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Hair transplants were developed and championed by dermatologists. However, dermatology literature has few contributions from within our specialty. In this manuscript, we present our evaluation of a specific graft harvesting approach for hair transplants referred to as Follicular unit extraction (FUE). In particular, we sought to evaluate the rate of harvest attempts that did not produce an actual hair folliclular unit graft.

Alopecia affects many individuals worldwide. Owing to the large role that hair loss plays in self-image and self-confidence, an increasing number of these men and women seek options for hair restoration. Major considerations and sources of hesitation for strip surgical restoration are the visible linear scar, prolonged downtime, and other expected side effects of invasive procedures. These problems can be circumvented by smaller harvest approaches. However, the traditional punch harvest, which produces no linear scar, does leave patients with an often-unsatisfactory "doll hair" appearance. Follicular Unit Extraction (FUE) is a minimally invasive surgical procedure that utilizes a punch device to harvest occipital follicular units that are later transplanted in areas of loss to restore hair growth. FUE captures the benefit of multiple available restoration techniques and avoids the disadvantages of traditional strip surgery. A number of variations on the procedure are currently in practice and many more exciting advances are underway.

Hair transplants were developed and championed by dermatologists. However, dermatology literature has few contributions from within our specialty. In this manuscript, we present our evaluation of a specific graft harvesting approach for hair transplants referred to as Follicular unit extraction (FUE). In particular, we sought to evaluate the rate of harvest attempts that did not produce an actual hair folliclular unit graft.

Alopecia affects many individuals worldwide. Owing to the large role that hair loss plays in self-image and self-confidence, an increasing number of these men and women seek options for hair restoration. Major considerations and sources of hesitation for strip surgical restoration are the visible linear scar, prolonged downtime, and other expected side effects of invasive procedures. These problems can be circumvented by smaller harvest approaches. However, the traditional punch harvest, which produces no linear scar, does leave patients with an often-unsatisfactory "doll hair" appearance. Follicular Unit Extraction (FUE) is a minimally invasive surgical procedure that utilizes a punch device to harvest occipital follicular units that are later transplanted in areas of loss to restore hair growth. FUE captures the benefit of multiple available restoration techniques and avoids the disadvantages of traditional strip surgery. A number of variations on the procedure are currently in practice and many more exciting advances are underway.

Background Appointment attendance has always been a concern for physicians and the landscape is changing now that patients can book appointments online in many practices. Objective This manuscript examined attendance rates of appointments made on the internet for rural and urban dermatology clinics. Methods The study analyzed appointment records made over a 6-month period on ZocDoc.com for 3 dermatology clinics located outside Houston, Texas. Results Non-attendance rates for online appointments were much lower (6.9%) than non-attendance rates at dermatology clinics through traditional means. The average age of patients who missed their appointments was lower than the average age of those who made their appointments. In addition, the average age of those who cancelled their appointments was higher than those who made their appointments. Also, urban non-attendance rates were higher than rural rates. Limitations This study has a small sample size because online appointment scheduling is not a common practice. Conclusion The early returns of online appointment scheduling indicate that appointments made online are more likely to have lower non-attendance rates than appointments made through traditional means.

Follicular unit extraction (FUE) provides many advantages over the strip surgical method of harvesting hair grafts for hair restoration. However, FUE also has its shortcomings because it is a more time intensive approach that results in increased costs and is technically a more challenging technique of hair transplantation. In this manuscript, we seek to share approaches used at our center to help minimize and/or improve on some of the challenges of FUE.

Follicular unit extraction (FUE) provides many advantages over the strip surgical method of harvesting hair grafts for hair restoration. However, FUE also has its shortcomings because it is a more time intensive approach that results in increased costs and is technically a more challenging technique of hair transplantation. In this manuscript, we seek to share approaches used at our center to help minimize and/or improve on some of the challenges of FUE.

The use of filler for depressed scars has been documented but is rare in the literature. We present a case of a patient treated with hyaluronic acid fillers at the site of a long-standing depressed scar.

Since the 1980s, laser technology has become increasingly popular to treat a variety of cutaneous conditions. Its successful use as an epilator comes with the rare but interesting side effect of paradoxical hypertrichosis. In this review, we summarize cases describing hair growth after photoepilation, as well as studies testing laser and light sources as treatment for alopecia, particularly androgenetic alopecia and alopecia areata. We also discuss the possible biologic mechanisms by which phototherapy induces hair regeneration.

