Background Dermoscopy can be helpful in assessing nonpigmented lesions and inflammatory processes like lichen planopilaris (LPP). Material & Methods In this observational prospective study, 81 patients with a cicatricial alopecic patch on their scalp were included and underwent dermatologic examination. A biopsy was taken from the active part of the lesion based on dermoscopy evaluation. Results Analysis of 44 patients with definite diagnosis of LPP revealed that the mean age at the time of presentation was 44.05 ± 12.62 years. More than 77% of patients had at least one form of the follicular opening disorder. About 75% of patients had shaft disorders. The most common pattern of pigmentation was milky‐red (97.73%). The irregular and ectatic vascular network were seen in 59.09% of patients. Patients with coiled and twisted hairs, small yellow dots, large yellow dots, and peripilar sign were more likely to have shorter disease duration (P < 0.05). Those with overall shaft disorders were younger (P = 0.02). Small yellow dots (P = 0.025) and peripilar sign (P = 0.039) were more common in female patients. Conclusion Dermoscopy can be a helpful diagnostic tool in differentiating LPP among patients with primary cicatricial alopecia (PCA). Larger cohort studies are recommended to find the role of demographic factors in predicting the dermoscopic patterns among LPP patients.

BackgroundIsolated distant cutaneous metastasis of breast carcinoma is uncommon. Furthermore, isolated metastasis of the scalp seems to be very rare in breast cancer.Case presentationA 44-year-old woman was referred to our dermatology department with concerns of a firm, painless, immobile, hardened, skin-colored mass fixed to the underlying tissues. The lesion measured 2 to 3 cm on the scalp frontalis without regional or distant lymphadenopathy. The patient had a history of benign right breast biopsy test results.Immunohistochemistry test results were positive for cytokeratin (AE1/AE3), cytokeratin 7, chromogranin, estrogen receptor, and gross cystic disease fluid protein-15; group PR/HER2 were both weakly positive. Cytokeratin 20, thyroid-lung transcription factor, S100 protein, vimentin and thyroglobulin were all negative. Pathology test results showed adenocarcinoma that was consistent with breast primary.ConclusionAlthough cutaneous metastasis of the chest wall due to breast carcinoma is a common condition, scalp metastasis as the first sign of occult breast cancer is an extremely rare condition. We describe an isolated scalp metastasis as the initial presentation of breast cancer in a young woman in this report, which highlights that health care providers should be alert to the possibility that atypical soft tissue masses may represent a neoplasm. Further consideration of the scalp lesions among healthy looking patients is recommended.

Background Psoriatic arthritis (PsA) results in an increased burden of psoriasis and impairs both quality of life and an individual's functional capacity. The relationship between nail involvement and PsA in psoriasis is not fully characterized. Aim To evaluate the frequency and characteristics of nail involvement in psoriatic patients and to assess the relationship with joint involvement. Methods A total of 197 patients with moderate-to-severe psoriasis were consecutively invited to participate in this cross-sectional study. The patients are divided into two groups: those with and those without psoriatic arthritis. Results 69.5% of psoriatic (137 out of 197) patients had nail involvement. The most common nail abnormality was onycholysis, followed by pitting and oil droplet changes. Nail involvement was more common in patients with psoriatic arthritis (82.1% versus 57.8%, p=0.001). Conclusion Nail involvement is commonly associated with PsA. Onycholysis, splinter hemorrhage, and oil drop were significantly more common in the PsA group as opposed to patients with just skin findings. In general, psoriatic patients with arthritis had more severe disease.

Basal cell carcinoma (BCC) is the most common skin cancer but usually has a good prognosis. However, there is a subset of BCC cases with a less favorable prognosis. For patients with locally advanced, recurrent or metastatic BCCs who are not suitable for surgery or radiotherapy, small-molecule drug inhibitors of hedgehog pathway are a new therapeutic opportunity. Here, we present a case of infiltrative BCC with multiple recurrences. Wide excision with reconstructive plastic surgery was performed initially with adjuvant radiotherapy. Due to multiple recurrences afterward, radiotherapy, topical imiquimod and oral itraconazole were used but were not effective. Finally, the patient was treated with vismodegib which led to a complete response. Moreover, the patient's symptoms due to the locally diffused cancer resolved.