Nonscarring Alopecia and Hypopigmented Lesions May Be Unusual Signs of Secondary Syphilis

2021 ◽  
pp. 1-3
Author(s):  
Magdalena Ciupińska ◽  
Justyna Skibińska ◽  
Mariusz Sikora ◽  
Leszek Blicharz ◽  
Maja Kotowska ◽  
...  
Keyword(s):  
Hair Loss ◽  
Alopecia Areata ◽  
Early Stage ◽  
Skin Lesions ◽  
Secondary Syphilis ◽  
Exclamation Mark ◽  
Benzathine Benzylpenicillin

Noncicatricial patchy alopecia of the scalp and focal areas of skin hypopigmentation imply a diagnosis of alopecia areata and vitiligo. We present a case of a 22-year-old patient in whom these symptoms were associated with positive spirochete reactions, which allowed making a diagnosis of syphilitic alopecia coexisting with leukoderma syphiliticum. Skin lesions and hair loss resolved after the treatment with benzathine benzylpenicillin. Trichoscopy in syphilitic alopecia is nonspecific, but the absence of features typical for alopecia areata such as exclamation mark hairs may be important on an early stage of the clinical workup.

scholarly journals To Study Dermoscopic Findings in Alopecia Areata

2020 ◽  
pp. 29-35
Author(s):  
Kovi Sneha ◽  
Jayakar Thomas
Keyword(s):  
Clinical Diagnosis ◽  
Hair Loss ◽  
Alopecia Areata ◽  
Liquid Paraffin ◽  
Skin Lesions ◽  
Acute Stage ◽  
Hair Follicles ◽  
The Body ◽  
Cross Sectional ◽  
Exclamation Mark

Introduction: Alopecia areata is a common chronic autoimmune inflammatory disease that involves hair follicles, characterized by hair loss on the scalp and/or body without scarring. Clinically, the disease presents as smooth, patchy hair loss with various patterns - diffuse or reticulate alopecia, ophiasis, ophiasis inversus, alopecia totalis (loss of hair all the scalp), or alopecia universalis (loss of hair all over the body). Clinical diagnosis of AA is made based on typical pattern of hair loss and the presence of characteristic exclamation mark hair in microscopy. Invasive (punch biopsy) techniques are often required in some cases where the clinical diagnosis is not straight forward Biopsy shows peribulbar lymphocytic infiltrates in a “swarm of bee pattern” which is characteristic of the acute stage of the disease. Dermoscopy is an imaging instrument that immensely magnifies surface features of skin lesions. It works on the principle of illumination and transillumination of skin with different light sources and studying it with a high magnification lens. Dry dermoscopy was done with heine delta 20 dermoscope which was followed by wet dermoscopy. Liquid paraffin was used as the immersion media. It is a noninvasive, repeatable, recordable bedside investigation. Objective: To study dermoscopic findings in alopecia areata. Materials and Methods: Study Design: Cross sectional study; Study Area: Skin Outpatient Department, Sree Balaji Medical College and Hospital; Study Population: All patients with hair loss, attending skin OPD, who are clinically diagnosed as Alopecia Areata; Study Method: Observational study; Sample Size: 30. Results: Clinically, the disease presents as smooth, patchy hair loss with various patterns. Dermoscopy is useful for diagnosis of AA clinically by the presence of cadaverized hairs (black dots), circle hair, coudablity hair, exclamation mark hairs (tapering hairs), broken hairs, yellow dots and clustered short vellus hairs in the hair loss areas. The results wear tabulated.

scholarly journals Essential syphilitic alopecia: Non-scarring alopecia in 21-year-old man

2021 ◽  
Vol 12 (e) ◽  
pp. 1-3
Author(s):  
Hafssa Chehab ◽  
Bertrand Richert
Keyword(s):  
Hair Loss ◽  
Previous History ◽  
Treponema Pallidum ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Secondary Syphilis ◽  
Laboratory Evaluation ◽  
History Of ◽  
High Level

