The Experts below are selected from a list of 819 Experts worldwide ranked by ideXlab platform
Lidia Rudnicka - One of the best experts on this subject based on the ideXlab platform.
-
Trichoscopy in Hair Shaft Disorders.
Dermatologic clinics, 2018Co-Authors: Lidia Rudnicka, Malgorzata Olszewska, Anna Waśkiel, Adriana RakowskaAbstract:Trichoscopy allows analyzing the structure and size of growing hair shafts in their natural environment in children and adults. The method replaces light microscopy, which requires pulling of multiple hairs for investigation. In monilethrix, trichoscopy shows uniform elliptical nodosities with intermittent constrictions. In Trichorrhexis nodosa nodular thickenings along hairs shafts are visible (low magnification) or splitting into numerous small fibers along the hair shaft may be observed (high magnification). In Trichorrhexis invaginata (bamboo hair) the hair shaft telescopes into itself at several points along the shaft. Trichoscopy shows small nodules along the shaft. Hairs bend and break in these diseases. Trichoscopy of pili torti shows twists of hair shafts along their long axis. In pili annulati hair shafts with alternating white and dark bands are visible. In woolly hair the examination demonstrates hair shafts with waves at very short intervals. For trichothiodystrophy polarized trichoscopy should be used. In ectodermal dysplasias, trichoscopy shows a variety of hair abnormalities, but the most characteristic finding is hair shaft pigmentation heterogeneity.
-
Trichoscopy of scalp dysesthesia
Advances in Dermatology and Allergology, 2017Co-Authors: Adriana Rakowska, Małgorzata Olszewska, Lidia RudnickaAbstract:Introduction: Scalp dysesthesia is characterized by localized pruritus, burning sensations or even pain. Aim : To describe characteristic trichoscopic features of scalp dysesthesia. Material and methods: The study was a retrospective analysis (2010–2016) of 9 patients (8 females and 1 male; median age: 52 years; range: 38–66 years). A total of 61 trichoscopic images were analyzed by two independent evaluators. Results: In all cases, oval or round areas covered with short hairs: broom hairs (77%; 7/9), block hairs (88%; 8/9), short hairs with Trichorrhexis nodosa (78%; 7/9) were found. In 4 of 9 cases these areas were circumscribed by brownish linear discoloration. Background features included: areas lacking hair shafts (44%; 4/9) covered by wavy-shaped scaling, whitish areas with prominent perifollicular yellow discoloration and cloud vessels arranged around follicular openings and around empty follicles (33%, 3/9); focal brownish discoloration with darker wavy lines (78%; 7/9). Conclusions : Trichoscopy can be helpful in establishing the diagnosis of scalp dysesthesia – broom hairs, block hairs and short hairs with Trichorrhexis nodosa covering the alopecia patch, uniform in length, can be considered as characteristic for this condition
-
Trichoscopic Hair Evaluation in Patients with Ectodermal Dysplasia
The Journal of pediatrics, 2015Co-Authors: Adriana Rakowska, Lidia Rudnicka, Renata Górska, Małgorzata ZadurskaAbstract:Hair abnormalities in ectodermal dysplasia may be difficult to identify. Among 16 patients with ectodermal dysplasia trichoscopy (hair dermoscopy) revealed predominance of pilosebaceous units with 1 hair (69%), abnormalities of hair shaft pigmentation (gray hair with single dark hairs, 56%), pili torti, trichothiodystrophy, Trichorrhexis nodosa, and rarely, cicatricial alopecia.
-
dermoscopy for the pediatric dermatologist part i dermoscopy of pediatric infectious and inflammatory skin lesions and hair disorders
Pediatric Dermatology, 2013Co-Authors: C Elena M D Haliasos, Lidia Rudnicka, M Miryam D Kerner, M Natalia D Jaimeslopez, M Iris D Zalaudek, M Josep D Malvehy, M Rainer D Hofmannwellenhof, P Ralph M D Braun, Ashfaq A MarghoobAbstract:The dermoscope allows physicians to examine the macroscopic and microscopic primary morphology of skin lesions, identify subtle clinical clues, confirm naked-eye clinical diagnoses, and monitor treatment progress while posing little threat to the young patient. This review summarizes important dermoscopic structures seen in infectious and inflammatory skin conditions and hair disorders in children. Scabies, pediculosis, phthiriasis, molluscum contagiosum, tinea nigra, and verrucae are well characterized dermoscopically by delta-shaped structures, ovoid-shaped nits, the crab louse, red corona, brown strands or spicules, and multiple densely packed papilla with a central black dot surrounded by a whitish halo, respectively. These dermoscopic structures will be discussed, focusing on the dermoscopic morphologies and dermoscopic sensitivity for diagnosis and its utility in monitoring treatment progress. Dermoscopy has also been shown to significantly improve the clinician's diagnostic and monitoring accuracy of inflammatory skin lesions such as psoriasis, which is characterized dermoscopically by uniformly distributed dotted blood vessels, and lichen planus, which is characterized by whitish lines on a purple to reddish background. Dermoscopy of the hair and scalp (trichoscopy) facilitates the differential diagnosis of hair diseases in children, including alopecia areata, trichotillomania, and tinea capitis. It can also assist in the diagnosis of multiple genetic hair shaft disorders, such as monilethrix, Trichorrhexis invaginata, Trichorrhexis nodosa, pili torti, and pili annulati.
