1/13. Diffuse alopecia with stem cell folliculitis: chronic diffuse alopecia areata or a distinct entity?A 34-year-old woman presented with an 8-year history of slowly progressive diffuse nonscarring alopecia with loss of hair density. scalp biopsy specimens showed increased miniaturized follicles and an asymmetric wedge-shaped lymphocytic infiltrate concentrated on the stem cell-rich region at the point of entry of sebaceous ducts and at bulge-like regions of multiple follicles. Several hair bulbs emerging at the stem cell compartment also were inflamed, but the hair bulbs in the deeper dermis and subcutis were spared. I speculate whether these findings may represent a stem cell folliculitis similar to the reaction pattern previously observed in graft versus host disease and in androgenetic alopecia. The additional presence of peribulbar lymphocytic inflammation could indicate that the patient had a variant of alopecia areata. The clinical presentation of a slowly progressive diffuse alopecia without progression to clinically recognizable alopecia areata and the prominent lymphocytic inflammation involving the stem cell compartment may prompt a reexamination of similar cases currently classified as chronic diffuse alopecia areata. The concept that lymphocytes can inhibit stem cell function without destroying the stem cells themselves needs consideration.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
2/13. Solitary sclerotic fibroma of the skin: degenerated sclerotic change of inflammatory conditions, especially folliculitis.Two cases showing changes of sclerotic fibroma developed in association with an inflammatory process, especially folliculitis. The lesion in the first case showed a well-circumscribed, nonencapsulated nodule in the dermis, which consisted of a perifollicular fibrotic area and a peripheral sclerotic area. In addition to the usual findings of sclerotic fibroma, spindle cells were heavily infiltrated in a storiform and fascicular pattern around the degenerated hair follicle, suggestive of dermatofibroma. The lesion in the second case showed the typical findings of sclerotic fibroma in association with folliculitis and hair follicle remnants. Our observations suggest that solitary sclerotic fibroma of the skin may be a degenerated or sclerotic end stage of other fibrous conditions, such as dermatofibroma, and that it may be induced by inflammation, especially folliculitis.- - - - - - - - - - ranking = 0.5keywords = inflammation (Clic here for more details about this article) |
3/13. folliculitis spinulosa decalvans: an uncommon entity within the keratosis pilaris atrophicans spectrum.folliculitis spinulosa decalvans is an uncommon condition characterized by follicular hyperkeratosis, followed by scarring alopecia. We report a 12-year-old boy affected by keratotic papules of the scalp and keratosis pilaris of the limbs who developed erythema, pustules, and scale crusts on the scalp associated with scarring alopecia. Histologic examination showed follicular and interfollicular hyperkeratosis, follicular plugging, mild inflammation, and focal scarring. A transient remission of the inflammatory changes on the scalp was obtained after treatment with isotretinoin. The follicular spinulous hyperkeratosis persisted. A severe relapse of the scalp inflammation was observed during a 2-year follow-up.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
4/13. Acne keloidalis. Transverse microscopy, immunohistochemistry, and electron microscopy.The earliest stages of acne keloidalis are not well characterized. In the present study, transverse sections of the early lesions revealed follicular units in several stages of inflammation. These follicles surrounded the central follicular units that gave rise to the clinically evident papule. Despite a spectrum of inflammatory changes, the most marked inflammation consistently occurred in the deep infundibular and isthmian levels of the hair follicles. Two follicles, presumably in the earliest stage, exhibited primarily an acute folliculitis and perifolliculitis, with destruction of the follicular wall and the release of hair. Central follicles showed predominantly acute neutrophilic or chronic lymphocytic inflammation at the upper isthmian levels and granulomatous inflammation at the deeper isthmian levels. Other follicles showed scar at the isthmian levels trapping hair fragments in the inferior portion of the follicle, with granulomatous inflammation and scarring. sebaceous glands were absent in all stages of folliculitis in seven of eight follicular units.- - - - - - - - - - ranking = 2.5keywords = inflammation (Clic here for more details about this article) |
