Leonardo Spagnol Abraham

Pistas dermatoscópicas para diferenciar a tricotilomania da alopecia areata em placa

BACKGROUND Trichotillomania and patchy alopecia areata have similar clinical and dermoscopic features. OBSERVATIONS In trichotillomania, dermoscopy shows decreased hair density, short vellus hair, broken hairs with different shaft lengths, coiled hairs, short vellus hair, trichoptilosis, sparse yellow dots, which may or may not contain black dots and no exclamation mark hairs. CONCLUSIONS In the case of patchy alopecia and broken hairs, the absence of exclamation mark hairs suggests a diagnosis of trichotillomania. On the other hand, the finding of yellow dots without black dots does not exclude it.

Dermoscopy findings of alopecia areata in an African-American patient

BACKGROUND Dermoscopy has been established as an indispensable tool in the diagnosis and follow up of hair disorders. In alopecia areata, dermoscopy of active disease shows yellow dots, dystrophic hairs, as well as cadaverized (black dots) and exclamation mark hairs. Alopecia areata has been reported to occur equally among races, however, until date, there are no published data regarding dermoscopic findings in African-American patient. MAIN OBSERVATION We report a case of scalp dermoscopy of alopecia areata in an African-American patient that shows a diffuse honeycomb-like pigmented network, few yellow dots and white dots. CONCLUSION This case shows that skin color may affect dermoscopic findings in alopecia areata. In our African-American patient with alopecia areata dermoscopy showed a diffuse honeycomb-like pigmented network, which was previously considered characteristic for androgenic alopecia and white dots, which were considered characteristic for cicatricial alopecia. Further studies are needed to elucidate the presence of white dots in alopecia areata.

Dermoscopy features for the diagnosis of furuncular myiasis

We describe a 56-year-old Brazilian woman presenting three nodular lesions on the scalp. Dermoscopy of all lesions showed a creamy-white body with central birds feet-like structures surrounded by a thorn crown, corresponding to the posterior segment of the Dermatobia hominis larvae. These novel dermoscopic features allowed us to easily diagnose furuncular myiasis.

In vivo reflectance confocal microscopy for varicella prompt diagnosis and treatment in a severely immunosuppressed patient

In vivo reflectance confocal microscopy for varicella prompt diagnosis and treatment in a severely immunosuppressed patient Leonardo Spagnol Abraham, Mariana Carvalho Costa, Marina Agozzino, Beatrice Amorosi, Carlo Cota and Marco Ardigo IRCCS San Gallicano Dermatological Institute, Rome, Italy, Department of Dermatology, Instituto de Dermatologia Prof. Rubem David Azulay, Rio de Janeiro, Brazil and Department of Pathology, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil

In vivo reflectance confocal microscopy in a typical case of melasma

Melasma is a common disorder of hypermelanosis that affects mainly young and middle-aged women of Fitzpatricks phototypes III-V. The disease significantly impacts their lives. In vivo reflectance confocal microscopy, a spreading technology for the noninvasive evaluation of the skin up to the papillary dermis, provides real-time en face images with cellular resolution. We present a case of melasma with in vivo reflectance confocal microscopy findings closely correlated to the histopathological features described in the literature.

Lentigo maligno tratado com imiquimode tópico: o valor da dermatoscopia no monitoramento clínico

Dermoscopy has its usefulness well established in the diagnostic evaluation of melanocytic lesions. Recently, however, it has also shown to be an important tool in monitoring therapeutic response to various dermatoses. We report the case of an elderly patient diagnosed with lentigo maligna of difficult surgical management, which we have chosen to treat with topical imiquimod. The dermoscopic monitoring of this alternative therapy has shown to be of great usefulness

It's not all traction: the pseudo ‘fringe sign’ in frontal fibrosing alopecia

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Cutaneous endometriosis: dermoscopic findings related to phases of the female hormonal cycle

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Trichoscopy of Steroid-Induced Atrophy

Intralesional corticosteroid (IL-CS) injections have been used to treat a variety of dermatological and nondermatological diseases. Although an important therapeutic tool in dermatology, a number of local side effects, including skin atrophy, have been reported following IL-CS injections. We recently noticed that a subset of patients with steroid-induced atrophy presented with ivory-colored areas under trichoscopy. We performed a retrospective analysis of trichoscopic images and medical records from patients presenting ivory-colored areas associated with atrophic scalp lesions. In this paper, we associate this feature with the presence of steroid deposits in the dermis and report additional trichoscopic features of steroid-induced atrophy on the scalp, such as prominent blood vessels and visualization of hair bulbs.

In Vivo Reflectance Confocal Microscopy for Inflammatory Skin Diseases’ Assessment

In vivo reflectance confocal microscopy (RCM) is a relatively new technique for real time, en face, non-invasive microscopical imaging of the superficial layers of the skin down to the superficial dermis, with cellular-level resolution close to conventional histopathology. The technology works on the bases of light reflection according to the different reflectance indexes of the different skin structures [1]. RCM gives to clinicians the possibility of a real time and non-invasive “virtual” punch biopsy ranging from 2 to 8 mm in horizontal dimension and 250–300 μm in vertical dimension and providing collection of microscopical features and consequential, immediate “clinical-microscopical” correlation. In specific, RCM has been already successfully tested for the evaluation of several inflammatory, neoplastic skin conditions and has been demonstrated to constitute, in selected cases, an excellent alternative to invasive biopsy. In specific, RCM has been used in several inflammatory skin conditions, such as acute contact dermatitis, discoid lupus erythematosus and psoriasis, and has been correlated with conventional histology in several instances [2–4]. Also pigmentary disorders and more recently hair diseases have been evaluated using confocal microscopy [5, 6].