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BACKGROUND: Frontal fibrosing alopecia (FFA) is a scarring alopecia that mainly affects postmenopausal women characterized by recession of the frontotemporal hairline and eyebrow loss. Current techniques to assess FFA activity are limited and involve noninvasive tools that assess disease progression or an invasive technique such as scalp biopsies. However, since progression of FFA is very slow, it is very important to develop a noninvasive technique to assess disease activity to monitor treatment response. OBJECTIVES: To provide a standardized and objective method to assess FFA activity. METHODS: We evaluated the correlation between trichoscopy and pathological features (degree of lymphocytic infiltration) in 20 dermoscopy-guided biopsies of FFA. At trichoscopy, we divided the severity of peripilar casts into 3 grades according to their thickness. To validate the trichoscopic visual scale, we showed the images to 7 dermatologists with interest in hair diseases. Concordance was assessed using the Kendall Tau-b concordance test. RESULTS: A strong correlation between severity of peripilar casts at trichoscopy and degree of lymphocytic infiltrate was observed by the Kendall Tau-b test. Validation showed very good inter- and intraobserver agreement. CONCLUSION: The trichoscopic visual scale allows noninvasive assessment of scalp inflammation in FFA in different scalp regions and therefore provides optimal guidance for treatment.
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BACKGROUND: Mexican mestizo population has a pluriethnic mixture of Amerindian, European and African ancestry, predominant in most Latin American countries. Until now, there are no reports about hair characteristics in this population, necessary to define normal values, for hair diseases evaluation and comparison among other ethnic groups. METHODS: The VivoSight® swept-source multibeam optical coherence tomography system was used to evaluate hair diameter and shape in 30 females. Three hair samples from each volunteer were measured transversely along three distances, generating nine cross-sectional images, two measurements per image and 18 measurements per patient for a total of 540 diameter measurements. RESULTS: Minimum hair diameter (n = 540) was 0.06 mm while maximum was 0.14 mm. Mean diameter was 0.10 ± 0.01 mm as compared with Asian hair, which ranges from 0.08 mm to 0.12 mm. On morphological analysis, Mexican Mestizo hair tends to have a round shape with homogenous diameters, resembling Caucasian and Asian hair. CONCLUSION: Mexican hair is similar to Asian hair in diameter and shape and can be classified as 'thick' hair, which make it more resistant and with more volume. Cosmetic products intended to improve hair care in this population must to consider this characteristic.
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Cabelo/anatomia & histologia , Adolescente , Adulto , Estudos Transversais , Feminino , Cabelo/diagnóstico por imagem , Voluntários Saudáveis , Humanos , Indígenas Norte-Americanos/etnologia , México/etnologia , Pessoa de Meia-Idade , Tomografia de Coerência Óptica/métodos , População Branca/etnologia , Adulto JovemRESUMO
INTRODUCTION: There are no reports of the density of hair follicles in the scalp of Mexican mestizo population, necessitating the determination of normal references values for this population compared with other ethnic groups. OBJECTIVE: To determine the average hair follicle count on the scalp in Mexican mestizo population. MATERIALS AND METHODS: A total of 50 scalp samples (25 men and 25 women) from Mexican mestizo individuals aged between 19 and 60 years, with no clinical evidence of hair disease, obtained by biopsy punch at General Hospital "Dr. Manuel Gea González" were collected over 2 years. The total follicular density, vellus and terminal hair follicles, and the percentage in anagen and catagen-telogen phase were measured. χ2 was used as the basic statistical test. RESULTS: The mean number of total hair follicles in our Mexican mestizo population was 23.2 ± 4.2, which is lower compared with Thais, Iranians, and Caucasians. However, the ratio of terminal and vellus hair follicles was higher than in Thais, Caucasians, and African-Americans. The percentage of terminal hairs in anagen phase was lower than in the other populations, and higher in telogen, without exceeding 15%, established as the normal reference value. There was an association between sex and terminal hairs in telogen phase (p < 0.05). The average follicular density per mm2 was slightly higher compared with African-Americans and Asians. Women had more terminal hairs than men. CONCLUSIONS: The density of total follicles is lower in the Mexican mestizo population compared with Iranians, Thais, and Caucasians. However, the greater number of terminal hairs compared to vellus hairs gives the appearance of greater overall volume. The results of this study can be used as a reference for diseases of the scalp in the Mexican population.
