Triangular Alopecia Research Articles

Variable Clinical Features of Temporal Triangular Alopecia

Variable Clinical Features of Temporal Triangular Alopecia

Clinical and dermatoscopic features of temporal triangular alopecia in infants.

To summarize the clinical and dermatoscopic features of temporal triangular alopecia in infants and explore the clinical significance of dermatoscopy in the diagnosis of triangular alopecia temporalis in infants. A retrospective analysis was performed on 20 children with temporal triangular alopecia diagnosed in the dermatology clinic of Tianjin Children's Hospital from January 2015 to December 2021. Dermatoscopy was performed on all children, and images were collected. The clinical features of 20 children were 15 males and five females, all of which were born immediately after birth; There were eight cases (40%) in the left temporal region, 10 cases (50%) in the right temporal region, one case (5%) in the head region, and one case (5%) in the occipital region; 19 cases were single (95%), one case was multiple (5%); There were 21 skin lesions, 15 triangular lesions (71.4%), four quasi-circular lesions (19%), and two lance-shaped lesions (9.5%). Trichoscopic features: The hair follicle opening in all skin lesions is normal, and the hair follicle opening can be seen with fluffy hair (vellus hair). The vellus hair is evenly distributed, and the length is diverse (both short and long vellus hair exist in the same hair loss area). There are 14 cases of white vellus hair (70%), five cases of white spots (25%), one case of honeycomb pigment pattern (5%), and one case of vascular dilation pattern (5%). Temporal triangular alopecia in infants has typical clinical and dermatoscopic characteristics, and the dermatoscopy can provide clinical basis for its diagnosis and differential diagnosis.

A Case of Temporal Triangular Alopecia in a Chinese Child Misdiagnosed with Alopecia Areata

A Case of Temporal Triangular Alopecia in a Chinese Child Misdiagnosed with Alopecia Areata

Two Cases of Temporal Triangular Alopecia

Temporal triangular alopesi (TTA), doğumda ya da erken çocukluk çağında ortaya çıkan, sıklıkla frontotemporal bölgede unilateral ya da bilateral yerleşim gösteren, asemptomatik, skar bırakmayan lokalize saç kaybıdır. Etkilenen bölgede tam bir saç kaybı olabilir ya da ince vellüs tüyleri görülebilir. Alopesi genellikle kalıcıdır. Çoğunlukla alopesi areata ile karıştırılmasından dolayı literatürde bildirilen TTA olguları az sayıdadır. Burada öykü ve klinik inceleme ile TTA tanısı alan iki olgu sunularak literatür gözden geçirilecektir.

Occipito-Linear and Temporo-Fronto-Parietal Alopecia as a Form of Transient Hair Loss in Infants

Neonate’s temporal triangular alopecia, transient neonatal hair loss (TNHL) or neonatal occipital alopecia (NOA) is observed in the occipital of infants at the second to third months after birth in a band–like shape or oval alopecia patch. We present two infants with hypotrichosis over the occipital region and fronto-temporo-parietal region in triangular form bilaterally, based on the clinical hypotrichosis distribution pattern and trichoscopic features, with the exclusion of other alopecias. The diagnosis of occipito-linear and triangular fronto-temporo-parietal marginal alopecia was made accordingly. We also discussed the two different lesions in the presented case as a combined form of neonatal occipital alopecia.

Congenital triangular alopecia: Clinical and dermoscopic differentials

Congenital triangular alopecia (CTA), also known as temporal triangular alopecia; originally described by Sabouraud in 1905; is a type of triangular, unilateral, nonprogressive, noncicatricial type of alopecia affecting mostly the temporal region of the scalp. It usually presents at birth or in early childhood, however adult cases have also been reported. Routinely confused with alopecia areata; dermoscopy helps in the diagnosis of this condition. We report a case of CTA with clinical and dermoscopic findings and discuss the differential diagnosis.

