeship and the lowest in the Podlasie Voivodeship. Treatments with the use of fillers cost the least in Kuyavian-Pomeranian, and the most in Mazowieckie. The most expensive treatment among the examined was the correction of the shape of the lips - 910 PLN and the cheapest was the reduction of wrinkles around the eyes - 460 PLN.Discussion. Higher prices than average can be expected in provincial cities. This is often dictated by the level of service innovation and / or patient wealth. Sometimes offering lower prices than the average can be an effective way to attract customers.Results. Treatments with the use of fillers are more expensive than those with the use of botulinum toxin by almost half. Most surgeries offer services in the field of facial aesthetic medicine using botulinum toxin and / or fillers at comparable prices.

Platelet‑rich plasma as a method of treatment of androgenetic alopecia in men — a case report

Androgenetic alopecia is a common condition, accounting for about 95% of all male hair loss. Standard therapeutic solutions recommend the use of minoxidil, finasteride, spironolactone, nutritional supplementation, phototherapy and hair transplant surgery. An increasingly popular alternative method that has been used in the case report is platelet rich plasma (PRP) mesotherapy characterized by autologous character, minimal invasiveness and no serious side effects. A series of 3 treatments was performed at 3-week intervals. The effects of using medical photographic documentation after completing a series of treatments.