Rodrigo Pirmez

Intrusion Detection System for Wireless Sensor Networks Using Danger Theory Immune-Inspired Techniques

An IDS framework inspired in the Human Immune System to be applied in the wireless sensor network context is proposed. It uses an improved decentralized and customized version of the Dendritic Cell Algorithm, which allows nodes to monitor their neighborhood and collaborate to identify an intruder. The work was implemented and tested both in simulation and in real sensor platform scenarios, comparing them to each other and was also compared to a Negative Selection Theory implementation in order to demonstrate its efficiency in detecting a denial-of-sleep attack and in energy consumption. Results demonstrated the success of the proposal.

Exclamation marks and other trichoscopic signs of chemotherapy-induced alopecia

Chemotherapy-induced alopecia (CIA) represents one of the major unresolved problems in clinical oncology. It is still considered one of the most traumatic factors in cancer patient care and occurs with an estimated incidence of 65%. It is a medical issue requiring more research for further clarification of its pathogenesis and management. In 1960, by means of a microscopic examination of epilated scalp hairs, Crounse and Van Scott first described the effect of a wide range of cytotoxic drugs on the hair shafts. Trichoscopy is a non-invasive technique that has been recently used to facilitate the diagnosis and management of hair and scalp disorders. To our knowledge, there are still no published data on the trichoscopic findings of CIA. We report here our findings, including those on exclamation mark hairs, considered by many authors to be pathognomonic of alopecia areata (AA).

Red face revisited: Disorders of hair growth and the pilosebaceous unit

This paper reviews the recent literature on the diseases of the hair and pilosebaceous unit that may cause a red face. We discuss the epidemiology, clinicals, pathogenesis, and therapy of lichen planopilaris with its variants, discoid lupus erythematosus, folliculitis decalvans, dissecting folliculitis, acne keloidalis nuchae, pseudofolliculitis barbae, tinea capitis, tinea barbae, folliculitis of diverse causative factors and inflammatory follicular keratotic syndromes, ulerythema ophryogenes, atrophoderma vermiculatum, keratosis follicularis spinulosa decalvans, and folliculitis spinulosa decalvans.

Acantholytic hair casts: A dermoscopic sign of pemphigus vulgaris of the scalp

We report the dermoscopic features of pemphigus vulgaris (PV) involving the scalp of a 57-year-old African-American female. Among our findings, there were hair casts – movable tubular structures that envelop the hair shafts. We suggest that the development of those casts occurs through acantholysis within the outer root sheath, a mechanism not yet considered in the literature. This report also highlights how dermoscopy may contribute to the evaluation of disease activity, especially in those cases of PV in which scalp involvement is recalcitrant to treatment. Finally, we recommend that the presence of hair casts should herald the need of therapy adjustment for better disease control.

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

1 St€ander S, Weisshaar E, Mettang T et al. Clinical classification of itch: a position paper of the International Forum for the Study of Itch. Acta Derm Venereol 2007; 87:291–4. 2 Ikoma A, Steinhoff M, St€ander S et al. The neurobiology of itch. Nat Rev Neurosci 2006; 7:535–47. 3 Bergasa NV. The pruritus of cholestasis. J Hepatol 2005; 43:1078– 88. 4 Kremer AE, Martens JJ, Kulik W et al. Lysophosphatidic acid is a potential mediator of cholestatic pruritus. Gastroenterology 2010; 139:1008–18. 5 Nakamura K, Kishimoto T, Ohkawa R et al. Suppression of lysophosphatidic acid and lysophosphatidylcholine formation in the plasma in vitro: proposal of a plasma sample preparation method for laboratory testing of these lipids. Anal Biochem 2007; 367:20–7. 6 Kremer AE, van Dijk R, Leckie P et al. Serum autotaxin is increased in pruritus of cholestasis, but not of other origin, and responds to therapeutic interventions. Hepatology 2012; 56:1391–400. 7 Hashimoto T, Ohata H, Honda K. Lysophosphatidic acid (LPA) induces plasma exudation and histamine release in mice via LPA receptors. J Pharmacol Sci 2006; 100:82–7.

Follicular red dots: a normal trichoscopy feature in patients with pigmentary disorders?

