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Lygia A. F. Prado - One of the best experts on this subject based on the ideXlab platform.
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Folliculitis Decalvans and Human T Cell Lymphotropic Virus Type I-Associated Myelopathy/Tropical Spastic Paraparesis
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 1995Co-Authors: Abelardo Q.-c. Araújo, Maria José Andrada-serpa, Thomas A. Paulo-filho, Monica T. Rodrigues, Lygia A. F. PradoAbstract:Human T-cell lymphotropic virus type I (HTLV-I) can be associated with either adult T-cell leukemia or HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP), a chronic progressive immune-mediated myelopathy. Skin manifestations such as xerosis and erythema may be associated with HAM/TSP. Infective dermatitis due to Staphylococcus aureus or beta-hemolytic Streptococcus has recently been described as a marker for HTLV-I infection and as a probable risk factor for the development of adult T-cell leukemia and lymphoma in Jamaican children. We report a case of Folliculitis Decalvans, a rare chronic follicular inflammatory process of bacterial origin that is extremely resistant to treatment, in a patient with HAM/TSP. This case suggests the possibility that the disturbance of the immune system that was observed in patients with HAM/TSP can play a role in the persistence of this severe skin lesion. In addition, the findings of our case cast doubt on the hypothesis that the cause of infective dermatitis in persons infected with HTLV-I is immunosuppression due to congenital or perinatal infection of the immature immune system.
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Folliculitis Decalvans and human t cell lymphotropic virus type i associated myelopathy tropical spastic paraparesis
Clinical Infectious Diseases, 1995Co-Authors: Abelardo Q.-c. Araújo, Monica T. Rodrigues, Maria Jose Andradaserpa, Thomas A Paulofilho, Lygia A. F. PradoAbstract:Human T-cell lymphotropic virus type I (HTLV-I) can be associated with either adult T-cell leukemia or HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP), a chronic progressive immune-mediated myelopathy. Skin manifestations such as xerosis and erythema may be associated with HAM/TSP. Infective dermatitis due to Staphylococcus aureus or beta-hemolytic Streptococcus has recently been described as a marker for HTLV-I infection and as a probable risk factor for the development of adult T-cell leukemia and lymphoma in Jamaican children. We report a case of Folliculitis Decalvans, a rare chronic follicular inflammatory process of bacterial origin that is extremely resistant to treatment, in a patient with HAM/TSP. This case suggests the possibility that the disturbance of the immune system that was observed in patients with HAM/TSP can play a role in the persistence of this severe skin lesion. In addition, the findings of our case cast doubt on the hypothesis that the cause of infective dermatitis in persons infected with HTLV-I is immunosuppression due to congenital or perinatal infection of the immature immune system.
Jerry Shapiro - One of the best experts on this subject based on the ideXlab platform.
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Primary cicatricial alopecia: Other lymphocytic primary cicatricial alopecias and neutrophilic and mixed primary cicatricial alopecias
Journal of The American Academy of Dermatology, 2016Co-Authors: Chantal Bolduc, Leonard C. Sperling, Jerry ShapiroAbstract:Primary cicatricial alopecias can be frustrating for both patients and physicians. Proper diagnosis guides more successful management of these challenging conditions. Part II will cover the remaining lymphocytic primary cicatricial alopecias, which include pseudopelade of Brocq, central centrifugal cicatricial alopecia, alopecia mucinosa, and keratosis follicularis spinulosa Decalvans. It will also discuss the neutrophilic and mixed primary cicatricial alopecias, namely Folliculitis Decalvans, dissecting cellulitis, Folliculitis keloidalis, Folliculitis (acne) necrotica, and erosive pustular dermatosis.
