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Practical Dermoscopy
Erythematous Scaly Plaque
Placa eritemato descamativa
P. Vilas Boas
Corresponding author
Pedro.22.pvb@gmail.com

Corresponding author.
, I. Hernández-Aragües, O. Baniandrés-Rodríguez
Servicios de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Dermoscopy showing comma hairs &#40;arrow&#41; and curly hairs &#40;&#42;&#41; associated with broken hairs &#40;arrow tip&#41;&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Case Description</span><p id="par0005" class="elsevierStylePara elsevierViewall">A 73-year-old woman with a history of systemic lupus erythematosus &#40;SLE&#41;&#44; predominantly affecting the joints&#44; and palmoplantar pustulosis visited our department with a plaque of alopecia on the scalp that had appeared a year earlier&#44; coinciding with an episode of SLE &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">&#91;&#91;&#63;&#93;&#93;What is your Diagnosis&#63;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Diagnosis</span><p id="par0015" class="elsevierStylePara elsevierViewall">Tinea capitis&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Comment</span><p id="par0020" class="elsevierStylePara elsevierViewall">We report the case of a 73-year-old woman with a history of alopecia plaques that had appeared a year earlier&#46; The plaques of alopecia have poorly demarcated edges and intense&#44; thick desquamation&#46; A polarized-light dermoscopy study revealed abundant comma hairs &#40;arrow&#41; and curly hairs &#40;&#42;&#41; associated with broken hairs &#40;arrow tip&#41; and intense desquamation &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">The presence of these dermatoscopic structures led to the clinical suspicion of tinea capitis&#44; which was subsequently confirmed from a culture of scales from the lesion&#44; from which <span class="elsevierStyleItalic">Microsporum canis</span> was isolated&#46; Treatment was instated with itraconazole at a dosage of 100&#8239;mg per day for a month&#44; with resolution of the lesions&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Comma hairs and broken hairs were initially reported as markers for tinea capitis due to <span class="elsevierStyleItalic">Microsporum canis</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Subsequent publications described corkscrew hairs in infections by <span class="elsevierStyleItalic">Microsporum</span> and in infections by <span class="elsevierStyleItalic">Trichophyton</span>&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The main differential diagnoses include other scaly erythematous skin disorders&#44; such as seborrheic dermatitis&#44; psoriasis&#44; lupus erythematosus discoides&#44; and lichen planopilaris&#46; Lupus discoides is characterized by the presence of red spots and follicular plugs&#44; which subsequently evolve into the loss of follicular ostia&#46; Lichen planopilaris is characterized by erythema and perifollicular hyperkeratosis that evolves into erythematous areas without follicular ostia&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Psoriasis of the scalp is characterized by its vascular pattern on dermatoscopic examination&#44; with forked or looped vessels&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Tinea capitis is characterized by broken hairs&#44; comma hairs and corkscrew hairs associated with desquamation of the scalp&#46; This pattern is useful for the differential diagnosis with other scaly erythematous disorders of the scalp&#44; such as lupus discoides or psoriasis&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Conflicts of Interest</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Vilas Boas P&#44; Hern&#225;ndez-Arag&#252;es I&#44; Baniandr&#233;s-Rodr&#237;guez O&#46; Placa eritemato descamativa&#46; Actas Dermosifiliogr&#46; 2021&#59;112&#58;169&#8211;170&#46;</p>"
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