Comma hairs: A dermatoscopic marker for tinea capitis

Słowińska, Monika; Rudnicka, Lidia; Schwartz, Robert A.; Kowalska-Olędzka, Elżbieta; Rakowska, Adriana; Sicińska, Justyna; Lukomska, Malgorzata; Olszewska, Małgorzata; Szymańska, Elżbieta

doi:10.1016/j.jaad.2008.07.009

Cited by 161 publications

(157 citation statements)

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“…Absence of exclamation hair, coma hair, flame hairs or v-sign can be used to exclude AA, tinea capitis and trichotillomania, respectively. 7,8,9 The diagnosis of SA in this case was confirmed by patient's sexual history and positive serological tests for RPR and TPPA. Although SA resembles AA clinically, lack of exclamation hair and uneven diameter of hairs under trichoscopy can be used to differentiate these two conditions.…”

Section: Case Reportmentioning

confidence: 52%

The clinical and trichoscopic features of syphilitic alopecia

Ye¹,

Zhang²,

Zhang³

et al. 2014

J Dermatol Case Rep

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Background: Syphilitic alopecia is not common in patients with secondary syphilis. Though the clinical and histopathological findings of syphilitic alopecia have been described, the trichoscopy features are unknown yet. Main observation:A 42-year-old Chinese man was admitted to our clinic with a complaint of hair loss. The patient presented clinically with moth-eaten alopecia over the whole scalp without any previous discomfort or skin rashes. The serology for syphilis was positive. Trichoscopy showed black dots, focal atrichia, hypopigmentation of hair shaft and yellow dots. Conclusions:On the basis of trichoscopy, along with serology testing syphilitic alopecia can be differentiated from other hair loss diseases with similar clinical presentation. (J Dermatol Case Rep. 2014; 8(3): 78-80) The clinical and trichoscopic features of syphilitic alopecia Yanting Ye, Xiaoting Zhang, Ying Zhao, Yugang Gong, Jian Yang, Huan Li, Xingqi Zhang Department of Dermatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, People's Republic of China. IntroductionSyphilis as a "great mimic" can present various manifestations indistinguishable from other diseases. Syphilitic alopecia is an uncommon clinical manifestation of secondary syphilis with an incidence of 2.9%-11.2%. 1,2The clinical manifestations and histopathological features of syphilitic alopecia have been described in detail, but the trichoscopic features of syphilitic alopecia have not been described yet. Here we present a case of syphilitic alopecia, and describe the clinical and trichoscopic features. Case reportA 42-year-old Chinese man came to our clinic with a complaint of hair loss for 2 weeks, without scalp pruritus or pain. He also complained about being under high mental stress recently. He was heterosexual and was engaging in casual sex. He denied having any skin lesions in the genital area before the hair loss, i.e., the clinical manifestations of primary syphilis. The patient had a past history of asthma and diabetes mellitus, but no history of hair loss.On physical examination of the scalp area, numerous small scattered non-scarring hairless patches with incomplete hair loss were observed. The patches were irregular in size without defined borders, ranged from 0.2cm-0.5cm in diameter, distributed over the whole scalp giving the appearance of moth-eaten alopecia (Fig. 1). The hairless areas showed no signs of inflammation or desquamation. The gentle pull test was negative. Under trichoscopy black dots, focal atrichia, hypopigmentation of hair shafts and yellow dots were observed (Fig. 2). The empty ostia of hair follicle were presented. No skin rash was found all over the body. Up till now, the primary clinical impressions include syphilitic alopecia (SA) and alopecia areata (AA).Blood tests were performed including blood count, total IgE, antinuclear autoantibodies tests, serology for HIV and syphilis. The results of serology for syphilis were positive: rapid plasma reagin test (RPR) with titer of 1:64...