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Retrospective Review of Folliculitis Decalvans in 23 Patients with Course and Treatment Analysis of Long-standing Cases
2016Co-Authors: M.j. Kristine Bunagan, Nusrat Banka, Jerry ShapiroAbstract:Background: To date, there is no standard treatment of Folliculitis Decalvans (FD), a rare type of cicatricial alopecia. Objective and Methods: The records of 23 patients with FD (1998–2012) were retrospectively analyzed, with added data review on the course and treatment of long-standing cases. Results: Initial management consisted mostly of intralesional triamcinolone acetonide, clobetasol lotion, and either cephalexin, minocycline, doxycycline, or tetracycline. Alternatives consisted of rifampicin, clindamycin, ciprofloxacin, and isotretinoin. Remission was achieved in weeks to months in more than half of the cases, with low occurrence of relapse. The poor responders had a protracted course of temporary improvement and multiple relapses. Conclusion: The majority of patients showed improvement and subsequent remission with oral antibiotics. In some patients, it took years of slow taper before the antibiotic could be discontinued. Only a few patients had recalcitrant disease, with minimal response to their initial and alternative medications. Contexte: Il n’existe pas, a ̀ l’heure actuelle, de traitement type de la folliculite décalvante (FD), une forme rare d’alopécie cicatricielle. Objectif et méthode: Nous avons procéde ́ a ̀ un examen rétrospectif des dossiers de 23 patients atteints de FD (1998–2012), auquel s’est ajoute ́ un examen des données sur l’évolution et le traitement des cas de maladie prolongée. Résultats: Le traitement initial consistait principalement en des injections intralésionnelles d’acétonide de triamcinolone, e
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Retrospective Review of Folliculitis Decalvans in 23 Patients with Course and Treatment Analysis of Long-standing Cases:
Journal of cutaneous medicine and surgery, 2015Co-Authors: M.j. Kristine Bunagan, Nusrat Banka, Jerry ShapiroAbstract:Background:To date, there is no standard treatment of Folliculitis Decalvans (FD), a rare type of cicatricial alopecia.Objective and Methods:The records of 23 patients with FD (1998–2012) were retrospectively analyzed, with added data review on the course and treatment of long-standing cases.Results:Initial management consisted mostly of intralesional triamcinolone acetonide, clobetasol lotion, and either cephalexin, minocycline, doxycycline, or tetracycline. Alternatives consisted of rifampicin, clindamycin, ciprofloxacin, and isotretinoin. Remission was achieved in weeks to months in more than half of the cases, with low occurrence of relapse. The poor responders had a protracted course of temporary improvement and multiple relapses.Conclusion:The majority of patients showed improvement and subsequent remission with oral antibiotics. In some patients, it took years of slow taper before the antibiotic could be discontinued. Only a few patients had recalcitrant disease, with minimal response to their init...
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Retrospective Review of Folliculitis Decalvans in 23 Patients with Course and Treatment Analysis of Long-standing Cases.
Journal of cutaneous medicine and surgery, 2014Co-Authors: M.j. Kristine Bunagan, Nusrat Banka, Jerry ShapiroAbstract:To date, there is no standard treatment of Folliculitis Decalvans (FD), a rare type of cicatricial alopecia. The records of 23 patients with FD (1998-2012) were retrospectively analyzed, with added data review on the course and treatment of long-standing cases. Initial management consisted mostly of intralesional triamcinolone acetonide, clobetasol lotion, and either cephalexin, minocycline, doxycycline, or tetracycline. Alternatives consisted of rifampicin, clindamycin, ciprofloxacin, and isotretinoin. Remission was achieved in weeks to months in more than half of the cases, with low occurrence of relapse. The poor responders had a protracted course of temporary improvement and multiple relapses. The majority of patients showed improvement and subsequent remission with oral antibiotics. In some patients, it took years of slow taper before the antibiotic could be discontinued. Only a few patients had recalcitrant disease, with minimal response to their initial and alternative medications.
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Diagnosis and management of primary cicatricial alopecia: part II.
Skinmed, 2008Co-Authors: Nina Otberg, Kevin John Mcelwee, Jerry ShapiroAbstract:The second part of this 2-part article reviews clinical features, histology, management, and treatment of neutrophilic primary cicatricial alopecias (Folliculitis Decalvans and dissecting Folliculitis) and mixed primary cicatricial alopecias (acne keloidalis, acne necrotica, and erosive pustular dermatosis).
Abelardo Q.-c. Araújo - One of the best experts on this subject based on the ideXlab platform.
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Folliculitis Decalvans and Human T Cell Lymphotropic Virus Type I-Associated Myelopathy/Tropical Spastic Paraparesis
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 1995Co-Authors: Abelardo Q.-c. Araújo, Maria José Andrada-serpa, Thomas A. Paulo-filho, Monica T. Rodrigues, Lygia A. F. PradoAbstract:Human T-cell lymphotropic virus type I (HTLV-I) can be associated with either adult T-cell leukemia or HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP), a chronic progressive immune-mediated myelopathy. Skin manifestations such as xerosis and erythema may be associated with HAM/TSP. Infective dermatitis due to Staphylococcus aureus or beta-hemolytic Streptococcus has recently been described as a marker for HTLV-I infection and as a probable risk factor for the development of adult T-cell leukemia and lymphoma in Jamaican children. We report a case of Folliculitis Decalvans, a rare chronic follicular inflammatory process of bacterial origin that is extremely resistant to treatment, in a patient with HAM/TSP. This case suggests the possibility that the disturbance of the immune system that was observed in patients with HAM/TSP can play a role in the persistence of this severe skin lesion. In addition, the findings of our case cast doubt on the hypothesis that the cause of infective dermatitis in persons infected with HTLV-I is immunosuppression due to congenital or perinatal infection of the immature immune system.
