The origin of dermoscopy can be traced back to the middle of the modern age and Borel's discovery (1655 - 1656) laid the foundation stone with important contributions from Ernst Karl Abbe, Unna, ...Muller, Saphier and others. However, the work done by Dr. Ronald Mackie (1971) for the early detection of melanoma marks the peak. The entire journey of evolution was eventful. This article is a brief overview on the history of dermoscopy and the contribution of various scientists leading to emergence of dermoscopy as an independent, dynamic field today.
Objective: The aim of the study is to establish normal values of measurable parameters, set the standard, and provide a framework for future reference. Materials and Methods: A total of 750 children ...of Malayalam speaking ethnicity with no hair or scalp diseases in anamnesis and clinical examination were included in the study. Children were divided into six age groups (neonates, infants, 1-5, 6-10, 11-14, and 15-17 years), and trichoscopy was performed in frontal, left and right temporal, vertex, crown, and occiput using Wi-Fi cordless digital dermoscope. Hair shaft, follicular opening, and perifollicular and interfollicular area were evaluated and analyzed with SPSS software. Results: Among the parameters analyzed, we observed that with 0.95 probability (95%), the terminal: vellus ratios are (26,29), (22,25), (22,26), (29,33), (25,29), and (19,24) in neonates; (11,14), (7,11), (9,13), (13,17), (12,16), and (7,12) in infants; (16,17), (10,11), (10,11), (16,18), (15,16), and (14,15) in 1-5 years; (17,18), (11), (11), (19,21), (23), and (16,17) in 6-10 years; (17,18), (9,10), (10), (19,20), (18,19), and (16,17) in 11-14 years; and (14,15), (8-9), (8,9), (15,16), (14, 16), and (13,14) in 15-17 years. Likewise, we have documented the various trichoscopic findings of different age groups. Conclusion: We propose the summary of trichoscopic patterns of different age groups with normal hair and scalp to accurately identify the abnormal.
Hypertrichosis refers to the growth of hair, of an excessive amount and thickness, on any part of the body. It must be distinguished from hirsutism which is characterized by excess growth of hair in ...androgen-dependent areas on the upper lip, chin, chest, linea alba, thigh and axilla. Hypertrichosis may be localized or generalized, and congenital or acquired. Excess hair growth has a psychological impact on the child as well as the parents due to the cosmetic disfigurement it produces. Current treatment options are limited and not wholly satisfactory. Treatment should be customized according to the area, nature and amount of hair growth, age of the patient and personal preferences. In addition, when hypertrichosis occurs as a component of a syndrome, multidisciplinary management is required to address the associated systemic features. A detailed review of inherited generalized hypertrichosis is presented here with emphasis on clinical clues to identifying complex syndromes with multisystem involvement.
Cicatricial alopecias in children do not contribute to substantial pediatric consultations as they are relatively uncommon. Cicatricial alopecias are often missed in pediatric population as it is ...diagnostically and therapeutically challenging. No single treatment is usually effective and hence several off label treatments are used in children and adolescents with unknown safety and efficacy. Hair loss due to scarring may thus have a significant impact on the emotional well-being of young patients and diminishes the quality of life which often requires additional treatment. Traditional surgical treatments for cicatricial alopecia include excision, scar reduction, tissue expansion, scalp flap, and follicular unit transplantation. However, these procedures often result in unsightly scarring or unfavorable hair growth direction. Recently, hair grafting by follicular unit extraction (FUE) has now replaced the strip technique as it is minimally invasive, well-tolerated, and effective treatment for use in children and adolescents. However, use of this technique is limited in young patients. The article presents a comprehensive review of an effective surgical technique, i.e., FUE for the management of burnt-out inactive cicatricial alopecia in pediatric population. For the purpose of review, a PubMed search was done using keywords, “cicatricial alopecia,” “hair transplantation,” and “children.” All the articles were retrieved, and the final data were then analyzed and presented in a narrative fashion.
Introduction: Rituximab, a chimeric monoclonal anti-CD20 antibody, has shown efficacy as an adjuvant in the treatment with refractory vesiculobullous disorders. We, hereby, present a study of five ...pediatric patients of extensive vesiculobullous disorders showing resistance to conventional therapy of 40 mg of prednisolone daily and treated effectively with rituximab as an adjuvant.
Aim of the Study: To study the efficacy, safety, and clinical outcome of rituximab in refractory autoimmune vesiculobullous disorders.
Method: Five patients (3: Pemphigus vulgaris, 1: Pemphigus foliaceous, 1: Chronic bullous disease of childhood CBDC) were selected for treatment with rituximab after confirmation with tzanck, biopsy, direct immunofluorescence (DIF) and desmoglein (DSG) level. Three hundred milligram intravenous infusion in children over 4-5 h duration. Two doses were given at 15 days interval. DSG 1 and 3 and differential item functioning were repeated after 1-month of the second dose of rituximab. Follow-up (weekly for 1-month, fortnightly for next 2 months). Two patients (1: Pemphigus vulgaris, 1: CBDC) showed relapse after 6 months. So, they were given two more doses of rituximab at an interval of 15 days.
Observation: All five patients showed complete remission during the 6 months follow-up period, along with a consensual decline of the serum anti-DSG titers.
Conclusion: Rituximab can be considered as an effective adjuvant therapy when treating resistant cases of autoimmune blistering diseases in pediatric patients. However, more number of patients and long-term follow-up is required to draw a definite conclusion.
Port‐wine stain (PWS) is a benign capillary malformation that most commonly occurs in the head and neck. It is present at birth and progresses over time. It is formed by progressive dilatation of ...post‐capillary venules and is associated with hypertrophy and nodularity with increasing age, leading to cosmetic disfigurement and psychological aggravation. It is caused by genetic mosaicism in GNAQ and GNA11 genes. Histopathology is the gold standard for assessment of PWS but it is invasive and may cause scarring. Inadequate characterization of the lesions may predispose to inadequate treatment protocols as well as higher treatment dosages. Clinical evaluation of treatment efficacy is subjective and may not be a representative of actual results. Therefore, an objective visualization modality is required. With evolving technology, numerous optical instruments have been developed for objective evaluation and visualization of subsurface structures. These include VISIA‐CR™ system, videodermoscopy, high‐frequency ultrasound (HFUS), laser speckle contrast imaging (LSCI), reflectance spectrophotometers and tristimulus colorimeter, laser Doppler flowmetry (LDF), cross‐polarized diffuse reflectance imaging system (CDR), reflectance confocal microscopy (RCM), optical coherence tomography (OCT), and spatial frequency domain imaging (SFDI). These semi‐quantitative modes of diagnosis are complementary to each other. Some can be used in the clinical setting while others, due to high instrument cost, are limited to the research settings. In this review, we bring to you a brief overview of noninvasive diagnostic modalities in PWS.
Idiopathic guttate hypomelanosis (IGH) is a benign, typically asymptomatic, acquired leukoderma characteristically affecting mature individuals. Although the etiopathogenesis is unclear, chronic sun ...exposure and senile degeneration are important triggers. Researchers have been engaged in a continuous effort to unveil the gray areas encompassing different aspects of IGH pathogenesis. IGH is a clinical diagnosis; however, histopathology and dermoscopy may aid in quetionable cases. Patients often seek cosmetic treatment. There has been no standard therapy for this condition. Newer treatment modalities range from topical agents to procedure-based therapies and have enhanced the therapeutic armamentarium. Here we discuss the pathogenesis, presentation, and management of IGH.
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