SnapshotDx Quiz: September 2016

August 2016 in “ Journal of Investigative Dermatology ”

Farhaan Hafeez, Mariya Miteva

scalp psoriasis dermatoscopic images pathologic images perifollicular lymphocytic inflammation sebaceous gland atrophy lipid biosynthetic genes psoriatic alopecia Th1 cytokine activation Th17 cytokine activation TNF-alpha antagonists scalp conditions immune profile hair regrowth

TLDR Scalp psoriasis features reversible hair loss and specific immune activation, with no significant hair follicle damage.

The SnapshotDx Quiz from September 2016 focused on diagnosing scalp conditions, particularly scalp psoriasis, using dermatoscopic and pathologic images. It emphasized that scalp psoriasis was characterized by thick silvery scales, specific vascular patterns, perifollicular lymphocytic inflammation, and sebaceous gland atrophy. A study by Rittié et al. found significant sebaceous gland atrophy and down-regulation of lipid biosynthetic genes in psoriatic lesions, but no significant damage to hair follicles, which were longer in lesional skin. Psoriatic alopecia was noted to be reversible, with common hair regrowth, and the immune profile of scalp psoriasis was similar to skin psoriasis, involving Th1/Th17 cytokine activation. The quiz also addressed misconceptions about psoriatic alopecia and the effects of TNF-alpha antagonists.