Paula Finnegan, YiXuan Goh, Michelle Murphy, Cathal O'Connor
{"title":"A Qualitative Review of Misinformation on Alopecia.","authors":"Paula Finnegan, YiXuan Goh, Michelle Murphy, Cathal O'Connor","doi":"10.1159/000541809","DOIUrl":"10.1159/000541809","url":null,"abstract":"<p><strong>Background: </strong>Alopecia is common and can lead to significant distress for patients. Patients often seek medical information on the Internet, which may leave them susceptible to misinformation from poor-quality sources. The aim of this study was to qualitatively assess misinformation available online related to alopecia.</p><p><strong>Summary: </strong>Several alopecia-related myths were identified, including false causes, criticism of conventional treatments, and bogus \"natural\" cures or remedies. False causes included headwear, haircare practices, and sexual practices. Treatments which were criticized included minoxidil, finasteride, topical corticosteroids, ciclosporin, methotrexate, and Janus kinase inhibitors. Alternative unfounded therapies which were touted included mineral supplements, biotin, B vitamin complexes, fish oils, shark cartilage, onion juice, rosemary oil, horsetail extract, and saw palmetto.</p><p><strong>Key messages: </strong>Misinformation related to alopecia is prevalent online and may lead to suboptimal therapeutic outcomes. Dermatologists and other healthcare professionals should combat misinformation when encountered.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":"11 2","pages":"182-185"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773514","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":"Efficacy of Methotrexate Microinfusion in Scalp Lesions of Patients with Frontal Fibrosing Alopecia: A Prospective Controlled Trial.","authors":"Tatiane Elen de Souza Pitlovanciv, Thelma Larocca Skare, Karina Bittencourt Medeiros, Andréa Buosi Fabri","doi":"10.1159/000540846","DOIUrl":"10.1159/000540846","url":null,"abstract":"<p><strong>Introduction: </strong>Topical and systemic drugs, as methotrexate (MTX), do not control the frontal fibrosing alopecia (FFA) activity in most of the cases showing the need for new therapies. Therefore, we aimed to evaluate the effectiveness of MTX microinfusion in FFA.</p><p><strong>Methods: </strong>Prospective, controlled clinical trial, carried out with 17 volunteers with clinical and histological diagnosis of FFA. Applications of MTX by MMP<sup>®</sup> (microinfusion of drugs into the skin method) were made every 30 days, in a total of 03 applications, in the right half of the alopecia area; the other half served as a control.</p><p><strong>Results: </strong>There was a significant reduction in frontal-glabella and frontal temporoparietal measurements at treated site while in the untreated site the FFA increased. Patient's referred improvement of pruritus and desquamation but not in hair loss and local erythema. Analysis of the dermoscopic photos and the LPPAI calculation did not show relevant changes. About 95% of the participants were satisfied or very satisfied with the results and none of them had alteration in the laboratory test results.</p><p><strong>Conclusion: </strong>The MTX application by MMP<sup>®</sup> improved symptoms associated with FFA, and the frontal-glabella and frontal temporoparietal measurements. This technique proved to be safe and well tolerated.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":"11 2","pages":"151-158"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773526","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}
A E Soliman, Olfat Shaker, Samar M El-Tahlawi, Ghada Abdaltwab Mahgoub, Sara M Yaseen
{"title":"Assessment of Intestinal Free Fatty Acid Binding Protein 4 in Alopecia Areata Patients.","authors":"A E Soliman, Olfat Shaker, Samar M El-Tahlawi, Ghada Abdaltwab Mahgoub, Sara M Yaseen","doi":"10.1159/000541111","DOIUrl":"10.1159/000541111","url":null,"abstract":"<p><strong>Introduction: </strong>Alopecia areata (AA) is an immune-mediated disease characterized by non-scaring hair loss. High levels of FABP4 have been implicated in different inflammatory diseases. We aim to assess and correlate the level of FABP4 in AA patients and compare with healthy controls.</p><p><strong>Methods: </strong>Eighty-Eight subjects enrolled subdivided equally into AA and healthy controls. AA patients were classified according to the severity and pattern of the disease. The concentration level of FABP4 in serum was assessed and compared to healthy controls using ELISA.