5/13. Tufted hair folliculitis.A case of scarring alopecia presenting as two circumscribed, tender and inflamed areas in the occiput with residual tufted follicles is reported. Each tuft comprised 10 to 15 normal-appearing hairs arising from individual hair follicles in the reticular dermis or subcutaneous fat, converging toward a single orifice in the epidermis. The initial pathologic finding was inflammation and scarring of the papillary and mid dermis with almost total sparing of the hair follicles in the subcutaneous fat. Successful treatment was achieved by surgical excision of the two areas. It is suggested that the areas of tufting represented nevoid lesions that underwent inflammation and scarring.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
6/13. Necrotizing lymphocytic folliculitis: the early lesion of acne necrotica (varioliformis).skin biopsy specimens from four patients who had recurrent bouts of lesions conforming to the clinical description of acne necrotica were studied. The pathologic findings were dominated by lymphocytic inflammation around centrally placed follicles evolving to follicular necrosis that extended to the perifollicular epidermis and dermis. Early lesions showed the development of multiple individual necrotic keratinocytes within the follicular sheath and adjacent epidermis with lymphocytic exocytosis. Later lesions showed more intense necrosis and scale crust obscuring the central target but were still dominated by a peripheral lymphocytic infiltrate. The early pathologic findings of acne necrotica (varioliformis) are represented by a necrotizing lymphocytic folliculitis and differ from the pattern seen in association with nonspecific excoriations, acute bacterial folliculitis, classic comedogenic acne, or acnitis.- - - - - - - - - - ranking = 0.5keywords = inflammation (Clic here for more details about this article) |
7/13. Pustular pyoderma gangrenosum associated with ulcerative colitis in childhood. Report of two cases and review of the literature.pyoderma gangrenosum is a cutaneous disorder associated with systemic diseases such as ulcerative colitis, Crohn's disease, rheumatoid arthritis, and blood dyscrasias. We are reporting two cases of pustular pyoderma gangrenosum associated with ulcerative colitis. One patient had inactive bowel disease when she developed her third episode of pustules, erosions, and nodules on the left leg. The other patient exhibited a widespread painful vesiculopustular eruption that coincided with the onset of her colitis. Both patients presented with pustules as the primary manifestation of their pyoderma gangrenosum. Histologic examination of skin from both patients revealed an acute perifollicular inflammation. pyoderma gangrenosum should be considered in the differential diagnosis of pustular disorders in children with underlying conditions such as ulcerative colitis.- - - - - - - - - - ranking = 0.5keywords = inflammation (Clic here for more details about this article) |
8/13. Superficial and systemic illness related to a hot tub.In an outbreak of folliculitis in alaska among bathers in a contaminated hot tub, one person was found in whom follicular lesions were preceded by deep, tender, peripheral nodules. Of nine affected bathers, five showed inflammation of Montgomery's follicles of the breast. Bathing longer in the tub and later in the day was associated with increased risk of disease. This investigation added serotype O-7,8 to the list of pseudomonads associated with hot tub infections.- - - - - - - - - - ranking = 0.5keywords = inflammation (Clic here for more details about this article) |
9/13. Alopecia mucinosa. Report of a case with diffuse alopecia and normal-appearing scalp skin.A 69-year-old man had reversible generalized thinning of the scalp hair and normal-appearing scalp skin that proved to be secondary to follicular mucinosis. This case illustrates that when mild degrees of follicular degeneration and inflammation occur in this disorder, physical findings other than alopecia may be absent. In rare instances, follicular mucinosis can occur as a chronic diffuse noncicatricial alopecia.- - - - - - - - - - ranking = 0.5keywords = inflammation (Clic here for more details about this article) |
10/13. Haematobium schistosomiasis presenting in the netherlands as a skin disease.A rare case is reported of extragenital skin schistosomiasis as the presenting symptom in a 24-year-old Dutch student, who had swum some months earlier in Lake malawi in mozambique. Grouped papules dorsolateral on the lower thorax were shown by biopsy to be due to infection by schistosoma haematobium. The eggs were viable and surrounded by necrosis and partly purulent, partly granulomatous dermatitis that also affected hair follicles. The second biopsy, taken 2.5 months after treatment with praziquantel, still showed viable eggs and necrosis but no more microabscesses. In the third biopsy 5 weeks after a second praziquantel treatment, no eggs were found, but a partly granulomatous abscess forming inflammation affecting a hair follicle was still present.- - - - - - - - - - ranking = 0.5keywords = inflammation (Clic here for more details about this article) |
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