RESUMO
Lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA) are primary cicatricial alopecia that cause a major impact on quality of life due to irreversible hair loss and symptoms as itching, burning and pain. They are characterized by permanent loss of hair follicle stem cells (HFSCs) by pathomechanisms still poorly understood, resulting in poor efficacy of currently available treatments. Caveolae are flask-shaped lipid rafts invaginated within the plasma membrane of multiple cell types. Although their role in the HF physiology and pathophysiology is relatively unknown, we have previously demonstrated that the primary structural component of caveolae (caveolin-1 or Cav1) is upregulated in FFA. Thus, we propose to investigate the expression and localization of caveolae-associated structural proteins (Cav1, Cav2, and Cavin-1) and HFSCs (identified by K15) in both LPP and FFA. We analyzed 4 patients with LPP biopsied in affected and non-affected (NA) scalp, 4 patients with FFA biopsied in affected scalp and 4 healthy controls. Affected scalp of LPP and FFA demonstrated increased levels of Cav1 and Cavin-1 compared with HC and LPP-NA. Moreover, Cav1, Cav2 and Cavin1 all exhibit high colocalization with K15 and their expression appears to be negatively correlated, supporting the hypothesis that these proteins are important players in LPP/FFA and may serve as therapeutic targets in future treatments.
Assuntos
Alopecia , Cavéolas , Caveolina 1 , Folículo Piloso , Líquen Plano , Regulação para Cima , Humanos , Alopecia/patologia , Alopecia/metabolismo , Folículo Piloso/patologia , Folículo Piloso/metabolismo , Líquen Plano/metabolismo , Líquen Plano/patologia , Pessoa de Meia-Idade , Feminino , Caveolina 1/metabolismo , Masculino , Cavéolas/metabolismo , Couro Cabeludo/patologia , Adulto , Queratina-15/metabolismo , Idoso , Biópsia , Fibrose , Células-Tronco/metabolismo , Células-Tronco/patologia , Proteínas de Ligação a RNA/metabolismoRESUMO
CONTEXT.: Clinical, dermoscopic, and histologic diagnostic criteria may overlap in cases with scarring and nonscarring alopecia, making diagnosis difficult for clinicians and pathologists. New histopathologic discoveries indicate that the cutaneous adnexal structural and homeostatic unit made up of the pilosebaceous unit, eccrine sweat gland coils (ESGCs), and dermal white adipose tissue may have a role in hair follicle renewal. OBJECTIVE.: To verify the presence of adipose tissue in the dermis at the level of the isthmus, infiltrating the bundles of the arrector pili muscle in biopsies from the scalp of 3 scarring alopecias: frontal fibrosing alopecia (FFA), fibrosing alopecia in a pattern distribution (FAPD), and lichen planopilaris (LPP). DESIGN.: We performed a retrospective and descriptive survey of 71 female scalp biopsies from 2016 to 2022 diagnosed at the Dermatopathology Laboratory at Fluminense Federal University of Rio de Janeiro. Two pathologists reviewed and diagnosed the cases, correlating pathologic features with clinical and dermoscopic findings. RESULTS.: The histopathologic findings of adipose tissue infiltration in the dermis at the level of the isthmus and in the bundles of the arrector pili muscle and the displacement of ESGCs were more frequently identified in FFA, followed by FAPD and less frequently found in LPP. CONCLUSIONS.: According to our research, adipose tissue infiltration in the dermis at the level of the isthmus and in the bundles of the arrector pili muscle and the displacement of ESGCs were observed in 3 scarring alopecias (FFA, FAPD, and LPP) and seems to be involved in the development of scarring alopecia.
Assuntos
Tecido Adiposo , Alopecia , Cicatriz , Glândulas Écrinas , Fibrose , Líquen Plano , Humanos , Alopecia/patologia , Feminino , Líquen Plano/patologia , Líquen Plano/diagnóstico , Estudos Retrospectivos , Cicatriz/patologia , Tecido Adiposo/patologia , Glândulas Écrinas/patologia , Fibrose/patologia , Pessoa de Meia-Idade , Adulto , Couro Cabeludo/patologia , Folículo Piloso/patologia , Idoso , BiópsiaRESUMO
Surgical facelifts and noninvasive techniques such as mesotherapy, hyaluronic fillers and botulinum toxin, among other procedures are widely used nowadays to reverse skin ageing and achieve rejuvenation effects. Secondary alopecia due to cosmetic procedures is a rare side effect and is poorly described in the literature. The mechanisms in which hair loss develops after an aesthetical procedure or surgical technique are not well known. The development of secondary scarring alopecia or non-scarring alopecia depends upon the interaction between different external factors, the individual host response and the extent of damage to the hair follicle anatomy. Current knowledge hints at the type of substance used, pressure to hair structures and vasculature due to the materials used, previously unknown or unaware hair disorder, and poor surgical techniques to be the main factors contributing to the development of secondary alopecia. Physicians and patients must be aware of all the substances used for the procedures and be attentive to any change in hair density or hair loss. Clinicians must have a low threshold to take biopsies if the risk of scarring alopecia may occur. Herein, we review the clinical, trichoscopic, histopathological findings and potential pathophysiological mechanisms of hair loss due to different aesthetic procedures.
