Hairless Lesion Research Articles

Infrared thermography in the diagnostics of hidden infections – case reports

Two interesting case reports are presented that prove the many advantages of infrared thermography as a new diagnostic tool that can be successfully used in detecting hidden pathological processes. The first case report is about a 40-year-old female patient with alopecia areata – head lesion. The dermatological treatment gave no results, so the patient was sent for focal diagnostics. The infrared thermography showed two sites with hidden infection. The first one was of dental origin – periapical granuloma on the first mandibular left molar; the second site was in the genital area – endometriosis. A root canal retreatment of the molar and a gynecological operation were performed. After elimination of the focal infection, the hairless lesion recovered fully. The second case report is of a 34-year-old healthy male with alopecia areata of the beard and no other complaints. Infrared thermography detected active sinusitis of the ethmoidal left sinus. A microbiology test confirmed the presence of Staphylococcus Aureus and after an antibiotic course the beard recovered fully. These cases clearly illustrate the advantages of infrared thermography as a novel promising, non-invasive and objective diagnostic tool for clarification of difficult-to-diagnose cases.

An Over View of Dermatophytosis in Camels

Dermatophytosis is a fungal infection of the skin caused by dermatophytes-filamentous fungi which have ability to invade the epidermis and keratinized tissues such as hair, skin or nails. Trichophyton verrucosum is the most common dermatophytes species isolated from camel. The disease is characterized by circumscribed crusty hairless lesion, (1-2 cm) distributed over the head, neck, shoulder, limbs and flanks. Dermatophytosis can be diagnosed by direct examination, fungal culture, skin biopsy and molecular diagnosis methods. This review forecast more light of the different aspects of this disease.

An outbreak of dermatophytosis in camels (Camelus dromedaríus) at Qassim Region, Central of Saudi Arabia

This study was carried out at Qassim Region, Central of Saudi Arabia, to study dermatophytosis in a private farm of dromedary camels. The prevalence of dermatophytosis in camels was 11.5% and significantly differed among different age groups (p ≤ .0001 and odds ratio = 14.61), with higher prevalence among camels younger than three years (22.10%). Clinical signs of ringworm recorded in this study were non-pruriginous dry circumscribed discrete, crusty hairless lesion distributed over the head, neck, shoulder, limbs and flanks. Mycological examination revealed Trichophyton verrucosum from the clinically diseased camels (n = 23). Significant improvement in the terms of rapid recovery was recorded in camels receiving topical application of 10% iodine ointment for three weeks in addition to intramuscular injection of vitamin A (400,000 IU/animal) on alternate days for three times and mineral mixture supplementation as dietary additives for three weeks compared to the group that was treated using iodine ointment for three weeks alone.

Trichofolliculomes : revue rétrospective de 8 cas

Trichofolliculoma is a rare benign tumor consisting of a pilosebaceous follicle hamartoma. While diagnosis of this condition is generally straightforward, fortuitous discovery of an atypical presentation can occur during histological examination of a biopsy or surgical sample. We report herein on 8 patients aged between 8 and 75 years illustrating the wide spectrum of clinical presentation of this lesion, for which there are numerous differential diagnoses in the event of atypical clinical (lack of central whitish hair plug) or topical features (extra-facial site). In our series, half of the patients displayed a clinically hairless lesion. Moreover, in one case, a patient presented abdominal trichofolliculoma. Trichofolliculoma may be under-diagnosed in the general population as illustrated by the frequency of atypical hairless lesions.

