Hair Loss in Children, Etiologies, and Treatment

Hair loss in children is a common and important complaint in dermatology and pediatric clinics and can be considered as a difficult and challenging problem in some cases. Early management is needed as this has its effect on development of normal mental and physical growth of children. Alopecia or hair loss is of particular concern in pediatric group, as it is associated with more significant psychological consequences in this growing age group and has patterns that are different from that seen in adults. There are common and uncommon causes for this complaint, and this usually covers a broad differential diagnosis. This chapter has been written in an attempt to distinguish the types of hair loss (acquired and congenital, common and uncommon), to facilitate the diagnostic causes of this problem, and finally to reach a proper treatment

A CASE OF LICHEN PLANUS WITH SCARRING RESPONCSE MIMICKING DISCOID LUPUS ERYTHEMATOSUS. A CASE REPORT

Lichen planus (LP) is a chronic inflammatory of unknown etiology that affects the skin, tongue, mucous membranes, and nails, and in rare forms, it may affect the scalp (lichen planaopilaris). Lichen planus is a non scarring disease (exception is lichen planaopilaris of the scalp) and the usual sequelae is post-inflammatory hyperpigmentation. In this case report, I presented a case of lichen planus of a glabrous skin associated with scarring response mimicking discoid lupus erythematosus (which is known to be a scarring dermatosis). This is the first report of lichen planus of glabrous skin healed with a scar like lesions with discoid lupus erythematosus

Dermoscopy is a new diagnostic tool in diagnosis of common hypopigmented macular disease: a descriptive study

One of the most frequent complaints in dermatology clinics is the eruption of hypopigmented patchy skin lesions. The aim of the study was to investigate the utility of dermoscopy in common hypopigmented macular diseases. Patients with the followings diseases were examined by dermoscopy: vitiligo, pityriasis alba, nevus depigmentosus, achromic pityriasis versicolor, idiopathic guttate hypomelanosis, and extragenital guttate lichen sclerosus. This study showed that these hypopigmented macular diseases might display specific dermoscopic features. In vitiligo, the mean dermoscopic features were the presence of a diffuse white glow with perifollicular pigment, perilesional hyperpigmentation, leukotrichia and the pigmentary network. In idiopathic guttate hypomelanosis, the characteristic features were the presence of multiple, shiny, scaly macules with well- and ill-defined edges borders that coalesced into polycyclic macules. For nevus depigmentosus, the mean features was hypopigmented patches with irregular border with a faint reticular network. For pityriasis alba, the fairly ill-demarcated hypopigmented macules with fine scales were the mean feature. In lichen sclerosus, there were white structureless areas, perilesional erythematous halo, follicular plugging and white chrysalis like structures. Dermoscopy of achromic pityriasis versicolor showed a fairly demarcated white area with fine scales localized in the skin creases

Non-invasive Approaches for the Diagnosis of Autoimmune/Autoinflammatory Skin Diseases—A Focus on Psoriasis and Lupus erythematosus

The traditional diagnostic gold standard for inflammatory skin lesions of unclear etiology is dermato-histopathology. As this approach requires an invasive skin biopsy, biopsy processing and analysis by specialized histologists, it is a resource intensive approach requiring trained healthcare professionals. In many health care settings access to this diagnostic approach can be difficult and outside emergency cases will usually take several weeks. This scenario leads to delayed or inappropriate treatment given to patients. With dramatically increased sensitivity of a range of analysis systems including mass spectrometry, high sensitivity, multiplex ELISA based systems and PCR approaches we are now able to “measure” samples with unprecedented sensitivity and accuracy. Other important developments include the long-term monitoring of parameters using microneedle approaches and the improvement in imaging systems such as optical coherence tomography. In this review we will focus on recent achievements regarding measurements from non-invasive sampling, in particular from plucked hair and skin tape-strips which seem well suited for the diagnosis of lupus erythematosus and psoriatic inflammation, respectively. While these approaches will not replace clinical observation—they can contribute to improved subgroup diagnosis, stratified therapeutic approaches and have great potential for providing molecular and mechanistic insight in to inflammatory skin diseases.With dramatically increased sensitivity of a range of analysis systems including mass spectrometry, high sensitivity, multiplex ELISA based systems and PCR approaches we are now able to “measure” samples with unprecedented sensitivity and accuracy. Other important developments include the long-term monitoring of parameters using microneedle approaches and the improvement in imaging systems such as optical coherence tomography. In this review we will focus on recent achievements regarding measurements from non-invasive sampling, in particular from plucked hair and skin tape-strips which seem well suited for the diagnosis of lupus erythematosus and psoriatic inflammation, respectively. While these approaches will not replace clinical observation – they can contribute to improved subgroup diagnosis, stratified therapeutic approaches and have great potential for providing molecular and mechanistic insight in to inflammatory skin disease