|Year : 2011 | Volume
| Issue : 3 | Page : 25-26
Session L: Short Presentations
|Date of Web Publication||16-Jun-2011|
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
. Session L: Short Presentations. Int J Trichol 2011;3, Suppl S1:25-6
Forensic examination of hair
Avner Rosengarten , Tzvi Rosenberg
Israel Forensic Science Institute, Jerusalem, Israel.
Hair plays an important role in crime scene investigation. The main purpose of the forensic examination of hair is to find the owner of a single hair found at crime scene. Forensic scientists submit the hair to four inspecting zones: Morphological characteristic of the hair, The root, inner structures and additives in the shaft, outer treatments. Each of these zones provides information about the owner of the hair, about materials used by the owner of the hair, and about the origin of the hair. Forensic examinations of hair include microscopic inspections, DNA and other biological tests, and chemical analysis of the hair and its additives.
Hair-related toxicity of cancer therapies
Sharett Institurte of Oncology, Hadassah- Hebrew University Medical Center, Jerusalem, Israel.
Chemotherapy-induced hair loss is one of the most feared side effects of cancer treatment. Within days to weeks from initiation anagen effluvium ensues and 80-90% of scalp hair may be lost. Scalp cooling usually fails to protect against alopecia and cell cycle arrest stopping keratinocytes division is experimental. Despite the lack of effective solutions, therapy related hair loss is seen less often. There are several reasons for this change: (1) wider use of non-alopetic drugs such as vinorelbine and gemcitabine; (2) preference of daily and weekly protocols over tri-weekly and monthly; and (3) new therapies including tyrosine kinase receptor inhibitors. The widely used epidermal growth factor inhibitors and other TKI blockers may cause partial hair loss in a more complex mechanism. Toxicity is also seen with other components of the hair-sebaceous unit accompanied with severe photosensitivity. In this talk new therapies against cancer will be reviewed for their effect on hair biology.
Evaluation of women with hirsutism
Endocrinology and Metabolism Service, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Hirsutism, defined as excessive male-pattern hair growth, affects between 5 and 10 percent of women of reproductive age. It may be the initial, and possibly only, sign of an underlying androgen disorder. The most common causes of hirsutism are idiopathic, polycystic ovary syndrome (PCOS) and non-classical 21-hydroxylase deficiency. Rare but serious causes include ovarian and adrenal androgen-secreting tumors. Abrupt onset, short duration, progressive worsening of hirsutism, onset late in life and elevated serum androgen concentrations raise the possibility of an androgen secreting tumor. The clinical evaluation includes the Ferriman-Gallwey clinical score on physical examination used to grade the severity of hair growth (normal ≤3) and laboratory testing including: Testosterone (total or free) (the most sensitive test) and DHEA-S. Prolactin, 17-OH-progesterone, testing for Cushing's syndrome are sometime indicated. Imaging is indicated when marked hyperandrogenism is present.
Graham-little-piccardi-lassauer syndrome associated with 46 XY complete gonadal dysgenesis
Amanda Hertz*, Adriana Llamas, Barbara Porto, Leonardo Spagnol Abraham, Celso Sodré, Fernanda Torres
Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa de Misericórdia, Rio de Janeiro, Brasil.
Graham-Little-Piccardi-Lausser syndrome (GLPL) is characterized by the triad of scarring alopecia of the scalp, noncicatricial loss of pubic and axillary hair and keratosis pilaris of the trunk and extremities. Most patients are adult women. Although its etiology is controversial, it has been considered a form of lichen planopilaris (LPP) based on clinical and histopatolological similarities. We report an 18 years-old female presenting progressive scarring alopecia of the vertex, hair loss of axillas and pubis, and disseminated follicular papules in the face, trunk and extremities that lasted for 5 years. Oral mucosa and nails were normal. Dermoscopy of the scalp showed erythema and perifollicular scaling. Past medical history revealed a 46 XY Complete Gonadal Dysgenesis and metabolic syndrome. She was taking oral oestrogens and progestagens for 2 and 1 years, respectively. Histopathology of the scalp was compatible with LPP. Recently, a case of GLPL associated with androgen insensitivity syndrome was described, raising the question about the actual role of the androgens in the pathogenesis of LPP. This correlation had been discussed since it has been reported that some patients with LPP seems to arrest the disease with anti-androgens. We report for the first time an association of GLPL syndrome with 46 XY complete gonadal dysgenesis. Our case support the idea that maybe other hormones such as oestrogens may play a major role in this condition. Further studies are needed to better understand the correlation between GLPL, LPP and sexual hormones.
Clinical aspects on neonatal hair
Department of Dermatology, Hospital Clínic, University of Barcelona, Spain.
