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International Journal of Trichology International Journal of Trichology
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   2020| May-June  | Volume 12 | Issue 3  
    Online since August 14, 2020

 
 
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LETTERS TO EDITOR
Dermatosis neglecta of the scalp complicated with alopecia areata
Xi Chen, Jianzhong Zhang, Cheng Zhou
May-June 2020, 12(3):138-139
DOI:10.4103/ijt.ijt_46_19  
  2 1,636 30
CASE REPORTS
Two erratic cases of tinea capitis in adults: Utility of trichoscopy
Maha Lahouel, Sana Mokni, Hamed Chouaieb, Mohamed Denguezli
May-June 2020, 12(3):118-120
DOI:10.4103/ijt.ijt_20_20  
Tinea capitis (TC) is a common infectious disease throughout the world, mainly seen in children, but it can occur in adults. Even if mycological examination is essential to confirm the diagnosis, it has been proved that trichoscopy is a very effective useful tool in the screening of TC. Herein, we report two cases of adult TC with atypical clinical presentations causing a diagnostic delay of several years.
  1 1,814 36
Scanning electron microscopy of subclinical gefitinib-induced hair changes
Hiram Larangeira de Almeida, Debora Sarzi Sartori, Antônia Larangeira de Almeida, Caroline Pires Ruas, Gustavo Zerwes
May-June 2020, 12(3):129-131
DOI:10.4103/ijt.ijt_69_20  
Oral inhibitors of epidermal growth factor receptor may have a wide range of cutaneous manifestations. Hair manifestations are observed in 10%–20% of the patients. At the ultrastructural level erlotinib-induced hair changes were already described as acquired pili torti et canaliculi. We examined a 78-year-old female patient, with lung carcinoma, taking gefitinib for 15 months. The treatment has no side effects with good tolerance and tumor response. Although the patient had not observed any change on the hairs under the therapy, some specimens were obtained to be examined in natura with scanning electron microscopy. Under low magnification incipient grooving was observed on the hair surface, tortions or angulations of the hair shaft were not found. With higher magnifications the surface grooving was even more evident. Our findings show that gefitinib may cause subclinical hair changes, similar to those described at the ultrastructural level with erlotinib.
  1 1,479 27
Nevus lipomatosus cutaneous superficialis associated with trichofolliculoma: An uncommon duet of rare pathologies
Arushi Agarwal, Harveen Kaur Gulati, Jayanta Kumar Das
May-June 2020, 12(3):132-134
DOI:10.4103/ijt.ijt_21_20  
Nevus lipomatosus cutaneous superficialis (NLCS) and trichofolliculoma (TF) are both rare cutaneous hamartomatous lesions. However, the coexistence of NLCS and TF as a single lesion has been reported only in two other cases, that too in middle-aged individuals. We report the first case of NLCS associated with TF in pediatric age group and also, to the best of our knowledge, the first case reported from India.
  1 1,416 31
LETTERS TO EDITOR
A proposed system for redefining of the zones of the scalp
Conor T Boylan, Michaela S Gaston, Puja Merwaha
May-June 2020, 12(3):140-141
DOI:10.4103/ijt.ijt_119_20  
  1 1,400 37
ORIGINAL ARTICLES
Utility of dermoscopic evaluation in predicting clinical response to diphencyprone in a cohort of patients with alopecia areata
Robabeh Abedini, Elham Alipour, Narges Ghandi, Maryam Nasimi
May-June 2020, 12(3):107-113
DOI:10.4103/ijt.ijt_73_20  
Background: Alopecia areata (AA) is a chronic and inflammatory disease of hair follicles, causing nonscarring alopecia. While the various types of treatment have been investigated, the definite cure for AA has not been established yet. Objectives: The objective of this study is to evaluate the clinical and dermoscopic features of patients with AA to identify the factors with prognostic values in diphenylcyclopropenone (DPCP) response rate. Methods: Eighty patients with AA were included, and baseline hair loss was calculated based on the severity alopecia tool (SALT) score. The characteristic dermoscopic features of AA were evaluated by two skilled dermatologists separately at baseline, 12 and 24 weeks afterward. Results: The mean SALT score in the 1st, 12th, and 24th week was 77 ± 24.7, 80 ± 27, and 71 ± 35.6, respectively, which were not significantly different over this time period (P = 0.085). SALT score correlated negatively with the short vellus hair/field (ρ = −0.361, P = 0.02), broken hair/field (ρ = −0.317, P = 0.044), and tapering hair/field (ρ = −0.388, P = 0.012) in the 1st week. Forty-one patients continued treatment courses over 24 weeks. Six patients had good response, 11 achieved partial response, and 24 had no hair regrowth. Statistically significant correlation was observed between treatment response and duration of disease (P = 0.04), frequency of relapses (P = 0.033), type of alopecia, and number of black dots (P = 0.028). The mean for all dermoscopic findings showed descending process during our three follow-up sessions which was statistically significant for black dot (P = 0.015) and broken hair (P = 0.006). Conclusion: The number of black dot per field initially was negatively correlated to DPCP therapy and the frequency of dermoscopic findings reduced during the treatment process.
