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Dermoscopic diagnosis of hair breakage caused by styling procedures in patients of African descent
Dermoscopic diagnosis of hair breakage caused by styling procedures in patients of African descent Maria Vict oria Quaresma, MD,a Marıa Abril Martinez Velasco, MD,b and Antonella Tosti, MDc Rio de Janeiro, Brazil; Mexico City, Mexico; and Miami, Florida
CLINICAL PRESENTATION Patients 1 and 2 complained of increased hair shedding for durations of 9 months and 1 year, respectively. Patients 3 to 5 complained of patches of alopecia (Fig 1) for [1 year. Patients 6 and 7 complained that their hair did not grow.
Fig 1. Patchy alopecia caused by several episodes of chemical straightening in the past.
DERMOSCOPIC APPEARANCE The dermoscopic examination of hairs obtained with a pull test allowed us to diagnose hair breakage in all cases. The hair fragments did not have a root but rather had brush-like tips and swelling along the shaft that was caused by trichorrhexis nodosa (Fig 2). Central trichoptilosis (ie, a longitudinal split in the central part of the shaft) was another common finding (Fig 3).
From the Departments of Dermatology at Professor Rubem David Azulay Institute of Dermatology,a Rio de Janeiro, and Hospital General Dr Manuel Gea Gonzalez,b Mexico City, and the Department of Dermatology and Cutaneous Surgery,c University of Miami Miller School of Medicine, Miami. Publication of this article was supported by 3Gen. Funding sources: None. Conflicts of interest: None declared.
Correspondence to: Maria Vict oria Quaresma, MD, Rua Francisco Otaviano, 240/204, Ipanema, 22080-045 Rio de Janeiro (RJ), Brazil. E-mail: [email protected]. J Am Acad Dermatol 2015;72:S39-40. 0190-9622/$36.00 ª 2014 by the American Academy of Dermatology, Inc. http://dx.doi.org/10.1016/j.jaad.2014.05.062
S39
S40 Quaresma, Martinez Velasco, and Tosti
J AM ACAD DERMATOL
JANUARY 2015
Fig 2. Trichorrhexis nodosa. Lighter node (characteristic of trichorrhexis nodosa in dark hair) and distal trichoptilosis caused by hair breakage.
Fig 3. Central trichoptilosis (longitudinal split) in a broken hair shaft.
KEY MESSAGE
Hair disorders are a significant problem in women of African descent.1 The clinical presentation of hair breakage caused by excessive styling and straightening can be heterogeneous, ranging from poor hair growth to patchy alopecia. Dermoscopy helps to show breakage caused by trichorrhexis nodosa, which can be seen in the scalp or, more easily, in the shed broken hairs.2 At low magnifications, the hair shaft features nodular swelling, which appears lighter than the original hair. Central trichoptilosis is seen as a longitudinal split in the central part of the shaft. Dermoscopy is an easy, inexpensive, quick method to diagnose alopecia caused by hair breakage.
REFERENCES 1. Miteva M, Tosti A. Dermatoscopy of hair shaft disorders. J Am Acad Dermatol 2013;68:473-81. 2. Yin NC, Tosti A. A systematic approach to afro-textured hair disorders dermatoscopy and when to biopsy. Dermatol Clin 2014;32:145-51.
CLINICAL PRESENTATION Patients 1 and 2 complained of increased hair shedding for durations of 9 months and 1 year, respectively. Patients 3 to 5 complained of patches of alopecia (Fig 1) for [1 year. Patients 6 and 7 complained that their hair did not grow.
Fig 1. Patchy alopecia caused by several episodes of chemical straightening in the past.
DERMOSCOPIC APPEARANCE The dermoscopic examination of hairs obtained with a pull test allowed us to diagnose hair breakage in all cases. The hair fragments did not have a root but rather had brush-like tips and swelling along the shaft that was caused by trichorrhexis nodosa (Fig 2). Central trichoptilosis (ie, a longitudinal split in the central part of the shaft) was another common finding (Fig 3).
From the Departments of Dermatology at Professor Rubem David Azulay Institute of Dermatology,a Rio de Janeiro, and Hospital General Dr Manuel Gea Gonzalez,b Mexico City, and the Department of Dermatology and Cutaneous Surgery,c University of Miami Miller School of Medicine, Miami. Publication of this article was supported by 3Gen. Funding sources: None. Conflicts of interest: None declared.
Correspondence to: Maria Vict oria Quaresma, MD, Rua Francisco Otaviano, 240/204, Ipanema, 22080-045 Rio de Janeiro (RJ), Brazil. E-mail: [email protected]. J Am Acad Dermatol 2015;72:S39-40. 0190-9622/$36.00 ª 2014 by the American Academy of Dermatology, Inc. http://dx.doi.org/10.1016/j.jaad.2014.05.062
S39
S40 Quaresma, Martinez Velasco, and Tosti
J AM ACAD DERMATOL
JANUARY 2015
Fig 2. Trichorrhexis nodosa. Lighter node (characteristic of trichorrhexis nodosa in dark hair) and distal trichoptilosis caused by hair breakage.
Fig 3. Central trichoptilosis (longitudinal split) in a broken hair shaft.
KEY MESSAGE
Hair disorders are a significant problem in women of African descent.1 The clinical presentation of hair breakage caused by excessive styling and straightening can be heterogeneous, ranging from poor hair growth to patchy alopecia. Dermoscopy helps to show breakage caused by trichorrhexis nodosa, which can be seen in the scalp or, more easily, in the shed broken hairs.2 At low magnifications, the hair shaft features nodular swelling, which appears lighter than the original hair. Central trichoptilosis is seen as a longitudinal split in the central part of the shaft. Dermoscopy is an easy, inexpensive, quick method to diagnose alopecia caused by hair breakage.
REFERENCES 1. Miteva M, Tosti A. Dermatoscopy of hair shaft disorders. J Am Acad Dermatol 2013;68:473-81. 2. Yin NC, Tosti A. A systematic approach to afro-textured hair disorders dermatoscopy and when to biopsy. Dermatol Clin 2014;32:145-51.