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INTRODUCTION: Hair shedding is a common consequence of the normal hair cycle that changes with internal and external factors. Female pattern hair loss (FPHL) is difficult to assess in terms of shedding severity as the conscious perception of hair shedding varies according to each individual, and most utilized methods are semi-invasive or very time consuming. In this study, we establish and validate a hair-shedding scale for women with thick hair of different lengths. METHODS: A visual analog scale was developed for thick hair of short, medium, and long lengths by dividing a bundle of hairs of each length into nine piles of increasing hair amount that were then photographed and arranged in order of size. Twenty women with no FPHL with each length of hair (60 total) were asked to select the photographed hair bundle that best correlated with the amount of hair they shed on an average day. A total of 94 women with FPHL with excessive shedding were then asked to repeat the same process. RESULTS: Women with no FPHL and short, medium and long hair had mean shedding scores of 2.5, 2.35 and 2.4, respectively. Women with FPHL and short, medium and long hair had mean shedding scores of 7.25, 7.0 and 7.14, respectively. Statistically significant Spearman's ρ coefficient and κ coefficient demonstrated correlation and inter-observer reliability. CONCLUSION: Our results show that women with FPHL not only shed considerable hair more than women with no FPHL, but that this hair-shedding visual scale is a fast and effective method of evaluating hair-shedding amounts in an office setting.
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Abstract Subungual melanoma represents 20% of all melanomas in Hispanic population. Here, we report the outcome of 15 patients with in situ subungual melanoma treated with resection of the nail unit with a 5-mm margin without amputation, followed up for 55.93 ± 43.08 months. The most common complications included inclusion cysts and nail spicules. We found no evidence of local or distant recurrences at the last visit of our follow up. Functional outcome was good, with only one patient reporting persistent mild pain. These results support functional, non-amputative surgical management of in situ subungual melanomas.
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Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Neoplasias Cutâneas/cirurgia , Melanoma/cirurgia , Doenças da Unha/cirurgia , Neoplasias Cutâneas/patologia , Fatores de Tempo , Biópsia , Reprodutibilidade dos Testes , Seguimentos , Resultado do Tratamento , Dermoscopia , Melanoma/patologia , Doenças da Unha/patologia , Recidiva Local de NeoplasiaRESUMO
Subungual melanoma represents 20% of all melanomas in Hispanic population. Here, we report the outcome of 15 patients with in situ subungual melanoma treated with resection of the nail unit with a 5-mm margin without amputation, followed up for 55.93 ± 43.08 months. The most common complications included inclusion cysts and nail spicules. We found no evidence of local or distant recurrences at the last visit of our follow up. Functional outcome was good, with only one patient reporting persistent mild pain. These results support functional, non-amputative surgical management of in situ subungual melanomas.
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Melanoma/cirurgia , Doenças da Unha/cirurgia , Neoplasias Cutâneas/cirurgia , Adolescente , Adulto , Idoso , Biópsia , Criança , Pré-Escolar , Dermoscopia , Feminino , Seguimentos , Humanos , Masculino , Melanoma/patologia , Pessoa de Meia-Idade , Doenças da Unha/patologia , Recidiva Local de Neoplasia , Reprodutibilidade dos Testes , Neoplasias Cutâneas/patologia , Fatores de Tempo , Resultado do Tratamento , Adulto JovemRESUMO
The vasculities are complex diseases. Their cutaneous manifestations are very important and often mirror several pathologies. Cocaine use has been related to both, vasculitis and thrombotic vasculopathy and pseudovasculitis. A new syndrome has been described in association with its adulteration with levamisole. It can be very serious, leading patients to death. This is relevant as levamisole-adultered cocaine seems to be increasingly offered to consumers. Our goal is to report the first two cases in Mexico, which faces an important raise in cocaine use, emphasizing that a high suspicion based on certain characteristics allows for early recognition and adequate treatment.
Las vasculitis son enfermedades complejas con manifestaciones cutáneas importantes que pueden traducir diversas patologías. El uso de cocaína está relacionado con casos tanto de vasculitis y vasculopatía trombótica, como de pseudovasculitis. Recientemente se ha descrito una condición peculiar asociada a su forma adulterada con levamisol, la cual puede ser incluso mortal, y cuya frecuencia va en aumento. Nuestro objetivo es reportar los primeros dos casos de alta sospecha en México, que enfrenta un incremento en el consumo de cocaína, enfatizando en que ciertas características y la realización de determinados estudios permiten la identificación temprana y el tratamiento adecuado de esta condición.
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Cocaína/química , Contaminação de Medicamentos , Drogas Ilícitas/química , Drogas Ilícitas/toxicidade , Levamisol/toxicidade , Trombose/induzido quimicamente , Vasculite/induzido quimicamente , Adulto , Capilares/efeitos dos fármacos , Humanos , Masculino , México , Pele/irrigação sanguínea , Trombose/diagnóstico , Vasculite/diagnósticoRESUMO
Dermoscopy represents a useful technique for the diagnosis and follow-up of hair and scalp disorders. To date, little has been published regarding dermoscopy findings of hair disorders in patients of African descent. This article illustrates how dermoscopy allows fast diagnosis of hair breakage due to intrinsic factors and chemical damage in African descent patients.