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Folliculitis Decalvans and human t cell lymphotropic virus type i associated myelopathy tropical spastic paraparesis
Clinical Infectious Diseases, 1995Co-Authors: Abelardo Q.-c. Araújo, Monica T. Rodrigues, Maria Jose Andradaserpa, Thomas A Paulofilho, Lygia A. F. PradoAbstract:Human T-cell lymphotropic virus type I (HTLV-I) can be associated with either adult T-cell leukemia or HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP), a chronic progressive immune-mediated myelopathy. Skin manifestations such as xerosis and erythema may be associated with HAM/TSP. Infective dermatitis due to Staphylococcus aureus or beta-hemolytic Streptococcus has recently been described as a marker for HTLV-I infection and as a probable risk factor for the development of adult T-cell leukemia and lymphoma in Jamaican children. We report a case of Folliculitis Decalvans, a rare chronic follicular inflammatory process of bacterial origin that is extremely resistant to treatment, in a patient with HAM/TSP. This case suggests the possibility that the disturbance of the immune system that was observed in patients with HAM/TSP can play a role in the persistence of this severe skin lesion. In addition, the findings of our case cast doubt on the hypothesis that the cause of infective dermatitis in persons infected with HTLV-I is immunosuppression due to congenital or perinatal infection of the immature immune system.
Ryoji Tsuboi - One of the best experts on this subject based on the ideXlab platform.
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Histopathologic and dermoscopic features of 42 cases of Folliculitis Decalvans: A case series.
Journal of the American Academy of Dermatology, 2020Co-Authors: Masaki Uchiyama, Kazutoshi Harada, Rie Tobita, Ryokichi Irisawa, Ryoji TsuboiAbstract:Abstract Background Folliculitis Decalvans (FD) is a form of inflamed primary cicatricial alopecia (PCA). FD is classified as a neutrophilic PCA; however, only a few previous studies have described its histopathology, including the assessment of systematically evaluated and quantified follicular changes in horizontally sectioned biopsy specimens with clinical and dermoscopic findings of the early and advanced stages. Objective We aimed to clarify the histopathological and dermoscopic features of early and advanced active stage FD. Methods We conducted a case series study of 42 patients with FD by dermoscopy and both horizontally and vertically sectioned biopsy specimens. Results The histopathological findings of the early-stage lesions included loss of sebaceous glands, interfollicular acanthosis, and fibrosis with depressed, fused follicular infundibula showing thickened interfollicular keloid-like areas with tufted hairs on dermoscopy. Active lesions revealed a greater number of hair clusters, clefting, and fused infundibula with dense inflammation predominantly in the upper follicles. Neutrophil-predominant infiltrates were observed in less than half the patients, including those with early-stage lesions. Limitations This was a retrospective study. Conclusion FD has the features of mixed cell-PCA. The features of early-stage FD are thickened interfollicular keloid-like areas with tufted hairs and loss of sebaceous glands.
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histopathologic and dermoscopic features of 42 cases of Folliculitis Decalvans a case series
Journal of The American Academy of Dermatology, 2020Co-Authors: Masaki Uchiyama, Kazutoshi Harada, Rie Tobita, Ryokichi Irisawa, Ryoji TsuboiAbstract:Background Folliculitis Decalvans (FD) is a form of inflamed primary cicatricial alopecia (PCA). FD is classified as a neutrophilic PCA; however, only a few previous studies have described its histopathology, including the assessment of systematically evaluated and quantified follicular changes in horizontally sectioned biopsy specimens with clinical and dermoscopic findings of the early and advanced stages. Objective We aimed to clarify the histopathologic and dermoscopic features of early and advanced active stage FD. Methods We conducted a case series study of 42 patients with FD by dermoscopy and both horizontally and vertically sectioned biopsy specimens. Results The histopathologic findings of the early-stage lesions included loss of sebaceous glands; interfollicular acanthosis; and fibrosis with depressed, fused follicular infundibula showing thickened interfollicular keloid-like areas with tufted hairs on dermoscopy. Active lesions showed a greater number of hair clusters, clefting, and fused infundibula with dense inflammation predominantly in the upper follicles. Neutrophil-predominant infiltrates were observed in fewer than half of the patients, including those with early-stage lesions. Limitations This was a retrospective study. Conclusion FD has the features of mixed-cell PCA. The features of early-stage FD are thickened interfollicular keloid-like areas with tufted hairs and loss of sebaceous glands.
Hans Theodor Eich - One of the best experts on this subject based on the ideXlab platform.