-
Trichorrhexis Invaginata and Netherton’s Syndrome
Atlas of Trichoscopy, 2012Co-Authors: Adriana Rakowska, Malgorzata Olszewska, Lidia RudnickaAbstract:Trichorrhexis invaginata (bamboo hair) is an abnormality of the hair in which the hair shaft telescopes into itself (invaginates) at several points along the shaft. On a handheld dermoscope, Trichorrhexis invaginata appears as multiple small nodules spaced along the shaft. High magnifications produced by a videodermoscope show invagination of the distal portion of the hair shaft into its proximal portion, forming a “ball-in-cup” appearance. When the hair shaft ruptures at the site of this abnormality, the distal end of the remaining hair shaft shows a “golf tee-like” invagination. Trichorrhexis invaginata is pathognomonic of Netherton’s syndrome.
Adriana Rakowska - One of the best experts on this subject based on the ideXlab platform.
-
Trichoscopy in Hair Shaft Disorders.
Dermatologic clinics, 2018Co-Authors: Lidia Rudnicka, Malgorzata Olszewska, Anna Waśkiel, Adriana RakowskaAbstract:Trichoscopy allows analyzing the structure and size of growing hair shafts in their natural environment in children and adults. The method replaces light microscopy, which requires pulling of multiple hairs for investigation. In monilethrix, trichoscopy shows uniform elliptical nodosities with intermittent constrictions. In Trichorrhexis nodosa nodular thickenings along hairs shafts are visible (low magnification) or splitting into numerous small fibers along the hair shaft may be observed (high magnification). In Trichorrhexis invaginata (bamboo hair) the hair shaft telescopes into itself at several points along the shaft. Trichoscopy shows small nodules along the shaft. Hairs bend and break in these diseases. Trichoscopy of pili torti shows twists of hair shafts along their long axis. In pili annulati hair shafts with alternating white and dark bands are visible. In woolly hair the examination demonstrates hair shafts with waves at very short intervals. For trichothiodystrophy polarized trichoscopy should be used. In ectodermal dysplasias, trichoscopy shows a variety of hair abnormalities, but the most characteristic finding is hair shaft pigmentation heterogeneity.
-
Trichoscopy of scalp dysesthesia
Advances in Dermatology and Allergology, 2017Co-Authors: Adriana Rakowska, Małgorzata Olszewska, Lidia RudnickaAbstract:Introduction: Scalp dysesthesia is characterized by localized pruritus, burning sensations or even pain. Aim : To describe characteristic trichoscopic features of scalp dysesthesia. Material and methods: The study was a retrospective analysis (2010–2016) of 9 patients (8 females and 1 male; median age: 52 years; range: 38–66 years). A total of 61 trichoscopic images were analyzed by two independent evaluators. Results: In all cases, oval or round areas covered with short hairs: broom hairs (77%; 7/9), block hairs (88%; 8/9), short hairs with Trichorrhexis nodosa (78%; 7/9) were found. In 4 of 9 cases these areas were circumscribed by brownish linear discoloration. Background features included: areas lacking hair shafts (44%; 4/9) covered by wavy-shaped scaling, whitish areas with prominent perifollicular yellow discoloration and cloud vessels arranged around follicular openings and around empty follicles (33%, 3/9); focal brownish discoloration with darker wavy lines (78%; 7/9). Conclusions : Trichoscopy can be helpful in establishing the diagnosis of scalp dysesthesia – broom hairs, block hairs and short hairs with Trichorrhexis nodosa covering the alopecia patch, uniform in length, can be considered as characteristic for this condition
-
Trichoscopic Hair Evaluation in Patients with Ectodermal Dysplasia
The Journal of pediatrics, 2015Co-Authors: Adriana Rakowska, Lidia Rudnicka, Renata Górska, Małgorzata ZadurskaAbstract:Hair abnormalities in ectodermal dysplasia may be difficult to identify. Among 16 patients with ectodermal dysplasia trichoscopy (hair dermoscopy) revealed predominance of pilosebaceous units with 1 hair (69%), abnormalities of hair shaft pigmentation (gray hair with single dark hairs, 56%), pili torti, trichothiodystrophy, Trichorrhexis nodosa, and rarely, cicatricial alopecia.
