The Experts below are selected from a list of 117 Experts worldwide ranked by ideXlab platform

Catherine M Stefanato - One of the best experts on this subject based on the ideXlab platform.

  • histopathology of Alopecia a clinicopathological approach to diagnosis
    Histopathology, 2010
    Co-Authors: Catherine M Stefanato
    Abstract:

    Stefanato C M (2010) Histopathology56, 24–38 Histopathology of Alopecia: a clinicopathological approach to diagnosis Interpretation of the histopathological findings of primary scarring and non-scarring Alopecias may prove daunting. This is especially true if the biopsy specimen is inadequate, and the clinical history and pattern of the Alopecia are not known. Common forms of scarring Alopecias discussed here are the lymphocytic (discoid lupus erythematosus, lichen planopilaris, central centrifugal cicatricial Alopecia, pseudopelade of Brocq), the neutrophilic (folliculitis decalvans, dissecting folliculitis), and the mixed (acne keloidalis) entities. The non-scarring Alopecias reviewed are androgenic Alopecia, telogen effluvium, Alopecia areata, trichotillomania and Traction Alopecia. In all cases of primary Alopecia, adequate tissue sampling and appropriate laboratory processing, in combination with pertinent clinical information, provide the key to diagnosis.

  • Histopathology of Alopecia: a clinicopathological approach to diagnosis
    Histopathology, 2010
    Co-Authors: Catherine M Stefanato
    Abstract:

    Interpretation of the histopathological findings of primary scarring and non-scarring Alopecias may prove daunting. This is especially true if the biopsy specimen is inadequate, and the clinical history and pattern of the Alopecia are not known. Common forms of scarring Alopecias discussed here are the lymphocytic (discoid lupus erythematosus, lichen planopilaris, central centrifugal cicatricial Alopecia, pseudopelade of Brocq), the neutrophilic (folliculitis decalvans, dissecting folliculitis), and the mixed (acne keloidalis) entities. The non-scarring Alopecias reviewed are androgenic Alopecia, telogen effluvium, Alopecia areata, trichotillomania and Traction Alopecia. In all cases of primary Alopecia, adequate tissue sampling and appropriate laboratory processing, in combination with pertinent clinical information, provide the key to diagnosis.

Antonella Tosti - One of the best experts on this subject based on the ideXlab platform.

  • central centrifugal cicatricial Alopecia presenting with irregular patchy Alopecia on the lateral and posterior scalp
    Skin Appendage Disorders, 2015
    Co-Authors: Mariya Miteva, Antonella Tosti
    Abstract:

    Background: Central centrifugal cicatricial Alopecia (CCCA) is the most common cause of scarring Alopecia among women of African descent which affects the central scalp and spreads centrifugally but spares the lateral and posterior scalp. Objectives: The objective of this study is to report on a new clinical variety of CCCA presenting with patchy Alopecia involving the lateral and posterior scalp in addition to the central scalp. Materials and Methods: We reviewed the medical records and the clinical, dermatoscopic and pathologic data of 14 African-American women with CCCA presenting with patchy Alopecia. Results: Two patients had individual well-delineated patches of hair loss, and 12 patients had multiple irregular patches of hair loss. In all cases, the Alopecia affected the lateral and posterior scalp in addition to the central scalp. Four patients had a history of traumatic hairstyles, and 10 patients were also affected by marginal Traction Alopecia. On dermatoscopy, the patches showed peripilar white-gray halos and broken hairs. The pathologic diagnosis of CCCA was based on the following features: follicular dropout, absent or only focally preserved sebaceous glands, premature desquamation of the inner root sheath and perifollicular fibrosis with mild inflammatory infiltrate. Conclusion: CCCA can present with patches of hair loss involving the parietal and posterior scalp in addition to the central scalp. Without dermatoscopy and pathology, this variety can be easily misdiagnosed as Traction Alopecia.

  • dermatoscopic features of central centrifugal cicatricial Alopecia
    Journal of The American Academy of Dermatology, 2014
    Co-Authors: Mariya Miteva, Antonella Tosti
    Abstract:

    Background No data exist on the dermatoscopic findings in central centrifugal cicatricial Alopecia (CCCA). Objective We sought to establish the spectrum of dermatoscopic features and their frequency in CCCA. Methods We retrospectively evaluated 153 nonpolarized dermatoscopic images obtained from 51 women with histologically proven CCCA and established a list of 12 dermatoscopic features that were independently scored for each image. Controls included 30 dermatoscopic images from histologically proven cases of scarring Traction Alopecia and discoid lupus erythematosus. The receiver operating characteristic curve analysis assessed the specificity and sensitivity; Cohen kappa statistics assessed the agreement. Dermatoscopic pathologic correlations were performed on the horizontal sections of 41 of the 51 specimens, which were obtained with dermatoscopy-guided biopsy procedures. Results Peripilar white gray halo around the emergence of hairs was observed in 94% of patients and was highly specific and sensitive for CCCA in all clinical stages. It corresponds on pathology to the lamellar fibrosis surrounding the outer root sheath. Limitations This was a retrospective study. Conclusion The presence of a peripilar white halo is a dermatoscopic feature that suggests the diagnosis of CCCA in African American patients with mild central thinning, and it is an optimal site from which to obtain a biopsy specimen.

Mariya Miteva - One of the best experts on this subject based on the ideXlab platform.