Follicular red dots have been described as a trichoscopic feature of active discoid lupus erythematosus of the scalp and its presence associated with a better prognosis. We report five patients with pigmentary disorders in whom follicular red dots were detected during scalp examination. We suggest that this pattern is probably related to the rich vasculature that naturally envelops the normal hair follicle. The possible implications of such proposition in cases of discoid lupus erythematosus and other scalp disorders are also discussed.

Successful Treatment of Facial Papules in Frontal Fibrosing Alopecia with Oral Isotretinoin

licular inflammation. Our findings include variable vellus hair follicle involvement, elastic fiber involvement, and preserved sebaceous glands ( Fig. 1 ) (unpublished data). Due to the effects of oral isotretinoin over sebaceous glands and previous studies reporting a possible role on the therapeutic regimen of FFA [5, 6] , we opted to use this drug in the treatment of 3 patients with FFA with prominent facial papules. All patients were female, biopsy-confirmed cases of FFA, with the age range 49–53 years. Clinical information, concurrent, and previous treatments are presented in Table 1 . All patients were started on the dosage of 20 mg/day of oral isotretinoin for the first month, which was then titrated to 0.5 mg/kg/day for the following 2 months (40 mg/day in all 3 patients). The patients were seen monthly for isotretinoin laboratory monitoring and, at the end of the third month, on a visit scheduled to evaluate FFA treatment efficacy. At the end of the first month, a remarkable improvement was noted, with a reduction in the number and size of facial papules. Patients reported perceiving that by the second week of treatment, the aspect of their facial skin had already considerably improved. At the end of the third month, facial papules had completely disappeared or were considered minimal ( Fig. 2 ). The patients did not show a significant progression of FFA, and all reported decreased pruritus. However, signs of disease activity were still present over the hairline in all 3 patients, namely perifollicular erythema and scaling. Isotretinoin was then discontinued and hydroxychloroquine 400 mg/day was introduced. Facial papules are a characteristic feature of FFA, being present in 14% of the patients, according to a large multicenter study [7] . Dear Editor, Frontal fibrosing alopecia (FFA) is considered a variant of lichen planopilaris affecting mainly postmenopausal women. A progressive frontal or frontotemporal symmetric band of alopecia is the usual presentation, with eyebrows being commonly involved [1] . Currently, several authors consider FFA as a generalized skin condition, and many features other than hair loss have been associated with the disease, including facial papules [2] . Facial papules as a sign of facial vellus hair follicle involvement in FFA was first recognized by Abbas et al. [3] in 2007 and was later confirmed by Donati et al. [4] . In a current ongoing study, our group observed that histopathological features of facial papules might not be limited to perifolReceived: February 6, 2017 Accepted: February 20, 2017 Published online: March 21, 2017

Trichoscopy of noncicatricial pressure-induced alopecia resembling alopecia areata

Pressure-induced alopecia is an unusual cause of hair loss, and reports of its trichoscopic features are scarce. In this paper, we describe a case of pressure-induced alopecia in which trichoscopic and histopathological findings overlap with those described for alopecia areata.

Cutaneous Manifestations in POEMS Syndrome: Case Report and Review

The authors report a case of sensorimotor polyneuropathy, diffuse cutaneous hyperpigmentation, skin sclerodermiform thickening and papular lesions in the infraclavicular and abdominal region. Besides weight loss, there were diabetes mellitus and hypothyroidism. The alterations were consistent with POEMS (Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal gammopathy and Skin changes) syndrome, which is a rare systemic disease with monoclonal proliferation of plasmacytes and slow progression. Cutaneous alterations are present in 68% of patients with diffuse cutaneous hyperpigmentation, plethora and acrocyanosis. Leukonychia, necrotizing vasculitis, hypertrichosis and cutaneous thickening of sclerodermiform type are also cited. The onset of multiple cutaneous angiomas in this syndrome has been observed in 24-44% of patients.

Disorders of hair growth and the pilosebaceous unit: facts and controversies.

We discuss three controversial situations related to disorders of hair growth and the pilosebaceous unit: alopecia areata incognita, pseudopelade of Brocq, and the association of psoriasis and alopecia.