Clinical-histopathological profile of the frontal fibrosing alopecia: a retrospective study of 16 cases of a university hospital

AbstractBackground: Frontal fibrosing alopecia is a condition of unknown origin, histologically similar to classic lichen planopilaris and generally observed in postmenopausal women with alopecia of the frontal-temporal hairline.Objectives: To describe the clinical, dermatoscopic, and histopathological characteristics and the treatment used in patients who have frontal fibrosing alopecia at the Alopecia Outpatient Clinic in a university hospital.Methods: Retrospective descriptive study performed by reviewing medical charts and biopsies of the scalp.Results: Sixteen patients were analyzed, all of them female, 93.75% of them postmenopausal, and 56.25% brown-skinned. All had frontal alopecia (100%), followed by temporal alopecia (87.5%) and madarosis (87.5%). On dermatoscopy, perifollicular erythema and tubular scales were found as a sign of disease activity. Of the patients, 68.75% had associated autoimmune diseases, including lupus, thyroid disease and vitiligo. Of the 13 biopsies from 8 patients, 10 showed microscopic aspects compatible with frontal fibrosing alopecia. Laboratory tests did not show major abnormalities and minoxidil was the most used treatment.Study limitation: Data collection limited by the study’s retrospective design associated to flaws while filling in the medical charts and absence in standards to the collection and processing of the pathology and histopathological examination.Conclusion: A demographical, clinical, and histopathological description of 16 patients diagnosed with frontal fibrosing alopecia, which remains a challenging disease, of unknown origin, and frequently associated with autoimmune diseases. This study reinforces literary findings. However, more research is needed to establish the pathogenesis and effective treatments.

Pallister-Killian syndrome: clinical, cytogenetic and molecular findings in 15 cases

BackgroundPallister Killian syndrome (PKS, OMIM 601803) is a rare genetic disorder with a distinct phenotype caused by tissue- limited mosaicism tetrasomy of the short arm of chromosome 12, which usually cytogenetically presents as an extra isochromosome 12p.Wide phenotypic variability in PKS has been reported, ranging from pre-to perinatal death due to multiple congenital anomalies, especially diaphragmatic hernia, and classic phenotypes including seizures, severe developmental delay, macrosomia at birth, deafness, and distinct dysmorphic features, such as coarse face, temporal alopecia, a small nose with anteverted nostrils, long philtrum, and hypo−/hyper- pigmented streaks on the skin.ResultsKaryotypes obtained from cultured peripheral lymphocytes of 13 cases, who were diagnosed as PKS, were normal, while karyotypes obtained from cultured skin samples and buccal mucosa revealed the supernumerary mosaic i(12p). Mosaic karyotype was found in both fibroblast and buccal mucosa in 14 of 15 patients in our series, whereas in one stillbirth, following the clinical diagnosis of PKS, skin and buccal smear samples were taken, and all karyotypes from cultured fibroblasts revealed a supernumerary i(12p), while I-FISH study showed 60% mosaicism in mucosal cells.ConclusionsWe here share the clinical, cytogenetic and molecular cytogenetic findings of 15 cases with PKS phenotype and the parental origin of seven i(12p) identified by molecular analyses. To our knowledge, this is the largest series of PKS patients with parental origin study from a single center. We believe that our study makes a significant contribution to the literature because we specifically found no differences in the phenotypes of cases with either a maternal or paternal origin of the extra element and differential imprinting appeared not to be a factor.

Triangular Temporal Alopecia - Two Case Reports, Dermoscopy and Review

Triangular Temporal Alopecia - Two Case Reports, Dermoscopy and Review

Sporadic association of Legg–Calve–Perthes disease with rare phakomatoses-Gomez-Lopez-Hernandez syndrome

Gomez-Lopez-Hernandez syndrome (GLH) is a very rare phakomatosis, which is characterized by the triad of rhombencephalosynapsis, facial anesthesia in the trigeminal area, and scalp alopecia. A 9-year-old boy with pain and limping right hip for 6 months was presented. Clinically, he was having bilateral symmetrical temporal alopecia, strabismus, and pseudoproptosis. Magnetic resonance imaging brain shows cerebellar fusion. Examination of the hip was consistent with the diagnosis of Perthes disease. Even though some of the phakomatoses are associated with skeletal abnormalities, there is no association of any phakomatoses with Legg–Calve–Perthes disease (LCPD) of the hip. This will be the first ever report of an association of GLH syndrome with LCPD.