ABSTRACT Alopecia syphilitica is a less common clinical manifestations of secondary syphilis. It is uncommon for hair loss to be the sole or predominant manifestation, as hair loss is the chief clinical and histologic differential diagnosis of. The main difference between alopecia areata and Alopecia syphilitica is the detection of Treponema pallidum in syphilis. We present the case of a 21- year-old belgium man with different patches of non-cicatricial alopecia of his scalp. The patient denied previous history of genital or other skin lesions. Laboratory evaluation was positive for syphilis. The diagnosis of alopecia syphilitica was made and he was treated with single intramuscular injections of benzathine penicillin. The lesions improved with treatment in all the patients who attended follow-up. Dermatologists should maintain a high level of clinical suspicion for this uncommon manifestation of syphilis, particularly when it is the only symptom.

Serum Interleukin-15 in Alopecia Areata and its correlation with dermoscopic findings

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Naziha Hafez Khafagy ◽  
Marwa Salah El Din Zaki ◽  
Aya Mahmoud Hussein
Keyword(s):  
Hair Loss ◽  
Alopecia Areata ◽  
Serum Levels ◽  
Common Finding ◽  
Control Group ◽  
University Hospitals ◽  
Exclamation Mark ◽  
Significant Difference ◽  
Initial Onset ◽  
And Control

Abstract Background Alopecia areata is an autoimmune hair loss which frequently starts in childhood. Its presentation had an extreme variability not only in the time of initial onset but also in the duration, extent, and pattern of hair loss during any given episode of active loss. Moreover, the course of disease is unpredictable, with spontaneous regrowth of hair occurring in 80% of patients within the first year and sudden relapse at any given time. Due to the clinical variability and unpredictable nature of spontaneous regrowth, diagnosis and management may be difficult and challenging. Objective The aim of this study is to evaluate the serum levels of IL-15 in active alopecia areata and correlate them with disease severity and activity according to dermoscopic findings. Methods This case-control study were conducted in Dermatology, Venereology and Andrology department, Ain Shams University Hospitals included 30 patients with different clinical variants of AA, the diagnosis was made via clinical examination and dermoscopic findings. In addition, 30 apparently healthy individuals of matched age and sex as a control group were included in the study. Results Dermoscopic examination among cases showed that the most common dermoscopic findings in patients were vellus hair and yellow dots, while the least common finding was exclamation mark hairs. On comparing serum IL-15 in patients and control groups, it was found that serum levels of IL-15 in patients were significantly higher than those in the control group. There was no statistically significant difference in serum IL-15 levels between patients with negative and positive pull test, nail involvement, or body involvement. Similarly, no statistically significant difference in serum IL-15 levels in patients with various subjective disease activity was detected. However, there was a highly significant difference between serum IL-15 levels in different SALT score groups, with the highest levels being in the S3 group. There was a highly significant difference between IL-15 levels in patients with and without black dots. Also, there was significant difference between IL-15 in patients with and without broken hair, and exclamation mark hair. There was no significant difference in level of IL-15 among patients with and without yellow dots, and with and without vellus hair. Conclusion On the basis of the current study, we can conclude that IL-15 is significantly elevated in AA patients when compared to the control subjects. It is also a possible marker of AA severity. It is positively correlated with dermoscopic findings in AA patients, so dermoscopic findings can be useful in evaluating severity of alopecia areata.

scholarly journals Different Trichoscopic Features of Tinea Capitis and Alopecia Areata in Pediatric Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Abd-Elaziz El-Taweel ◽  
Fatma El-Esawy ◽  
Osama Abdel-Salam
Keyword(s):  
Hair Loss ◽  
Alopecia Areata ◽  
Tinea Capitis ◽  
Pediatric Patients ◽  
Skin Surface ◽  
Fungal Culture ◽  
Exclamation Mark ◽  
Laboratory Investigations ◽  
Vellus Hairs ◽  
Clinical Dermatology

