47 research outputs found
The exposome impact on hair health: non-pharmacological management. Part II⋆
No full text: Hair holds a significance that surpasses mere aesthetics, as it plays a pivotal role in our social interactions and contributes significantly to the definition of our self-esteem. Central to this understanding is the concept of the exposome, which encompasses intrinsic elements like genetics and physiological changes, as well as extrinsic factors such as UV radiation, pollution, lifestyle choices, and chemical treatments. These factors may significantly impact hair health and hair aging. Expanding upon the groundwork laid by the first part of this research (Cedirian et al., 2024), this study aims to deepen our understanding of exposome influence on hair. Specifically, through a narrative review of current literature, this second part endeavors to provide non-pharmacological treatment solutions and effective strategies to mitigate the negative impact of the exposome on hair health
Trichoscopic clues of the scalp in moderate to severe atopic dermatitis: a monocentric analysis
No full textBackground: Atopic dermatitis (AD) stands as the prevailing chronic relapsing inflammatory dermatosis within the general population. Scalp involvement is a minor but frequent feature of AD, nevertheless it was relatively understudied up to now. This research aims to better describe the clinical and trichoscopic aspects of scalp involvement in moderate-to-severe AD, focusing on the vascular pattern of the vessels and scalp desquamation. Methods: A single-center retrospective and prospective study was conducted on 20 patients, collecting clinical and trichoscopic images at the Dermatology Unit of the University of Bologna, Italy. Results: Scalp lesions exhibited distinct morphological characteristics in both vascular and desquamation patterns. Three main trichoscopic patterns with a different grade of involvement were identified: erythematous pattern, erythematous desquamative pattern and exudative with crusts pattern. As for the limitations, the sample size was relatively small, and, being a single-centre study, the results may not be applicable to other populations or settings. In addition, no standardized criteria for trichoscopic analysis are available. Conclusions: This is the first study with the purpose to delineate the trichoscopic characteristics observed in patients with moderate-to-severe AD not in systemic therapy, thereby highlighting three distinct patterns of trichoscopy manifestations that define three distinct populations
STRIAA (Severity TRichoscopy Index Alopecia Areata): Validation of a Novel Trichoscopic Tool for Evaluation of Alopecia Areata
No full textIntroduction: Alopecia areata (AA) is a non-scarring autoimmune disease characterized by patchy hair loss. The aim of this study was to validate a novel trichoscopic scoring tool, the Severity TRichoscopy Index for Alopecia Areata (STRIAA), for rapid assessment of AA severity. Methods: Anonymized images from 340 patients were scored by two independent raters who analyzed four scalp areas (vertex, occipital, and left and right parietal) for trichoscopic signs: black dots, yellow dots, exclamation mark hairs, broken hairs, and short vellus hairs. Scores (0–3) were assigned according to the number of trichoscopic signs per area, resulting in a total STRIAA score out of 60. Results: STRIAA showed high interrater reliability (Cronbach’s alpha 0.99) and significant correlation with the Severity of Alopecia Tool (SALT) score (p < 0.001). Yellow and black dots were significantly associated with the SALT score. Conclusions: The STRIAA provides a rapid and comprehensive assessment of AA severity, complementing current assessment tools in clinical practice
Wounds resulting from intradermal injection of sodium hypochlorite: a case report
No full textBackground: Caustic substances can inflict severe damage on tissues upon contact. Knowledge about skin damage caused by sodium hypochlorite is quite limited, with only a few reports available in the literature. Case report: A 79-year-old female with severe cognitive decline presented with multiple skin ulcerations that were covered by a blackish-greyish eschar and surrounded by a purple erythematous halo. During the medical examination, in a moment of clarity the patient confessed to self-inflicting the wounds through injections of bleach at night. Analysis of the liquid beneath the eschar from the ulcer swab and the histological examination confirmed the compatibility of lesions with the injection of sodium hypochlorite. Conclusion: Intradermal injection of sodium hypochlorite can cause severe damage to the skin tissue, with rapid formation of ulcerations covered by a blackish-greyish eschar. The surrounding skin may have an erythematous, swollen appearance and a purple-colored halo around it. Moreover, for a patient with a neuropsychiatric medical history, negative laboratory findings, or irregular skin lesions, self-induced ulcerations should always be considered in the differential diagnosis
Vorasidenib-Induced Trichomegaly and Hypertrichosis: a New Side Effect in a Patient with Diffuse Astrocytoma
No full textVorasidenib, an oral dual inhibitor targeting mutant enzymes isocitrate dehydrogenase 1 and 2, is utilized in the management of diffuse low-grade gliomas. Despite limited documentation of its adverse events, we present the case of a 44-year-old male who exhibited trichomegaly and hypertrichosis of body hair, eyebrows, and eyelashes following one month of vorasidenib treatment. Notably, the patient experienced diffuse hair regrowth on the scalp, including in areas affected by severe androgenetic alopecia. This report holds significance as it highlights a previously unreported side effect, thereby enhancing our understanding of emerging therapies for brain tumors and their associated adverse reactions