  1 2,024 46
Plucked hair as a substrate for indirect immunofluorescence in cases of pemphigus vulgaris
Muthuvel Kumaresan, Umamaheshwari Gurusamy, Reena Rai, CR Srinivas
May-June 2020, 12(3):114-117
DOI:10.4103/ijt.ijt_59_20  
Introduction: Indirect immunofluorescence (IIF) is used to determine the circulating autoantibodies in cases of Pemphigus. For IIF in Pemphigus several substrates had been used. This study was done to determine whether plucked hair can be utilized as a substrate for IIF in cases of Pemphigus. Aim & Objectives: To determine the efficacy of utilizing the plucked hair as a substrate for indirect immunofluorescence among patients with Pemphigus vulgaris. Methodology: Thirty two consecutive patients with active and fresh diagnosed cases of pemphigus vulgaris (PV) who did not undergo any treatment and those patients who had positive DIF findings of characteristic fish net or chicken wire pattern of intercellular IgG deposits in the epidermis of perilesional skin were included in the study. A total of 32 control subjects without any auto immune disorders were selected and the blood samples were taken from these patients for IIF analysis. Anagen hair were collected from the healthy volunteers without pemphigus in the same way as for trichogram. Telogen hair were obtained by combing the hair and collecting the loose strands of hair on the comb and further confirmed under microscope. Three hairs each of anagen and telogen stage were collected from each subject to be utilized as a substrate for IIF. Results: Out of 32 samples 20 samples showed positive results for Ig G alone and 5 samples showed positivity for Ig G and C3. One sample showed positivity for C3alone. All these 26 samples were considered to have positive IIF test based on the intercellular pattern of deposit. Positive IIF results were observed in anagen hair samples and were negative in all the telogen hair samples. Six anagen hair samples did not show any positive findings in IIF for the study group. All the 32 control samples showed negative reports in IIF. Conclusion: In conclusion, IIF microscopy on plucked hair as a substrate is a more sensitive immunoassay for the detection of circulating intercellular autoantibodies in PV and the lower negative predictive value of this substrate is a limitation. Further large scale studies might provide better information regarding the practical utility.
  1 1,878 50
Trichoscopic patterns of nonscarring alopecia's
Shruthi Madhavi Govindarajulu, Rajashekar Talari Srinivas, Suresh Kumar Kuppuswamy, Priya Prem
May-June 2020, 12(3):99-106
DOI:10.4103/ijt.ijt_1_19  
Background: Hair loss (alopecia) is a common problem and is a major cause of psychological stress and anxiety among affected individuals. It is of utmost importance to diagnose these cases at the earliest and treat them accordingly. Trichoscopy provides a noninvasive option that can be used for early diagnosis and monitoring the progression of the hair disorders. Aims and Objectives: To perform trichoscopy and document the findings in patients with nonscarring alopecia's. Materials and Methods: A total of 100 cases satisfying the inclusion criteria were screened for general physical examination and scalp examination including hair shaft and root, and tests for hair anchorage and fragility were also done. The lesions were examined through dermoscope, photographs were taken, and findings were documented. Results: Among the total of 100 cases screened, 57 were female and 43 were male. The mean age of the study group was 26 ± 14.8 years. Females were affected by alopecia areata (AA) and female pattern hair loss (29.8%) equally, whereas males were most commonly affected by AA (41.8%). The common trichoscopic follicular features noted were broken hair (48%), black dots (48%), single hair follicle unit (45%), short vellus hair (44%), upright hair (41%), and yellow dots (40%). The common interfollicular features seen were honeycomb pigmentation (26%) and arborizing red lines (12%). Conclusion: The emergence of newer hair signs on trichoscopic studies aids in identification and has a definitive role in the diagnosis of clinically difficult cases, so it is recommended to use trichoscopy in the routine examination of nonscarring alopecia's.