Clinical and histologic features of incontinentia pigmenti in adults with nuclear factor-κB essential modulator gene mutations

Incontinentia pigmenti (IP) is a multisystem disorder, in which cutaneous symptoms can be accompanied by dental, ocular, and central nervous system defects. In adults, the clinical diagnosis of IP is based principally on the late onset of stage 4 lesions and their association with dental, nail, ocular, or central nervous system anomalies. Nevertheless, these lesions are often unrecognized. Our aim was assessment of IP manifestations in adults to clarify diagnostic criteria for mild forms of the disease, to help physicians detect adult IP in the presence of subtle lesions and avoid misdiagnosis. We conducted clinical and histologic examination of 25 adults with IP and nuclear factor-κB essential modulator gene rearrangement or mutations. Linear atrophic, hypopigmented, and hairless lesions (stage 4) are constant in adults. Apoptotic keratinocytes in the epidermis or dermis and atrophic hair follicles, with absence of arrector pili muscles, are frequently observed. In contrast, nipple anomalies are rare. We were unable to determine the age of the onset of IP stage 4 lesions. Skin manifestations are constant in adult patients with IP. Histology is characteristic and could be considered as a minor diagnostic criterion of IP. Nipple anomalies also may be considered as a minor criterion. Detection of such subtle manifestations can evoke IP in patients with repeated miscarriages or unexplained neurologic manifestations.

Encephalocraniocutaneous Lipomatosis (Haberland’s Syndrome) - A Case Report of a Neurocutaneous Syndrome and a Review of the Literature

We present the case of a full-term girl born to non-consanguineous parents. Physical examination revealed a large (14 x 6 centimeters) hairless lesion on the right frontal-parietal scalp (Fig.1), multiple nodular lesions of the right upper eyelid and eyebrow, and a reddish bulbar conjunctival lesion on the right eye consistent with choriocystoma (Fig.2).A CT scan of the brain showed cranial asymmetry, an arachnoid cyst of the right middle fossa, a right frontal subdural collection, a porencephalic cyst, hemiatrophy of the right hemisphere, and cortical calcifications of the parietal and occipital lobes (Fig.3).At the age of two years, the patient underwent a complete excision of the scalp lesion after tissue expansion and excision of the nodules on the eyelid (Fig.4). The histopathological examination of the scalp lesion showed absence of hair follicles, a thinned dermis, and extended adipose tissue into the dermis; the cutaneous nodules were

Loss of Hoxb8 alters spinal dorsal laminae and sensory responses in mice

Although Hox gene expression has been linked to motoneuron identity, a role of these genes in development of the spinal sensory system remained undocumented. Hoxb genes are expressed at high levels in the dorsal horn of the spinal cord. Hoxb8 null mutants manifest a striking phenotype of excessive grooming and hairless lesions on the lower back. Applying local anesthesia underneath the hairless skin suppressed excessive grooming, indicating that this behavior depends on peripheral nerve activity. Functional ablation of mouse Hoxb8 also leads to attenuated response to nociceptive and thermal stimuli. Although spinal ganglia were normal, a lower postmitotic neural count was found in the dorsalmost laminae at lumbar levels around birth, leading to a smaller dorsal horn and a correspondingly narrowed projection field of nociceptive and thermoceptive afferents. The distribution of the dorsal neuronal cell types that we assayed, including neurons expressing the itch-specific gastrin-releasing peptide receptor, was disorganized in the lumbar region of the mutant. BrdU labeling experiments and gene-expression studies at stages around the birth of these neurons suggest that loss of Hoxb8 starts impairing development of the upper laminae of the lumbar spinal cord at approximately embryonic day (E)15.5. Because none of the neuronal markers used was unexpressed in the adult dorsal horn, absence of Hoxb8 does not impair neuronal differentiation. The data therefore suggest that a lower number of neurons in the upper spinal laminae and neuronal disorganization in the dorsal horn underlie the sensory defects including the excessive grooming of the Hoxb8 mutant.

Old wine in new bottles: reviving old therapies for alopecia areata using rodent models.

