Mariya Miteva - Hair Pathology with Trichoscopic Correlations

1. Giselle Martins, MD

2. Giselle Martins, MD, and Rui Oliveira Soares, MD

Giselle Martins MD

Hair Department

Dermatology

Santa Casa de Misericrdia de Porto Alegre

Brazil

Rui Oliveira Soares, MD

Tricology Coordinator

Cuf Descobertas Hospital

Lisbon, Portugal

First edition published 2022

by CRC Press

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Library of Congress CataloginginPublication Data

Names: Miteva, Mariya I., author.

Title: Hair pathology with trichoscopic correlations / by Mariya Miteva.

Description: First edition. | Boca Raton : CRC Press, 2022. | Includes bibliographical references and index. | Summary: This highly illustrated text will help clinicians become familiar with how to obtain an optimal specimen and how to understand the pathology report, in order to create an individualized approach in managementProvided by publisher.

Identifiers: LCCN 2021011777 (print) | LCCN 2021011778 (ebook) | ISBN 9781138313538 (hardback) | ISBN 9781032049199 (paperback) | ISBN 9780429457609 (ebook)

Subjects: MESH: Hair Diseasesdiagnostic imaging | Dermoscopymethods | Hairdiagnostic imaging | Hairpathology | Scalpdiagnositc imaging | Scalppathology

Classification: LCC RL151 (print) | LCC RL151 (ebook) | NLM WR 450 | DDC 616.5/46dc23

LC record available at https://lccn.loc.gov/2021011777

LC ebook record available at https://lccn.loc.gov/2021011778

ISBN: 978-1-138-31353-8 (hbk)

ISBN: 978-1-032-04919-9 (pbk)

ISBN: 978-0-429-45760-9 (ebk)

Typeset in Times LT Std

by KnowledgeWorks Global Ltd.

The objective of this text is to demonstrate the power of the trichoscopic-pathologic correlation for the optimal management of hair disorders. Clinicians will become familiar with to obtain the optimal specimen and how to understand the pathology report in order to create an individualized approach in management. Pathologists will become familiar with the trichoscopic morphologic correlation of hair disorders, with diagnostic clues and the most common pitfalls in hair pathology.

Special acknowledgements to my dear friend Giselle Martins, MD, for her invaluable support with sharing many clinical and trichoscopic images from her practice and to Aisleen Diaz, MD, for her outstanding work on collecting and organizing the trichoscopic images. All other contributions are acknowledged in the book.

Mariya Miteva

Contents

Trichoscopy is a type of an epiluminescence microscopy (ELM) utilized to visualize the skin's undersurface and the hair shafts on the scalp. Any type of dermatoscope can be used for trichoscopy including handheld (pocket) dermatoscopes and videodermatoscopes. Since trichoscopy aims at analyzing simultaneously many hair shafts in a single field of view and most hand-held dermatoscope lenses measure less than 3010 mm, it is most practical to attach a hand-held dermatoscope to a smartphone/iPad or to a digital camera to expand the overview on a screen. Available options include Handyscope (FotoFinder systems, Bad Birnbach, Germany), DermScope (Canfield, Fairfield, NJ), and most of the DermLite dermatoscopes (3Gen Inc., San Juan Capistrano, CA). Hand-held dermatoscopes provide magnification of 10, whereas videodermatoscopes provide a variable magnification from 10 to 140 and have photo-storage software applications allowing for real-time comparing of before and after pictures. There are also portable USB dermatoscopes that offer alternative to videodermatoscopes (FotoFinder leviacam, 2070, 13 megapixels). Currently, most published trichoscopy data has been obtained with the FotoFinder videodermatoscope.

1. Suspect scarring from non-scarring alopecia ()

   

   FIGURE 1.1 Two patients with thick hair density. (A) is suspicious for scarring alopecia basedon the trichoscopic findings of lost follicular openings and small tufts of hairssurrounded by peripilar casts. (B) shows preserved follicular openings and is froma patient with non-scarring alopecia (telogen effluvium) (10).

2. Select the optimal site for a scalp biopsy (dermoscopy guided scalp biopsies) ()

   

   FIGURE 1.2 Dermoscopy helps to select the optimal site for the biopsy as in this case of lichenplanopilaris, which shows peripilar casts around the proximal emergences of the hairshafts (10).