Background. Diagnosis of patchy hair loss in pediatric patients is often a matter of considerable debate among dermatologists. Trichoscopy is a rapid and noninvasive tool to detect more details of patchy hair loss. Like clinical dermatology, trichoscopy works parallel to the skin surface and perpendicular to the histological plane; like the histopathology, it thus allows the viewing of structures not discovered by the naked eye.Objective. Aiming to compare the different trichoscopic features of tinea capitis and alopecia areata in pediatric patients.Patients and Methods. This study included 40 patients, 20 patients with tinea capitis and 20 patients with alopecia areata. They were exposed toclinical examination, laboratory investigations (10% KOH and fungal culture), and trichoscope examination.Results. Our obtained results reported that, in tinea capitis patients, comma shaped hairs, corkscrew hairs, and zigzag shaped hairs are the diagnostic trichoscopic features of tinea capitis. While in alopecia areata patients, the most trichoscopic specific features were yellow dots, exclamation mark, and short vellus hairs.Conclusion. Trichoscopy can be used as a noninvasive tool for rapid diagnosis of tinea capitis and alopecia areata in pediatric patients.

scholarly journals Frontier in hair loss and trichoscopy: A review

2016 ◽  
Vol 1 (2) ◽  
Author(s):  
Ebtisam Elghblawi
Keyword(s):  
Hair Loss ◽  
Skin Lesions ◽  
Hair Shaft ◽  
Hair Follicles ◽  
Invasive Technique ◽  
Non Invasive ◽  
Exclamation Mark ◽  
Indispensable Tool ◽  
Hair Diseases

<p>Skin surfaces have always been examined using dermoscopy, a familiar tool which is useful to magnify and examine skin especially in cases of pigmented skin lesions. However, to examine the hair and scalp, a practical tool called trichoscopy has surfaced recently and has proven to be handy and functional in diagnosing most hair-related diseases. It is also referred to as dermoscopy of the hair and the scalp. It can aid in assessing active diseases in the scalp and hair, such as yellow dots, dystrophic hairs, cadaverized black dots, white dots, and exclamation mark hairs – all of which denote specific criteria for hair diseases. Trichoscopy is a very newly developed non-invasive technique for hair image analysis. It permits non-invasive visualization of hair shafts at higher intensification (about ×70 and ×100) and enables measurement of hair shaft width without the need for removing hair for diagnostic reasons. Moreover, it helps <em>in vivo</em> visualization of the epidermal portion of hair follicles and perifollicular epidermis (orifices). Consequently, it is valuable as it permits the inspection of structures that are otherwise not seen by the naked eye. Trichoscopy is the new frontier for the diagnosis of hair and scalp disease. Nowadays, a trichoscope is considered a must for dermatologists and it is a hot topic in the treatment of hair diseases. There is pooled evidence that the utilization of trichoscopy in the clinical setting for evaluating hair disorders can improve its diagnostic capability beyond simple clinical scrutiny. Trichoscopy can identify both hair shaft and hair opening abnormalities without the need for hair sampling, as well as distinguish between different scalp and hair diseases. Furthermore, it can give easy and quick evaluation of the hair with a follow-up to determine progress and prognosis of the disease with photos. It can also aid in some genetic hair shaft dystrophies such as trichorrhexis nodosa, trichorrhexis invaginata, monilethrix, pili annulati, and pili torti. The limitation of trichoscopy is that it needs prior knowledge to apply it effectively in order to mandate an efficient use by correctly interpreting the findings and their significance. In cases where there are unsettled discrepancies, a histopathological investigation is needed. The interest in trichoscopy has vastly increased and has become an indispensable tool in evaluating patients with hair loss. The aim of this review is to supplement existing knowledge on trichoscopy with recent readings of different scalp and hair conditions that are commonly encountered in clinical settings.</p>

Alopecia Areata in United Arab Emirate Adult Men’s Locals the Pattern and Profile

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
M. Almalmi
Keyword(s):  
Hair Loss ◽  
Alopecia Areata ◽  
Psychosocial Stress ◽  
United Arab Emirate ◽  
Skin Lesions ◽  
Abu Dhabi ◽  
Health Departments ◽  
Adult Men ◽  
Smooth Skin ◽  
Health Organization

