RESUMO
INTRODUCTION: The eyebrows are an important facial feature that shape one's physical appearance and play a role in non-verbal communication. Partial or complete eyebrow loss is seen in most patients with frontal fibrosing alopecia (FFA). Despite the scarring nature of FFA, eyebrow hair regrowth has been previously reported. Nevertheless, treatment options and supporting evidence remain scarce. CASE PRESENTATION: We report eyebrow regrowth in 7 patients with FFA treated with low-dose oral minoxidil (OM). CONCLUSION: Low-dose OM could be a promising adjunctive therapy for treatment of the eyebrows in patients with FFA, particularly in early disease.
RESUMO
BACKGROUND: Frontal fibrosing alopecia (FFA) is a chronic cicatricial alopecia with unknown etiology and a worldwide rising incidence. OBJECTIVE: The objective of this study was to evaluate the association of FFA with demographic and exposure factors in a Brazilian multiracial population. METHODS: A multicenter case-control study was conducted in 11 referral centers throughout Brazil. The study was a case-control study that prospectively recruited 902 participants (451 patients with FFA and 451 sex-matched control individuals). Study participants completed a thorough questionnaire comprising variables grouped as baseline demographics, environmental exposure, diet, hormonal factors, allergies, and hair and skin care. RESULTS: When adjusted by sex, age, menopause, and skin color, FFA was associated with hair straightening with formalin (odds ratio [OR], 3.18), use of ordinary (nondermatologic) facial soap (OR, 2.09) and facial moisturizer (OR, 1.99), thyroid disorders (OR, 1.69), and rosacea (OR, 2.08). Smokers (OR, 0.33) and users of antiresidue/clarifying shampoo (OR, 0.35) presented a negative association with FFA. There was no association with the use of sunscreen. LIMITATIONS: Recall bias. CONCLUSIONS: The association with moisturizers, ordinary facial soap, and hair straightening with formalin and the negative association with antiresidue/clarifying shampoo reinforce the possibility of an exogenous particle triggering FFA.
Assuntos
Alopecia/epidemiologia , Cicatriz/epidemiologia , Rosácea/epidemiologia , Fumar/epidemiologia , Doenças da Glândula Tireoide/epidemiologia , Adulto , Idoso , Alopecia/etiologia , Alopecia/patologia , Brasil/epidemiologia , Estudos de Casos e Controles , Cicatriz/etiologia , Cicatriz/patologia , Feminino , Testa , Formaldeído/efeitos adversos , Preparações para Cabelo/efeitos adversos , Preparações para Cabelo/química , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Proteção , Medição de Risco/estatística & dados numéricos , Fatores de Risco , Pele/patologia , Sabões/efeitos adversos , Inquéritos e Questionários/estatística & dados numéricosRESUMO
Intralesional corticosteroid (IL-CS) injections have been used to treat a variety of dermatological and nondermatological diseases. Although an important therapeutic tool in dermatology, a number of local side effects, including skin atrophy, have been reported following IL-CS injections. We recently noticed that a subset of patients with steroid-induced atrophy presented with ivory-colored areas under trichoscopy. We performed a retrospective analysis of trichoscopic images and medical records from patients presenting ivory-colored areas associated with atrophic scalp lesions. In this paper, we associate this feature with the presence of steroid deposits in the dermis and report additional trichoscopic features of steroid-induced atrophy on the scalp, such as prominent blood vessels and visualization of hair bulbs.
Assuntos
Endometriose/patologia , Ciclo Menstrual , Dermatopatias/patologia , Adulto , Dermoscopia , Feminino , Humanos , UmbigoRESUMO
Primary cutaneous lymphomas have different clinical behavior and prognosis than systemic lymphomas of similar histological subtype. About 30% of non-Hodgkin lymphomas involve extranodal tissues, the skin being the second most affected body organ after the gastrointestinal tract (approximately 18%). According to the EORTC (European Organization for Research and Treatment of Cancer) classification, the lymphoma centrofollicular is indolent, since the lesions increase in size slowly over the years and spread to extracutaneous sites is uncommon. Based on this, radiotherapy has been considered the treatment of choice by many studies. We present the case of a patient who had cutaneous centrofollicular scalp lymphoma for 1 year and showed good response to radiotherapy.