Assuntos
Alopecia , Ritidoplastia , Humanos , Alopecia/patologia , Cabelo , Folículo Piloso/patologia , Biópsia/efeitos adversosRESUMO
We present a 21-day-old female child presenting with a large oral epithelialized tumor implanted at the rhinopharynx and ethmoid plate through a cleft palate, associated with feeding and respiratory difficulties. The histopathological exam showed mature central adipose tissue, hair follicles, sebaceous glands, and neurovascular structures, lined by keratinized stratified squamous epithelium. Proliferative cartilaginous, glandular, lymphatic, bony, and immature myxoid tissue was seen at the posterior region and insertion. Despite the characterization of the tumor as a teratoma containing structures derived from the three embryonic leaflets, the anterior portion presented a microscopic bigeminal pattern fully compatible with hairy polyp.
Assuntos
Hamartoma , Neoplasias Bucais , Pólipos , Teratoma , Criança , Humanos , Feminino , Teratoma/diagnóstico , Teratoma/cirurgia , Teratoma/complicações , Pólipos/diagnóstico , Pólipos/cirurgia , Pólipos/complicações , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/cirurgia , Hamartoma/patologia , Folículo Piloso/patologiaRESUMO
Background: Pilomatricomas are neoplasms of hair follicles, located in the hair bulb, and the incidence is uncommon in the clinical-surgical clinical routine of dogs and cats. It commonly affects adult animals, with no predisposition to sex or race, and is mainly located in the neck, back, and tail region. The diagnosis is made by histopathological examination, where cells are observed in which their nucleus does not stain with hematoxylin and eosin - empty nucleus. The present work aimed to report a case of benign pilomatricoma since it is a rare condition in dogs and cats and, consequently, there is little information in the literature. Case: A 6-year-old male Shih-Tzu dog, not submitted to surgical contraception, weighing 6.9 kg, was treated at the Veterinary School Hospital (HVE) of the North Parana State University (UENP), Bandeirantes, PR, Brazil, with a history of nodules in the tail region, lasting 6 months. On physical examination, no changes were identified in the patient's physiological parameters. However, the presence of neoformations in the distal and medial region of the tail, similar to a nail, adherent, non-ulcerated and non-alopecic, and absence of pruritus or self-mutilation were identified. Vaccination and deworming were updated. Hematological examination, serum biochemicals (urea, creatinine, alanine aminotransferase, alkaline phosphatase, and albumin), and abdominal ultrasound showed no changes. According to the clinical and laboratory signs, it was decided to perform an excisional biopsy, using a caudectomy, for subsequent histopathological examination. The specimens were fixed in 10% formaldehyde and sent for histopathological examination. Histological examination was compatible with benign pilomatricoma. Postoperatively, cephalexin, dipyrone, tramadol hydrochloride, and meloxicam were prescribed, surgical wound cleaning, and the use of an Elizabethan collar until the suture was removed. After 10 days of the surgical procedure, the patient was asked to remove the sutures, and no changes were identified regarding the physiological parameters and blood count. Discussion: Pilomatricomas are commonly benign neoplasms arising from the germ cells of the follicular matrix. They present dermal or subdermal forms, with several cystic structures which are surrounded by keratinocytes, similar to the matrix cells of an anagen hair follicle, more keratinized and firmer areas, corroborating the results of the present report. In the ultrasound examination, the presence of intra-abdominal metastases was not identified, which is consistent with the literature, since in this type of neoplasm it is not common to identify foci of intra-abdominal and thoracic metastases. In the present report, immunohistochemistry was not used, even though it is used to differentiate follicular neoplasms from pilomatricomas. However, histopathological examination is considered the best method for the definitive diagnosis of pilomatricomas in dogs. It was concluded that the surgical treatment through excisional biopsy, with safety margins of 2 cm, was effective as a therapeutic method in the case of benign pilomatricoma, and the definitive diagnosis must be made through histopathological examination.
Assuntos
Animais , Masculino , Cães , Pilomatrixoma/cirurgia , Pilomatrixoma/veterinária , Folículo Piloso/patologia , Neoplasias Cutâneas/veterináriaRESUMO
Collision tumours are a random association of two or more neoplasms arising in the same anatomical site. Dilated pore of Winer (DPW) - an adnexal tumour of pilar origin - has been described in collisions with basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and trichoblastoma. We present a literature review of melanoma-associated skin lesions and describe the first collision of a DPW with a melanoma in situ (MIS) and the sequential dermoscopic examination for diagnosis.
Assuntos
Doenças do Cabelo/patologia , Folículo Piloso/patologia , Melanoma/patologia , Neoplasias Cutâneas/patologia , Idoso de 80 Anos ou mais , Feminino , HumanosRESUMO
BACKGROUND: Frontal fibrosing alopecia (FFA) is a scarring alopecia that affects the frontotemporal hairline. Clinically, it may develop with cutaneous hypopigmentation of the affected areas, which has been associated with a reduction in the epidermal melanocyte count. In trichoscopy, peripilar white halos can be observed, which have been associated with fibrosis in other scarring alopecias. OBJECTIVE: To evaluate the trichoscopic, histopathological and immunohistochemical characteristics of the peripilar white halos in FFA patients. MATERIALS AND METHODS: We conducted a descriptive cross-sectional study that included 12 patients with FFA presenting peripilar white halos. Two 2-mm punch trichoscopy-guided biopsies were performed in all patients, one fragment for vertical section and another for horizontal section. The vertical sections were stained with Fontana-Mason and Melan-A. RESULTS: On trichoscopic examination, peripilar white halos ≤ 1 mm in size were observed on the affected scalp. In vertical sections, a reduction in basal melanin pigmentation and a decrease in the melanocyte count in the upper segment of the hair follicle were observed with Fontana-Masson staining and Melan-A immunostaining, respectively. LIMITATIONS: The small sample size and absence of a control group. CONCLUSION: This study shows follicular melanocyte involvement in FFA, and this finding may be associated with the peripilar white halos observed in trichoscopy.