Background:Alopecia areata (AA) is a recurrent nonscarring type of hair loss that can affect any hair-bearing area. Clinically, AA can present with many different patterns. Although medically benign, AA can cause tremendous emotional and psychosocial stress in affected patients and their families.Objectives:To study the pattern of alopecia areata in UAE adult men’s locals.Patients and methods:Twenty adult men united arab emirate local patients 20 to 40 years old presented with single or multiple hairless oval smooth skin lesions in the scalp and beared area. The duration was weeks or months. Skin and hair scraping and examined with 20% potasium hydroxide (KOH) for superfacial dermatophytosis was negative. There were no septic fossi. Most of the patients suffered or complained from anixiety neurosis, emotional stress, tention and social families problems. The treated with psychosocial reasssurance and interalesional injection therapy with Trimecinilone Acetonide (TA) vials for one set and they get better.Results:The clinical data, investigations, psychosocial analysis revealed that the twenty UAE locals had alopecia areata in the scalp or in the beared area. The most cuases were psychosocial.Conclusions:Alopecia areata in UAE adult men locals is very common hair and skin disorders. The psychological and social troubles play important role in the occurance. The governmental health departments as Dubai health organization (DOH), ministry of helath, (MOH) and Abu dhabi Health Authority (HAAD) in UAE must introduce psychological, social solutions, counciling and suporting for those patients.

Indian Dermoscopic Study of One Thirty Eight Cases of Alopecia Areata

2018 ◽  
Vol 3 (02) ◽  
Author(s):  
Rahul Kumar Sharma, Divya Sharma, Rajendra Kumar Sharma
Keyword(s):  
Alopecia Areata ◽  
Smart Phone ◽  
Cotton Wool ◽  
Exclusion Criteria ◽  
Dermatology Clinic ◽  
Exclamation Mark ◽  
Single Feature ◽  
Males And Females ◽  
Vellus Hairs ◽  
Difficult Cases

Alopecia areata (AA) is a type of non-scarring alopecia first described by Cornelius Celsus, characterized by hair loss without any clinical inflammatory signs and affecting both males and females equally. The activity of AA is by the presence of black dots, broken hair, and tapering, furthermore black dots and yellow dots are equated to severity of AA. Aim - To study dermoscopic features of untreated cases of alopecia areata. Study subjects-All the patients who attended the dermatology clinic from March 2015 to March 2017 with the clinical diagnosis of alopecia areata and who fulfilled the inclusion and exclusion criteria. Study period - Two year (from March 2015 to March 2017). Methodology - All the patients who attended the dermatology clinic from March 2015 to March 2017 with the diagnosis of alopecia areata and who fulfilled the inclusion and exclusion criteria were recruited for the study. Trichoscopy was performed with DL4 dermatoscope. The images were further magnified with smart phone. Results - We got various dermoscopic signs in different combinations in our study. Yellow dots were seen in 10 cases, White dots in cotton wool pattern were seen in 3 cases, Black dots were seen in 25 cases, Dermoscopic coudability sign was demonstrated in 38 cases, Pigtail hairs were present in 2 cases, five cases showed short vellus hairs, Short broken hairs were found in 18 cases, Exclamation mark hairs were very common and were detected in 131 patients out of 138. Discussion - Single feature is not leading to the diagnosis so we should use combination of features which will help in difficult cases like AA incognito. Dermatoscope is an indispensible valuable tool in trichology practice which helps in prognosticating and making early diagnosis of AA. It also helps to differentiate it from trichotillomania and other causes of alopecia. In our study the incidence of AA was almost similar in both sexes. Our study revealed that exclamation mark hair is very common and sensitive dermoscopic marker of AA.

scholarly journals Morphologic Features of Cutaneous T-Cell Lymphomas Using Dermoscopy and High Frequency Ultrasound

2020 ◽  
Vol 10 (1) ◽  
pp. 17
Author(s):  
Iris Wohlmuth-Wieser ◽  
Joel M. Ramjist ◽  
Neil Shear ◽  
Raed Alhusayen
Keyword(s):  
T Cell ◽  
High Frequency ◽  
Early Stage ◽  
Skin Lesions ◽  
Diagnostic Tools ◽  
Skin Thickness ◽  
High Frequency Ultrasound ◽  
T Cell Lymphomas ◽  
Standardized Parameters ◽  
Frequency Ultrasound

