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Click here for the corresponding questions to this CME article. [ABSTRACT FROM AUTHOR]

Trichoscopy is an efficient technique to diagnose hair diseases.1 However, in our daily practice, we have noticed that cosmetic colour products applied to the scalp and hair can resemble pathological trichoscopic findings, and thus misguide the diagnosis.2 These products are mainly used to colour or volumize the hair, or to make thinning hair look thicker.3 Although a few reports have previously described this issue,2,4 no studies have systematically assessed the artificial trichoscopic findings produced by these products. (a) Fibre hair products with thick fibres resembled broken hairs (arrows), whereas (b) those with thin fibres mimicked short vellus hairs (arrows), especially when scattered on the hair ostia. (g) Fibre hair products produced findings resembling broken hairs and short vellus hairs. [Extracted from the article]

Summary: Electron beam therapy (EBT) is an established treatment for mycosis fungoides (MF), but evidence for the use of EBT in advanced cutaneous conditions is limited, and optimal scheduling of the regimen for such conditions remains unclear. We report the case of a 44‐year‐old woman diagnosed with MF with widespread cutaneous lesions, including multiple huge tumours in the craniofacial area. Low‐dose total skin (TS)EBT and subsequent localized skin (LS)EBT achieved striking improvements in eruptions. Oral etretinate was also administered during therapy. Our experience implies that combined TSEBT and LSEBT may be worth attempting when a patient presents with both widespread lesions and prominent tumours, even when the tumours are extremely large. [ABSTRACT FROM AUTHOR]

Background Autosomal recessive woolly hair/hypotrichosis ( ARWH/H) is caused by mutations in LIPH. Homozygotes for the LIPH c.736T>A (p.C246S) mutation, the most prevalent genotype in Japanese patients, present varying degrees of hair loss; however, determinants of this phenotypic diversity remain elusive. Objectives To establish methodologies for quantitative assessment of clinical severity and provide a detailed characterization to elucidate the factors contributing to phenotypic divergence. Methods Digital image analyses were conducted to convert clinical severities into numerical values. Eight patients with ARWH/H were classified into three groups (mild, severe, very severe), based on severity scores. Dermoscopic images were collected and assessed for total hair numbers and hair thickness for intergroup comparisons. Results The image analysis detected a difference in hair thickness but not in total hair numbers, between mild and severe cases. A marked decrease in total hair number was noted in an atypical very severe case. Histopathologically, a patient with a mild case demonstrated hair miniaturization and a high telogen/anagen ratio without a decrease in total hair count, endorsing dermoscopic observations. Two children demonstrated spontaneous improvement without an increase in total hair numbers, and two adults responded well to topical minoxidil with increased total hair numbers and hair thickness. Conclusions The difference in the frequency of underdeveloped hairs may be a major factor contributing to the clinical diversity of hair sparseness in LIPH c.736T>A homozygotes with ARWH/H. Hence, pharmacological modification to thicken existing fine hairs may provide a therapeutic strategy. [ABSTRACT FROM AUTHOR]

Linked Article: Harries et al. Br J Dermatol 2020; 183:537–547. [ABSTRACT FROM AUTHOR]