Background Scalp biopsies are crucial for the diagnosis of cicatricial alopecia. However, the pathologic interpretation may not be diagnostic if biopsy is not obtained from the correct site. This is ...particularly relevant for cicatricial alopecia as the disease may be focal and disease activity difficult to appreciate by the naked eye.
Objective To report a new simple technique to select the optimal biopsy site in cicatricial alopecia.
Methods In the last 2 years we performed dermoscopy guided scalp biopsies using handled dermatoscopes in 80 patients with different forms of cicatricial alopecia. Biopsy site was selected based on presence of the following dermatoscopic features: perifollicular concentric white scales in lichen planopilaris, frontal fibrosing alopecia (FFA) and discoid lupus erythematosus (DLE); hair tufts in folliculitis decalvans, hairs surrounded by a peripilar grey‐white halo in central centrifugal cicatricial alopecia and follicular red dots or keratotic plugs in DLE.
Results The dermoscopy guided biopsies yielded a definitive pathological diagnosis in 95% of the cases.
Comment The advantage of this method is that it is a fast, precise way to identify even individually affected follicles in early or focal cicatricial alopecia. It also allows for the morphologic characterization of particular follicular structures.
Androgenetic alopecia is the most common hair loss disorder, affecting both men and women. Initial signs of androgenetic alopecia usually develop during teenage years leading to progressive hair loss ...with a pattern distribution. Moreover, its frequency increases with age and affects up to 80% Caucasian men and 42% of women. Patients afflicted with androgenetic alopecia may undergo significant impairment of quality of life. The European Dermatology Forum (EDF) initiated a project to develop evidence‐based guidelines for the treatment of androgenetic alopecia. Based on a systematic literature research the efficacy of the currently available therapeutic options was assessed and therapeutic recommendations were passed in a consensus conference. The purpose of the guideline is to provide dermatologists with an evidence‐based tool for choosing an efficacious and safe therapy for patients with androgenetic alopecia.
Onychomycosis: a review Gupta, A.K.; Stec, N.; Summerbell, R.C. ...
Journal of the European Academy of Dermatology and Venereology,
September 2020, 2020-Sep, 2020-09-00, Letnik:
34, Številka:
9
Journal Article
Recenzirano
Onychomycosis is a fungal infection of the nail, causing discoloration and thickening of the affected nail plate, and is the most common nail infection worldwide. Onychomycosis was initially thought ...to be predominantly caused by dermatophytes; however, new research has revealed that mixed infections and those caused by non‐dermatophyte moulds (NDMs) are more prevalent than previously thought, especially in warmer climates. Microscopy and fungal culture are the gold standard techniques for onychomycosis diagnosis, but high false‐negative rates have pushed for more accurate methods, such as histology and PCR. As NDMs are skin and laboratory contaminants, their presence as an infectious agent requires multiple confirmations and repeated sampling. There are several treatment options available, including oral antifungals, topicals and devices. Oral antifungals have higher cure rates and shorter treatment periods than topical treatments, but have adverse side effects such as hepatotoxicity and drug interactions. Terbinafine, itraconazole and fluconazole are most commonly used, with new oral antifungals such as fosravuconazole being evaluated. Topical treatments, such as efinaconazole, tavaborole, ciclopirox and amorolfine have less serious side effects, but also have generally lower cure rates and much longer treatment regimens. New topical formulations are being investigated as faster‐acting alternatives to the currently available topical treatments. Devices such as lasers have shown promise in improving the cosmetic appearance of the nail, but due to a high variation of study methods and definitions of cure, their effectiveness for onychomycosis has yet to be sufficiently proven. Recurrence rates for onychomycosis are high; once infected, patients should seek medical treatment as soon as possible and sanitize their shoes and socks. Prophylactic application of topicals and avoiding walking barefoot in public places may help prevent recurrence.
A review of nail findings associated with COVID‐19 infection Hadeler, E.; Morrison, B.W.; Tosti, A.
JEADV. Journal of the European Academy of Dermatology and Venereology/Journal of the European Academy of Dermatology and Venereology,
November 2021, Letnik:
35, Številka:
11
Journal Article
Microneedling for the treatment of hair loss? Fertig, R.M.; Gamret, A.C.; Cervantes, J. ...
