Linear Alopecia Research Articles

Linear Alopecia in a Healthy Young Woman: Answer.

Linear Alopecia in a Healthy Young Woman: Answer.

Linear Alopecia in a Healthy Young Woman: Challenge.

Linear Alopecia in a Healthy Young Woman: Challenge.

Linear alopecia in pediatrics: RCM and dermoscopy reveal diagnostic cues.

Alopecia areata (AA), trichotillomania (TM), nevus sebaceous (NS), and linear scleroderma en coup de sabre (LSCS) can all present with a patch of linear alopecia, making diagnosis challenging. The purpose of this study was to combine reflectance confocal microscopy (RCM) and dermoscopy in the diagnosis of these lesions in children. A total of 36 patients with linear alopecia were enrolled, of whom 14 had AA, seven had TM, nine had NS, and six had LSCS. We evaluated the characteristics and distinguishing features of the four conditions using RCM and dermoscopy. The key to differential diagnosis was the dermal Hair follicle density in the dermis was decreased in AA, and the size and density of the follicular openings were normal in TM. In NS, the major features were petal-like and frogspawn-like structures. In LSCS, dermal papillary rings, sebaceous glands, and follicles were partially or completely missing, and abundant fibrous material was distributed in the dermis. Dermoscopy revealed alopecia, and all four conditions resulted in decreased hair density. AA patients exhibited yellow dots, black dots, and exclamation mark hairs. TM patients presented with irregularly broken hairs and blood spots. Both NS and LSCS patients exhibited an absence of follicular openings; NS patients demonstrated whitish and yellowish round structures, while an atrophic area with white patches, linear vessels, and no yellow or black dots was observed in LSCS patients CONCLUSION: RCM combined with dermoscopy can provide additional information on disease states and differentiate between AA, TM, NS, and LSCS.

BH14: Linear alopecia affecting eyelashes, eyebrow and scalp

BH14: Linear alopecia affecting eyelashes, eyebrow and scalp

Distinctive lupus panniculitis of scalp with linear alopecia along Blaschko's lines: a review of the literature

Lupus panniculitis of the scalp (LPS) is a rare and distinctive clinical feature of lupus erythematosus panniculitis (LEP) with linear alopecia along Blaschko's lines. In this study, we investigated clinical features and treatments of LPS by literature review of articles in the English language from PubMed and SCOPUS databases up to April 2018. The following key words, "lupus panniculitis, "lupus erythematosus panniculitis", "lupus profundus", "head", and "scalp", were used. Twenty cases of LPS were identified (mean age=26.4 [10-53] years, female: male ratio=1:1, mean disease duration=86.89 [8-336] weeks). The most commonly affected areas of scalp included parietal (70%), frontal (45%), temporal (40%), occipital (30%), and vertex (10%), along 70% of Blaschko's lines with morphologic lesions linear, annular, arch-shaped, and ulcer. Besides, ANA (60%) was in particular noted. Hydroxychloroquine, oral prednisolone, intralesional corticosteroid, and methotrexate were the most common treatments, with complete response after an average period of 8.08 (2-12) weeks. Systemic lupus erythematosus (SLE) was developed in four cases (20%) during follow-up, with high recurrence of 35%. We reported distinctive and rare cases of LPS.The continuing follow-up was highly recommended to avoid probable recurrence and SLE development.

Linear alopecia areata versus trichotillomania: The game of time

Linear variant of alopecia areata (AA) is a rare entity posing as a diagnostic challenge owing to the ability to mimic multiple conditions ranging from trichotillomania, dermatitis artefacta to linear lupus erythematosus profundus. Awareness regarding this entity optimized with dermoscopy and histopathology examination is essential for an effective diagnosis and treatment. Herein, we describe a case of a 7-year-old female with linear AA simulating trichotillomania which we believe is the first reported case in pediatric age group in India.

A band-like balding disorder

An erythematous, non-scaling indurated plaque appeared on the forehead of a 34-year-old white man. Over a period of approxinately 1 year, it extended onto the scalp, resulting in a linear non-scarring alopecia, seemingly following the lines of Blaschko (fi gure). Initial therapy with topical glucocorticoids failed, and a skin biopsy was taken. Histopathological examination showed a normal epidermis, accumulation of mucin in the dermis, and lymphocytic panniculitis (fi gure). Linear cutaneous lupus profundus was diagnosed. Laboratory tests were normal, apart from positive antinuclear anti bodies (1:200) and slightly increased C3d complement. Under oral hydroxychloroquine therapy the disorder resolved within 12 weeks, followed by complete regrowth of hair. No relapse occurred during 1 year of maintenance treatment. The face and scalp are predilection sites of cutaneous lupus erythematosus profundus. This can result in an alopecia areata-like clinical picture or nonscarring linear alopecia, which has thus far mainly been reported in east Asians.

Linear lupus panniculitis of the scalp presenting as alopecia along Blaschko’s lines: A distinct variant of lupus panniculitis in East Asians?