Hair diseases represent a significant portion of cases seen by paediatric dermatologists although hair has always been a secondary aspect in paediatricians and dermatologists training, on the erroneous basis that there is not much information extractable from it. Dermatologists are in the enviable situation of being able to study many disorders with simple diagnostic techniques. The hair is easily accessible to examination but, paradoxically, this approach is often disregarded by non-dermatologist. On the purpose of trying to serve in the diagnostic process of daily practice, and trying to help, for example, to distinguish between certain acquired and some genetically determined hair diseases, this abstract has been written. We will focus on all the data that can be obtained from our patients hair and try to help on using the message that hair is giving us in each patient. Quite often is extremely hard to distinguish between abnormality and normality in neonatal hair aspects. We will specially focus in the most common physiological changes that may mislead to an incorrect diagnosis. Specific treatment for those hair diseases that do have one, and basic general approach to improve the cosmetic appearance of hair, will be also given for those hair disturbances that do not have a specific treatment.
Frontal fibrosing alopecia, vitiligo and hypothyroidism in twin sisters: A shared autoimmune pathogenesis
Cheryl Aber,* Mariya Miteva, Antonella Tosti
Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine; Miami, USA.
A 67 year old Caucasian woman presented with a prolonged history of progressive hair loss on the frontal scalp. Concurrently, she developed hair loss of her eyebrows and extremities. At age 13, she was diagnosed with vitiligo and hypothyroidism. Her identical twin sister also developed vitiligo, hypothyroidism and progressive hair thinning at age 23. On examination, the frontal-parietal scalp exhibited an atrophic band-like alopecia with confluent areas of depigmentation. Dermoscopy demonstrated an absence of follicular ostia and confluent hypopigmentation within the band, as well as perifollicular erythema with casts surrounding the remaining scalp hairs. She also exhibited patchy hair loss of the eyebrows and near complete hair loss of the extremities. A dermoscopy guided 4 mm punch biopsy from the scalp revealed a lichen planopilaris (LPP) pattern on vertical section. A dermoscopy guided biopsy from the extremity showed a similar pattern. Special stains including Fontana-Masson and MART-1 were negative, consistent with vitiligo. The diagnosis of frontal fibrosing alopecia (FFA) and vitiligo was confirmed. Colocalization of vitiligo and cutaneous lichen planus has been reported. Our case is the first report of colocalization of FFA and vitiligo in identical twin sisters with hypothyroidism. In FFA, the keratinocytes of the outer root sheath are continuous with the epidermal keratinocytes, and are thus susceptible to the same CD8+ lymphocytic inflammatory infiltrate which is seen in lichen planus and vitiligo.
Netherton's syndrome: Report of two cases - 15 years after
Clinic of Dermatovenereology, Medical Military Academy and Medical School University of Belgrade, Serbia.
E-mail: firstname.lastname@example.org; email@example.com
Here we report two cases of Netherton`s Syndrome (NS) observed in 20 year old male and his sister, 18 year old female. 15 years ago, these two cases, among 5 other children, were presented and published in the Giorn. Int. Derm. Ped., VIII, 2, 1996 - by the same author. Unfortunately, since then, there was no follow-up by dermatologist, so, they are presented to us after long period of time. In their available medical record, our previous documentation was missing. The disease featured the classical association of ichthyosis linearis circumflexa (ILC), trichorrhexis invaginata (TI), atopic diathesis (AD), and high serum IgE levels. There is also, as it was in the past, considerable clinical, immunological, and hair microscopical findings polymorphism. It is mostly presented now, as a significant improvement of skin and hair alterations in female. Furthermore, we are going to discuss the importance of follow-up in patients with NS. It is also need to be mentioned the existence of possible difficulties in establishing exact diagnose in elderly (after the childhood and puberty) NS patients, particularly in exceptional cases of missing previous medical documentation or follow-up.
Female pattern hair loss: Patterns, pathogenesis and pitfalls
Department of Dermatology, T.N. Medical College and B.Y.L. Nair Hospital, Mumbai Central, Mumbai, India.
Genetics of FPHL is complex. Polymorphism of androgens receptor gene, aromatase gene and Polymorphism of estrogen receptor beta gene (ESR 2) have been implicated. Women tend to have less obvious pattern of hair loss than men and non pattern types of hair loss are frequent in women than in men. Various patterns have been described. Patterns that may occur include: Diffuse central thinning with preservation of frontal margin, Frontal accentuation (Christmas tree), diffuse thinning of hair over entire scalp, often more noticeable thinning towards the back of the scalp, diffuse thinning of hair over the parietal region, Male pattern, There is no any recession of the frontal hairline although the hair on the frontal margin are miniaturized i.e. finer and shorter. Pitfalls are seen in prevalence, diagnosis, grading scales etc. True prevalence of female pattern hair loss is difficult to determine given that most authors either have not clearly stated the diagnostic criteria used or have chosen to focus on only one pattern of FHPL. Conventional classification systems like the Ludwig are over simplified and hence not very sensitive. Savin classification system is too complicated for everyday-use. Sinclair classification system is not known to all. BASP scale also has pitfalls. Not all patients of FPHL will present with obvious thinning, while patients with CTE may present with bitemporal recession, thus confusing the clinical picture. Dermatoscopy has not been promising tool in women with FPHL without increased thinning over the scalp.
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