BACKGROUND: Androgenetic alopecia is the most common form of hair loss. It is a clinical entity of relevant interest and presents a significant psychosocial impact as it undermines self-esteem and quality of life in female patients due to the importance of the hair for people's facial balance. OBJECTIVE: The purpose of the present study is to evaluate dermoscopic signs in women clinically diagnosed with androgenetic alopecia. METHOD: Observational study with 34 women between 17 and 68 years old who were diagnosed with androgenetic alopecia. All of them underwent photographic sessions with a 10x magnification dermoscope and a digital camera zoom set to 20x magnification and 40x magnification on the scalp frontal midline. RESULTS: All patients showed miniaturization. A peripilar brown halo was found in 22 patients, honeycomb-like scalp pigmentation was found in 14 and yellow dots in only 1 patient. Recent studies show dermoscopy as the new tool for diagnosis assistance and treatment follow up in scalp disorders. Our study used an ordinary dermoscope and we evaluated several findings reported in the literature with significant clarity and easiness. CONCLUSION: The dermoscope, which is used by dermatologists on a daily basis, is an excellent tool to assist in early diagnosis and assessment of therapeutic response in androgenetic alopecia. Keywords: Alopecia; Dermoscopy; Miniaturization Resumo: FUNDAMENTOS: Alopecia androgenética é forma mais comum de queda de cabelo. Constitui entidade clí-nica de interesse relevante e acarreta grande impacto psicossocial por comprometer a auto-estima e a qualidade de vida das pacientes. OBJETIVO: Procurar os sinais dermatoscópicos comuns em mulheres com diagnóstico clínico de alopecia androgenética, visando diagnóstico precoce e melhor resposta terapêutica. MÉTODOS: Estudo observacional em 34 mulheres com idades entre 17 e 68 anos, com diagnóstico clínico de alopecia androgenética. Todas pacientes foram avaliadas e submetidas a registros fotográficos com o dermatoscópio no aumento de 10x e câmera digital no aumento de 20x e 40x na linha média frontal do couro cabeludo. RESULTADOS: Todas as pacientes apresentaram miniaturização dos fios na área examinada. Halo castanho peripilar foi encontrado em 22 pacientes, pigmentação em favo de mel em 14 e pontos amarelos em apenas 1 paciente. Estudos recentes mostram a dermatoscopia como uma nova ferramenta no auxílio diagnóstico e acompanhamento do tratamento das desordens do couro cabeludo. Em nosso estudo utilizamos um dermatoscópio comum e avaliamos vários achados relatados na literatura com facilidade e clareza significativas. CONCLUSÃO: O dermatoscópio, instrumento de uso diário dos dermatologistas, é excelente ferramenta para auxí-lio no diagnóstico precoce e avaliação da resposta terapêutica na alopecia androgenética e é capaz de mostrar de forma simples sinais precoces de miniaturização capilar.
An 83 year old woman, exhibiting severe psoriasis, was treated conventionally (phototherapy, acitretin, and cyclosporine). After poor clinical results and significant changes in laboratory procedures, those treatments were suspended. She was then being prepared to be submitted to biological treatment, when preliminary results disclosed a 30mm PPD. Complete improvement occurred [only] after introducing prophylactic therapy for tuberculosis and anti-depressive medication. Keywords: Acitretin; Antidepressive agents; Cyclosporine; Isoniazid; Psoriasis; Tuberculosis Resumo: Mulher idosa apresentou psoríase em placas do tipo grave, com tendência eritrodérmica, e foi submetida a tratamento de acordo com o algoritmo consensual (fototerapia, acitretina, ciclosporina). Resultados clínicos insuficientes, recorrência e agravamento do quadro laboratorial orientaram no sentido da introdução de terapia biológica. A avaliação preliminar revelou PPD de 30mm. A resolução completa das lesões se verificou quando realizada profilaxia antituberculose e administrado antidepressivo.
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