Summary Trichorrhexis nodosa (TN) is a hair shaft disorder characterized by fragile hair with nodes on the hair shaft. Here we report a case of aquired localised trichorrhexis nodosa and describe the importance of noninvasive tools like trichoscopy and light microscopy in the diagnosis of an isolated TN.
Hair Diseases--diagnosis

BACKGROUND: Cervical vestibular evoked myogenic potential (cVEMP) testing is a strong tool that enables objective determination of balance functions in humans. However, it remains unknown whether cVEMP correctly expresses vestibular disorder in mice. OBJECTIVE: In this study, correlations of cVEMP with scores for balance-related behavior tests including rotarod, beam, and air-righting reflex tests were determined in ICR mice with vestibular disorder induced by 3,3'-iminodipropiontrile (IDPN) as a mouse model of vestibular disorder. METHODS: Male ICR mice at 4 weeks of age were orally administered IDPN in saline (28 mmol/kg body weight) once. Rotarod, beam crossing, and air-righting reflex tests were performed before and 3-4 days after oral exposure one time to IDPN to determine balance functions. The saccule and utricles were labeled with fluorescein phalloidin. cVEMP measurements were performed for mice in the control and IDPN groups. Finally, the correlations between the scores of behavior tests and the amplitude or latency of cVEMP were determined with Spearman's rank correlation coefficient. Two-tailed Student's t test and Welch's t test were used to determine a significant difference between the two groups. A difference with p < 0.05 was considered to indicate statistical significance. RESULTS: After oral administration of IDPN at 28 mmol/kg, scores of the rotarod, beam, and air-righting reflex tests in the IDPN group were significantly lower than those in the control group. The numbers of hair cells in the saccule, utricle, and cupula were decreased in the IDPN group. cVEMP in the IDPN group was significantly decreased in amplitude and increased in latency compared to those in the control group. cVEMP amplitude had significant correlations with the numbers of hair cells as well as scores for all of the behavior tests in mice. CONCLUSIONS This study demonstrated impaired cVEMP and correlations of cVEMP with imbalance determined by behavior tests in a mouse model of vestibular disorder.
Animals ; Behavior, Animal ; drug effects ; physiology ; Disease Models, Animal ; Hair Cells, Vestibular ; pathology ; Male ; Mice ; Mice, Inbred ICR ; Nitriles ; adverse effects ; Postural Balance ; drug effects ; physiology ; Saccule and Utricle ; pathology ; Sensation Disorders ; chemically induced ; physiopathology ; Vestibular Diseases ; chemically induced ; diagnosis ; pathology ; physiopathology ; Vestibular Evoked Myogenic Potentials ; drug effects ; physiology ; Vestibular Function Tests

BACKGROUND: P-phenylenediamine (PPD) has been identified as the most frequent contact sensitizer of hair dye and the clinical characteristics of hair dye contact allergy (HDCA) are diverse. OBJECTIVE: The purpose of this study was to identify the clinical characteristics of HDCA and to assess the relationships between HDCA, exposure time to PPD and PPD positivity. METHODS: We analyzed 105 patients with patch test-confirmed hair dye allergy who presented between July 2009 and March 2015. Clinical symptoms, signs, associated skin diseases, involved ACD area, and patterns of hair dye use were obtained by reviewing medical records and by interview. RESULTS: HDCA was more common in women and in individuals aged more than 50 years. Pruritus was the most common symptom; erythematous macules and patches were the most frequently observed clinical signs. The most common site of HDCA was the face and non-specific eczema and urticaria were frequently observed with HDCA. Exposure time to hair dye, represented as frequency and duration, showed a positive correlation with the area affected by hair dye allergy (p < 0.001). Hair dye allergy was identified in most patients (80%) before diagnosis by patch test. However, only 28.6% of all patients stopped using hair dye, even after the diagnosis was confirmed. CONCLUSION: The extent of hair dye allergy involvement was related to exposure time to hair dye. For effective treatment of HDCA, it is important to properly educate patients with HDCA about the clinical manifestations of HDCA and to keep away from allergens.
Allergens ; Dermatitis, Allergic Contact ; Diagnosis ; Eczema ; Female ; Hair Dyes ; Hair* ; Humans ; Hypersensitivity* ; Medical Records ; Patch Tests ; Phenylenediamines ; Pruritus ; Skin Diseases ; Urticaria

