Alternaria scalp infection in a patient with alopecia areata. Coexistence or causative relationship?

Background: Alopecia areata is an autoimmune disease that is affecting anagen hair follicles. The triggers of autoimmunity in patients with alopecia areata remain unknown.

Main Observation: A 13-year-old boy developed multiple hairless patches of focal hair loss with typical clinical and trichoscopy features of alopecia areata.

Trichoscopy: how it may help the clinician.

Trichoscopy (or dermoscopy of hair and scalp) is an easy in-office technique that may be performed with a handheld dermoscope or a digital videodermoscopy system. This method is gaining increasing popularity, because it may be applied in differential diagnosis of multiple hair and scalp diseases. The focus of this article is application of trichoscopy in differential diagnosis of the most frequent hair and scalp diseases in dermatologic practice.

'Black dots' seen under trichoscopy are not specific for alopecia areata.

Background: 'Black dots' are macrocomedo-like round structures localized to the follicular ostium, and are considered a specific trichoscopic feature of alopecia areata (AA).

Aim: To characterize specific features of 'black dots', and assess their possible presence in common hair and scalp disorders.

Methods: In total, 107 patients with hair loss [30 with alopecia areata (AA), 37 with androgenetic alopecia (AGA), 17 with chronic telogen effluvium (TE), 23 with other hair and scalp diseases] and 93 healthy controls were examined, using a videodermoscope with 20-70 times magnification.

[Methods of hair loss evaluation in patients with endocrine disorders].

Hair loss may accompany several endocrine disorders, including hypopituitarism, hypothyreosis, hyperthyreosis, hypoparathyroidism, diabetes mellitus, growth hormone deficiency, hyperprolactinaemia, polycystic ovary syndrome, SAHA syndrome, congenital adrenal hyperplasia, Cushing syndrome, or virilising tumours. Most patients with endocrine disorders present with diffuse non-scarring alopecia, such as anagen effluvium, telogen effluvium or androgenetic alopecia. Focal non-scarring alopecia, such as alopecia areata coexisting with autoimmune thyroiditis, is less frequent and scarring alopecia is a rare finding in patients with endocrine abnormalities.

Criteria for diagnosing pemphigus vulgaris and pemphigus foliaceus by reflectance confocal microscopy.

Background: Pemphigus is an autoimmune, bullous disease affecting the skin and mucous membranes. The aim of the study was to evaluate whether pemphigus vulgaris (PV) and pemphigus foliaceus (PF), may be diagnosed using reflectance confocal microscopy (RCM).

Methods: Thirty patients (18 with PV and 12 with PF) were included into the study.

Briakinumab for the treatment of plaque psoriasis.

Psoriasis is a chronic inflammatory skin disorder affecting approximately 2% of individuals worldwide. An improved understanding of the pathogenesis of psoriasis has led to the development of targeted biologic therapies. Briakinumab (ABT-874) is a recombinant human antibody that blocks the biological activity of the cytokines interleukin (IL)-12 and IL-23 through their shared subunit p40.

[The usefulness of high frequency ultrasonography in dermatological practice--ultrasound features of selected cutaneous lesions].

Unlabelled: Typical diagnostic process in dermatology includes clinical assessment, dermoscopic and histopathologic examination. Microsonography was initiated in seventies and much progress in the development of high-frequency scanners occurred since that time. The aim of the study was the assessment of high frequency ultrasonography in dermatologic diagnostics.

New interleukin-23 pathway inhibitors in dermatology: ustekinumab, briakinumab, and secukinumab.

Interleukin (IL)-23 is an important regulator of T helper-17 lymphocytes, which influence the cutaneous immune system by production of IL-17 and several other proinflammatory cytokines. This pathway has been recently linked to the pathogenesis of psoriasis and numerous other skin diseases. A newly developed biologic drug, ustekinumab (CNTO-1275), which targets the p40 subunit of IL-12 and IL-23, was approved by the US FDA and the European Medicines Agency in 2009 for the treatment of moderate to severe psoriasis.

Treatment of systemic lupus erythematosus with epratuzumab.

Systemic lupus erythematosus is a prototypic autoimmune disease characterized by abnormalities in the activity of B-cells and T-cells. A novel specific treatment for autoimmune diseases is B-cell depletion with monoclonal antibodies. Epratuzumab is a monoclonal antibody that targets CD22 antigen on B-cells.

[Rituximab in systemic lupus erythematosus. Part II: review of clinical experience].

Rituximab is a chimeric human-mouse monoclonal antibody, which binds to the CD20 antigen on B lymphocytes and causes depletion of CD20+ cells. Rituximab is currently registered for the treatment of non-Hodgkin's lymphoma, chronic lymphocytic leukemia and rheumatoid arthritis. Rituximab also demonstrated efficacy in a number of other autoimmune diseases, including systemic lupus erythematosus.

[Rituximab in systemic lupus erythematosus. Part I. Theoretical basis].