Clinical and trichoscopic characteristics of temporal triangular alopecia: A multicenter study

Clinical and trichoscopic characteristics of temporal triangular alopecia: A multicenter study

Trichoscopy of Focal Alopecia in Children - New Trichoscopic Findings: Hair Bulbs Arranged Radially along Hair-Bearing Margins in Aplasia Cutis Congenita

Purpose: To establish whether trichoscopy can be useful in the differential diagnosis of patchy alopecia in children. Procedures: The study was a retrospective analysis (2012-2015) and included 68 patients under 6 years of age. The inclusion criteria were age and the presence of 1-3 alopecia patches. A total of 124 alopecia patches were examined with the use of a videodermoscope: 102 alopecia areata, 8 tinea capitis, 6 trichotillomania, 3 temporal triangular alopecia and 5 aplasia cutis congenita. Results: In all aplasia cutis congenita lesions, trichoscopy revealed elongated hair bulbs visible through the semitranslucent epidermis, seen at the hair-bearing margin and radially arranged. Hair regrowth [upright regrowing hairs (44%), circular hairs (23%) and vellus hairs (20%)] was observed in the majority of alopecia areata patches. For triangular alopecia, upright regrowing hairs (100%; 3/3), vellus hairs (100%; 3/3) and circle hairs (33%; 1/3) were seen inside the alopecia patch. Conclusion: Trichoscopy is a useful technique for the differential diagnosis of patchy alopecia in children. A novel finding in this study indicates that radially arranged hair bulbs visible through the translucent epidermis are characteristic of nonbullous type aplasia cutis congenita.

Trichoscopic and clinical characteristics of temporal triangular alopecia. A multicenter study

Trichoscopic and clinical characteristics of temporal triangular alopecia. A multicenter study

Direct brow lifting: Specific indications for a simplified approach to eyebrow ptosis.

Context:Brow lifting is an essential element in the rejuvenation of the ageing face. Various surgical techniques have been described. Among these, the direct brow lifting is an easy and effective technique that is often neglected because the scar can remain visible. Thus, this approach is usually reserved for elderly patients and males, with thick bushy brows.Aims:The authors present their result from a series of fifty consecutive patients treated over 2 years with direct brow lift. The aim is to demonstrate when the hairline is high or temporal alopecia is present and whether this technique is the best in bald patients, when some surgical steps are carefully adhered to. In these cases, the scar is less visible, hidden in the brow and is a good solution in women too.Subjects and Methods:Between January 2011 and January 2013, fifty patients underwent direct brow lift surgery. All were men. In all the cases, brow lifting was undertaken together with an upper blepharoplasty. The amount of brow elevation produced was assessed by comparing the vertical distances between the superior eyebrow hairline and the inter-pupillary line, pre- and post-operatively. The result and the scar quality were assessed both by the patient and the surgeon.Statistical Analysis Used:The paired t-test.Results:The authors obtained statistically significant results in brow elevation in 98% of the patients after a 12-month follow-up. The main complication associated with this procedure was visibility of the scar in two patients.Conclusions:The direct brow lift technique in bald men and with a high anterior hairline provides excellent and long-lasting results.

Dermoscopic Findings of Temporal Triangular Alopecia

Dermoscopic Findings of Temporal Triangular Alopecia

A novel KRT86 mutation in a Turkish family with monilethrix, and identification of maternal mosaicism.

Monilethrix is a rare monogenic dystrophic hair loss disorder with high levels of intrafamilial and interfamilial variability. It is characterized by diffuse occipital or temporal alopecia, hair fragility and follicular hyperkeratosis of the occipital region. Mutations in the keratin genes KRT81, KRT83 and KRT86 lead to autosomal dominant monilethrix, whereas mutations in the desmoglein 4 gene (DSG4) cause an autosomal recessive form. To identify the mutation in a consanguineous Turkish family with three affected children and apparently unaffected parents. Sequencing analysis of the genes DSG4 and KRT86 was performed. SNaPshot analysis was conducted to quantify the proportion of cells carrying the KRT86 mutation and to confirm maternal mosaicism of KRT86. No pathogenic mutation was found by sequencing analysis of DSG4; however, analysis of KRT86 revealed a novel mutation, c.1231G>T;p.Glu411*, in exon 7 in the three affected children and their mother. The mutation signal was weaker in the mother than in the three siblings, and SNaPshot analysis revealed substantial mutation-level variation between the children and their mother. Our results extend the spectrum of KRT86 mutations and indicate KRT86 mosaicism in the family examined. This study is the first, to our knowledge, to describe mosaicism for a monogenic hair loss disorder, and suggests that mosaicism leads to a mild manifestation of monilethrix.

