Practical Dermoscopy
Erythematous Scaly Plaque
Placa eritemato descamativa
P. Vilas Boas
, I. Hernández-Aragües, O. Baniandrés-Rodríguez
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Servicios de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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Vilas Boas, I. Hernández-Aragües, O. Baniandrés-Rodríguez" "autores" => array:3 [ 0 => array:4 [ "nombre" => "P." "apellidos" => "Vilas Boas" "email" => array:1 [ 0 => "Pedro.22.pvb@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "I." "apellidos" => "Hernández-Aragües" ] 2 => array:2 [ "nombre" => "O." "apellidos" => "Baniandrés-Rodríguez" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicios de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Placa eritemato descamativa" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 605 "Ancho" => 905 "Tamanyo" => 171161 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Dermoscopy showing comma hairs (arrow) and curly hairs (*) associated with broken hairs (arrow tip).</p>" ] ] ] "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 (SLE), predominantly affecting the joints, and palmoplantar pustulosis visited our department with a plaque of alopecia on the scalp that had appeared a year earlier, coinciding with an episode of SLE (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">[[?]]What is your Diagnosis?</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Diagnosis</span><p id="par0015" class="elsevierStylePara elsevierViewall">Tinea capitis.</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. The plaques of alopecia have poorly demarcated edges and intense, thick desquamation. A polarized-light dermoscopy study revealed abundant comma hairs (arrow) and curly hairs (*) associated with broken hairs (arrow tip) and intense desquamation (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</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, which was subsequently confirmed from a culture of scales from the lesion, from which <span class="elsevierStyleItalic">Microsporum canis</span> was isolated. Treatment was instated with itraconazole at a dosage of 100 mg per day for a month, with resolution of the lesions.</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>.<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>.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The main differential diagnoses include other scaly erythematous skin disorders, such as seborrheic dermatitis, psoriasis, lupus erythematosus discoides, and lichen planopilaris. Lupus discoides is characterized by the presence of red spots and follicular plugs, which subsequently evolve into the loss of follicular ostia. Lichen planopilaris is characterized by erythema and perifollicular hyperkeratosis that evolves into erythematous areas without follicular ostia.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Psoriasis of the scalp is characterized by its vascular pattern on dermatoscopic examination, with forked or looped vessels.<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, comma hairs and corkscrew hairs associated with desquamation of the scalp. This pattern is useful for the differential diagnosis with other scaly erythematous disorders of the scalp, such as lupus discoides or psoriasis.</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.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:5 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Case Description" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Diagnosis" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Comment" ] 3 => array:2 [ "identificador" => "sec0020" "titulo" => "Conflicts of Interest" ] 4 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Vilas Boas P, Hernández-Aragües I, Baniandrés-Rodríguez O. Placa eritemato descamativa. Actas Dermosifiliogr. 2021;112:169–170.</p>" ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 661 "Ancho" => 905 "Tamanyo" => 159090 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Alopecia plaque with diffuse scaling and underlying erythema.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 605 "Ancho" => 905 "Tamanyo" => 171161 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Dermoscopy showing comma hairs (arrow) and curly hairs (*) associated with broken hairs (arrow tip).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comma hairs: a dermatoscopic marker for tinea capitis: a rapid diagnostic method" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 15 | 15 | 30 |
| 2024 Octubre | 115 | 40 | 155 |
| 2024 Septiembre | 114 | 33 | 147 |
| 2024 Agosto | 151 | 59 | 210 |
| 2024 Julio | 151 | 33 | 184 |
| 2024 Junio | 149 | 37 | 186 |
| 2024 Mayo | 150 | 34 | 184 |
| 2024 Abril | 125 | 39 | 164 |
| 2024 Marzo | 112 | 35 | 147 |
| 2024 Febrero | 137 | 39 | 176 |
| 2024 Enero | 143 | 35 | 178 |
| 2023 Diciembre | 126 | 21 | 147 |
| 2023 Noviembre | 152 | 33 | 185 |
| 2023 Octubre | 147 | 39 | 186 |
| 2023 Septiembre | 114 | 35 | 149 |
| 2023 Agosto | 83 | 25 | 108 |
| 2023 Julio | 106 | 37 | 143 |
| 2023 Junio | 82 | 24 | 106 |
| 2023 Mayo | 112 | 19 | 131 |
| 2023 Abril | 78 | 27 | 105 |
| 2023 Marzo | 94 | 29 | 123 |
| 2023 Febrero | 63 | 30 | 93 |
| 2023 Enero | 68 | 25 | 93 |
| 2022 Diciembre | 97 | 38 | 135 |
| 2022 Noviembre | 57 | 35 | 92 |
| 2022 Octubre | 47 | 18 | 65 |
| 2022 Septiembre | 65 | 44 | 109 |
| 2022 Agosto | 58 | 35 | 93 |
| 2022 Julio | 48 | 38 | 86 |
| 2022 Junio | 42 | 30 | 72 |
| 2022 Mayo | 117 | 44 | 161 |
| 2022 Abril | 130 | 29 | 159 |
| 2022 Marzo | 116 | 59 | 175 |
| 2022 Febrero | 102 | 32 | 134 |
| 2022 Enero | 133 | 34 | 167 |
| 2021 Diciembre | 99 | 41 | 140 |
| 2021 Noviembre | 113 | 38 | 151 |
| 2021 Octubre | 115 | 62 | 177 |
| 2021 Septiembre | 102 | 43 | 145 |
| 2021 Agosto | 129 | 33 | 162 |
| 2021 Julio | 107 | 25 | 132 |
| 2021 Junio | 82 | 25 | 107 |
| 2021 Mayo | 70 | 41 | 111 |
| 2021 Abril | 117 | 93 | 210 |
| 2021 Marzo | 63 | 39 | 102 |
| 2021 Febrero | 71 | 34 | 105 |
| 2021 Enero | 24 | 11 | 35 |
| 2020 Diciembre | 3 | 1 | 4 |
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