Benez-Miller Marcela Duarte, Gripp Alexandre, Melo Daniel Fernandes, Machado Carla Jorge, Sar-Pomian Marta, Azulay-Abulafia Luna
Department of Dermatology, State University of Rio de Janeiro - UERJ, Rio de Janeiro, Brazil.
Department of Preventive and Social Medicine, Federal University of Minas Gerais - UFMG, Belo Horizonte, Brazil.
Skin Appendage Disord. 2025 Apr;11(2):147-150. doi: 10.1159/000540968. Epub 2024 Oct 15.
Pemphigus foliaceus (PF) and pemphigus vulgaris (PV) are bullous diseases characterized by loss of keratinocyte adhesion, easily ruptured blisters, and erosions. The scalp is involved in up to 60% of patients due to the high concentration of antigens in hair follicles. Trichoscopy has been studied in bullous diseases. However, research on pemphigus trichoscopy remains scarce. This study aimed to analyze the main trichoscopic features of pemphigus on the black scalp, a topic poorly appraised thus far.
Ten male and 8 female patients were enrolled, evenly distributed between PV (aged 16-59) and PF (aged 20-72), with Fitzpatrick phototypes equal to or greater than IV. Scalp evaluations were conducted using digital dermoscopy, with 20-to-70-fold magnification. Our results were compared with original research on Caucasian scalp pemphigus.
Our study identified the previously published and also novel trichoscopic features. Our patients exhibited higher percentages ( < 0.05) of eight classic structures, considering both PF and PV; PF only; PV only. Aside from yellow dots ( = 0.002), our sample showed no statistically significant differences between the PV and PF groups in black patients.
Peculiarities of black scalp trichoscopy did not interfere in the diagnosis of pemphigus. Trichoscopy should be a routine diagnostic tool in patients with bullous scalp diseases, especially in the early stages, and to guide biopsy. To our knowledge, this is the first study focused on trichoscopy of pemphigus affecting black scalp. It indicates that, among other findings, yellow dots may be a relevant hallmark of scalp PV.
落叶型天疱疮（PF）和寻常型天疱疮（PV）是大疱性疾病，其特征为角质形成细胞黏附丧失、水疱易破裂及糜烂。由于毛囊中抗原浓度高，高达60%的患者头皮会受累。已对大疱性疾病进行了毛发镜检查研究。然而，关于天疱疮毛发镜检查的研究仍然很少。本研究旨在分析黑种人头皮上天疱疮的主要毛发镜特征，这一主题迄今评估不足。
纳入10名男性和8名女性患者，年龄在16 - 59岁的PV患者和20 - 72岁的PF患者中均匀分布，Fitzpatrick皮肤光类型等于或大于IV型。使用数字皮肤镜进行头皮评估，放大倍数为20至70倍。将我们的结果与关于白种人头皮天疱疮的原始研究进行比较。
我们的研究确定了先前已发表的以及新的毛发镜特征。考虑到PF和PV、仅PF、仅PV，我们的患者中八种经典结构的比例更高（<0.05）。除了黄点（=0.002）外，我们的样本显示黑种人患者的PV组和PF组之间无统计学显著差异。
黑种人头皮毛发镜检查的特点不影响天疱疮的诊断。毛发镜检查应成为头皮大疱性疾病患者的常规诊断工具，尤其是在早期阶段，并用于指导活检。据我们所知，这是第一项专注于影响黑种人头皮的天疱疮毛发镜检查的研究。它表明，除其他发现外，黄点可能是头皮PV的一个相关标志。