Assuntos
Neoplasias de Cabeça e Pescoço/radioterapia , Linfoma de Células B/radioterapia , Couro Cabeludo , Neoplasias Cutâneas/radioterapia , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Linfoma de Células B/patologia , Masculino , Pessoa de Meia-Idade , Couro Cabeludo/patologia , Neoplasias Cutâneas/patologia , Resultado do TratamentoRESUMO
Primary cutaneous lymphomas have different clinical behavior and prognosis than systemic lymphomas of similar histological subtype. About 30% of non-Hodgkin lymphomas involve extranodal tissues, the skin being the second most affected body organ after the gastrointestinal tract (approximately 18%). According to the EORTC (European Organization for Research and Treatment of Cancer) classification, the lymphoma centrofollicular is indolent, since the lesions increase in size slowly over the years and spread to extracutaneous sites is uncommon. Based on this, radiotherapy has been considered the treatment of choice by many studies. We present the case of a patient who had cutaneous centrofollicular scalp lymphoma for 1 year and showed good response to radiotherapy.
Os linfomas cutâneos primários têm comportamento clínico e prognóstico diferente dos linfomas sistêmicos de subtipo histológico semelhante. Cerca de 30% dos linfomas não-Hodgkin acometem tecidos extranodais, sendo a pele o segundo órgão mais envolvido após o trato gastrointestinal (aproximadamente 18%). De acordo com a classificação EORTC (European Organization for Research and Treatment of Cancer), o linfoma centrofolicular cutâneo é indolente, uma vez que as lesões aumentam de tamanho lentamente ao longo dos anos e a disseminação para sitios extracutâneos é incomum. Com base nisso, a radioterapia tem sido apontada como o tratamento de primeira escolha por muitos estudos. Apresentamos um caso de paciente com linfoma cutâneo centrofolicular no couro cabeludo há 1 ano e que apresentou boa resposta à radioterapia.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias de Cabeça e Pescoço/radioterapia , Linfoma de Células B/radioterapia , Couro Cabeludo , Neoplasias Cutâneas/radioterapia , Neoplasias de Cabeça e Pescoço/patologia , Linfoma de Células B/patologia , Couro Cabeludo/patologia , Neoplasias Cutâneas/patologia , Resultado do TratamentoRESUMO
Melasma is a common disorder of hypermelanosis that affects mainly young and middle-aged women of Fitzpatrick's phototypes III-V. The disease significantly impacts their lives. In vivo reflectance confocal microscopy, a spreading technology for the noninvasive evaluation of the skin up to the papillary dermis, provides real-time en face images with cellular resolution. We present a case of melasma with in vivo reflectance confocal microscopy findings closely correlated to the histopathological features described in the literature.
Assuntos
Dermatoses Faciais/patologia , Melanose/patologia , Microscopia Confocal/métodos , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
Melasma is a common disorder of hypermelanosis that affects mainly young and middle-aged women of Fitzpatrick's phototypes III-V. The disease significantly impacts their lives. In vivo reflectance confocal microscopy, a spreading technology for the noninvasive evaluation of the skin up to the papillary dermis, provides real-time en face images with cellular resolution. We present a case of melasma with in vivo reflectance confocal microscopy findings closely correlated to the histopathological features described in the literature.