</p><p><strong>Results: </strong>The level of FABP4 tends to increase in AA patients than controls with a significant difference (<i>p</i> = 0.0001).There were no statistically significant differences between FABP4 and gender, history, family history, related diseases, or prior treatments. There is a high significant difference between patients with relapse and progressive patients with <i>p</i> = 0.037. Also patients with positive effects in other body sites have higher FABP4 levels than patients without infection in other sites with <i>p</i> = 0.05. The level of FABP4 tends to increase with the severity of the patients. Findings show that there are positive correlations between FABP4 and (disease duration; number of attacks; SALT Score) with <i>r</i> = 0.45, <i>p</i> = 0.0021; <i>r</i> = 0.41, <i>p</i> = 0.007, and <i>r</i> = 0.88, <i>p</i> < 0.0001, respectively.</p><p><strong>Conclusion: </strong>Elevation of FABP4 in serum may correlate with disease severity and could play a vital role in the diagnosis of AA.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":"11 2","pages":"112-118"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773520","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}
Andrea Sechi, Angelo Valerio Marzano, Anna Belloni-Fortina, Anna Zambello
{"title":"Concomitant Allergic Contact Dermatitis and Frontal Fibrosing Alopecia: A Potential Trigger for Relapse or Onset?","authors":"Andrea Sechi, Angelo Valerio Marzano, Anna Belloni-Fortina, Anna Zambello","doi":"10.1159/000541604","DOIUrl":"10.1159/000541604","url":null,"abstract":"<p><strong>Introduction: </strong>Frontal fibrosing alopecia (FFA) is a primary lymphocytic scarring alopecia predominantly affecting postmenopausal women, with histopathological similarities to lichen planopilaris but distinct clinical features. The global rise in FFA cases over the past 15 years points to potential environmental factors.</p><p><strong>Case presentation: </strong>This study presents 2 FFA cases: one experiencing a flare-up and another with disease onset, both associated with allergic contact dermatitis. Case 1 involved a 58-year-old female with a flare-up linked to a nickel allergy, while case 2 described a 60-year-old female with new-onset FFA following exposure to hair dye allergens.</p><p><strong>Discussion: </strong>Environmental particles, such as titanium dioxide found on hair shafts of FFA patients, are hypothesized to contribute to FFA through photocatalytic activity causing tissue damage and inflammation. Studies indicate a higher use of facial moisturizers and sunscreens among FFA patients, with frequent positive patch test reactions to allergens in personal care products. These allergens may disrupt hair follicle immune privilege, leading to inflammation, fibrosis, and follicular destruction. Understanding the role of environmental factors in FFA pathogenesis may improve management strategies, emphasizing allergen avoidance and targeted treatments.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":"11 2","pages":"198-201"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773524","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}
Sara A Galal, Hend G Kotb, Radwa O M Kamel, Hala M Elsadek, Hala S A Hafiz, Eman M Nassef, Sammar A Kasim, Samah M Akab, Ahmed S Abdel Sattar, Laila A Ahmed
{"title":"Dermoscopic Evaluation of Nail Changes in Patients with End-Stage Renal Disease on Regular Hemodialysis.","authors":"Sara A Galal, Hend G Kotb, Radwa O M Kamel, Hala M Elsadek, Hala S A Hafiz, Eman M Nassef, Sammar A Kasim, Samah M Akab, Ahmed S Abdel Sattar, Laila A Ahmed","doi":"10.1159/000539924","DOIUrl":"10.1159/000539924","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic renal failure can impact various body systems, including the skin and its appendages. Patients with uremic conditions have been observed to experience a variety of nail changes. This study was conducted to evaluate the presence and type of fingernail changes in patients with end-stage renal failure (ESRF) on regular hemodialysis (HD) by nail dermoscopy.</p><p><strong>Methods: </strong>A total of 100 patients with ESRF on regular HD three times a week. Nails were examined by dermoscopy for the presence of subtle nail changes.</p><p><strong>Results: </strong>Nail changes were found in 91% of patients, while 9% did not have nail changes. The most common dermoscopic findings were as follows; scales in lateral nail fold in 91% of the patients, dry cuticle in 84%, onychoschizia in 72%, and longitudinal striation in 69%. There was no significant relation between nail changes and sex, duration of HD, and albumin level.</p><p><strong>Conclusion: </strong>Patients with end-stage renal disease on HD are more likely to experience nail disorders. Scales in LNF, dry cuticle, onychoschizia, longitudinal striation, terry's nails, and half-and-half nails were the most common nail changes in HD patients.