At the Root: Cutaneous Langerhans Cell Histiocytosis

    May 2018 in “ The American Journal of Medicine ”
    Roberto Maglie, Margherita Vannucchi, Lavinia Quintarelli, Marzia Caproni, Daniela Massi, Emiliano Antiga
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    TLDR A woman's long-term scalp issues were diagnosed as a rare skin disorder called cutaneous Langerhans cell histiocytosis.
    The document reports on a 33-year-old woman who suffered from scalp eruptions, intense itching, and hair loss for 15 years, initially misdiagnosed as seborrheic dermatitis and female androgenic alopecia. Despite treatment with topical steroids, her symptoms persisted. A physical exam showed hair thinning and erythematous, scaling papules without scarring alopecia, and laboratory tests were normal. A biopsy revealed a dermal infiltrate of Langerhans cells, which was confirmed by immunohistochemical analysis, although she did not have the BRAF V600E mutation commonly associated with Langerhans cell histiocytosis (LCH). She was diagnosed with cutaneous LCH, a rare malignant disorder, and had no internal organ involvement. She began treatment with oral methotrexate, which led to moderate improvement. This case emphasizes the need to consider LCH in persistent skin conditions unresponsive to standard treatments.
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      If You Have DUPA, PLEASE READ THIS: Everyone Should Be Scalp Biopsied

      community If You Have DUPA, PLEASE READ THIS: Everyone Should Be Scalp Biopsied

      in Research  828 upvotes 5 months ago
      Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.

      community I am a dermatologist with a clinical interest in alopecia. AMA

      in Will treatment work for me? 2 years ago
      In this conversation, 4990 discussed various treatments for hair loss, including oral minoxidil, PRP, transplan, Jak inhibitors, Dutasteride, Finasteride, Olumiant, Ketoconazole, RU58841, microneedling, baricitinib, and CCCA. They recommended scalp biopsies in unclear cases of DUPA, twice weekly to twice daily shampooing for topical minoxidil users, and two sessions spaced one month apart with follow up at month three to determine the effectiveness of PRP treatment.
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      community Why is no one pointing out dandruff as the number 1 evidence/symptom of MPB?

      in Chat  55 upvotes 1 year ago
      The post discusses the theory that persistent dandruff in areas prone to hair loss could be a sign of hair follicles dying due to DHT, indicating balding. The responses vary, with some users noting improvements in dandruff and hair loss with treatments like Dutasteride, while others experienced hair loss without dandruff.

      community HT / Meds results are reverting, thinning, crazy shedding..

      in Progress Pictures  164 upvotes 3 months ago
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