O melasma é um distúrbio pigmentar caracterizado por hipermelanose, que afeta principalmente mulheres jovens e de meia-idade com fototipos III-V de Fitzpatrick e acarreta em impacto significativo na qualidade de vida das mesmas. A microscopia confocal reflectante in vivo, uma tecnologia em expansão voltada para análise da pele até a derme superior, proporciona imagens en face em tempo real com resolução celular. Apresentamos um caso de melasma com achados na microscopia confocal reflectante in vivo fortemente correlacionados com as características histopatológicas descritas na literatura.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Dermatoses Faciais/patologia , Melanose/patologia , Microscopia Confocal/métodosRESUMO
Dermoscopy has its usefulness well established in the diagnostic evaluation of melanocytic lesions. Recently, however, it has also shown to be an important tool in monitoring therapeutic response to various dermatoses. We report the case of an elderly patient diagnosed with lentigo maligna of difficult surgical management, which we have chosen to treat with topical imiquimod. The dermoscopic monitoring of this alternative therapy has shown to be of great usefulness.
Assuntos
Aminoquinolinas/uso terapêutico , Antineoplásicos/uso terapêutico , Sarda Melanótica de Hutchinson/tratamento farmacológico , Neoplasias Cutâneas/tratamento farmacológico , Idoso de 80 Anos ou mais , Dermoscopia , Feminino , Humanos , Sarda Melanótica de Hutchinson/patologia , Imiquimode , Neoplasias Cutâneas/patologia , Resultado do TratamentoRESUMO
A dermatoscopia tem seu uso consagrado na avaliação diagnóstica de lesões melanocíticas. Recentemente, entretanto, tem se revelado também como importante ferramenta no acompanhamento da resposta terapêutica em diversas dermatoses. Relatamos o caso de uma paciente idosa, com diagnóstico de lentigo maligno de difícil manejo cirúrgico, para a qual optamos pelo uso do imiquimode tópico. O acompanhamento dermatoscópico dessa alternativa terapêutica se mostrou de grande utilidade.
Dermoscopy has its usefulness well established in the diagnostic evaluation of melanocytic lesions. Recently, however, it has also shown to be an important tool in monitoring therapeutic response to various dermatoses. We report the case of an elderly patient diagnosed with lentigo maligna of difficult surgical management, which we have chosen to treat with topical imiquimod. The dermoscopic monitoring of this alternative therapy has shown to be of great usefulness.
Assuntos
Idoso de 80 Anos ou mais , Feminino , Humanos , Aminoquinolinas/uso terapêutico , Antineoplásicos/uso terapêutico , Sarda Melanótica de Hutchinson/tratamento farmacológico , Neoplasias Cutâneas/tratamento farmacológico , Dermoscopia , Sarda Melanótica de Hutchinson/patologia , Neoplasias Cutâneas/patologia , Resultado do TratamentoRESUMO
We describe a 56-year-old Brazilian woman presenting three nodular lesions on the scalp. Dermoscopy of all lesions showed a creamy-white body with central bird's feet-like structures surrounded by a thorn crown, corresponding to the posterior segment of the Dermatobia hominis larvae. These novel dermoscopic features allowed us to easily diagnose furuncular myiasis.
Assuntos
Dermoscopia/métodos , Miíase/diagnóstico , Dermatoses do Couro Cabeludo/diagnóstico , Animais , Feminino , Humanos , Larva , Pessoa de Meia-Idade , Dermatoses do Couro Cabeludo/parasitologiaRESUMO
We describe a 56-year-old Brazilian woman presenting three nodular lesions on the scalp. Dermoscopy of all lesions showed a creamy-white body with central bird's feet-like structures surrounded by a thorn crown, corresponding to the posterior segment of the Dermatobia hominis larvae. These novel dermoscopic features allowed us to easily diagnose furuncular myiasis.
Descrevemos o caso de uma paciente brasileira de 56 anos de idade do sexo feminino que apresentou três lesões nodulares no couro cabeludo. A dermatoscopia das lesões mostrou um corpo branco-amarelado com uma estrutura central similar a pés de pássaro, circundado por uma coroa de espinhos, correspondendo ao segmento posterior das larvas de Dermatobia hominis. Estas novas características dermatoscópicas nos permitiram diagnosticar facilmente miíase furuncular.