-
Trichorrhexis Invaginata and Netherton’s Syndrome
Atlas of Trichoscopy, 2012Co-Authors: Adriana Rakowska, Malgorzata Olszewska, Lidia RudnickaAbstract:Trichorrhexis invaginata (bamboo hair) is an abnormality of the hair in which the hair shaft telescopes into itself (invaginates) at several points along the shaft. On a handheld dermoscope, Trichorrhexis invaginata appears as multiple small nodules spaced along the shaft. High magnifications produced by a videodermoscope show invagination of the distal portion of the hair shaft into its proximal portion, forming a “ball-in-cup” appearance. When the hair shaft ruptures at the site of this abnormality, the distal end of the remaining hair shaft shows a “golf tee-like” invagination. Trichorrhexis invaginata is pathognomonic of Netherton’s syndrome.
-
Trichorrhexis invaginata and netherton s syndrome
2012Co-Authors: Adriana Rakowska, Malgorzata Olszewska, Lidia RudnickaAbstract:Trichorrhexis invaginata (bamboo hair) is an abnormality of the hair in which the hair shaft telescopes into itself (invaginates) at several points along the shaft. On a handheld dermoscope, Trichorrhexis invaginata appears as multiple small nodules spaced along the shaft. High magnifications produced by a videodermoscope show invagination of the distal portion of the hair shaft into its proximal portion, forming a “ball-in-cup” appearance. When the hair shaft ruptures at the site of this abnormality, the distal end of the remaining hair shaft shows a “golf tee-like” invagination. Trichorrhexis invaginata is pathognomonic of Netherton’s syndrome.
Adarshlata Singh - One of the best experts on this subject based on the ideXlab platform.
-
Bamboo Hair in Netherton's Syndrome.
International journal of trichology, 2009Co-Authors: Atul Salodkar, Sanjiv V Choudhary, Gori Jadwani, Adarshlata SinghAbstract:Sir, Netherton's syndrome is a rare autosomal recessive genodermatosis of unknown cause characterized by erythroderma, Trichorrhexis invaginata (bamboo hair), ichthyosis linearis circumflexa and atopic diathesis. In 1949, Comel[1] first coined the term ichthyosis linearis circumflexa. In 1958, Netherton[2] described a young girl with generalized scaly dermatitis and fragile nodular hair-shaft deformities that he termed Trichorrhexis nodosa. Later, this was more appropriately renamed as Trichorrhexis invaginata (bamboo hair). In 1974, Mevorah et al.[3] established the clinical relationship between ichthyosis linearis circumflexa and Netherton's syndrome. The atopic diathesis occurs in approximately 75% of patients with Netherton's syndrome. This syndrome is caused by mutation in the Spinks gene, which is located on the long arm of Chromosome 5.[4] This gene codes for production of a protein LEKTI, which inhibits the enzyme serine proteinase in the outermost layer of the skin. The function of this enzyme is to break down the intracellular cement leading to desquamation of epidermal cells. A LEKTI deficiency leads to an uninhibited desquamation of horny cells; as a result, the skin becomes red and scaly. This is responsible for all the characteristic symptoms of Netherton's syndrome. A 24-year-old male patient presented with generalized scaly lesions since birth. History of frequent exacerbations and complete remissions of skin lesions was present since childhood. Personal history of atopy in the form of recurrent allergic rhinitis was present since childhood. History of parental consanguinity was not present. There was no history of fluid-filled lesions. On general examination, patient was moderately built and nourished. Cutaneous examination revealed multiple widespread erythematous annular and polycyclic, scaly patches with double-edged scales at the periphery of the lesions [Figures 1‐3], involving the trunk and extremities. Skin lesions were continuously changing their shape and size during each exacerbations and leaving no scarring or pigmentary changes upon healing. Nails were shiny. Scalp hairs were sparse, rough and lusterless. Mucus membrane and other systemic examination were within normal limits. Blood investigations revealed hemoglobin-9.5 gm%, white blood count-7300 cells/ m3, mild eosinophilia, raised erythrocyte sedimentation rate-54 mm/h and raised serum IgE level-11412.30 IU/ ml. The light microscopic examination of scalp hairs showed the typical Trichorrhexis invaginata (bamboo hair), with the distal portion of the shaft invaginated into the proximal portion [Figure 4]. Biopsy taken from the lesion on the back was consistent with the clinical diagnosis of ichthyosis linearis circumflexa. Figure 1 Erythematous annular and polycyclic, scaly patches with double edged scales at the periphery