sym s012 - tosti - 12963 10427 · 2018-01-29 · menkes syndrome rapp-hodgkin syndrome salti-salem...
TRANSCRIPT
Hair disorders
Antonella TostiFredric Brandt Endowed Professor of
Dermatology&Cutaneous Surgery Miller School of Medicine, University of Miami
Antonella Tosti, MDF073 Hair Disorders
DISCLOSURES
Fotofinder :Consultant. CRC Press /Trichoscopyonline :Author-Royalties , Karger : Editor in chief
DISCLOSURE OF RELATIONSHIPS WITH INDUSTRY
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Monilethrix
Autosomal dominant
Mutations in the human basic hair keratins hHb6 and hHb1
Hair shaft breakage with alopecia more severe in areas of friction
Monilethrix
Hair beading : elliptical nodes and intermittent constrictions at regular distance
Medulla absent at internode level
MonilethrixMild forms can be misdiagnosed
de Lencastre A, Tosti A. Monilethrix. J Pediatr. 2012 Dec;161(6):1176.
Keratosis follicularis spinulosa decalvans
Rare genetic disorder with X-linked or autosomal dominant pattern of inheritance
Scarring alopecia of scalp and eyebrows.
Pili torti Hair appears curly, brittle, thin and opaque because of the light reflectionloss in the twistedhair surface
Pili torti Genetic syndromes
Bazex Dupré syndromeBeare syndromeBjörnstad syndromeCitrullinemiaConradi-HünnermannsyndromeCrandall’s syndromeFamilial acnes conglobataHypohidrotic ectodermaldysplasiaMenkes syndromeRapp-Hodgkin syndromeSalti-Salem syndromeTrichothiodystrophy
May be an isolated findingor could represent an hallmark of severalcongenital multisystemic disorders involving skin, cutaneous annexes, skeletal and neurologicalsystems
Bazex -Duprè Syndrome
Pili torti
Congenital hypotrichosis
Follicular atrophoderma
Trichorrexis nodosa
Hypohidrosis
Multiple milia
Basal cell carcinomas of early onset
Loose anagen hair syndrome
Rectangular black granular structures
Rakowska et al Trichoscopy findings in loose anagen hair syndrome:rectangular granular structures and solitary yellow dots. J Dermatol Case Rep.2015 Mar 31;9(1):1-5.
Loose anagen hair syndromeCan use the dermatoscope to look at the roots
Anagen hairs devoid of sheaths
Ruffled cuticle
Pili annulatiHair shaft more seusceptible to weathering
Usually not associated with breakage
Donati A, Andriolo AC, Barletta M, Valente N, RomitiR. Pili Annulati and Trichorrhexis Nodosa in the Same Patient: Cause or Coincidence? Skin Appendage Disord. 2015 Mar;1(1):25-7.
Congenital triangular alopecia
Carpet of vellus hair
Lacarrubba F, Micali G. Congenital triangular alopecia. BMJ Case Rep. 2014 Jan 8;2014.
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Sebaceous nevusCommonly present at birth
Well demarcated yellowishplaque of alopecia
Becomes verrucoid atpuberty
Presence of bright yellowdots at dermoscopy ischaracteristic and distinguish sebaceousnevus from other causesof patchy alopecia in children
Neri et al . Usefulness of dermatoscopy for the early diagnosis of sebaceousnaevus and differentiation from aplasia cutis congenita. Clin Exp Dermatol. 2009 Jul;34(5):e50-2.
Sebaceous nevus
15 year old boy
Patchy alopecia since a few days
Recent history of complicated surgerybecause of multiple gun shots with liverand stomaclacerations
Tinea capitis
Slowinska M, Rudnicka L, Schwartz RA, et al Comma hairs: a dermatoscopic marker for tinea capitis: a rapiddiagnostic method. J Am Acad Dermatol. 2008 Nov;59(5 Suppl):S77-9Hughes R, Chiaverini C, Bahadoran P, Lacour JP. Corkscrew hair: a new dermoscopic sign for diagnosis oftinea capitis in black children Arch Dermatol. 2011 Mar;147(3):355-6.
Comma and corkscrew hairs
Tinea Capitis
Comma hairSeen both in ectothrix and endothrix infection
More numerous in recent infections