Lipedematous alopecia (LA) is a rare disease entity that manifests as increased thickness of subcutaneous fatty tissue in the scalp with a variable degree of acquired, non-scarring alopecia. Although the pathogenesis of alopecia in LA is not clear, it is assumed that the increased thickness of subcutaneous fat retards hair growth by disturbing the peripheral microenvironment of the hair bulb. LA is clinically distinguishable from lipedematous scalp (LS) in that LS is not associated with any hair abnormalities, while LA is characterized by variable degree of hair loss. However, both LA and LS share increased scalp thickness. Here, we describe a rare case of LA on the frontal scalp of an Asian woman, further characterize the clinical and histologic features, and suggest applying an integrated diagnosis as lipedematous diseases of the scalp.
Adipose Tissue ; Alopecia* ; Asian Continental Ancestry Group* ; Diagnosis ; Female ; Hair ; Humans ; Lipomatosis ; Rare Diseases ; Scalp* ; Subcutaneous Fat

While mycological examinations, potassium hydroxide preparation, and fungus culture remain the gold standard for the diagnosis of superficial dermatomycoses, mycological procedures have limitations because they are rather complex, time-consuming, and require skilled personnel and additional mycological tools. Dermoscopy is a simple, non-invasive diagnostic technique that allows better visualization of morphologic structures of the skin than the naked eye. It is easily performed with a hand-held dermoscope and allows immediate diagnosis. It has been primarily used to evaluate pigmented skin lesions, but recent advances indicate that it can also be a useful and convenient tool for diagnosing superficial dermatomycoses. The determination of specific dermoscopic patterns of fungal infection, especially in selected cases involving terminal hairs or nails, could lead to a straightforward diagnosis and facilitate their differentiation from non-fungal skin diseases. In addition, dermoscopy permits better inspection of subtle clinical features caused by fungi that are less evident to the naked eye; thus, in most cases, it can enhance clinician's diagnostic accuracy and confidence level, and allow determination of the best site for adequate mycological sampling as well as therapeutic monitoring. However, it should be a part of the evaluation in combination with other mycological tests because it does not substitute confirmatory examination for superficial dermatomycoses.
Dermatomycoses* ; Dermoscopy* ; Diagnosis ; Fungi ; Hair ; Onychomycosis ; Potassium ; Skin ; Skin Diseases ; Tinea Capitis

BACKGROUND: To date, numerous studies have investigated the epidemiology and clinical characteristics of male pattern hair loss (MPHL). OBJECTIVE: The purpose of this study was to evaluate a large number of long-term MPHL patients and to compare them to shorter term ones from other studies. METHODS: We retrospectively reviewed charts of patients diagnosed with MPHL during a 10-year period at the alopecia clinic at the Department of Dermatology of Myongji Hospital. RESULTS: Among 3,549 alopecia patients who had visited the hospital's alopecia clinic, 1,360 were patients demonstrating MPHL (38.3%). The most frequent age group was patients in their 20's (30.1%) followed by those in their 30's (28.2%), 40's (17.2%), 50's (9.9%), and teenagers (8.9%). There were 599 MPHL patients (44.0%) with a paternal familial predisposition, 182 (13.4%) with a maternal familial predisposition, and 118 (8.7%) with familial predisposition on maternal and paternal sides. MPHL was classified based on the Norwood-Hamilton classification: type 2 (20.0%), type 3v (19.4%), and type 3a (16.3%) were the most frequent. Abnormalities in total serum cholesterol were found in 15.1% patients and triglycerides in 36.1% of patients. The most common comorbidity was seborrheic dermatitis, followed by hypertension, hyperlipidemia, diabetes mellitus, and gastrointestinal diseases. CONCLUSION: This study demonstrated that the period of MPHL diagnosis and treatment becomes earlier in age and milder regarding MPHL type, which may be due to early puberty in teenagers.
Adolescent ; Alopecia ; Cholesterol ; Classification ; Comorbidity ; Dermatitis, Seborrheic ; Dermatology ; Diabetes Mellitus ; Diagnosis ; Epidemiology ; Gastrointestinal Diseases ; Hair* ; Humans ; Hyperlipidemias ; Hypertension ; Male* ; Puberty ; Retrospective Studies ; Triglycerides