  • central centrifugal cicatricial Alopecia presenting with irregular patchy Alopecia on the lateral and posterior scalp
    Skin Appendage Disorders, 2015
    Co-Authors: Mariya Miteva, Antonella Tosti
    Abstract:

    Background: Central centrifugal cicatricial Alopecia (CCCA) is the most common cause of scarring Alopecia among women of African descent which affects the central scalp and spreads centrifugally but spares the lateral and posterior scalp. Objectives: The objective of this study is to report on a new clinical variety of CCCA presenting with patchy Alopecia involving the lateral and posterior scalp in addition to the central scalp. Materials and Methods: We reviewed the medical records and the clinical, dermatoscopic and pathologic data of 14 African-American women with CCCA presenting with patchy Alopecia. Results: Two patients had individual well-delineated patches of hair loss, and 12 patients had multiple irregular patches of hair loss. In all cases, the Alopecia affected the lateral and posterior scalp in addition to the central scalp. Four patients had a history of traumatic hairstyles, and 10 patients were also affected by marginal Traction Alopecia. On dermatoscopy, the patches showed peripilar white-gray halos and broken hairs. The pathologic diagnosis of CCCA was based on the following features: follicular dropout, absent or only focally preserved sebaceous glands, premature desquamation of the inner root sheath and perifollicular fibrosis with mild inflammatory infiltrate. Conclusion: CCCA can present with patches of hair loss involving the parietal and posterior scalp in addition to the central scalp. Without dermatoscopy and pathology, this variety can be easily misdiagnosed as Traction Alopecia.

  • dermatoscopic features of central centrifugal cicatricial Alopecia
    Journal of The American Academy of Dermatology, 2014
    Co-Authors: Mariya Miteva, Antonella Tosti
    Abstract:

    Background No data exist on the dermatoscopic findings in central centrifugal cicatricial Alopecia (CCCA). Objective We sought to establish the spectrum of dermatoscopic features and their frequency in CCCA. Methods We retrospectively evaluated 153 nonpolarized dermatoscopic images obtained from 51 women with histologically proven CCCA and established a list of 12 dermatoscopic features that were independently scored for each image. Controls included 30 dermatoscopic images from histologically proven cases of scarring Traction Alopecia and discoid lupus erythematosus. The receiver operating characteristic curve analysis assessed the specificity and sensitivity; Cohen kappa statistics assessed the agreement. Dermatoscopic pathologic correlations were performed on the horizontal sections of 41 of the 51 specimens, which were obtained with dermatoscopy-guided biopsy procedures. Results Peripilar white gray halo around the emergence of hairs was observed in 94% of patients and was highly specific and sensitive for CCCA in all clinical stages. It corresponds on pathology to the lamellar fibrosis surrounding the outer root sheath. Limitations This was a retrospective study. Conclusion The presence of a peripilar white halo is a dermatoscopic feature that suggests the diagnosis of CCCA in African American patients with mild central thinning, and it is an optimal site from which to obtain a biopsy specimen.

Roopal V. Kundu - One of the best experts on this subject based on the ideXlab platform.

  • Follicular and Scarring Disorders in Skin of Color: Presentation and Management
    American Journal of Clinical Dermatology, 2014
    Co-Authors: Pamela Madu, Roopal V. Kundu
    Abstract:

    Skin of color, also known as ethnic skin, is described as skin of individuals of African, Asian, Hispanic, Native-American, Middle Eastern, and Pacific Island backgrounds. Differences in hair morphology, hair grooming, cultural practices, and susceptibility to keloid scarring exist within these populations and have been implicated in hair, scalp, and skin disorders. Acne keloidalis (AK), central centrifugal cicatricial Alopecia (CCCA), dissecting cellulitis of the scalp (DCS), pseudofolliculitis barbae (PFB), Traction Alopecia (TA), and keloids are the most prevalent follicular and scarring disorders in skin of color. They have been associated with disfigurement, permanent hair loss, emotional distress, and decreased quality of life. Hair grooming practices, such as the use of chemical relaxers, heat straightening, and tight braiding and weaving can cause scalp irritation and follicular damage and are linked to the pathogenesis of some of these conditions. Consequently, patient education and behavior modifications are integral to the prevention and management of these disorders. Scarring disorders are also of concern in ethnic populations. Keloid scarring is more prevalent in individuals of African, Asian, and Hispanic descent. The scarring Alopecia CCCA is almost exclusively seen in patients of African descent. Therapeutic regimens such as intralesional corticosteroids, surgical excision, and laser therapy can be effective for these follicular and scarring disorders, but carry a risk of dyspigmentation and keloid scarring. Ethnic skin and hair may present unique challenges to the clinician, and knowledge of these differences is essential to providing quality care.

Maryanne M Senna - One of the best experts on this subject based on the ideXlab platform.

  • a practical approach to the diagnosis and management of hair loss in children and adolescents
    Frontiers in Medicine, 2017
    Co-Authors: Kevin X Liu, Maryanne M Senna
    Abstract:

    Hair loss or Alopecia is a common and distressing clinical complaint in the primary care setting and can arise from heterogeneous etiologies. In the pediatric population, hair loss often presents with patterns that are different from that of their adult counterparts. Given the psychosocial complications that may arise from pediatric Alopecia, prompt diagnosis and management is particularly important. Common causes of Alopecia in children and adolescents include Alopecia areata, tinea capitis, androgenetic Alopecia, Traction Alopecia, trichotillomania, hair cycle disturbances, and congenital Alopecia conditions. Diagnostic tools for hair loss in children include a detailed history, physical examination with a focused evaluation of the child's hair and scalp, fungal screens, hair pull and tug test, and if possible, light microscopy and/or trichoscopy. Management of Alopecia requires a holistic approach including psychosocial support because treatments are only available for some hair loss conditions, and even the available treatments are not always effective. This review outlines the clinical presentations, presents a diagnostic algorithm, and discusses management of these various hair loss disorders.