ISABELLA IBRAHIM DOCHE SOARES
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- Evidence for neurogenic inflammation in lichen planopilaris and frontal fibrosing alopecia pathogenic mechanism(2020) DOCHE, Isabella; WILCOX, George L.; ERICSON, Marna; VALENTE, Neusa S.; ROMITI, Ricardo; MCADAMS, Brian. D.; HORDINSKY, Maria K.Lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA) are lymphocytic scarring alopecias affecting primarily the scalp. Although both diseases may share some clinical and histopathological features, in the last decade, FFA has become an ""epidemic"" particularly in Europe, North and South America with unique clinical manifestations compared to LPP, thus, raising the idea that this disease may have a different pathogenesis. Symptoms such as scalp burning, pruritus or pain are usually present in both diseases, suggesting a possible role for nerves and neuropeptides in the pathogenesis of both diseases. Based on some previous studies, neuropeptides, such as substance P (SP) and calcitonin gene-related peptide (CGRP), have been associated with lipid metabolism and many chronic inflammatory disorders. In this study, we asked if these neuropeptides are associated with LPP and FFA scalp lesions. Alteration in the expression of SP and CGRP in affected and unaffected scalp skin from patients with both diseases was found with examination of sections using immunohistochemical techniques and confocal microscopy. We then quantitatively assessed and compared SP and CGRP expression from control, LPP and FFA scalp biopsies. Although LPP and FFA share similar histopathologic findings, opposite results were found in affected and unaffected scalp in the ELISA tests, suggesting that these diseases may have different pathogenic mechanisms. We also found presence of histopathological inflammation irrespective of evident clinical lesions, which raises the possibility that both diseases may be more generalized processes affecting the scalp.
- Quality-of-life impairment is not related to disease activity in lichen planopilaris and frontal fibrosing alopecia. Results of a preliminary cross-sectional study(2022) DOCHE, I.; ROMITI, R.; RIVITTI-MACHADO, M. C.; GORBATENKO-ROTH, K.; FREESE, R. L.; HORDINSKY, M. K.
- Overexpression of the aryl hydrocarbon receptor in frontal fibrosing alopecia and lichen planopilaris: a potential pathogenic role for dioxins?: an investigational study of 38 patients(2020) DOCHE, I.; PAGLIARI, C.; HORDINSKY, M. K.; WILCOX, G. L.; RIVITTI-MACHADO, M. C. M.; ROMITI, R.; VALENTE, N. Y. S.; SHAIK, J. A.; SALDANHA, M.; SOTTO, M. N.
- Normal-appearing scalp areas are also affected in lichen planopilaris and frontal fibrosing alopecia: An observational histopathologic study of 40 patients(2020) DOCHE, Isabella; ROMITI, Ricardo; HORDINSKY, Maria K.; VALENTE, Neusa S.Lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA) are lymphocyte-mediated scarring alopecias which clinically affect primarily the anterior and mid-scalp. However, unaffected scalp areas have not yet been investigated in a systemic manner. In this study, we assessed histopathologic changes in affected and unaffected scalp in both diseases and healthy control subjects and compared these findings with clinical signs and scalp symptoms. We have demonstrated that ""normal-appearing"" scalp that is devoid of clinical lesions of LPP and FFA showed lymphocytic perifollicular inflammation around the isthmus/infundibulum areas in 65% of biopsy specimens, perifollicular fibrosis in 15% and mucin deposits in 7.5% of the cases. None of these findings were found in control samples. No direct correlation was found between the degree of histopathological inflammation, scalp symptoms and clinical lesions in the corresponding affected scalp areas. This preliminary study suggests that both diseases may be more generalized processes which affect the scalp and therefore need systemic or total scalp therapy.
- Trichostasis spinulosa of the scalp mimicking Alopecia Areata black dots(2014) CHAGAS, Flavianne Sobral Cardoso; DONATI, Aline; SOARES, Isabella Ibrahim Doche; VALENTE, Neusa Sakai; ROMITI, RicardoAlopecia areata is a common autoimmune disorder that leads to nonscarring hair loss. Black dots, also called comedo-like cadaver hairs, can be found in almost 50% of alopecia areata patients and indicate disease activity. Trichostasis spinulosa is a follicular disorder resulting from the retention of numerous hairs surrounded by a keratinous sheath in dilated follicles. Trichostasis spinulosa is a relatively common but underdiagnosed disorder of hair follicles. Here, we describe a man with alopecia areata of the eyebrows, androgenetic alopecia and trichostasis spinulosa at the vertex and show how dermoscopy can be useful in distinguishing black dots from Trichostasis spinulosa lesions.