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":"11 2","pages":"103-111"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773525","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":"Nail Clubbing: A Dermatologic Window into Underlying Systemic Disease - an All of Us Study.","authors":"Noelle Desir, Shari R Lipner","doi":"10.1159/000542382","DOIUrl":"10.1159/000542382","url":null,"abstract":"<p><strong>Introduction: </strong>Nail clubbing is defined as distal phalanx thickening resulting in a bulbous appearance of the digit. We aimed to describe non-pulmonary medical conditions associated with nail clubbing using a cross-sectional approach.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of the All of Us Research Program, identifying nail clubbing patients by <i>ICD-10-CM</i> and/or <i>SNOMED</i> code. Nail clubbing patients with pulmonary disease (cases) were compared to nail clubbing patients without pulmonary disease (controls). Fisher's exact test/Pearson's χ<sup>2</sup> test analyzed categorical variables. Independent two-sample <i>t</i> tests analyzed continuous variables. Odds ratios (ORs) were analyzed with multivariate logistic regression adjusted for sociodemographic characteristics.</p><p><strong>Results: </strong>In total, 85 participants had nail clubbing, of which 63.53% had a pulmonary disease versus 36.47% of controls. Overall, across both cases and controls, 22% of patients had chronic liver disease, 17% hypothyroidism, 8% HIV infection, and 5% Graves' disease/hyperthyroidism. Male versus female patients with nail clubbing had decreased odds of having concurrent respiratory disease diagnosis (OR, 0.37; 95% CI, 0.14-0.92, <i>p</i> = 0.03).</p><p><strong>Conclusion: </strong>Greater than one-third of patients had nail clubbing associated with a non-pulmonary systemic disease, and a significant proportion were male. Consideration of a broad differential of pathologies associated with nail clubbing is needed to initiate workup and make appropriate screening referrals.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":"11 2","pages":"186-191"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773484","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":"Nail Supplements: When, How, and Why?","authors":"Ines Zaraa, Bertrand Richert","doi":"10.1159/000541048","DOIUrl":"10.1159/000541048","url":null,"abstract":"<p><strong>Background: </strong>The number of supplements for nail health is continuously increasing, and consumers are no longer familial with them, which can create confusion, as they do not always understand what they are consuming, and some will seek advice from their dermatologist, who must have as clear and a precise answer.</p><p><strong>Summary: </strong>Biotin, collagen peptides, solubilized keratin MSM, and choline-stabilized orthosilicic acid have been shown to improve the clinical appearance of nails, strength, and brittleness. There is a lack of regulation from the health authorities concerning dietary supplements. Manufacturers are not required to carry out efficacy and safety studies before marketing.</p><p><strong>Key messages: </strong>Dermatologists must be aware of the ingredients available on the market, their possible benefits but also their risks. It is important to specify to patients that our recommendations are as solid as the available evidence. In this article, we will discuss about the supplements available for nails, their mechanisms of action, and possible side effects.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":"11 2","pages":"176-181"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773489","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}
Luis Eduardo Prieto, Diana Marcela Vasquez-Forero, Harry Pachajoa
{"title":"The First Colombian Patient with <i>CDH3</i>-Related Hypotrichosis with Juvenile Macular Dystrophy.","authors":"Luis Eduardo Prieto, Diana Marcela Vasquez-Forero, Harry Pachajoa","doi":"10.1159/000545293","DOIUrl":"https://doi.org/10.1159/000545293","url":null,"abstract":"<p><strong>Introduction: </strong>Ectodermal dysplasias (ED) encompass a broad group of hereditary disorders, within which both the structure and functionality of various ectoderm-derived tissues can be affected depending on the involved gene. Congenital hypotrichosis with juvenile macular dystrophy is one of the entities included in ED, which is associated with an alteration in the <i>CDH3</i> gene encoding P-cadherin.