Acute hair matting: case report and trichoscopy findings

Abstract

patient. 1 Cidofovir is an acyclic nucleoside phosphonate that exhibits antiviral activity against a broad range of DNA viruses, including HPV. 2 Topical cidofovir is the most common form for recalcitrant warts but is no longer available in France and would not have been sufficient for our patient. IV cidofovir is approved for the treatment of Cytomegalovirus retinitis in Human Immunodeficiency Virus (HIV)-infected patients. The usual schedule is 5 mg/kg once a week for 2 weeks, then 5 mg/kg every 2 weeks. 2 Its main side-effect is nephrotoxicity, which can be avoided by administration of probenecid and saline hydration. 2 Cidofovir enhances apoptosis and stops viral replication, without direct cell destruction, therefore inducing no local sideeffect.So far, six cases of successful treatment of HPV infections with IV cidofovir in monotherapy have been reported. Two of them concerned HIV-infected patients with severe verruca vulgaris. 3,4 There was one case of recalcitrant warts in a patient with myelodysplastic syndrome, 5 one case of resistant cutaneous warts in a patient with psoriasis treated with efalizumab, 6 one case of respiratory papillomatosis, 7 one 11-yearold girl with florid warts and a history of Milroy syndrome. 8 No major side-effect was reported. The efficacy was not associated with immune restoration. In the event of cidofovir failure, and also to prevent recurrences after healing, HPV vaccination might be contemplated. Warts resolution after vaccination has been described in immunocompromised patients. 9 Though all genotypes are not targeted by the available vaccines, a cross-reaction between HPV genotypes may lead to effective vaccination. 10 Our case is a further demonstration that IV cidofovir is a safe and helpful therapeutic option to be considered in severe HPV infections in immunocompromised patients. A combination with vaccination is yet to be evaluated.

Plica neuropathica in severe reactive depression: clinical and trichoscopic features

“…Trichoscopic characteristics in PN include bent and fractured hair shafts, trichorrhexis nodosa, retained telogen hairs, and 180º twisted hairs [5]. Our patient presented with the last two features.…”

“…The disorder is irreversible in affected hair and treatment consists of cutting the felted hair [1]. Manual separation with organic solvents with care to avoid toxicity can be useful in early cases [5].…”

Plica Neuropathica in 2 Hispanic Patients

“…Certain cosmetics have been associated with PN, including the use of harsh shampoos, cationic surfactants, as well as certain hairdressing and hairstyle practices [7]. Severe contact dermatitis resulting from exposure to Croton tiglium has been documented as a cause of acute hair matting [8]. In addition, a single case of PN has been reported following the use of a shampoo containing canthelin [9].…”

Plica Neuropathica as a Presenting Rare Dermatologic Symptom of Schizophrenia

“…PN is an acquired hair disorder characterized by sudden onset, irreversible matting of hair, which appears as a compact mass with irregular twists and normal appearing scalp. [3][4][5] Its trichoscopic features include 180° twisted hair, honey-colored concretions resembling a "wrangled mesh of wires" appearance, fractured hair shafts, and trichorrhexis nodosa. 3,6 PN is considered a relatively rare condition with an unknown incidence; however, a female predilection has been documented, likely since women tend to have longer hair and increased risk of developing psychological disorders.…”

“…[3][4][5] Its trichoscopic features include 180° twisted hair, honey-colored concretions resembling a "wrangled mesh of wires" appearance, fractured hair shafts, and trichorrhexis nodosa. 3,6 PN is considered a relatively rare condition with an unknown incidence; however, a female predilection has been documented, likely since women tend to have longer hair and increased risk of developing psychological disorders. [7][8][9] PN was initially reported by Le Page in 1884, who described a 17-year-old female patient suffering from hysteria, whose hair was tangled into a solid mass that she could not untangle.…”