Dermoscopic Findings and Their Therapeutic Implications in Trichostasis Spinulosa: A Retrospective Study of 306 Patients

Abstract

Background: Data about the contribution and the implications of dermoscopy in trichostasis spinulosa (TS) are lacking in the literature. Objective: To describe dermoscopic features of TS in a large sample of patients and to correlate dermoscopy with clinical characteristics of the patients and therapeutic responses to medical treatments. Methods: A descriptive study was conducted (from October 2015 to June 2016) at the Department of Dermatology of Fez in Morocco. Dermoscopic signs were divided into signs of hair retention (SHR) and follicular keratosis (FK). Results: SHR was severe in 8.8% and minimal in 40.5% of all cases. Vellus hairs were observed in 81.6% of all cases and hair tufts were described in 48.7%. Dermoscopic blackhead-like structures (DBH) were found in 53.9% of all cases. FK was observed as orange-yellowish keratotic plugs in 92.7% of all cases. Therapeutic demand was significantly related to female gender (p = 0.002) and recurrences after medical treatment (p = 0.004). Complete improvement after medical treatment was only described in patients with DBH and minimal SHR (p = 0.001). Conclusion: Dermoscopy not only increases the accuracy of the clinical diagnosis in TS, but a new description of dermoscopic classification has also been proposed leading to therapeutic implications.

Two new dermoscopic features of trichostasis spinulosa and its reflectance confocal microscopic appearance

“…However, dermoscopy is the most helpful tool in clinical practice. The main dermoscopic characteristics of TS, including tufts of short, vellus hairs emerging together and keratotic plugs of some follicular openings, were noticed in our patient as previously described[2]. Furthermore, we observed two new dermoscopic findings of TS: circle hair and rolled hair.Circle hair is almost exclusively found incidentally on the trunk and upper legs of overweight men, where they are interspersed with normal hairs [4].…”

Microbotox for the treatment of wide facial pores: A promising therapeutic approach

“…Dermoscopic picture of the facial pores was described in few previous studies as dilated follicular openings of different sizes filled with yellow plugs. 10 In this study, we added a brief description of the dermoscopic appearance of the facial pores in the form of variable sized yellow dots or shallow holes. The holes represent the enlarged follicular opening that may be occluded by yellowish keratotic plugs or pierced by hair.…”

Trichostasis Spinulosa: A Case Report with an Unusual Presentation

“…The etiology of this skin disorder remains inconclusive. Some theories believed that the ceased hair shedding by hyperkeratosis of the hair follicle and the abnormal angulation between the isthmus and the infundibulum are the leading causes of TS [14, 15]. Factors that contribute to follicle damage are congenital dysplasia of the hair follicles and external factors, including ultraviolet light, dust, oils, heat, topical minoxidil, chronic renal failure, Malassezia yeast, Propionibacterium acne, whichalso have been proposed [1, 9, 14, 16].…”