</p><p><strong>Case presentation: </strong>We describe a 6-year-old patient with history of atopic dermatitis, amblyopia, and reduced vision acuity. Physical examination revealed hypotrichosis on the scalp with alopecia patches, microretrognathia, dental enamel abnormalities, dry skin, keratosis pilaris. Molecular analysis identified a homozygous variant in the <i>CDH3</i> gene (NM_001793.6) c.1508G>A p.Arg503His.</p><p><strong>Conclusion: </strong>We present the first Colombian case of clinical and molecular diagnosis of hypotrichosis with juvenile macular dystrophy associated with <i>CDH3</i>.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":" ","pages":"1-7"},"PeriodicalIF":1.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027152","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":"Secondary Intention Healing after Functional Surgery for Melanoma of the Nail Apparatus: Functional, Cosmetic, and Patient Satisfaction Results.","authors":"Jonathan Stevens, Martín Céspede-Núñez","doi":"10.1159/000545468","DOIUrl":"https://doi.org/10.1159/000545468","url":null,"abstract":"<p><strong>Introduction: </strong>Functional surgery is the preferred approach for nail melanoma in situ (NMIS) and minimally invasive nail melanoma (MINM, Breslow ≤0.5 mm). Secondary intention healing (SIH) offers an alternative to traditional skin grafting, with favorable cosmetic, functional, and satisfaction outcomes and minimal complications.</p><p><strong>Methods: </strong>Six patients (mean age 54.8 years; 4 SMIS, 2 MISSM) underwent functional surgery with SIH. Healing times (granulation [T1] and re-epithelialization [T2]), complications, and outcomes were assessed at 12 weeks using QUICK-DASH, VBSAS, VAS, satisfaction scores, and DLQI.</p><p><strong>Results: </strong>Mean T1 and T2 were 2.83 and 8.45 weeks, respectively. One patient experienced intense postoperative pain; another had a late nail spike. No hyperpigmentation or recurrences were observed. Outcomes: QUICK-DASH 18.92%; VBSAS 2.8 (12 weeks) and 0.25 (24 weeks); VAS 2; DLQI 2; and satisfaction 9.8/10 (10/10 after amputation discussion).</p><p><strong>Conclusions: </strong>SIH provides an effective alternative to grafting, allowing acceptable healing times, flexibility for margin extension or amputation, and excellent cosmetic, functional, and satisfaction outcomes with minimal complications.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":" ","pages":"1-8"},"PeriodicalIF":1.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047661","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}
Jorge Ocampo-Garza, Adriana G Peña-Romero, Eduardo Bertolli, Mayra A Reyes Soto, Nilton Gioia Di Chiacchio, Francisco A Belfort, Veronica Fonte-Avalos, Nilton Di Chiacchio, Judith Domínguez-Cherit
{"title":"Non-Amputative Digit Preservation Surgery versus Amputation in Nail Unit Melanoma: A Retrospective Study in Mexico and Brazil.","authors":"Jorge Ocampo-Garza, Adriana G Peña-Romero, Eduardo Bertolli, Mayra A Reyes Soto, Nilton Gioia Di Chiacchio, Francisco A Belfort, Veronica Fonte-Avalos, Nilton Di Chiacchio, Judith Domínguez-Cherit","doi":"10.1159/000544995","DOIUrl":"https://doi.org/10.1159/000544995","url":null,"abstract":"<p><strong>Introduction: </strong>Nail unit melanoma (NUM) is a rare but aggressive malignancy with historically poor outcomes. Currently, there are no treatment guidelines for NUM.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients diagnosed with NUM in Mexico and Brazil. Clinical and histopathological data were reviewed, and outcomes were compared between those who underwent amputation versus digit preservation surgery. Survival rates, recurrence, and functional status were assessed.</p><p><strong>Results: </strong>A total of 75 patients from Mexico (51.9%) and Brazil (48.1%) were evaluated. Clinical and pathological characteristics were similar between both groups. Functional surgery was performed in 40 patients (49.4%), including six with invasive melanomas. The median follow-up was 50.3 months (95% CI: 29.4-71.3, SE: 10.7). Among the 7 patients with invasive melanomas who underwent functional surgery, one experienced a recurrence, and one died from a cerebrovascular accident. The remaining 5 patients are alive and disease-free, with follow-up periods ranging from 1 to 27 months.</p><p><strong>Conclusions: </strong>Non-amputative surgery may be a safe alternative for thin NUMs, reducing amputation-related morbidity. Long-term follow-up and larger studies are needed to confirm guidelines.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":" ","pages":"1-9"},"PeriodicalIF":1.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038764","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}