of the lesions involving neck Figure 2 Annular and polycyclic, scaly patches with double edged scales at the periphery of the lesions involving trunk and extremities Figure 3 Annular and polycyclic, scaly patches with double edged scales at the periphery of the lesions involving back Figure 4 The light microscopic examination of scalp hair showed the typical Trichorrhexis invaginata (bamboo hair) On the bases of ichthyosis linearis circumflexa, characteristic hair anomaly and atopic manifestations [recurrent allergic rhinitis and raised IgE level], a diagnosis of Netherton's syndrome was made. Netherton's syndrome is characterized by the triad of ichthyosis linearis circumflexa, Trichorrhexis invaginata (bamboo hair) and an atopic diathesis.[5] Our case had classical cutaneous lesions of ichthyosis linearis circumflexa in the form of recurrent crops of erythematous annular and polycyclic scaly patches with double-edged scales, which constantly change their size and shape and involutes spontaneously. Our case also had the Trichorrhexis invaginata involving scalp hairs, which is pathognomonic of Netherton's syndrome and its presence confirms the diagnosis. Personal or family history of atopy is another association.[6] From 30 to 75% of patients with Netherton's syndrome develop atopic manifestations such as atopic dermatitis-like skin lesions, urticaria, angioneurotic edema, asthma, allergic rhinitis, food allergy, peripheral eosinophilia and elevated serum IgE level. Other associated manifestations of Netherton's syndrome include aminoaciduria, failure to thrive, mental and neurological retardation and immune abnormalities[3 7 8] In our patient, atopic manifestations were present in the form of recurrent allergic rhinitis, peripheral eosinophilia and grossly elevated serum IgE level. Netherton's syndrome has been observed almost always in females. Smith et al. in his review of 43 patients described a male patient[8] In our case report also, all the manifestations of Netherton's syndrome was seen in a male patient. Teeth and nails are not affected in this syndrome. Though mental retardation has been reported in some children,[9] our patient had normal intelligence and had normal teeth and nails. We report this case for its rarity and classical presentation.
Atul Salodkar - One of the best experts on this subject based on the ideXlab platform.
-
Bamboo Hair in Netherton's Syndrome.
International journal of trichology, 2009Co-Authors: Atul Salodkar, Sanjiv V Choudhary, Gori Jadwani, Adarshlata SinghAbstract:Sir, Netherton's syndrome is a rare autosomal recessive genodermatosis of unknown cause characterized by erythroderma, Trichorrhexis invaginata (bamboo hair), ichthyosis linearis circumflexa and atopic diathesis. In 1949, Comel[1] first coined the term ichthyosis linearis circumflexa. In 1958, Netherton[2] described a young girl with generalized scaly dermatitis and fragile nodular hair-shaft deformities that he termed Trichorrhexis nodosa. Later, this was more appropriately renamed as Trichorrhexis invaginata (bamboo hair). In 1974, Mevorah et al.[3] established the clinical relationship between ichthyosis linearis circumflexa and Netherton's syndrome. The atopic diathesis occurs in approximately 75% of patients with Netherton's syndrome. This syndrome is caused by mutation in the Spinks gene, which is located on the long arm of Chromosome 5.[4] This gene codes for production of a protein LEKTI, which inhibits the enzyme serine proteinase in the outermost layer of the skin. The function of this enzyme is to break down the intracellular cement leading to desquamation of epidermal cells. A LEKTI deficiency leads to an uninhibited desquamation of horny cells; as a result, the skin becomes red and scaly. This is responsible for all the characteristic symptoms of Netherton's syndrome. A 24-year-old male patient presented with generalized scaly lesions since birth. History of frequent exacerbations and complete remissions of skin lesions was present since childhood. Personal history of atopy in the form of recurrent allergic rhinitis was present since childhood. History of parental consanguinity was not present. There was no history of fluid-filled lesions. On general examination, patient was moderately built and nourished. Cutaneous examination revealed multiple widespread erythematous annular and polycyclic, scaly patches with double-edged scales at the periphery of the lesions [Figures 1‐3], involving the trunk and extremities. Skin lesions were continuously changing their shape and size during each exacerbations and leaving no scarring or pigmentary changes upon healing. Nails were shiny. Scalp hairs were