Daniel Asz Sigall, MD President of the Mexican Society of Trichology MEXICO

Transcription

1 Daniel Asz Sigall, MD President of the Mexican Society of Trichology MEXICO

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4 Tinea capitis Non inflammatory- Non cicatricial Microsporic Trichophytic (90%) An Bras Dermatol. 2015;90(3 Suppl 1):S13-5.

5 Tinea capitis (Kerion Celsi) Inflammatory- cicatricial An Bras Dermatol. 2015;90(3 Suppl 1):S13-5.

6 Tinea capitis in eldery and immunossupression Non inflammatory with cicatricial alopecia An Bras Dermatol. 2015;90(3 Suppl 1):S13-5.

7 KOH Ectothrix (Microsporic) Endothrix (Trichophytic) 40X 40X An Bras Dermatol. 2015;90(3 Suppl 1):S13-5.

8 Trichoscopy Comma hairs: subsequent cracking and bending of a hair shaft filled with hyphae An Bras Dermatol. 2015;90(3 Suppl 1):S13-5.

9 Corkscrew hairs Mainly African-American and Latin American patients An Bras Dermatol. 2015;90(3 Suppl 1):S13-5.

10 Morse-code and zig-zag hairs An Bras Dermatol. 2015;90(3 Suppl 1):S13-5.

11 Trichoscopy of tinea capitis Short hairs Black dots Broken and dystrophic hairs Scales Peripilar casts Pustules (Kerion Celsi) Crusts (Kerion Celsi) Costa Pinheiro AM, et al. An. Bras. Dermatol 2012; 87(2) Arrazola J, Isa-Isa R, Torres E, Arenas R. Rev IberoAm Micol 2014 An Bras Dermatol. 2015;90(3 Suppl 1):S13-5.

12 Message to take Home Trichoscopy of tinea capitis

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14 Nodular lesions in hair shafts Trichorrhexis nodosa Monilethrix Trichomycosis Pediculosis Piedra Keratin casts Trichoptilosis J Environ Biol 2013;34(1):17-22 J Am Acad Dermatol Feb;76(2S1):S3-S4

15 Differencial diagnosis Keratin casts Trichorrhexis nodosa J Am Acad Dermatol Feb;76(2S1):S3-S4

16 Message to take Home Trichoscopy is very useful in differencial diagnosis of the nodular lesions of the hair shafts Pruritus and crusts on the occipital area of the scalp Find the lice and nits Treatment follow-up

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18 Classical scabies Sarcoptes scabiei var hominis Families, nocturnal pruritus, Hebra lines An Bras Dermatol. 2010;85(2):221-3.

19 Classical scabies Dermoscopy: Triangle sign (mite head) Fox G.BMJ Case Rep. 2009;2009.

20 Norwaegian scabies Immunosuppressed patients Disseminated Crusts Scalp affection An Bras Dermatol. 2010;85(2):221-3.

21 Message to take Home Scabies: Families, poor hygiene, nocturnal pruritus Classical form: No affection of scalp, Triangle sign Norwaegian form: Immunosuppression, scalp affection, multiple mites between scales

22 Treatment: pediculosis - Scabies Oral ivermectine 200 µg kg (2 tabs 6 mg) Topical options (Malathion, permetrine, others)

23 Arenas R Bonifaz A

24 Piedra Asymptomatic fungal infection of the hair shaft in endemic areas Nodules: concretion of hyphae and fruiting bodies (ascomata) of the fungus. Two varieties: White (Trichosporon spp) and black (Piedraia hortae) Braz J Microbiol. 2012; 43(4): J Am Acad Dermatol Feb;76(2S1):S3-S4

25 Treatment Shaving the infected hair Topical or systemic antifungals Braz J Microbiol. 2012; 43(4): J Am Acad Dermatol Feb;76(2S1):S3-S4

26 Message to take Home Piedras: Asymptomatic hair fungal infections White and Black Differential diagnosis of other nodular lesions of hair shafts in endemic areas

27 Arenas R Bonifaz A

28 Trichomycosis Pseudomycosis caused by Corynebacterium flavescens (tenuis) Axillary and pubic hairs (scalp affection very rare) Poor hygiene and hyperhidrosis Asymptomatic creamy yellow concretions allong hair shafts J Dermatol Case Rep. 2011; 5(2): Bonifaz A. Rev Chil Pediatr May 5.

29 Treatment Shaving the infected hair Topical or systemic antibiotics Bonifaz A. Rev Chil Pediatr May 5.

30 Message to take Home Trichomycosis is an asymptomatic pseudomycosis Axillary and pubic hairs Scalp affection very rare Differential diagnosis with other nodular lesions of hair shafts

31 Arenas R

32 Sand fly: Lutzomyia & Phlebotomus Intracellular protozoan Endemic countries

33 Dermoscopy Generalized erythema Yellow hue Central ulcers Hyperkeratosis Milia-like cysts Yellow teardrop-like structures Starburst pattern Vascular patterns: Dotted vessels Hairpin vessels Linear irregular vessels Glomerular vessels Comma shaped vessels Arborizing telangiectasia Corkscrew vessels Int J Dermatol 2013 Nov;52(11):1361-6

34 Hyperkeratosis, hairpin vessels Starbursts pattern

35 Treatment Intralesional pentavalent antimonials Criotherapy Itraconazol mg/day Rifampicin mg/day Folia Med (Plovdiv) Jan-Mar;57(1):65-8

36 Message to take Home Leishmaniasis Chronic ulcers of endemic areas Scalp affection is exceptional

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