Celebrating Diversity: Unveiling the Characteristics of Nail Psoriasis and Nail Lichen Planus in 30 Patients With Skin of Color
No full textIntroduction: Dermatological conditions affecting the nails can manifest differently in individuals with distinct skin tones. This often leads to difficulty in the recognition of nail diseases, especially in people with skin of color (SoC), who are not well represented in the literature. Objectives: Our aim was to provide dermatologists with useful clues for prompt recognition and diagnosis of nail psoriasis (NPso) and nail lichen planus (NLP) in people with SoC. Methods: We described the ungual manifestations of NPso and NLP in a population of 30 patients with SoC. Diagnosis was primarily based on clinical examination; in cases of diagnostic uncertainty, a biopsy of the nail matrix was performed to obtain histological conclusive evidence. Results: Of the 30 people with SoC in the analysis, 24 patients had NPso with a median Fitzpatrick phototype of 4.77, and six patients had NLP with a median Fitzpatrick phototype of 5. Regarding the 24 patients with NPso, 10 presented with trachyonychia, nine displayed nail pitting, eight showed onycholysis, and 12 had subungual hyperkeratosis, while splinter hemorrhages were visible in two patients, and activation melanonychia was discernible on the nail plates of eight patients. Of the six patients diagnosed with NLP, all had post-inflammatory pigmentation on the proximal nail, with three patients exhibiting trachyonychia and three others having longitudinal fissures; subungual hyperkeratosis was found in five patients, while three patients displayed activated melanonychia. Conclusion: People with SoC exhibit a peculiar clinical presentation of both NPso and NLP, and a better understanding is essential to providing timely and effective car
Safety of Hydroxychloroquine: What a Dermatologist Should Know
No full textThe unique immunomodulatory properties of hydroxychloroquine (HCQ) have attracted considerable interest beyond its use for malaria and rheumatological diseases, including a variety of dermatological conditions. Over recent years, especially after the coronavirus disease 2019 (COVID-19) pandemic, the prescription of HCQ has also significantly expanded, sometimes inappropriately, thus posing additional challenges on its optimal use, due to emerging safety issues. In this review, we provide dermatologists with the latest advancements on selected clinically relevant toxicities, namely retinopathy, pro-arrhythmia, cutaneous reactions, and neuropsychiatric effects. It is hoped this update can assist dermatologists to identify high-risk patients for tailored monitoring, screening, and risk minimization strategies, thus supporting safer HCQ prescribing
The exposome impact on hair health: etiology, pathogenesis and clinical features ‒ Part I
No full textHuman hair, particularly on the scalp, serves as a significant aspect of social identity and well-being. The exposome, encompassing both intrinsic and extrinsic factors, plays a fundamental role in hair weathering. Intrinsic factors include genetic predispositions and physiological changes within the body, while extrinsic factors comprise environmental exposures such as UV radiation, pollution, humidity, temperature variations, lifestyle choices, and chemical treatments. These elements collectively contribute to the cumulative damage experienced by hair over time. Understanding the comprehensive impact of the exposome on hair health and hair aging necessitates an exploration of various environmental conditions, lifestyle factors, and technical artifacts. Despite advancements in research, the intricate mechanisms underlying the exposome influence on hair remain incompletely understood. Through a comprehensive review of current literature and emerging research findings, this study aims to enhance the understanding of exposome impact on hair health
Assessing the normality of the frontal hairline: a comparison between female patients with frontal fibrosing alopecia and those with a normal scalp
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Dupilumab and Alopecia Areata: A Possible Combined or Disturbance Therapy? A Review of The Literature
No full textIntroduction: Dupilumab, a monoclonal antibody targeting IL-4 receptor subunit alpha, treats atopic dermatitis (AD) and may impact alopecia areata (AA). AA involves Th1-driven immune activity, and recent studies suggest a role for Th2 pathways. Dupilumab’s effects on AA are mixed, with reports of both improvement and worsening. Objectives: This study aims to review the effects of dupilumab on AA in patients with AD, analyzing literature to understand cases of improvement or worsening and identifying contributing factors. Methods: A literature review was conducted using articles in platforms such as PubMed, Scopus, and Web of Science written up to April 2024, focusing on studies involving AA, AD, and dupilumab. Articles were analyzed for patient demographics, disease characteristics, and responses to treatment. Results: Out of 35 articles reviewed, 13 AA cases worsened after dupilumab (mean age 32.8; mostly males with patchy alopecia), and 38 cases showed improvement (mean age 27.6; majority females, varying AA types). Full hair regrowth occurred in 11 improved cases, while 9 had partial regrowth. Conclusions: Dupilumab shows dual effects on AA, influenced by Th1/Th2 immune profiles. Worsening was more common in males with Th1-driven AA, while females with Th2-skewed AA saw improvement. Factors like age, disease severity, and IgE levels may affect outcomes, suggesting a need for personalized treatment approaches for AA patients with AD