Congenital triangular alopecia

Congenital triangular alopecia (CTA) also known as temporal triangular alopecia is a benign noncicatricial pattern of hair loss. It typically affects the frontotemporal region and rarely involves the temporoparietal or occipital scalp. It is a nonprogressive disorder that presents as a triangular, oval or lancet-shaped patch of alopecia. CTA can manifest at birth or develop later in life. The exact etiology of this condition remains unknown. Rarely, it may be associated with other disorders such as Down's syndrome and phakomatosis pigmentovascularis. The diagnosis is based on its distinct clinical appearance. Histologically, hair follicles are miniaturized and replaced by sparse vellus hair follicles. Tricoscopy using a polarized light handheld dermatoscope can be a useful diagnostic tool. CTA is often asymptomatic and remains unchanged throughout the life. No treatment is required. Surgical intervention with follicular unit hair transplantation can provide a satisfactory cosmetic result. In this paper, we have identified 126 cases of CTA in the published literature cited on PubMed between 1905 and 2015. From the available evidence, 79% of patients with CTA presented with unilateral hair loss, 18.5% with bilateral involvement and rarely, with occipital alopecia (2.5%). There was no gender predilection. These figures are entirely consistent with previously published data. Physicians should remember to consider CTA as a potential diagnosis in any patient presenting with a nonscarring alopecia in order to avoid unnecessary investigations and treatments.

TRICOSCOPIA - UMA FERRAMENTA ÚTIL NO DIAGNÓSTICO DA ALOPECIA TRIANGULAR TEMPORAL

Os autores descrevem o caso de um menino de 3 anos de idade, saudável, com o diagnóstico de alopecia triangular temporal, e abordam os principais aspectos clínicos e tricoscópicos desta condição, comparando-a de um ponto de vista tricoscópico, com outras causas de alopecia focal.

Cardiac manifestations of Pallister–Killian syndrome

Pallister-Killian syndrome (PKS) is a sporadic multisystem genetic diagnosis characterized by facial dysmorphia, variable developmental delay and intellectual impairment, hypotonia, hearing loss, seizures, differences in skin pigmentation, temporal alopecia, diaphragmatic hernia, congenital heart defects, and other systemic abnormalities. Although congenital heart defects have been described in association with PKS, the full spectrum of heart disease is still not entirely known. Here, we describe the pattern of cardiac findings of 81 probands with PKS who have had at least one cardiac evaluation, demonstrating structural heart difference in 37% of our cohort (n = 30). Septal defects such as atrial or ventricular septal defects (n = 12) were the most commonly seen congenital heart differences. Additional findings included the occasional occurrence of bicuspid aortic valve, aortic dilatation, and cardiac hypertrophy/cardiomyopathy. We suggest cardiac evaluation for all individuals with PKS at the time of diagnosis as well as subsequent longitudinal follow-up to monitor for the development of cardiomyopathy and aortic dilatation.

Double-Skin Paddled Superficial Temporofascial Flap for the Reconstruction of Full-Thickness Cheek Defect

The most common causes of cheek defects include trauma, burn, and tumor resections. In the reconstruction of the defects in this region, it is essential to use similar or adjacent tissue considering the aesthetic and functional properties. For this purpose, numerous local, regional, or distant free flaps were described. The local flaps harvested from the head and neck region are the most frequent methods because of the similar skin color, texture, and compatibility with cheek.In this study, the reconstruction in a 29-year-old male patient who had a full-thickness cheek defect due to tumor resection on the left side was performed, wherein a hairless skin island was carried through the frontal branch of superficial temporal artery for oral mucosa, and a hairy skin island through the parietal branch of the same pedicle was carried for the bearded skin defect. No complication occurred postoperatively and both aesthetic and functional satisfactory results were obtained, providing the oral mucosal and natural beard integrity. Donor-site scarring and temporal alopecia were recorded as the disadvantages of this method.This technique is a useful method for the reconstruction of full-thickness cheek defects because of its advantages including compatibility of color and texture, reliable blood supply, requiring single-session procedure, and being able to carry 2 different skin islands on the same pedicle.