  1 3,299 131
CASE REPORTS
Female androgenetic alopecia with male pattern caused by an androgen-producing tumor
Angelica Ruiz Dueñas, Luis Enrique Sánchez Dueñas, Valeria Taylor Sánchez, Ivonne Deyanira García Rico
May-June 2020, 12(3):121-123
DOI:10.4103/ijt.ijt_93_20  
Female androgenetic alopecia (FAGA) is a common cause of hair loss in women. Typically, it is characterized by a reduction of hair density on biparietal and vertex regions of the scalp with preservation of the anterior hair implantation line. However, it can also appear with recession of the anterior hairline known as FAGA with male pattern (FAGA-M). In these cases, it is important to consider a state of hyperandrogenism and look for other signs such as hirsutism, acne, and menstrual irregularities. A sudden onset in a postmenopausal woman must make us suspicious of an androgen-secreting tumor. We present two cases of FAGA-M secondary to an ovarian tumor that was successfully resolved after surgical treatment.
  - 84 8
Brauer nevus of eyebrow: A rare entity
Sumir Kumar, Priya Kapoor, Narvinderjeet Kaur
May-June 2020, 12(3):124-125
DOI:10.4103/ijt.ijt_8_20  
Brauer nevus presents as a local circumscribed area of noncicatricial alopecia. It usually involves the frontotemporal scalp. We report an unusual case of Brauer nevus involving the right eyebrow. Trichoscopy helps to confirm the diagnosis and differentiate this condition from other types of nonscarring alopecias. It also helps to avoid unnecessary diagnostic and therapeutic interventions.
  - 1,898 37
Transient treatment response of platelet-rich plasma injection for temporal triangular alopecia: A case report with dermoscopic examination follow-up
Suparuj Lueangarun, Sarun Pacharapakornpong, Therdpong Tempark
May-June 2020, 12(3):126-128
DOI:10.4103/ijt.ijt_52_20  
Temporal triangular alopecia (TTA) is congenital anomalies that usually develops in childhood, with rarely acquired cases in adults. TTA shares common clinical, dermoscopic, and histologic features of characterized vellus hair formation change, similar to androgenetic alopecia (AGA). Whereas, platelet-rich plasma (PRP) with multiple growth factors can provide treatment efficacy in AGA. Due to limited treatment for TTA, such as topical minoxidil, complete surgical excision, and hair transplantation, the multiple growth factors in PRP is thus postulated to be also effective for TTA treatment, just as in AGA. We present a case of TTA with unsatisfactory treatment outcome of only increased number and thickness of vellus hair by dermoscopic examination follow-up after the 5-session PRP injection and only transient response for 6 months. Unlike, AGA, the PRP injection might not consequently be a suitable treatment option for TTA. Nonetheless, further studies should be performed to investigate the potential treatment modality for TTA.
  - 2,216 28
LETTERS TO EDITOR
“Blister ring hydration”: Innovative use of medicine blister pack to prevent desiccation of follicular grafts
Vikas Pathania, Sunmeet Sandhu
May-June 2020, 12(3):135-136
DOI:10.4103/ijt.ijt_65_20  
  - 1,407 42
A study of association of premature graying of hair and osteopenia in North Indian Population
Mahmood Dhahir Al-Mendalawi
May-June 2020, 12(3):137-137
DOI:10.4103/ijt.ijt_72_20  
  - 1,253 32
Pubic trichotillomania in a beauty pageant contestant
Jaime Piquero-Casals, Daniel Morgado-Carrasco
May-June 2020, 12(3):142-143
DOI:10.4103/ijt.ijt_40_20  
  - 3,972 31
Tinea capitis masquerading discoid lupus erythematosus
Anuja Yadav, Taru Garg, Barnita Saha, Ram Chander, Anita Nangia
May-June 2020, 12(3):144-145
DOI:10.4103/ijt.ijt_90_19  
  - 1,355 34
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