{"title":"Giant Cell Tumor of Flexor Tendon Sheath: An Interesting Clinical Presentation as Subungual Growth.","authors":"Chander Grover, Pratibha Gupta, Rajesh Arora, Pragya Jain","doi":"10.1159/000540487","DOIUrl":"10.1159/000540487","url":null,"abstract":"<p><strong>Introduction: </strong>Giant cell tumor of tendon sheath (GCTTS), presenting as a subungual mass, is a diagnostic challenge and requires differentiation from other subungual tumors such as fibroma of tendon sheath and superficial acral fibromyxoma.</p><p><strong>Case report: </strong>We describe a 32-year-old female patient with a relatively rare subungual presentation of GCTTS. The patient presented with slowly enlarging, painless subungual swelling over the dorsum of the right thumb, raising the proximo-lateral nail plate, extending under the proximal nail fold. The clinical, onychoscopic, radiological, and histopathological features of the case are described, which helped in confirmation of diagnosis and differentiation from other subungual tumors.</p><p><strong>Conclusion: </strong>GCTTS can present as a diagnostic challenge due to its varied clinical manifestations, especially in the subungual location. A combination of clinical features and onychoscopy can point toward a diagnosis, which can be confirmed upon excision and histopathology.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":"11 1","pages":"87-92"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11793894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kimberly N Williams, Juwon Lee, Esthefani Robles, Antonella Tosti
{"title":"Hairbrushes: A Guide for Dermatologists.","authors":"Kimberly N Williams, Juwon Lee, Esthefani Robles, Antonella Tosti","doi":"10.1159/000540486","DOIUrl":"10.1159/000540486","url":null,"abstract":"<p><strong>Background: </strong>Hairbrushes play an integral role in our day-to-day life. As dermatologists, it can be difficult to keep up with this constant influx of new and unique brush types. This article provides a summary of the ten most commonly used hair brushes all dermatologists should know, focusing on their design, suitable hair types, and proper usage.</p><p><strong>Summary: </strong>There are a wide variety of hairbrushes on the market today ranging from detangling brushes to boar bristle brushes. Improper use of these hairbrushes can lead to trichomalacia, trichorrhexis nodosa, and traction alopecia. This guide aims to summarize the most common types of hairbrushes and their proper use for dermatologists.</p><p><strong>Key messages: </strong>Improper use of hairbrushes can lead to trichomalacia, trichorrhexis nodosa, and traction alopecia. Through this guide, we hope to provide helpful information on hairbrushes that can be utilized daily in clinical practice for hair types ranging from straight to coily.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":"11 1","pages":"58-62"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11793887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Drug-Induced Hair Loss: Analysis of the Food and Drug Administration's Adverse Events Reporting System Database.","authors":"Rachel C Hill, Steven D Zeldin, Shari R Lipner","doi":"10.1159/000540104","DOIUrl":"10.1159/000540104","url":null,"abstract":"<p><strong>Introduction: </strong>Drug-induced hair loss is one of several causes of hair loss commonly seen in clinical practice, and it is often a daunting task to determine a potential culprit drug when a patient is taking numerous medications. Our objective was to identify drugs responsible for hair loss, using the Food and Drug Administration's Adverse Events Reporting System (FAERS) database, a compilation of drug-related adverse events (AEs).</p><p><strong>Methods: </strong>Using the FAERS database, we queried all domestic reports with the reaction term \"alopecia\" listed as an AE in patients ≥18 years old from April 1, 1968, to September 29, 2023. Using descriptive statistics, individual agents were grouped by drug class.</p><p><strong>Results: </strong>We analyzed a total of 39,346 hair loss AE reports related to a single agent. Immunomodulatory agents and monoclonal antibodies represented the highest proportion of AE reports for alopecia, followed by hair loss drugs, contraceptives, and antitumor necrosis factor (anti-TNF) biologics.</p><p><strong>Conclusion: </strong>In sum, we showed that immunomodulatory agents and monoclonal antibodies, hair loss drugs, including minoxidil and finasteride, contraceptives, kinase inhibitors, and anti-TNF drugs are most frequently associated with hair loss AEs in the FAERS database. Because many of these drugs are not prescribed primarily for dermatologic indications, our study provides guidance for dermatologists in identifying common medications associated with alopecia.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":"11 1","pages":"63-69"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11793883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effectiveness and Safety of Intramatricial Triamcinolone Acetonide for Trachyonychia: A Retrospective Data Analysis.","authors":"Chander Grover, Bharti Aggarwal, Subhojit Ray","doi":"10.1159/000540703","DOIUrl":"10.1159/000540703","url":null,"abstract":"<p><strong>Introduction: </strong>Trachyonychia is a clinical presentation characterised by dry, rough, longitudinally ridged nails or opalescent shiny nail plates with pits. Intramatricial steroids are an accepted form of therapy, but efficacy data are lacking.