The “Starry night sky sign” Using ultraviolet-light-enhanced trichoscopy: A new sign that may predict efficacy of treatment in frontal fibrosing alopecia

Rodrigues-Barata, Ana Rita; Moreno‐Arrones, Óscar M.; Corralo, David Saceda; Galván, Sergio Vañó

doi:10.4103/ijt.ijt_17_18

Cited by 8 publications

(4 citation statements)

References 6 publications

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“…Ultraviolet light-enhanced trichoscopy may be helpful to predict the efficacy of local treatment, so that positive fluorescence (“starry night sky sign” pattern), which is due to the presence of Propionibacterium acnes, may be a sign of a still-preserved hair follicle [ 159 ].…”

Section: Trichoscopymentioning

confidence: 99%

Frontal Fibrosing Alopecia: A Review

Porriño‐Bustamante

Fernández‐Pugnaire

Arias‐Santiago

2021

JCM

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Frontal fibrosing alopecia is a scarring alopecia, the prevalence of which is increasing worldwide since its first description in 1994. The reason for this emerging epidemic may be a higher exposure to an unknown trigger, although its aethiology and pathogenesis still remain enigmatic. Clinical, trichoscopic, sonographic, and histopathologic findings are allowing clinicians to understand more aspects about this type of cicatricial alopecia. Several treatments have been used in frontal fibrosing alopecia, although the 5-alpha reductase inhibitors seem to be the most promising. The aim of this report is to provide a compilation about the published data regarding frontal fibrosing alopecia in a narrative review.

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Section: Trichoscopymentioning

confidence: 99%

Frontal Fibrosing Alopecia: A Review

Porriño‐Bustamante

Fernández‐Pugnaire

Arias‐Santiago

2021

JCM

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“…Dark regions in UVFD images result from the high absorption of UV light by melanin and hemoglobin, which leads to the absence of any background fluorescence in these areas (all light absorbed, no reflected light visible). The method also appears in the literature as UV-enhanced trichoscopy (UVET) [ 18 , 19 ].…”

Section: Methodsmentioning

confidence: 99%

“…No regrowth was observed in five patients lacking fluorescence. The authors suggested that the Cutibacterium colonization was maintained exclusively within viable hair follicle units [ 19 ]. Hair follicle regrowth is dependent on viable hair follicle progenitor cells that are normally located in a bulge region, just between the arrector pili muscle and intrafollicular opening of the sebaceous duct [ 55 ].…”

Section: Methodsmentioning

confidence: 99%

Applications of Ultraviolet and Sub-ultraviolet Dermatoscopy in Neoplastic and Non-neoplastic Dermatoses: A Systematic Review

Pietkiewicz,

Navarrete-Dechent,

Togawa

et al. 2024

Dermatol Ther (Heidelb)

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Dermatoscopy is a non-invasive and cost-efficient imaging technique augmenting clinical examination in neoplastic and non-neoplastic dermatoses. Recently, novel dermatoscopic techniques based on principles of reflectance/absorption and excited fluorescence have been developed. However, comprehensive data on their applications are sparse, and terminology is inconsistent. In this systematic review, we addressed the principles of ultraviolet (UV) imaging and proposed categorization based on spectral characteristics and signal acquisition, as well as discussed documented and potential clinical applications, safety measures during examination, and limitations associated with reflectance and fluorescence dermatoscopy. A literature search was conducted in the PubMed medical database until 2 December 2023 according to PRISMA guidelines, and 28 papers fit the scope of this review, whereas additional relevant articles were included to provide broader context regarding the chosen terminology, chromophores described, safety of sub-UV/UV, and regulations for light-emitting devices. UV and sub-UV dermatoscopy, categorized into different methods on the basis of the emitted wavelength and signal acquisition process (reflectance versus fluorescence), augment conventional dermatoscopy by optimizing safety margins in melanoma, facilitating early detection of tumor recurrence, and enhancing visualization in non-neoplastic conditions, including pigmentation disorders, intertrigo, papulo-desquamative dermatoses, and beyond. The review highlights the limitations of these techniques, including difficulty in differentiating melanin from hemoglobin, challenges in evaluating uneven surfaces, and artifacts. Although UV dermatoscopy complements conventional dermatoscopy, clinicians should be aware of their peculiarities, artifacts, limitations, and safety concerns to optimize their diagnostic accuracy and ensure patient’s safety. Supplementary Information The online version contains supplementary material available at 10.1007/s13555-024-01104-4.

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“…Type I, the most common, has an intermediate prognosis [41]. Additionally, the presence of follicular fluorescence on ultraviolet-enhanced trichoscopy (UVET), known as the "starry sky sign," may indicate a potential for hair regrowth [44].…”

Section: Clinical Course and Prognostic Factorsmentioning

confidence: 99%

The Frontal Fibrosing Alopecia Treatment Dilemma

Krzesłowska,

Woźniacka

2024

JCM

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Frontal fibrosing alopecia (FFA) is a type of cicatricial alopecia predominantly observed in postmenopausal women, with the incidence rising since its initial description in 1994. The exact etiopathogenesis of the disease has not been completely elucidated. FFA is characterized by an inflammatory process affecting the hair follicles of the fronto-temporal hairline, leading to its gradual recession. Eyebrows, particularly the lateral parts, may also be affected. Early diagnosis and an implementation of effective therapy to limit the inflammatory process are crucial in halting disease progression. Various treatment possibilities have been reported, including anti-inflammatory and immunosuppressive agents, as well as 5-alpha-reductase inhibitors, retinoids, and antimalarial agents. The use of phototherapy and surgical procedures has also been described. However, most available data have been obtained retrospectively, frequently consisting of descriptions of case reports or small case series, and not from randomized controlled trials. In addition, the etiopathogenesis of FFA remains unclear and its course unpredictable, occasionally being linked with spontaneous stabilization. Hence, no precise guidelines exist regarding treatment modalities. Therefore, the aims of this study were to provide a comprehensive review of the efficacy of existing therapeutic modalities for FFA and to highlight novel therapeutic options.

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The “Starry night sky sign” Using ultraviolet-light-enhanced trichoscopy: A new sign that may predict efficacy of treatment in frontal fibrosing alopecia

Cited by 8 publications

References 6 publications

Frontal Fibrosing Alopecia: A Review

Frontal Fibrosing Alopecia: A Review

Applications of Ultraviolet and Sub-ultraviolet Dermatoscopy in Neoplastic and Non-neoplastic Dermatoses: A Systematic Review

The Frontal Fibrosing Alopecia Treatment Dilemma

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