Background: Fibrosing alopecia in a pattern distribution (FAPD) has only been described in Caucasian patients, and it is not clear whether it can develop in dark-skin ethnicities. Materials and Methods: Sixteen Brazilian female patients, 12 of African descent and 4 Hispanic, with progressive scarring alopecia in a pattern distribution were analyzed. Results: Dermatoscopic features showed perifollicular erythema and scaling (14/16), hair fiber diameter diversity (16/16), loss of follicular ostia (16/16), and follicular keratosis (3/16). Late stages showed a honeycomb pigmented network (12/16), a hyperpigmented perifollicular halo (12/16), and small white patches (12/16). Histopathological features showed lichenoid perifollicular infiltrate (14/16), follicular miniaturization (16/16), concentric fibrosis (16/16), perifollicular lymphocytic infiltrate (16/16), and vellus hair involvement (10/16). Premature desquamation of the inner root sheath was found in 11 patients. Conclusions: The concomitant findings of cicatricial pattern hair loss (with or without the recess of the front hair line), hair fiber diversity, perifollicular erythema and scaling, a whitish perifollicular halo, and histological findings of androgenetic alopecia, with vacuolar interface alteration of the upper portion of the follicular epithelium, are the main key features to suggest the diagnosis of FAPD. FAPD is a possible diagnosis in patients of color with cicatricial pattern hair loss. Clinical, dermatoscopic, and histopathological examination allow a proper final differential diagnosis.
Skin metastases are relatively rare and occur most often when the cancer is
already advanced, invading other organs. As to location, they often seem to
elect areas located close to the primary tumor, although distant sites, such as
the scalp, may be affected with some frequency. We present a case of a
76-year-old woman with colon adenocarcinoma that had a single metastatic lesion
on the scalp.
Spitz nevus is a benign melanocytic lesion and also one of the main differential
diagnosis of melanoma. A descriptive and retrospective study of surgical specimens
from patients with a diagnosis of Spitz nevus was conducted at two institutions in
Niterói - RJ. 32 cases were analyzed. The most frequent histological subtype was
compound (60 %), with a predominance of epithelioid cells (17 cases - 53%). Pagetoid
spread was observed in 21 cases (68%). Maturation of melanocytes was present in 13
cases (81%). Kamino bodies were found in eight cases (25%). Atypical melanocytes were
present in 18 cases (56%). Mitoses were present in 11 cases (34%). Detailed knowledge
of the classical form of Spitz nevi is essential for the differential diagnosis with
melanoma. However, no single criterium is definitive in the differential diagnosis
between Spitz nevus and melanoma.
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