<p>Autoimmune bullous diseases (AIBDs) are life-threatening diseases caused by immunologically mediated cell adhesion compromise in the skin and mucous membranes. Proposed diagnosis of AIBDs on a clinicopathological basis usually requires confirmation by other sophisticated and expensive laboratory facilities. This emphasizes the urgency of a simple, approachable and cost-effective method to clarify the diagnosis of AIBDs. This work aimed to outline the distinguishing trichoscopic characters of some immunobullous disorders [pemphigus vulgaris (PV), pemphigus foliaceus (PF) and bullous pemphigoid (BP)] in a group of Upper Egyptian patients and to examine any potential connections between these features and certain disease aspects. Sixty patients with AIBDs affecting the scalp were included. Twenty-nine patients were diagnosed as PV, seventeen patients were PF and fourteen were diagnosed as BP. Diagnosis was based on clinico-pathological correlations. The scalp’s Pemphigus disease area index (PDAI-Scalp) was determined for every patient. Trichoscopic examination of scalp lesions and documentation of features were done. Yellow haemorrhagic crusts were the most frequent trichoscopic observation in the three patients’ groups. Extravasation was also common in all groups. In PV, dotted vessels, linear serpentine vessels, polymorphic vessels, and dotted vessels with whitish halo were significantly more frequent as compared to the other groups. Regarding PF, polygonal scaling, perifollicular scaling and hair casts were the most characteristic trichoscopic features. However, in BP, the characteristic trichoscopic feature was well-defined creamy yellow round/oval areas. Trichoscopy can serve as a rapid preliminary non-invasive diagnostic procedure to signify AIBDs.</p>

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Trichoscopy: a possible diagnostic role in autoimmune bullous diseases

  • Nagwa Essa Abd Elazim,
  • Ayman Mohamed Mahran,
  • Tasbeeh Salah El-Deen,
  • Aya Sayed,
  • Alaa Ghazally

摘要

Autoimmune bullous diseases (AIBDs) are life-threatening diseases caused by immunologically mediated cell adhesion compromise in the skin and mucous membranes. Proposed diagnosis of AIBDs on a clinicopathological basis usually requires confirmation by other sophisticated and expensive laboratory facilities. This emphasizes the urgency of a simple, approachable and cost-effective method to clarify the diagnosis of AIBDs. This work aimed to outline the distinguishing trichoscopic characters of some immunobullous disorders [pemphigus vulgaris (PV), pemphigus foliaceus (PF) and bullous pemphigoid (BP)] in a group of Upper Egyptian patients and to examine any potential connections between these features and certain disease aspects. Sixty patients with AIBDs affecting the scalp were included. Twenty-nine patients were diagnosed as PV, seventeen patients were PF and fourteen were diagnosed as BP. Diagnosis was based on clinico-pathological correlations. The scalp’s Pemphigus disease area index (PDAI-Scalp) was determined for every patient. Trichoscopic examination of scalp lesions and documentation of features were done. Yellow haemorrhagic crusts were the most frequent trichoscopic observation in the three patients’ groups. Extravasation was also common in all groups. In PV, dotted vessels, linear serpentine vessels, polymorphic vessels, and dotted vessels with whitish halo were significantly more frequent as compared to the other groups. Regarding PF, polygonal scaling, perifollicular scaling and hair casts were the most characteristic trichoscopic features. However, in BP, the characteristic trichoscopic feature was well-defined creamy yellow round/oval areas. Trichoscopy can serve as a rapid preliminary non-invasive diagnostic procedure to signify AIBDs.