Journal of the European Academy of Dermatology and Venereology,
April 2018, 2018-Apr, 2018-04-00, 20180401, Letnik:
32, Številka:
4
Journal Article
Recenzirano
Microneedling is a minimally invasive dermatological procedure in which fine needles are rolled over the skin to puncture the stratum corneum. This therapy is used to induce collagen formation, ...neovascularization and growth factor production of treated areas. It has been used in a wide range of dermatologic conditions, including androgenetic alopecia (AGA) and alopecia areata, among others. While there are a limited number of studies examining this therapy in the use of hair loss, microneedling has been successfully paired with other hair growth promoting therapies, such as minoxidil, platelet‐rich plasma and topical steroids, and shown to stimulate hair follicle growth. It is thought that microneedling facilitates penetration of such first‐line medications, and this is one mechanism by which it promotes hair growth. To date, the area most studied and with the most success has been microneedling treatment of AGA. While the current evidence does not allow one to conclude superiority of microneedling over existing standard therapies for hair loss, microneedling shows some promise in improving hair growth, especially in combination with existing techniques. This review summarizes the current literature regarding microneedling in the treatment of alopecia and calls for further studies to define a standard treatment protocol.
Alopecia totalis and universalis long‐term outcomes: a review Burroway, B.; Griggs, J.; Tosti, A.
Journal of the European Academy of Dermatology and Venereology,
April 2020, 2020-Apr, 2020-04-00, 20200401, Letnik:
34, Številka:
4
Journal Article
Recenzirano
Alopecia totalis (AT) and universalis (AU) represent the most severe subtypes of alopecia areata with more dramatic features and worse prognosis. The goal of this review is to identify all studies ...with long‐term prognostic data on patients with AT and AU and provide a long‐term outcome estimate. The PubMed database was queried to identify all articles discussing the long‐term prognosis of AT and AU. A total of nine articles discussing long‐term recovery rates of AT and AU were identified. The articles described 689 (162 = AT, 245 = AU, 282 = not specified) total patients. Six of the nine studies identified complete recovery as a potential end point in a total of 375 (39 = AT, 75 = AU, 261 = not specified) patients. According to these studies 8.5% (32/375) of AT and AU patients achieved complete recovery. A larger proportion of patients will obtain at least transient recovery periods of partial or total hair regrowth. The poor long‐term outcomes of AT and AU may cause patients to lose hope with treatment. Response to treatment is often unpredictable, and physicians should be aware of the prognosis and its effects in order to properly counsel patients.
Tinea capitis in children: a systematic review of management Gupta, A.K.; Mays, R.R.; Versteeg, S.G. ...
JEADV. Journal of the European Academy of Dermatology and Venereology/Journal of the European Academy of Dermatology and Venereology,
December 2018, 2018-Dec, 2018-12-00, 20181201, Letnik:
32, Številka:
12
Journal Article
Recenzirano
Odprti dostop
Background
Tinea capitis is the most common cutaneous fungal infection in children.
Objectives
This review aims to evaluate the differences that exist between medications for the treatment of tinea ...capitis, to determine whether there are any significant adverse effects associated and to define the usefulness of sample collection methods.
Methods
We conducted a systematic literature search of available papers using the databases PubMed, OVID, Cochrane Libraries and ClinicalTrials.gov. Twenty‐one RCTs and 17 CTs were found.
Results
Among the different antifungal therapies (oral and combination thereof), continuous itraconazole and terbinafine had the highest mycological cure rates (79% and 81%, respectively), griseofulvin and terbinafine had the highest clinical cure rates (46% and 58%, respectively) and griseofulvin and terbinafine had the highest complete cure rate (72% and 92%, respectively). Griseofulvin more effectively treated Microsporum infections; terbinafine and itraconazole more effectively cured Trichophyton infections. Only 1.0% of children had to discontinue medication based on adverse events. T. tonsurans was the most common organism found in North America, and hairbrush collection method is the most efficient method of sample collection. Additionally, using a hairbrush, toothbrush or cotton swab to identify the infecting organism(s) is the least invasive and most efficient method of tinea capitis sample collection in children.
Conclusions
Current dosing regimens of reported drugs are effective and safe for use in tinea capitis in children.
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