Assuntos
Animais , Feminino , Humanos , Pessoa de Meia-Idade , Dermoscopia/métodos , Miíase/diagnóstico , Dermatoses do Couro Cabeludo/diagnóstico , Larva , Dermatoses do Couro Cabeludo/parasitologiaRESUMO
BACKGROUND: Trichotillomania and patchy alopecia areata have similar clinical and dermoscopic features. OBSERVATIONS: In trichotillomania, dermoscopy shows decreased hair density, short vellus hair, broken hairs with different shaft lengths, coiled hairs, short vellus hair, trichoptilosis, sparse yellow dots, which may or may not contain black dots and no exclamation mark hairs. CONCLUSIONS: In the case of patchy alopecia and broken hairs, the absence of exclamation mark hairs suggests a diagnosis of trichotillomania. On the other hand, the finding of yellow dots without black dots does not exclude it.
Assuntos
Alopecia em Áreas/patologia , Tricotilomania/patologia , Dermoscopia , Diagnóstico Diferencial , HumanosRESUMO
INTRODUÇÃO: Tricotilomania e alopecia areata em placa possuem características clínicas e dermatoscópicas semelhantes. OBSERVAÇÕES: O exame dermatoscópico da tricotilomania revela densidade capilar diminuída, cabelos fraturados em diferentes tamanhos, enovelados e vellus, tricoptilose, pontos amarelos com ou sem pontos pretos e ausência de cabelos em "ponto de exclamação". CONCLUSÃO: No contexto de alopecia em placa e cabelos fraturados, a ausência de "pontos de exclamação" sugere o diagnóstico de tricotilomania. Por outro lado, o achado de pontos amarelos sem pontos pretos não afasta o mesmo.
BACKGROUND: Trichotillomania and patchy alopecia areata have similar clinical and dermoscopic features. OBSERVATIONS: In trichotillomania, dermoscopy shows decreased hair density, short vellus hair, broken hairs with different shaft lengths, coiled hairs, short vellus hair, trichoptilosis, sparse yellow dots, which may or may not contain black dots and no exclamation mark hairs. CONCLUSIONS: In the case of patchy alopecia and broken hairs, the absence of exclamation mark hairs suggests a diagnosis of trichotillomania. On the other hand, the finding of yellow dots without black dots does not exclude it.
Assuntos
Humanos , Alopecia em Áreas/patologia , Tricotilomania/patologia , Dermoscopia , Diagnóstico DiferencialRESUMO
Neste artigo, os autores complementam o primeiro trabalho sobre a pesquisa dermatológica dos tratamentos estéticos capilares. O alisamento capilar defi nitivo com os principais alisantes legalizados hidróxidos de sódio e lítio, hidróxido de guanidina e tioglicolato de amônio , suas diferenças, mecanismos de ação, indicações e segurança para a saúde são aqui abordados. O artigo ainda discute sobre o uso ilegal e indiscriminado de produtos do grupo dos aldeídos (formaldeído e glutaraldeído) nos salões de cabeleireiro no Brasil, suas implicações legais e em saúde pública, sua carcinogenicidade e a identifi cação dos referidos registros junto à ANVISA. Também são estudados os xampus e agentes condicionadores indicados para tratamento da haste capilar. Ao fi nal, são discutidas as implicações dos tratamentos capilares em geral, para a saúde do fi o e do couro cabeludo.
The authors complement the fi rst article on the approach of dermatological aesthetic hair treatments. This article addresses the ultimate hair straightening with major straightening legalized sodium, lithium and guanidine hydroxides and ammonium thioglycolate , their differences, mechanisms of action, indications and safety to human health. Besides these straighteners, we discuss the illegal and indiscriminate use of hairdressers salons in Brazil in the group of aldehydes (formaldehyde and glutaraldehyde) for smoothing hair. This study focuses its legal implications and public health, carcinogenic potencial and the identifi cation of such fi lings with ANVISA. Also studied the shampoos and conditioning agents indicated for treatment of the hair shaft. Finally, we discuss the implications of hair care in general health of the hair shaft and the scalp.