</p><p><strong>Materials and methods: </strong>A retrospective data analysis of 6 patients (84 nails) with trachyonychia who received treatment for at least 6 sessions, with intramatricial triamcinolone acetonide (TA) (5 mg/mL), administered at 4 weekly intervals, was conducted. Photographic records were analysed for scoring severity of disease with Nail Surface Abnormality Index (NSI) score. Endpoint of therapy was 4 weeks after the sixth injection.</p><p><strong>Results: </strong>Among the 6 patients analysed as per protocol, 4 had both finger and toenails involved, while 2 had only fingernails affected. Overall 56/60 fingernails (93.3%) and 28/60 toenails (46.6%) were affected in these patients, and were treated. The mean baseline NSI score for fingernails was 10.34 ± 4.1 (range 2-16) which improved to 6.61 ± 3.21 (range 0-12 at endpoint, showing a 37.86% reduction [<i>p</i> < 0.0001]). The mean baseline NSI score of toenails improved from 10.25 ± 3.51 (range 4-14) to 5.00 ± 1.91 (range 1-8) at endpoint, showing a 50.05% reduction (<i>p</i> < 0.0001). Adverse effects included pain (5.88%), subungual hematoma (5.88%), proximal nail fold hyperpigmentation (21.17%), and atrophy (22.35%).</p><p><strong>Conclusion: </strong>Intramatricial TA is a safe and effective modality for treating trachyonychia.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":"11 1","pages":"74-79"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11793888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Novel Insights Malalignment or Retronychia: Which Comes First?","authors":"André Lencastre, Bertrand Richert","doi":"10.1159/000540488","DOIUrl":"10.1159/000540488","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic retronychia cases oftentimes look similar to congenital great toenail malalignment. It is quite possible that, on the toenails, both are related as both clinically portray changes in nail growth in a setting of ongoing microtrauma.</p><p><strong>Case presentation: </strong>A 2-year-old girl presented with a left great toenail change compatible with chronic retronychia. The likely culprit was a lateral deviation of the distal phalanx. Only conservative measures were recommended but an onset of retronychia-related complications was already appreciable.</p><p><strong>Conclusion: </strong>This case illustrates the relationship between retronychia and what could be veritably called acquired great toenail malalignment.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":"11 1","pages":"80-83"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11793898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Patient Characteristics, Diagnostic Testing Utilization, and Antifungal Prescribing Pattern for Onychomycosis in the USA: A Cohort Study Using DataDerm, 2016-2022.","authors":"Aditya K Gupta, Tong Wang, Anh N Tran","doi":"10.1159/000540704","DOIUrl":"10.1159/000540704","url":null,"abstract":"<p><strong>Introduction: </strong>Onychomycosis is a complex nail disease that is commonly seen in daily practice.</p><p><strong>Methods: </strong>Electronic health records of clinically diagnosed onychomycosis patients were extracted using DataDerm - a dermatology data registry hosted by the American Academy of Dermatology - spanning from the year 2016 to 2022.</p><p><strong>Results: </strong>Regardless of age, an increasing trend in patient volume was observed in the Southern US region, which accounted for 50.7-56.9% of onychomycosis patients in 2022. A coinfection of tinea pedis was present among 15.6-22.5% of patients. Diagnostic testing was infrequently utilized with less than one-quarter of patients having a histopathologic examination (12.7-21.9%) followed by fungal culture (5.5-8.2%) and direct microscopic examination (3.3-6.0%). Treatments were infrequently prescribed, accounting for less than one-quarter of patients (orals, terbinafine: 20.8-29.1%, fluconazole: 12.9-16.5%; topicals, efinaconazole: 3.2-13.8%); over 30% of treated patients received a combination regimen or experienced switching of treatments. Prescribing patterns did not significantly differ in vulnerable patient groups such as elderly patients and in patients with concomitant tinea pedis. Patients receiving a topical and/or oral antifungal prescription were frequently not tested to confirm the onychomycosis diagnosis (76.9%).</p><p><strong>Conclusion: </strong>Our findings add to a growing body of literature calling for the improvement of onychomycosis management practices.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":"11 1","pages":"36-44"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11793902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sisaipho Revisited: Inverse Ophiasis or More than That?","authors":"Alexandros Katoulis, Georgia Pappa, Effie Markou, Antonios Kanelleas, Evangelia Bozi, Dimitrios Sgouros, Dimitris Rigopoulos, Lidia Rudnicka","doi":"10.1159/000540489","DOIUrl":"10.1159/000540489","url":null,"abstract":"<p><strong>Introduction: </strong>Alopecia areata exhibits diverse clinical forms, encompassing the less common variant, sisaipho. Clinical observations suggest its unique ability to emulate both male and female pattern hair loss, implying a potential androgenic influence akin to androgenetic alopecia.</p><p><strong>Case presentations: </strong>Herein, we present 3 cases of alopecia areata in adults exhibiting a male or female pattern distribution or accentuation.</p><p><strong>Conclusion: </strong>To improve diagnosis and differential diagnosis of alopecia, the term \"alopecia areata in a male or female pattern distribution\" may be introduced as a new clinical subtype of alopecia areata. This new subtype could also integrate sisaipho. By introducing this refined terminology, we seek to improve our comprehension of the condition, enabling more precise diagnoses and tailored treatment approaches.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":"11 1","pages":"84-86"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11793896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Juste Baksanskaite, Natalia Caballero Uribe, Ralph M Trüeb