The diagnosis of cutaneous T-cell lymphomas (CTCL) is frequently delayed by a median of three years and requires the clinical evaluation of an experienced dermatologist and a confirmatory skin biopsy. Dermoscopy and high-frequency ultrasound (HFUS) represent two non-invasive diagnostic tools. While dermoscopy is inexpensive and widely used for the diagnosis of melanoma and non-melanoma skin cancers, HFUS of skin lymphomas represents a novel diagnostic approach that is not yet implemented in the routine dermatologic practice. The aim of our study was to prospectively assess skin lesions of patients with either CTCL patches or plaques with dermoscopy and HFUS and to compare the findings with atopic dermatitis (AD) and psoriasis. Thirteen patients with an established diagnosis of CTCL, psoriasis, or AD were studied: Dermoscopy features including spermatozoa-like structures and the presence of white scales could assist in differentiating between early-stage CTCL and AD. HFUS measurements of the skin thickness indicated increased epidermal-, thickness in CTCL, and psoriasis compared with AD. Our results support the use of dermoscopy as a useful tool to diagnose CTCL. HFUS could augment the dermatologic assessment, but further studies will be needed to define standardized parameters.

Hair Growth in a Patient with Alopecia Areata on Tocilizumab

2021 ◽  
pp. 1-5
Author(s):  
Chloe J. Walker ◽  
Kelly E. Flanagan ◽  
James T. Pathoulas ◽  
Isabel Pupo Wiss ◽  
Maryanne M. Senna
Keyword(s):  
Monoclonal Antibody ◽  
Autoimmune Disease ◽  
Hair Loss ◽  
Alopecia Areata ◽  
Interleukin 6 ◽  
Hair Growth ◽  
Posterior Uveitis ◽  
Case Presentation ◽  
Antibody Targeting ◽  
Growth Changes

<b><i>Introduction:</i></b> Tocilizumab (TCZ), a recombinant humanized antihuman monoclonal antibody targeting interleukin-6 (IL-6) signaling, is often utilized in the management of autoimmune disease. Few reports have demonstrated hair growth changes in patients on TCZ. <b><i>Case Presentation:</i></b> Herein, we review the literature and report a 21-year-old woman with progressive alopecia areata (AA) presenting with AA improvement while on TCZ for concomitant posterior uveitis. <b><i>Discussion:</i></b> Our case demonstrates the potential ability of TCZ to disrupt IL-6 signaling involved in AA, leading to hair loss and regrowth.

scholarly journals A Case of Rupioid Syphilis Masquerading as Aggressive Cutaneous Lymphoma

2015 ◽  
Vol 7 ◽  
pp. e2015026 ◽  
Author(s):  
Jonathan Braue ◽  
Thomas Hagele ◽  
Abraham Tareq Yacoub ◽  
Suganya Mannivanan ◽  
Frank Glass ◽  
...  
Keyword(s):  
19Th Century ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Rare Case ◽  
Skin Lesions ◽  
Secondary Syphilis ◽  
Cutaneous Lymphoma ◽  
Hiv Positive ◽  
Late 19Th Century ◽  
Inflammatory Syndrome

Secondary syphilis has been known since the late 19th century as the great imitator; however, some experts now regard cutaneous lymphoma as the great imitator of skin disease. Either disease, at times an equally fastidious diagnosis, has reported to even mimic each other. It is thus vital to consider these possibilities when presented with a patient demonstrating peculiar skin lesions. No other manifestation of secondary syphilis may pose such quandary as a rare case of rupioid syphilis impersonating cutaneous lymphoma. We present such a case, of a 36-year-old HIV positive male, misdiagnosed with aggressive cutaneous lymphoma, actually exhibiting rupioid syphilis thought secondary to immune reconstitution inflammatory syndrome (IRIS).

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