Sanchez-Duenas Luis Enrique, Ruiz-Dueñas Angelica, Guevara-Gutiérrez Elizabeth, Tlacuilo-Parra Alberto
Hair Restoration Center, Dermika Laser Dermatology Center, Guadalajara, Mexico.
Dermika Laser Dermatology Center, UMAE Hospital de Pediatría, Guadalajara, Mexico.
Int J Trichology. 2022 May-Jun;14(3):103-108. doi: 10.4103/ijt.ijt_62_21. Epub 2022 May 24.
Hair straightening products like the Brazilian Keratin Treatment (BKT) contain high concentrations of formaldehyde, and its use is associated with adverse effects. In 2016, seven cases of eczema-like psoriasiform skin reaction secondary to BKT were described for the first time. We aim to investigate the clinical characteristics and dermatoscopic findings of patients with psoriasiform skin reactions due to BKT.
A cross-sectional study was performed from October 2017 to June 2020. Patients who developed erythema and scales on the scalp following the use of BKT were included. Age, sex, number of BKTs, time elapsed between BKT and the skin reaction, pull test, and dermatoscopic findings were investigated. Descriptive and inferential statistics were used.
We found 43 patients with a mean age of 35 ± 10 years, predominantly females in 42 (98%) cases. The mean number of BKTs was 2 ± 2. The mean length of time elapsed to present the reaction was 12 ± 17 months and this was related to the number of BKTs ( = 0.01). The pull test was positive in 37 (86%) patients. The most frequent dermatoscopic findings were perifollicular scales in 42 (98%), red patches in 35 (81%), and peripilar desquamation resembling the outer skin of an onion bulb in 32 (74%).
Hair straightening products are widely used and the psoriasiform skin reaction that develops afterward might be underdiagnosed. It is important to investigate the background of BKT in conjunction with the clinical and dermatoscopic findings suggestive of this cutaneous reaction.
像巴西角蛋白疗法（BKT）这样的直发产品含有高浓度甲醛，其使用与不良反应相关。2016年，首次描述了7例继发于BKT的湿疹样银屑病样皮肤反应病例。我们旨在调查因BKT导致的银屑病样皮肤反应患者的临床特征和皮肤镜表现。
于2017年10月至2020年6月进行了一项横断面研究。纳入在使用BKT后头皮出现红斑和鳞屑的患者。调查了年龄、性别、BKT使用次数、BKT与皮肤反应之间的时间间隔、拔发试验以及皮肤镜表现。使用了描述性和推断性统计方法。
我们发现43例患者，平均年龄为35±10岁，其中42例（98%）主要为女性。BKT的平均使用次数为2±2次。出现反应的平均时间为12±17个月，这与BKT的使用次数相关（P = 0.01）。37例（86%）患者的拔发试验呈阳性。最常见的皮肤镜表现为42例（98%）有毛囊周鳞屑，35例（81%）有红色斑片，32例（74%）有类似洋葱鳞茎外皮的毛发周围脱屑。
直发产品被广泛使用，其后发生的银屑病样皮肤反应可能未得到充分诊断。结合提示这种皮肤反应的临床和皮肤镜表现来调查BKT的背景很重要。