{"title":"Secondary Cutis Verticis Gyrata Induced by Long-Term Use of High-Dose Topical Minoxidil.","authors":"Juste Baksanskaite, Natalia Caballero Uribe, Ralph M Trüeb","doi":"10.1159/000540243","DOIUrl":"10.1159/000540243","url":null,"abstract":"<p><strong>Introduction: </strong>Cutis verticis gyrata (CVG) is a medical condition that is characterized by thickening of the scalp giving the scalp a cerebriform appearance. Due to an apparent paucity of the condition, limited research exists, and causes are as yet undetermined. What is known, is that the condition may either be a feature of several syndromes or occur as a consequence of a number of diseases or drugs that produce changes in scalp structure, particularly acromegaly, and theoretically, the use of growth hormone (GH) itself or the use of drugs that mimic the effect of GH (secretagogues).</p><p><strong>Case presentation: </strong>We present a case of CVG that resulted from long-term topical use of minoxidil at a high concentration.</p><p><strong>Discussion and conclusion: </strong>Minoxidil has been shown to be able to potentiate the mitogenic effects of insulin-like growth factor (IGF-1). Meanwhile, the striking manifestations of acromegaly are due to excessive IGF-1 production by the liver in response to GH stimulation. The growth-promoting properties of IGF-1 trigger soft tissue hypertrophy, and hypertrichosis. Pseudoacromegaly has been reported to be induced by the long-term use of oral minoxidil. This is the first case report of secondary CVG from the use of topical minoxidil for the treatment of male androgenetic alopecia.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":"11 1","pages":"93-97"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11793878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Circumscribed Alopecia Areata Incognita and Response to Tofacitinib.","authors":"Mayra A Reyes Soto, Rodrigo Pirmez","doi":"10.1159/000540778","DOIUrl":"10.1159/000540778","url":null,"abstract":"<p><strong>Introduction: </strong>Alopecia areata incognita (AAI) remains a subject of ongoing debate in the literature, with some authors advocating its classification as a subtype of alopecia areata. A localized form of this condition, entitled circumscribed AAI, has been rarely reported in the literature. We report an unusual case of circumscribed AAI treated with oral tofacitinib.</p><p><strong>Case report: </strong>A 21-year-old woman presented with a large patch of localized hair thinning on the parietal area. Trichoscopy revealed yellow dots and short thin hairs. A diagnosis of circumscribed AAI was established. Due to the frequent relapses to conventional treatment and associated weight gain secondary to oral dexamethasone, oral tofacitinib 5 mg twice daily was started with a sustained response.</p><p><strong>Discussion: </strong>AAI is a controversial condition, and its circumscribed variant is scarcely reported in the literature. We hypothesize that AAI clinical presentation may be secondary to cycle disturbance leading to rapid and incomplete hair follicle cycling. Most papers established that the best treatment for AAI is corticosteroids, either topical, intralesional or systemic.</p><p><strong>Conclusion: </strong>Oral tofacitinib represents a potential treatment for AAI cases that do not present a sustained response to corticosteroids.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":"11 1","pages":"98-102"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11793895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Exploring the Link: Trichostasis Spinulosa and Its Association with Early Phymatous Rosacea.","authors":"Sechi Andrea, Mariano Luca, Galvan Arturo","doi":"10.1159/000540509","DOIUrl":"10.1159/000540509","url":null,"abstract":"<p><strong>Introduction: </strong>Rosacea is a chronic inflammatory skin condition with several clinical subtypes, including phymatous rosacea, which is distinguished by thickened skin, enlarged pores, and irregular surface nodularities, primarily affecting the nose. This manuscript aims to explore the underrecognized connection between early to moderate phymatous rosacea and trichostasis spinulosa (TS), a follicular disorder characterized by the retention of multiple telogen hairs.</p><p><strong>Methods: </strong>A total of consecutive 13 patients with initial phymatous changes and black dilated openings were enrolled. Detailed dermatological assessments, including dermoscopy, were conducted to identify and confirm trichostasis spinulosa. Dermoscopy of the black openings confirmed the presence of hair tufts emerging from dilated follicular openings and plugs. Patients underwent minor procedures using a comedo extractor to remove the hair bundles.</p><p><strong>Results: </strong>All extracted follicular units showed typical characteristics of trichostasis spinulosa, including bundles of telogen hairs surrounded by a sebokeratinous plug.</p><p><strong>Conclusion: </strong>We postulate that the fibrotic processes characteristic of phymatous rosacea may promote the development of TS. Recognizing TS as an early indicator of phymatous rosacea could help prevent disease progression.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":"11 1","pages":"9-13"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11793881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}