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Skin Appendage Disorders
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ISSN (Print) 2296-9195 - ISSN (Online) 2296-9160
Published by Karger

[120 journals]

Meeting Calendar
- Abstract:
  Skin Appendage Disord 2021;7:82
  PubDate: Tue, 19 Jan 2021 08:41:59 +010
A Rare Case of Osteoinvasive Amelanotic Melanoma of the Nail Unit
- Abstract: Introduction: Amelanotic melanoma is a rare subtype, which may be clinically difficult to diagnose due to lack of pigmentation and variable histopathological features. Osteoinvasion is another rare characteristic of melanoma. There are few reports in the literature of amelanotic melanoma of the nail unit (nail bed, matrix, and nail folds) with invasion of bone. Case Presentation: We present a case of a 73-year-old Caucasian male with a 13-month history of an ungual lesion on his right hallux. The lesion was initially treated as a chronic diabetic ulceration with failure to resolve with standard of care. Discussion/Conclusion: A heightened index of suspicion for a malignant process is necessary when standard of care fails to lead to improvement or resolution. In these instances, biopsy should be seriously considered.
  Skin Appendage Disord
  PubDate: Wed, 23 Dec 2020 07:35:44 +010
Occipital Fibrosing Alopecia in a Young Male: A Case Report
- Abstract: Introduction: Lichen planopilaris (LPP) is a primary lymphocytic cicatricial alopecia with 3 recognized clinical variants. Lately, LPP clinical spectrum has expanded with new and overlapping clinical variants. First considered as a subtype of LPP affecting postmenopausal women, the increasing worldwide incidence of FFA including atypical lesions in young female and male suggests a different pathomechanism for this disease. Although LPP-spectrum disorders may share similar histopathological findings, clinical features and prognosis are different. Case Report: A 26-year-old Caucasian male presented with occipital scarring alopecia and pruritus for the last 6 months. The patient had been treated for an associated androgenetic alopecia and superficial recurrent scalp folliculitis over the vertex scalp for the last 5 years. Trichoscopy of the occipital scalp showed mild diffuse erythema, moderate peripilar scaling, and absence of follicular openings, suggestive of a scarring process. The patient underwent an occipital scalp biopsy that confirmed the diagnosis of a LPP-spectrum disorder. Discussion/Conclusion: Both LPP and FFA mostly affect the anterior-mid scalp of females. However, recent reports on FFA also in premenopausal women and men should make physicians aware of atypical features of this disease and unusual clinical presentation.
  Skin Appendage Disord
  PubDate: Thu, 17 Dec 2020 11:01:54 +010
Multiple Koenen Tumors, a Rare Entity: Combination Treatment with 1%
Topical Sirolimus Electrofulguration and Excision
- Abstract: Introduction: Koenen tumors are benign, cutaneous manifestations of tuberous sclerosis. These are disfiguring, painful, and challenging to treat as they frequently recur. We report a case of long-standing, multiple Koenen tumors affecting all twenty nails in an elderly female who was successfully treated with a combination of topical sirolimus 1%, surgical excision, and electrofulguration. Case Report: A 57-year-old lady presented with multiple, asymptomatic periungual, and subungual tumors affecting all twenty nails since 27 years. Cutaneous examination revealed confetti macules, ash-leaf macule, and shagreen patch over trunk. Nail biopsy was compatible with Koenen’s tumor. Computerized tomography of brain showed diffuse patchy sclerosis. The tumors were treated with topical sirolimus 1% ointment for 10 months with excellent regression. Electrofulguration for both great toenails and surgical excision of right thumbnail periungual fibroma was done. 1% sirolimus was advised after the surgical treatment. There were no adverse effects or recurrence of tumors over a 2-year follow-up. Discussion: Topical sirolimus 1% was effective in tumor regression and preventing new tumor formation. Larger tumors that interfered in daily chores were treated with excision and electrofulguration. Thus, a combination treatment for this rare presentation of tuberous sclerosis provided optimum results.
  Skin Appendage Disord
  PubDate: Wed, 16 Dec 2020 10:49:24 +010
Trichotillomania Incognito: Two Case Reports and Literature Review
- Abstract: Trichotillomania is a compulsive disorder characterized by repetitive hairpulling. It is an important cause of patchy alopecia, especially in children between 9 and 13 years of age. The aim of this paper is to report 2 pediatric cases presenting with trichotillomania without patches. This condition may be extremely distressful, impacting psychosocial development of children. In these case reports, we reinforce the relevance of trichoscopy in hair disorder evaluation, which allowed early recognition to better advise and conduct these unique pediatric cases.