sparse, rough and lusterless. Mucus membrane and other systemic examination were within normal limits. Blood investigations revealed hemoglobin-9.5 gm%, white blood count-7300 cells/ m3, mild eosinophilia, raised erythrocyte sedimentation rate-54 mm/h and raised serum IgE level-11412.30 IU/ ml. The light microscopic examination of scalp hairs showed the typical Trichorrhexis invaginata (bamboo hair), with the distal portion of the shaft invaginated into the proximal portion [Figure 4]. Biopsy taken from the lesion on the back was consistent with the clinical diagnosis of ichthyosis linearis circumflexa. Figure 1 Erythematous annular and polycyclic, scaly patches with double edged scales at the periphery of the lesions involving neck Figure 2 Annular and polycyclic, scaly patches with double edged scales at the periphery of the lesions involving trunk and extremities Figure 3 Annular and polycyclic, scaly patches with double edged scales at the periphery of the lesions involving back Figure 4 The light microscopic examination of scalp hair showed the typical Trichorrhexis invaginata (bamboo hair) On the bases of ichthyosis linearis circumflexa, characteristic hair anomaly and atopic manifestations [recurrent allergic rhinitis and raised IgE level], a diagnosis of Netherton's syndrome was made. Netherton's syndrome is characterized by the triad of ichthyosis linearis circumflexa, Trichorrhexis invaginata (bamboo hair) and an atopic diathesis.[5] Our case had classical cutaneous lesions of ichthyosis linearis circumflexa in the form of recurrent crops of erythematous annular and polycyclic scaly patches with double-edged scales, which constantly change their size and shape and involutes spontaneously. Our case also had the Trichorrhexis invaginata involving scalp hairs, which is pathognomonic of Netherton's syndrome and its presence confirms the diagnosis. Personal or family history of atopy is another association.[6] From 30 to 75% of patients with Netherton's syndrome develop atopic manifestations such as atopic dermatitis-like skin lesions, urticaria, angioneurotic edema, asthma, allergic rhinitis, food allergy, peripheral eosinophilia and elevated serum IgE level. Other associated manifestations of Netherton's syndrome include aminoaciduria, failure to thrive, mental and neurological retardation and immune abnormalities[3 7 8] In our patient, atopic manifestations were present in the form of recurrent allergic rhinitis, peripheral eosinophilia and grossly elevated serum IgE level. Netherton's syndrome has been observed almost always in females. Smith et al. in his review of 43 patients described a male patient[8] In our case report also, all the manifestations of Netherton's syndrome was seen in a male patient. Teeth and nails are not affected in this syndrome. Though mental retardation has been reported in some children,[9] our patient had normal intelligence and had normal teeth and nails. We report this case for its rarity and classical presentation.
Antonella Tosti - One of the best experts on this subject based on the ideXlab platform.
-
A Case of Friction Alopecia in a Healthy 15-Year-Old Girl.
Skin appendage disorders, 2018Co-Authors: Emilie Fowler, Antonella TostiAbstract:Friction alopecia is a non-scarring alopecia that causes hair breakage and may cause Trichorrhexis nodosa. We report a case of a 15-year-old girl with self-inflicting friction alopecia that demonstrated broken hairs and proximal Trichorrhexis nodosa on dermoscopy. We review various causes of friction alopecia and clinical findings, as well as Trichorrhexis nodosa.
-
Pili Annulati with Severe Trichorrhexis Nodosa: A Case Report and Review of the Literature.
Skin appendage disorders, 2018Co-Authors: Adrianna Gonzalez, Luis J. Borda, Antonella TostiAbstract:Pili annulati is generally classified as a hair shaft disorder without fragility. However, increased susceptibility to weathering is common. Severe breakage due to Trichorrhexis nodosa is uncommon. We report a case and review the literature on this topic.
-
Dermoscopic diagnosis of hair breakage caused by styling procedures in patients of African descent
Journal of the American Academy of Dermatology, 2015Co-Authors: Maria Victória Quaresma, María Abril Martinez Velasco, Antonella TostiAbstract:DERMOSCOPIC APPEARANCE The dermoscopic examination of hairs obtained with a pull test allowed us to diagnose hair breakage in all cases. The hair fragments did not have a root but rather had brush-like tips and swelling along the shaft that was caused by Trichorrhexis nodosa (Fig 2). Central trichoptilosis (ie, a longitudinal split in the central part of the shaft) was another common finding (Fig 3).
