Pressure-induced alopecia (PA) is an unusual pattern of circumscribed hair loss that occurs after ischemic changes on the scalp. Trichoscopic findings described in the literature are scarce, nonspecific, and include black dots, broken hairs, circle hairs, and erythema. However, we report 3 cases of PA in which trichoscopy also showed many vellus and thin hairs. Possibly, the maintenance of these hair shafts may be explained by the more superficial insertion of their bulbs on the skin and/or their lower metabolic rates, making them suffer less from local hypoxia. Therefore, the authors suggest that these relevant signs should be added as a clue for the diagnosis of PA in doubtful cases.
Androgenetic alopecia (AGA) is the most common type of alopecia, affecting up to 80% of males and 50% of females. 1 It is a chronic, progressive, noncicatricial, androgen-dependent condition that affects genetically predisposed individuals, leading to progressive follicular miniaturization. Currently, only topical minoxidil and oral finasteride are approved for its treatment. 2 2 | C A S E REP ORT A 47-year-old healthy white male patient came to our clinic with a complaint of hair loss. On examination, the patient had diffuse thinning on his scalp hair and recession of the frontal and temporal hairline (Hamilton-Norwood Scale IV) without evidence of inflammation or scarring (Figure 1A). He had a positive family history of hair loss, and extensive laboratory analyses were unremarkable. We made the diagnosis of male pattern AGA, and we started the gold-standard treatment with minoxidil 5% topical solution twice daily and finasteride 1mg daily for 2 years, with improvement during this period. However, after that, the patient's clinical response stabilized and he requested hair transplantation. After a discussion of all treatment options, we added mesotherapy, a minimally invasive technique, to his previous treatment, postponing the need for an invasive procedure. The patient received 10 sessions of sterile injectable blend containing 1ml minoxidil 0,5%, 1ml finasteride 0,05%, 2ml biotin 5mg/ml, and 2ml D-panthenol 50mg/ml (Pineda®
Dissecting cellulitis is an inflammatory, chronic, and recurrent disease of the hair follicles that mainly affects young Afro-descendent men. Trichoscopy is a method of great diagnostic value for disorders of the scalp. Clinical and trichoscopic findings of dissecting cellulitis are heterogeneous and may present features common to non-cicatricial and scarring alopecia. This article presents the trichoscopic findings of dissecting cellulitis that help in the diagnosis and consequent institution of the appropriate therapy and better prognosis of the disease.
Dermatofibroma is a benign fibrohistiocytic tumor, common and easily diagnosed when
classical clinicopathologic features are present. The atrophic variant of
dermatofibroma is of uncertain origin. This lesion is characterized clinically by a
flat or atrophic and depressible surface. Histopathological features show reduction
of the thickness of the dermis and elastic fibers. We report a typical case of this
uncommon and probably underdiagnosed variant.
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