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Section: Case Reportmentioning

confidence: 52%

The clinical and trichoscopic features of syphilitic alopecia

Ye¹,

Zhang²,

Zhang³

et al. 2014

J Dermatol Case Rep

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“…The atypical forms are: Sisaifo-type alopecia areata (inverse ophiasis), reticular AA and diffuse AA. [1][2][3] The diagnosis of AA involves studying the patient´s case history, conducting a clinical examination and trichological workup. AA contains numerous propedeutic signs, thus a careful trichological examination is essential for diagnosis.…”

confidence: 99%

“…Exclamation-point hairs: thinner and less pigmented at the base, thicker and more pigmented at the distal end (Figure 1), [1][2][3]5,7,8 occurring more frequently at the periphery of the plaque, and indicating disease activity. 4,5,9 Exclamation point hairs can also be spindle-like, similar to those found in cases of beaded hair (monilethrix).…”

confidence: 99%

“…The yellow spots also occur in androgenetic alopecia (when hair follicle is empty at the xenogenous stage). 3,4,7 As the lesions progress to more chronic phases of AA the presence of these signs is no longer detected and mild follicular hyperkeratosis may occur, indicating a poor prognosis. 2.10 Finally, numerous telogen hairs can be observed in the trichogram 1,2,4-7 with bulbs or clubshaped tips either of similar size or with dystrophic tips (Figure 2).…”

confidence: 99%

“…1 In conclusion, we believe that a trichology examination assists the diagnosis and assessment of the progression of any capillary disorder. 3,7,8,10 In cases of suspected AA, a dermoscopy and trichogram enhances diagnostic confirmation while eliminating the need for invasive anatopathology evaluations etc. The trichological examination should therefore be incorporated into the diagnostic methods employed by the dermatologist given that it is a highly effective way of diagnosing AA.…”

confidence: 99%

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A importância do exame tricológico no diagnóstico da alopecia areata

Silva¹,

Sanchez²,

Pereira³

2011

An. Bras. Dermatol.

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Abstract:In this article we discuss the propedeutic aspects of alopecia areata, especially those found by dermatoscopy, an invaluable tool for diagnosis of the condition. Dermatoscopy facilitates the early detection of the characteristic changes in alopecia areata hair such as exclamation-point hairs, cadaverous hair, fuzzy hair, vellus type hair and yellow spots. Keywords: Alopecia; Alopecia areata; Dermoscopy Resumo: Neste artigo, destacam-se os aspectos propedêuticos da alopecia areata, em especial, os encontrados na dermatoscopia, ferramenta muito útil para o diagnóstico. A dermatoscopia facilita a detecção precoce das alterações características dos cabelos na alopecia areata, como: pelos em ponto de exclamação, pelos cadavéricos, fuzzy, pelos tipo velo e pontos amarelos.

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Follicular Red Dots

Tosti¹,

Torres²,

Misciali³

et al. 2009

Arch Dermatol

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Background: Scalp dermoscopy plays an important role in the diagnosis of hair and scalp disorders, and specific dermoscopic patterns have recently been associated with several disorders causing noncicatricial alopecia, such as androgenetic alopecia, alopecia areata, trichotillomania, and tinea capitis. Observations: We describe the morphologic and pathologic features of a new dermoscopic pattern, referred to as "follicular red dots," that was found in scalp lesions of 5 patients with active discoid lupus erythematosus (DLE). Follicular red dots appear as erythematous polycyclic, concentric structures, with a diameter ranging from 0.16 to 0.47 mm, regularly distributed in and around the follicular ostia. In the pathologic findings, red dots correspond to widened infundibula plugged by keratin and surrounded by dilated vessels and extravasated erythrocytes. Retrospective blinded evaluation of the dermoscopic images of 155 patients with cicatricial alopecia suggests that follicular red dots are a specific feature of DLE because the pattern was not identified in the images of cicatricial alopecia resulting from other diseases. Conclusions: The follicular red dot pattern is a specific feature of scalp lesions of active lupus erythematosus of the scalp. Recognition of this distinctive dermoscopic pattern may help the clinician to differentiate DLE from other diseases causing cicatricial alopecia.

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Comma hairs: A dermatoscopic marker for tinea capitis

Cited by 161 publications

References 4 publications

The clinical and trichoscopic features of syphilitic alopecia

The clinical and trichoscopic features of syphilitic alopecia

A importância do exame tricológico no diagnóstico da alopecia areata

Follicular Red Dots

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