Rituximab is a chimeric human-mouse monoclonal antibody, which binds to the CD20 antigen on B lymphocytes and causes depletion of CD20+ cells in the mechanism of complement-dependent and independent cytolysis, cell cytotoxicity and antibody-dependent mechanism and apoptosis. Rituximab is currently registered for the treatment of non-Hodgkin's lymphoma, chronic lymphocytic leukemia and rheumatoid arthritis. Rituximab also demonstrated efficacy in a number of other autoimmune diseases, including systemic lupus erythematosus.

Methods of hair loss evaluation in patients with endocrine disorders.

Hair loss may accompany several endocrine disorders, including hypopituitarism, hypothyreosis, hyperthyreosis, hypoparathyroidism, diabetes mellitus, growth hormone deficiency, hyperprolactinaemia, polycystic ovary syndrome, SAHA syndrome, congenital adrenal hyperplasia, Cushing syndrome, or virilising tumours. Most patients with endocrine disorders present with diffuse non-scarring alopecia, such as anagen effluvium, telogen effluvium or androgenetic alopecia. Focal non-scarring alopecia, such as alopecia areata coexisting with autoimmune thyroiditis, is less frequent and scarring alopecia is a rare finding in patients with endocrine abnormalities.

[Psychiatric comorbidities of psoriasis: pilot study].

Aim: There are some reports about the relatively frequent occurrence of depression in the case of psoriasis and some hypothesis about interactions between those two diseases. However there are no studies verifying those hypothesis based on reliable structured psychiatric interviews according to the current diagnostic criteria of mental disorders. The aim of the study was to compare the frequency of depression in patients suffering from psoriasis and from other chronic skin diseases with the use of a structured questionnaire for the diagnosis of the main mental disorders Mini International Neuropsychiatric Interview.

Alopecia areata developing paralell to improvement of psoriasis during ustekinumab therapy.

Background: Ustekinumab is a new immunosuppressive anti-psoriasis agent. The drug targets the p40 subunit of IL-12 and IL-23 and indirectly inhibits cytokine production by Th17 cells.

Main Observations: We present a case of a 36-year-old male patient with psoriasis, who received ustekinumab therapy, applied in 45mg subcutaneous injections at week 0, 4 and than every 12 weeks.

Hair shaft videodermoscopy in netherton syndrome.

Netherton syndrome is an autosomal recessive disorder, characterized by ichthyosis, atopic manifestations, and hair shaft abnormalities (trichorrhexis invaginata). The diagnosis of Netherton syndrome may be established on the basis of just one abnormal hair, but it is often difficult to find a hair with pathognomonic features on light microscopic examination. Every attempt requires pulling new hairs.

Dermoscopy in female androgenic alopecia: method standardization and diagnostic criteria.

Objective: Establishing the trichoscopy criteria of female androgenic alopecia (FAGA).

Design: Trichoscopy images were retrospectively evaluated.

Setting: Dermatologic hospital-based clinic and private practice offices.

The 'PDA nail': traumatic nail dystrophy in habitual users of personal digital assistants.

All-in-one devices with mobile phone, web browser, and organizer are now owned by over 6 million people and their popularity is increasing. These devices are often called personal digital assistants (PDAs) or 'BlackBerry(R)' devices, after a popular brand name of these appliances. The use of PDAs is associated with exposure of distal thumbs and nails to repeated pressure with a frequency of up to a few thousand times per hour and several tens of thousands of times per day.

Comma hairs: a dermatoscopic marker for tinea capitis: a rapid diagnostic method.

Background: Dermatoscopy and videodermatoscopy have been used for several years in the diagnosis of skin disorders.

Objective: We sought to determine whether tinea capitis (TC) shows characteristic videodermatoscopy features that may facilitate its differentiation from alopecia areata (AA).

Methods: Two patients with TC caused by Microsporum canis, confirmed by mycological culture and fluorescence under Wood lamp, were examined with videodermatoscopy and results were compared with videodermatoscopy results of 12 patients with AA.

In vivo reflectance confocal microscopy: usefulness for diagnosing hair diseases.

Background: Reflectance confocal laser scanning microscopy (R-CSLM) is a new diagnostic technique which allows visualization of "optical intersections" within the epidermis and superficial layers of the dermis. Outlines of cells and their architecture are imaged and may be analyzed both horizontally and vertically to the skin surface. The method proved useful in early melanoma detection.

[Current treatment of systemic sclerosis. Part II. Vascular and antifibrotic treatment].

Microvascular abnormalities and fibrosis are important targets of therapy in systemic sclerosis (scleroderma). Calcium channel blockers, ACE inhibitors, sartans, phosphodiesterase-5 inhibitors and serotonin re-uptake blockers are used for Raynaud's phenomenon. Intravenous prostanoids (alprostadil, iloprost, epoprostenol, treprostinil) and endothelin receptor antagonists (bosentan, sitaxsentan, ambrisentan) show efficacy in treatment of pulmonary hypertension and distal ischemia.