A 32-year-old Taiwanese man presented to our clinic with a 6-month history of linear hair loss in a wavy and curved pattern across the parietal and occipital scalp, resembling the distribution of Blaschko's lines. Physical examination showed interfollicular erythema and follicular plugging without skin atrophy or sclerotic change. Histopathology revealed a lymphoplasmacytic infiltrate in the perifollicular dermis and subcutis with abundant mucin deposition, consistent with the diagnosis of lupus panniculitis. Treatment with hydroxychloroquine and local steroid injection resulted in complete hair regrowth but recurrence was noted. Linear lupus panniculitis of the scalp presenting as alopecia along Blaschko's lines had so far been reported exclusively in five East Asians. Apart from classical lupus panniculitis, it had distinct clinical and histopathological features such as younger age of onset, male predominance, reversible clinical course without scarring, fewer associations with systemic lupus erythematosus, exclusive involvement of scalp, sparse inflammatory infiltration, abundant mucin deposition, higher degree of hyaline fat degeneration and negative results of immunofluorescent studies. Therefore, we propose linear lupus panniculitis of the scalp to be a distinct variant of lupus panniculitis and should be included in the differential diagnosis for focal or linear alopecia, especially in East Asians.

Two Cases of Linear Alopecia on the Occipital Scalp

Alopecia of a scalp shows various shapes and extents of hair loss, from a small round patch to polymorphous patches or total global alopecia. But alopecia of a linear shape is very rare. Only a few such cases have currently been reported in the medical literature. We recently had the chance to observe and treat two cases of linear alopecia that developed on the occipital scalp. The lesions themselves were like alopecia areata that shows a smooth bald area without any abnormality except the hair loss, but histopathologically, the lesions were compatible with lupus erythematosus profundus.

Novel EBP gene mutations in Conradi–Hünermann–Happle syndrome

Conradi-Hünermann-Happle syndrome [X-linked dominant chondrodysplasia punctata type 2 (CDPX2); MIM no. 302960] is an X-linked dominant disorder of cholesterol metabolism that causes a wide spectrum of skeletal abnormalities and linear ichthyosiform skin lesions. Mosaicism is probably responsible for the variability of the phenotype. To describe new mutations in patients with variable manifestations of the disease. We studied three patients with CDPX2. We performed mutation analysis of the EBP (formerly known as CDPX2) gene and gas chromatography-mass spectroscopy on serum of two patients. We found two novel (3G-->T and 419-422delTTCT) and one known mutation in the EBP gene. We demonstrated the presence of increased levels of dehydrocholesterol and 8(9)-cholestenol in the two patients with new mutations, confirming the diagnosis of CDPX2 and strongly suggesting that the mutations are indeed pathogenic. One patient had a very mild phenotype, presenting with linear alopecia and a mild symmetrical epiphyseal dysplasia. X-inactivation studies in peripheral blood of all patients showed skewing in only the most severely affected patient. The strong phenotypic variability in our patients suggests that there is no clear genotype-phenotype correlation.

Alopecia in the horse - an overview.

Dr Stannard explains different forms of alopecia in the horse with emphasis on the hair follicle and its function in the production of hairs. Both normal and abnormal patterns of hair growth and shedding in the horse are reviewed. Overviews of several specific hair follicle abnormalities, both inflammatory and noninflammatory, are discussed in detail with their clinical relevance. Some of the clinical entities covered in this section (linear alopecia and alopecia areata) are caused by immunological attack against normal structures and could have been placed in Immunologic diseases. However, because the clinical presentation for these entities is alopecia, Dr Stannard chose to include them in his notes on alopecia. Other inclusions in this section include cutaneous bacterial infections (e.g. pastern folliculitis and dermatophilosis) as well as fungal infections of the hair (dermatophytosis).

Oral calcitriol in the treatment of scleroderma 'en coupe de sabre'

A 20-year-old girl presented with a rapidly enlarging band of linear scleroderma involving the forehead and frontal scalp with linear alopecia. The parietal skull contained an arciform bone depression with mild thinning of the hair. Previous treatment with hydroxychloroquine and systemic steroids had failed to arrest the progression of the plaque. Treatment with calcitriol (Rocaltrol®, Roche) 0.75 m g/day for 12 months produced a prompt resolution of the perilesional erythema, gradual thinning of the band of scleroderma and partial hair regrowth. ( J Dermatol Treat (2000) 11: 207-208)

Update on Four Unusual Equine Dermatoses

This article discusses some new thoughts on the pathogenesis of four unusual equine dermatoses: reticulated leukotrichia, hyper-esthetic leukotrichia, mane and tail dystrophy, and linear alopecia of the Quarter Horse. Although many of the thoughts contained herein are speculative, it is hoped that they stimulate discussion among those of us interested in the wonderful world of equine dermatology. More importantly, it is hoped that they stimulate further investigation and research. These diseases represent only the tip of the iceberg pf what we don't know about equine skin diseases!

Linear alopecia mucinosa along Blaschko lines.

We present a case of linear reversible non-inflammatory alopecia mucinosa in a 25-year-old Nigerian patient. The patient exhibited an arciform bald patch on the scalp and follicular mucinosis in both lesions. The possible relationships between the unusual linear arrangement of alopecia mucinosa along Blaschko's lines and lichen striatus are discussed.

A reassessment of sympathetic blocks as long term therapeutic modality for “RSD”

This article discusses some new thoughts on the pathogenesis of four unusual equine dermatoses: reticulated leukotrichia, hyperesthetic leukotrichia, mane and tail dystrophy, and linear alopecia of the Quarter Horse. Although many of the thoughts contained herein are speculative, it is hoped that they stimulate discussion among those of us interested in the wonderful world of equine dermatology. More importantly, it is hoped that they stimulate further investigation and research. These diseases represent only the tip of the iceberg of what we don’t know about equine skin diseases!