The Skin as a Mirror of Internal Disease: Comorbidities and Epidemiology of Acne Vulgaris and Adult Female Acne – A Cross-sectional Study and Current State of Knowledge

Acne vulgaris is a common skin condition affecting an increasing number of adults and might be a clue to identifying systemic disease. Objective of this study is assessment of the demographic and clinical characteristic, including comorbidities, of patients with acne with a special focus on adult female acne (AFA). This cross-sectional study analyzed the medical records of 354 patients with acne (323 outpatients and 31 hospitalized). Data concerning patient age, sex, lesions morphology and distribution on body areas, duration of the disease, Body Mass Index, and dermatologic and systemic comorbidities were collected. 61% of all patients were female, 45.37% of women were classified as AFA. The median age of patients with acne was 24 years and 32.5 years for AFA. The face was the most commonly affected area; patients with AFA had lesions on their back than less frequently non-AFA. Predominant eruptions were pustules and papules. 38.7% of patients had concomitant systemic chronic disease, 15.25% had an endocrinologic disorder, and 6.21% had thyroid gland dysfunction. Women with AFA had endocrinologic disorders more frequently (P=0.002), whereas cutaneous signs of hyperandrogenism were observed less frequently than in the non-AFA group (P=0.034). AFA possess distinct clinical features and it should raise suspicion towards possible underlying endocrinologic disturbance

How to Optimize Trichoscopy for Evaluation of Scalp Vessels

INTRODUCTION: Trichoscopy greatly facilitates clinical diagnosis in patients with hair loss and may decrease the necessity for histopathological examination. Structures which may be revealed by trichoscopy include hair shafts, hair follicle openings, the perifollicular epidermis, and cutaneous microvessels. Cutaneous microvessels revealed in trichoscopy may vary in type and number depending on the scalp area, type of the disease, and its activity. Firm direct pressure (diascopy) might result in their blanching, but as of yet, there are no studies on the types of vessels that do or do not blanch on applying pressure. METHODS: We studied interfollicular twisted loops in 16 cases of biopsy-confirmed scalp psoriasis and 37 cases of arborizing vessels in normal subjects and seborrheic dermatitis patients. RESULTS: We observed that all arborizing red line vessels blanched on applying pressure. Instead, the vast majority of twisted and simple loops, despite their vascular nature, did not blanch on performing diascopy. CONCLUSION: In the light of these findings, diascopy of vascular changes in hair loss patients might provide additional clues for a proper diagnosis, especially in differentiating scalp psoriasis, seborrheic dermatitis, and discoid lupus erythematosus

Age-related graying of the hair — a brief summary of potential mechanisms

Graying of the hair is one of the most eye-catching phenotypic changes related to the chronological aging. During the last decades, scientists have engaged in research that has increased our understanding of different mechanisms of aging of a hair follicle, however many aspects of this process remain unclear. Progressive hypopigmentation of the hair shaft has been associated with decrease in number of melanocytes and tyrosinase hypoactivity in the hair bulb along with the depletion of melanocyte stem cells (MSCs) in the bulge area. Pathogenesis of graying may involve oxidative damage and incompetent MSCs maintenance. Moreover, other factors such as defective melanosomal transfer as well as insufficient neuroendocrine stimulation of MSCs and melanogenesis are hypothesized to play an important role