  Skin Appendage Disord
  PubDate: Tue, 15 Dec 2020 10:25:41 +010
Hypotrichosis with Juvenile Macular Dystrophy in Saudi Arabia: A Case
Report
- Abstract: Hypotrichosis with juvenile macular dystrophy is an autosomal recessive disorder due to a mutation in the CDH3 gene. As its name indicates, the disease classically presented with hypotrichosis and early visual impairment. We describe herein a family member with alopecia since birth associated with severe visual impairment in their early life. We suspect the diagnosis of hypotrichosis with juvenile macular dystrophy. Genetic testing confirms the clinical suspension. We emphasize the importance of genetic testing for proper genetic counseling.
  Skin Appendage Disord
  PubDate: Tue, 15 Dec 2020 07:40:44 +010
Excellent Response of Dermatophytoma and Nail Splitting to Nail Plate
Debridement Plus Topical Ciclopirox Olamine 1% Solution
- Abstract: Onychomycosis often presents as thickened, discolored nails. Usually, one or both great toenails are affected. Eventually, the nail plate becomes friable and may split and break up, often due to trauma or invasion of the plate by dermatophytes that have keratolytic properties. Dermatophytoma is a unique feature of onychomycosis that occurred by abundant fungal filaments and spores forming a fungal ball under the nail plate. It is often refractory to traditional therapy. Based on the clinical and mycological examination, a case of onychomycosis in a 45-year-old woman presented as dermatophytoma with longitudinal nail splitting caused by Trichophyton rubrum is presented. The case was successfully treated with nail plate debridement plus topical ciclopirox olamine 1% solution. Nail debridement was performed using a 15-scalpel blade to remove the affected nail portion with the underlying subungual debris to enhance the effect of topical ciclopirox 1% solution which was then applied 3 times daily to the debrided area. Follow-up visits with nail photography were planned every 2 weeks after the procedure to check treatment progress. A complete clinical resolution was achieved after 5 months. This treatment option can be advocated for similar nail conditions avoiding unnecessary and expensive lines of treatment.
  Skin Appendage Disord
  PubDate: Wed, 09 Dec 2020 11:13:59 +010
Rapid Response to Certolizumab Pegol in Hidradenitis Suppurativa: A Case
Report
- Abstract: Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease of hair follicles which usually affects patients’ quality of life negatively. Although there are various therapeutic approaches including topical and systemic antibiotics, retinoids, biological agents, and also surgical modalities, there is no curative treatment option and clinical management of HS is still challenging. Case Presentation: Herein, we present a 43 year-old man with HS who had used different treatments in 15 years. The patient showed improvement initially with adalimumab, then exhibited secondary unresponsiveness after 18 months. While worsening of HS was recorded due to increased discharge under secukinumab, no additional benefit was observed with methotrexate. He was not willing to undergo surgical procedures due to previous surgical experience. Finally, certolizumab pegol has been started to patient with similar dosing to psoriasis patients. Sartorius, 10-point visual analogue scale (VAS), and dermatological life quality index (DLQI) scores regressed from 171 to 105, 9/10 to 3/10, and 27 to 19 after 3 months with certolizumab pegol treatment. Discussion/Conclusion: Certolizumab pegol is a humanized antigen-binding fragment of a monoclonal antibody which binds to TNF-alpha. However, certolizumab pegol is only approved for plaque psoriasis in dermatology; it is likely to be a promising effective agent for HS, especially in challenging cases.
  Skin Appendage Disord
  PubDate: Wed, 09 Dec 2020 11:13:35 +010
Repigmentation of White Forelock in a Familial Case of Piebaldism Reported
via Teledermatology in the COVID-19 Era
- Abstract: Piebaldism is a rare autosomal dominant disorder characterized by leucoderma with leucotrichia. We describe a case of white forelock repigmentation in an infant with piebaldism, thanks to a photograph sent by the patient’s mother to our dermatology clinic, during COVID-19 pandemic.
  Skin Appendage Disord
  PubDate: Wed, 09 Dec 2020 11:13:11 +010
Androgenetic Alopecia in a Patient with Klinefelter Syndrome: Case Report
and Literature Review
- Abstract: Introduction: Klinefelter syndrome (KS) is defined as (a chromosomal disorder in which males have an extra X chromosome). KS presents clinically with signs of androgen deficiency including low testosterone. Androgenetic alopecia (AGA) develops as a response of the hair follicle cells to androgens in individuals with genetic predisposition. Case Presentation: We describe a 17-year-old male patient with KS who developed AGA with a Ludwig pattern. Conclusion: Our patient had a good response to oral minoxidil, finasteride, and low-level light therapy.
  Skin Appendage Disord
  PubDate: Mon, 07 Dec 2020 14:59:52 +010