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      Alopecic and Aseptic Nodules of the Scalp with Trichoscopic and Ultrasonographic Findings

      case-report

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          Abstract

          Alopecic and aseptic nodules of the scalp (AANS) is a rare entity, etiology of which is already unknown. It consists of a few dome-shaped, skin-colored nodules associated with nonscarring alopecia. They are usually located in the upper part of the occiput and surrounded by normal scalp. Most of the times, a biopsy is performed to make an accurate diagnosis. AANS have a good prognosis and even can resolve spontaneously. We present a new case of this entity with the description of trichoscopic and ultrasonographic findings that have recently been reported. These noninvasive techniques are useful for the diagnosis and could replace histological examination in the near future.

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          Most cited references11

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          Alopecic and Aseptic Nodules of the Scalp (Pseudocyst of the Scalp): A Prospective Clinicopathological Study of 15 Cases

          Background: Alopecic and aseptic nodules of the scalp (AANS) is a new entity reported first in Japan as ‘pseudocyst of the scalp’. Only retrospective studies have been published. Objectives: To describe the clinicopathological features of AANS (pseudocyst), to evaluate the response to doxycycline and to compare the results to those obtained from patients with dissecting cellulitis of the scalp (DCS). Methods: Fifteen patients with AANS and 7 with DCS were prospectively included. A puncture and a biopsy were made. Patients were treated with doxycycline (100 mg/day) for 3 months. Results: AANS affects predominantly young (mean age 29.7 years), Caucasian (11/15), male (14/15) patients. The main location of the nodules was the occiput. The associated alopecia was nonscarring. Material from the puncture was aseptic. The histopathology showed a deep granuloma in 7 of 14 patients and a nonspecific inflammation in 7 patients. After 3 months, 8 patients were cured and 3 had a good response. Conclusions: The singular aspect of the nodules, the nonscarring alopecia, the deep inflammatory infiltrate and the efficacy of doxycycline confer specificity to AANS.
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              Alopecic and Aseptic Nodules of the Scalp/Pseudocyst of the Scalp: Clinicopathological and Therapeutic Analyses in 11 Korean Patients

              Background: Alopecic and aseptic nodule of the scalp (AANS) is a rare disease entity first reported in 1992 as pseudocyst of the scalp (PCS). Controversy exists regarding the histopathology and etiology of reported cases. Objective: We performed this study to analyze the clinical and histopathologic features of AANS/PCS in Korean patients. Methods: A retrospective review of medical records from 2008 to 2013 at Inje University Busan Paik Hospital was performed. Results: Eleven patients were enrolled. All patients were male, and their mean age was 21.6 years. Most patients had a solitary nodule (10/11) located predominantly on the vertex. The mean nodule size was 20 mm. Inflammatory cell infiltration in the deep dermis was a histologic feature of AANS/PCS. Eight patients showed granulomatous infiltration. All patients were treated with short-term antibiotics and intralesional steroid injection. Conclusion: Our results suggest that dermatologists should consider AANS when diagnosing an alopecic nodule on the scalp.
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                Author and article information

                Journal
                Indian J Dermatol
                Indian J Dermatol
                IJD
                Indian Journal of Dermatology
                Medknow Publications & Media Pvt Ltd (India )
                0019-5154
                1998-3611
                Sep-Oct 2017
                : 62
                : 5
                : 515-518
                Affiliations
                [1] From the Department of Dermatology, Sagrat Cor Hospital, Barcelona, Spain
                [1 ] Department of Dermatopathology, Sagrat Cor Hospital, Barcelona, Spain
                Author notes
                Address for correspondence: Dr. Anna Isabel Lázaro-Simó, Viladomat Street, 288. ZIP 08029, Barcelona, Spain. E-mail: anna.lazarosimo@ 123456gmail.com
                Article
                IJD-62-515
                10.4103/ijd.IJD_266_16
                5618841
                28979016
                0e9a5c53-3542-49f9-90d0-7bdd71983b34
                Copyright: © 2017 Indian Journal of Dermatology

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                : May 2016
                : July 2017
                Categories
                Case Report

                Dermatology
                dermoscopy,scalp,ultrasonography
                Dermatology
                dermoscopy, scalp, ultrasonography

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