Alopecia areata is regarded as a tissue-restricted autoimmune disease of hair follicles in which follicular activity is arrested because of the continued activity of lymphocytic infiltrates. Actual loss of hair follicles does not occur, even in hairless lesions. A variety of immunomodulating therapies, including contact sensitizers and immunomodulators, are part of the usual armamentarium for this disorder. None of these treatments have been consistent in their efficacy, and many have untoward side effects. Nevertheless, their uses in valid animal models provide a tool to dissect out molecular mechanisms of therapeutic effects. For several decades, both mechlorethamine (for the treatment of cutaneous T cell lymphoma) and anthralin (for the treatment of psoriasis) have been used successfully. When these therapies were tested in rat and mouse alopecia areata models, we found anthralin and mechlorethamine to be the most effective topical modalities, respectively. The underlying cellular mechanisms may act through targeting infiltrative lymphocytes, and the molecular mechanisms may involve specific cytokine expression changes. These visible, accessible, and unilaterally treated animal model systems are ideal for studying novel alopecia areata therapies, particularly in terms of their in vivo molecular mechanisms of action.

Use of a polymerase chain reaction assay to detect bovine herpesvirus type 2 DNA in skin lesions from cattle suspected to have pseudo-lumpy skin disease.

Beef cattle from a herd in north Alabama were examined because of an outbreak of nonfatal skin disease characterized by discrete circumscribed areas of inflammation that developed on the skin from the neck to the hips. Areas of inflammation, which tended to be superficial, underwent necrosis and scabbed over. The scabs eventually dropped off leaving discrete, round, whitish, hairless lesions that were 1.2 to 2.5 cm diameter. Because clinical signs were consistent with those expected with pseudo-lumpy skin disease (PLSD) caused by bovine herpesvirus type 2 (BHV-2), samples from 16 representative animals were submitted for BHV-2 testing. All 16 animals were seropositive for BHV-2, but the virus could not be isolated from skin biopsy specimens or buffy coat samples. Results of a polymerase chain reaction assay incorporating primers designed to amplify 2 DNA sequences from BHV-2 were positive for 3 of the 10 cattle, suggesting that skin lesions in these cattle were a result of PLSD. Our findings suggest that PLSD may be more common and widespread in the United States than suggested by the frequency with which BHV-2 has been isolated from cattle with PLSD-like skin lesions.

An outbreak of a mixed infection of Dermatophilus congolensis and Microsporum gypseum in camels (Camelus dromedarius) in Saudi Arabia.

Although both Dermatophilus congolensis and Microsporum gypseum infections have been reported separately in camels, mixed infection involving both agents has not been reported to date. The authors describe a mixed infection of D. congolensis and M. gypseum in camels reared on a dairy farm in Saudi Arabia. A total of 131 out of 559 camels (23.4%) were affected. Forty-eight camels less than one year of age had discrete, circumscribed, crusty, hairless lesions, found in particular on the neck and forelegs. Eighty-three camels of varying ages had extensive hair matting with crusty, hairless lesions, especially on the flanks. Camel calves and young camels demonstrated a relatively greater amount of skin lesions. D. congolensis and M. gypseum were diagnosed by direct microscopy, isolation and histopathology.

Nevus psiloliparus: A Distinct Fatty Tissue Nevus

Background: Encephalocraniocutaneous lipomatosis is usually associated with a peculiar type of fatty tissue nevus which represents a smoothly surfaced and hairless lesion involving the scalp. This disorder has so far not been recognized as a cutaneous entity. Objective: The purpose of this article is to describe the characteristic features of this nevus and to give it a name. Method: From the study of two cases and from a review of the literature we delineate the clinical and histopathological criteria of this disorder for which we propose the term ‘nevus psiloliparus’. This name is derived from the Greek words psilós = hairless and liparós = fatty, and describes the two most characteristic features of the disorder. Results: A comprehensive comparison shows that nevus psiloliparus can be distinguished from other types of fatty tissue nevi by clinical criteria such as localization on the scalp, a flat smooth surface and absence of hair follicles, by the histopathological feature of isolated arrector pili muscles and by the presence of associated extracutaneous features in the form of encephalocraniocutaneous lipomatosis. In particular, nevus psiloliparus can be separated from the Hoffmann-Zurhelle nevus that has so far never been observed in cases of encephalocraniocutaneous lipomatosis. Conclusion: The presently available data suggest that nevus psiloliparus represents a distinct cutaneous entity. Future clinical and genetic research should show whether this concept holds true.