Trichilemmal cysts are common fluid-filled growths that arise from the isthmus of the hair follicle. They can form rapidly multiplying trichilemmal tumors-, also called proliferating trichilemmal cysts, which are typically benign. Rarely, proliferating trichilemmal cysts can become cancerous. Here we report the case of a patient who experienced this series of changes. The 27-year-old male patient had been observed to have a 1×1 cm cyst 7 years ago. Eight months prior to presentation at our institution, incision and drainage was performed at his local clinic. However, the size of the mass had gradually increased. At our clinic, he presented with a 5×4 cm hard mass that had recurred on the posterior side of his neck. The tumor was removed without safety margin, and the skin defect was covered with a split-thickness skin graft. The pathologic diagnosis was a benign proliferating trichilemmal cyst. The mass recurred after 4months, at which point, a wide excision (1.3-cm safety margin) and split-thickness skin graft were performed. The biopsy revealed a trichilemmal carcinoma arising from a proliferating trichilemmal cyst. This clinical experience suggests that clinicians should consider the possibility of malignant changes when diagnosing and treating trichilemmal cysts.
Adult ; Biopsy ; Diagnosis ; Drainage ; Epidermal Cyst ; Hair Diseases ; Hair Follicle ; Humans ; Male ; Neck* ; Skin ; Skin Neoplasms ; Transplants

Alopecia areata (AA) is a disease in which the patient experiences a sudden loss of scalp hair leaving round patches. It has a lifetime risk of 1.7%. AA is known to occur on any part of the body, including the scalp, beard area, axilla, and even the pubic area. Although the pathogenesis of AA is poorly understood, the consensus is that AA is an organ-specific autoimmune disease that typically presents in the hair follicles. Susceptibility to the development of AA may be modified by environmental factors, including exposure to pro-inflammatory agents and other modulators. The differentiation of AA can sometimes be challenging as several conditions (such as trichotillomania, tinea capitis, telogen effluvium, and lupus) may resemble AA. Obtaining the patient's history, performing a hair pull test, and skin biopsy or dermoscopic findings can be helpful for confirmation. Treatment for AA is usually based on patient age and the extent of hair loss, but there are no therapeutic agents that are curative or preventive for AA. AA can progress unpredictably. Indicators of poor prognosis include atopy, co-occurring immune diseases, positive family history, young age of onset, and ophiasis.
Age of Onset ; Alopecia Areata* ; Alopecia* ; Autoimmune Diseases ; Axilla ; Biopsy ; Consensus ; Diagnosis* ; Hair ; Hair Follicle ; Humans ; Immune System Diseases ; Prognosis ; Scalp ; Skin ; Tinea Capitis ; Trichotillomania

Polycystic ovary syndrome affects 6%-7% of reproductive-aged women, making it the most common endocrine disorder in this population. It is characterized by chronic anovulation and hyperandrogenism. Affected women may present with reproductive manifestations such as irregular menses or infertility, or cutaneous manifestations, including hirsutism, acne, or male-pattern hair loss. Over the past decade, several serious metabolic complications also have been associated with polycystic ovary syndrome including type 2 diabetes mellitus, metabolic syndrome, sleep apnea, and possibly cardiovascular disease and nonalcoholic fatty liver disease. In addition to treating symptoms by regulating menstrual cycles and improving hyperandrogenism, it is imperative that clinicians recognize and treat metabolic complications. Lifestyle therapies are first-line treatment in women with polycystic ovary syndrome, particularly if they are overweight. Pharmacological therapies are also available and should be tailored on an individual basis. This article reviews the diagnosis, clinical manifestations, metabolic complications, and treatment of the syndrome.
Acne Vulgaris ; Anovulation ; Cardiovascular Diseases ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Diagnosis ; Fatty Liver ; Female ; Hair ; Hirsutism ; Humans ; Hyperandrogenism ; Infertility ; Insulin Resistance ; Life Style ; Menstrual Cycle ; Overweight ; Polycystic Ovary Syndrome* ; Sleep Apnea Syndromes

A 6 years old boy came to our department with a complaint of a growing goitre behind and below the right ear that started 4 years ago. Clinical features: there was a 2.0 cm x 1.5 cm nontender goitre behind and below the right ear, protruding from the skin with clear boundary. The temperature and color of the skin covered the goitre were normal. B-mode ultrasound features: there was a mass under the skin with the size of 2.0 cm x 0.8 cm showing strong echo. The borders of the mass were unclear, and no signal of blood flow was detected. Pathology diagnosis: pilomatricoma.
Child ; Face ; Goiter ; Hair Diseases ; diagnosis ; pathology ; Humans ; Male ; Pilomatrixoma ; diagnosis ; pathology ; Skin ; Skin Neoplasms ; diagnosis ; pathology