RESUMO
Dúvidas sobre a ação dos cosméticos capilares sobre a saúde do corpo e dos cabelos são cada vez mais frequentes nas consultas dermatológicas. Os médicos dermatologistas necessitam enriquecer o conhecimento a respeito, não somente, das doenças do couro cabeludo, como também das interações moleculares dos cosméticos usados na fibra capilar, incluindo a influência de tais produtos quando absorvidos pelo epitélio do couro cabeludo. A cada dia, aumentam as consultas médicas para esclarecimento de quais técnicas e produtos químicos são mais indicados para permitir que os cabelos sofram as alterações desejadas de seu aspecto natural e, ao mesmo tempo, mantenhamse saudáveis e belos. Neste artigo, dividido em duas partes, abordamos a fisiologia dos cabelos, sua estrutura e natureza química, os agentes usados para seu alisamento, sua coloração, higiene e seu tratamento estético e as consequências que tais procedimentos podem ter na saúde em geral, incluindo sua segurança no uso durante a gravidez e lactação.
Doubts concerning the action of hair cosmetics and the health of both body and hair are very frequent in the dermatological visits. Dermatologists need no only to enrich the knowledge of scalp diseases but also of molecular interactions of cosmetics used in hair fi ber, including the infl uence of such products when absorbed by the epithelium of the scalp. The amount of medical visits increases every day to fi nd out which techniques and chemical products are best indicated to enable the desired changes in hair from its natural appearance and, at the same time, to keep the hair healthy and beautiful. In this article, divided in two parts, we discuss the hair physiology, structure and chemical nature, as well as the agents used for its smoothing, coloring, hygiene and cosmetic treatment, and the consequences that such procedures can have on overall health, including their use safety during pregnancy and lactation.
RESUMO
BACKGROUND: Dermoscopy has been established as an indispensable tool in the diagnosis and follow up of hair disorders. In alopecia areata, dermoscopy of active disease shows yellow dots, dystrophic hairs, as well as cadaverized (black dots) and exclamation mark hairs. Alopecia areata has been reported to occur equally among races, however, until date, there are no published data regarding dermoscopic findings in African-American patient. MAIN OBSERVATION: We report a case of scalp dermoscopy of alopecia areata in an African-American patient that shows a diffuse honeycomb-like pigmented network, few yellow dots and white dots. CONCLUSION: This case shows that skin color may affect dermoscopic findings in alopecia areata. In our African-American patient with alopecia areata dermoscopy showed a diffuse honeycomb-like pigmented network, which was previously considered characteristic for androgenic alopecia and white dots, which were considered characteristic for cicatricial alopecia. Further studies are needed to elucidate the presence of white dots in alopecia areata.
RESUMO
El objeto de este trabajo es presentar nuestra experiencia en el tratamiento quirúrgico de las fracturas laterales de la cadera observadas en 150 osteosíntesis realizadas en el Hospital "José María Cullen" y en la práctica privada de la ciudad de Santa Fe. De un total de 500 pacientes afectados de fracturas del extremo proximal del fémur entre los años 1982 y 1992, 150 osteosíntesis en fracturas laterales fueron evaluados personalmente por los autores. De ellos, 107 pertenecían al sexo femenino y 43 al sexo masculino. La edad promedio fue de 72 años, con un mínimo de 29 años y un máximo de 96 años. El tiempo promedio de seguimiento fue de 4 años y 6 meses, con un mínimo de 6 meses y un máximo de 10 años. En el tratamiento quirúrgico se realizó la reducción y osteosíntesis quirúrgico utilizando el clavo-placa de Jewett