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Treatment of Folliculitis Decalvans using intensity-modulated radiation via tomotherapy
Strahlentherapie und Onkologie, 2015Co-Authors: Khaled Elsayad, Jan Kriz, Uwe Haverkamp, Kerasia-maria Plachouri, Antonia Jeskowiak, Cord Sunderkötter, Hans Theodor EichAbstract:Background Folliculitis Decalvans (FD) is a form of primary neutrophilic scarring alopecia that is characterized clinically by chronic suppurative Folliculitis and often associated with pruritus or even pain. Treatment of FD is often difficult. Herein, we report a case of recalcitrant and painful Folliculitis Decalvans refractory to antibiotic and anti-inflammatory therapies, which was successfully treated by intensity-modulated radiotherapy (IMRT) in order to irreversibly eliminate hair follicles that prove to be one etiological trigger. Case presentation A 45-year-old male patient with a refractory FD presented with a crusting suppurative Folliculitis and atrophic scarring patches on the scalp associated with pain and pruritus. We attempted relief of symptoms by reducing scalp inflammation and eliminating hair follicles through radiation. We delivered 11.0 Gy in two radiation series using tomotherapy, 5.0 Gy in 5 equivalent fractions as a first radiation course. The symptoms markedly decreased but did not totally disappear. Therefore, we delivered a second radiation series 4 months later with an additional 6 Gy. This led to almost complete epilation on the scalp and abolished pain and pruritus on the capillitium. The patient was regularly followed up until 26 months after radiotherapy. Draining lesions or exudation did not recur. He only experienced discrete hair regrowth in the occipital region with Folliculitis 12 months after radiotherapy. These residual lesions are currently treated with laser epilation therapy. Conclusion A radical approach to eliminating hair follicles by repeated radiation therapy may induce lasting relief of symptoms in chronic suppurative FD associated with persistent trichodynia. Hintergrund Die Folliculitis Decalvans (FD) ist eine Form der primär neutrophilen Alopezie, welche klinisch durch Schmerzen und eitrige Follikel gekennzeichnet ist. Da es bisher kein einheitliches Behandlungskonzept gibt, wird hier über eine FD berichtet, welche trotz mehrfacher antibiotischer- und antiinflammatorischer Therapie rezidivierte. Die Behandlung erfolgte mit intensitätsmodulierter Radiotherapie (IMRT), um eine dauerhafte Schädigung der Haarfollikel zu erzielen. Fallbericht Beschrieben wird der Fall eines 45-jährigen Patienten, der sich mit rezidivierender, chronisch-eitriger Alopezie sowie Schmerzen und Pruritus vorstellte. Die Autoren entschieden sich, eine Radiotherapie (RT) durchzuführen, welche eine Verringerung der Entzündung im Bereich der Kopfhaut sowie eine dauerhafte Schädigung der Haarfollikel erzielen sollte, um somit die Symptome der FD zu lindern. Es wurden 11,0 Gy in 2 Bestrahlungsserien unter Einsatz der Tomotherapie durchgeführt. Bei der ersten Serie wurde eine Gesamtreferenzdosis (GRD) von 5 Gy in 5 gleichwertigen Fraktionen appliziert. Aufgrund weiterhin bestehender Beschwerden, erfolgte 4 Monate später erneut die Applikation einer RT-Serie mit einer GRD von 6 Gy. Damit wurden eine komplette Epilation und Beschwerdefreiheit erreicht. Der Patient nimmt regelmäßig Nachsorgekontrollen wahr und befindet sich aktuell in einem Follow-up von 26 Monaten. Im weiteren Verlauf traten keine neuen Exsudate auf. Lediglich in der Okzipitalregion kam es zu einem diskreten Haarwuchs, welcher mit einer leichten Follikulitis einherging. Aktuell wird eine Haarentfernung mittels Laser durchgeführt. Schlussfolgerung Bei einer chronisch-eitrigen FD mit anhaltender Trichodynie können wiederholte RT-Serien zu einer dauerhaften Entfernung der Haarfollikel mit langfristiger Besserung der Symptome eingesetzt werden.
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Treatment of Folliculitis Decalvans using intensity-modulated radiation via tomotherapy.
Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al], 2015Co-Authors: Khaled Elsayad, Jan Kriz, Uwe Haverkamp, Kerasia-maria Plachouri, Antonia Jeskowiak, Cord Sunderkötter, Hans Theodor EichAbstract:Background Folliculitis Decalvans (FD) is a form of primary neutrophilic scarring alopecia that is characterized clinically by chronic suppurative Folliculitis and often associated with pruritus or even pain. Treatment of FD is often difficult. Herein, we report a case of recalcitrant and painful Folliculitis Decalvans refractory to antibiotic and anti-inflammatory therapies, which was successfully treated by intensity-modulated radiotherapy (IMRT) in order to irreversibly eliminate hair follicles that prove to be one etiological trigger.