Onycholemmal carcinoma is believed to be of trichilemmal origin, and shows differentiation similar to that found in the trichilemmal portion of the hair follicle. Less then 3 cases are currently in the English literature. All reported cases presented in elderly patients and were without recurrence after amputation. Clinical presentation has been varied and can be very subtle. As with most nail tumors, pain is not a common feature. The diagnosis is based on the histology showing an infiltrative growth of atypical keratinocytes, one or more foci of abrupt keratinization, and usually also keratinous cysts devoid of a granular layer. When a cystic component and clear cells predominate, the subtype description of malignant proliferating onycholemmal cyst has been applied. No standard treatment option or follow up has been established.

The role of vitamin D in the proliferation and differentiation of keratinocytes is well known within the field of dermatology.We sought to evaluate the role that vitamin D and the vitamin D receptor play in the hair cycle and assess how this can be clinically applied to the treatment of hair disorders.A MEDLINE search (1955-July 2009) was preformed to find relevant articles pertaining to vitamin D, the vitamin D receptor, and hair loss.The vitamin D receptor, independent of vitamin D, plays an important role in hair cycling, specifically anagen initiation. The role of vitamin D in hair follicle cycling is not as well understood.The review is broad and there are limited human studies available to date.Additional studies to evaluate the role of vitamin D in the hair cycle should be done. Treatments that up regulate the vitamin D receptor may be successful in treating hair disorders and are a potential area of further study.

BACKGROUND The role of vitamin D in the proliferation and differentiation of keratinocytes is well known within the field of dermatology. OBJECTIVE We sought to evaluate the role that vitamin D and the vitamin D receptor play in the hair cycle and assess how this can be clinically applied to the treatment of hair disorders. METHODS A MEDLINE search (1955-July 2009) was preformed to find relevant articles pertaining to vitamin D, the vitamin D receptor, and hair loss. RESULTS The vitamin D receptor, independent of vitamin D, plays an important role in hair cycling, specifically anagen initiation. The role of vitamin D in hair follicle cycling is not as well understood. LIMITATIONS The review is broad and there are limited human studies available to date. CONCLUSION Additional studies to evaluate the role of vitamin D in the hair cycle should be done. Treatments that up regulate the vitamin D receptor may be successful in treating hair disorders and are a potential area of further study.

Patients affected by pemphigus vulgaris will occasionally present with associated and characteristic nail changes. This manuscript was prepared as a review of this unique presentation of pemphigus. Articles describing pemphigus vulgaris of the nail were compiled and reviewed and pertinent information was extracted to provide a concise analysis. The literature on this topic is still maturing. Publications to date suggest the incidence of nail and periungal involvement may correlate with the severity of mucocutaneous symptoms and the duration of the disease. The most common nail manifestations reported were acute or chronic paronychia and onychomadesis, and involvement of the fingernails. The nail changes may precede or develop concurrently with the mucocutaneous presentation. The diagnosis can be made by histologic identification and/or by the presence of IgG and C3 with direct immunoflourescence testing. Systemic treatment is required and highly effective; it includes a tailored combination of anti-inflammatory medications, immunosuppressive agents, and/or immunomodulatory treatments. This review aims to provide a better understanding of pemphigus vulgaris nail changes and guidance for clinical treatment. Unknown etiologies, predisposing factors, discrepancies evident in the literature, and limited research warrant further investigation of pemphigus vulgaris of the nail.

Patients affected by pemphigus vulgaris will occasionally present with associated and characteristic nail changes. This manuscript was prepared as a review of this unique presentation of pemphigus. Articles describing pemphigus vulgaris of the nail were compiled and reviewed and pertinent information was extracted to provide a concise analysis. The literature on this topic is still maturing. Publications to date suggest the incidence of nail and periungal involvement may correlate with the severity of mucocutaneous symptoms and the duration of the disease. The most common nail manifestations reported were acute or chronic paronychia and onychomadesis, and involvement of the fingernails. The nail changes may precede or develop concurrently with the mucocutaneous presentation. The diagnosis can be made by histologic identification and/or by the presence of IgG and C3 with direct immunoflourescence testing. Systemic treatment is required and highly effective; it includes a tailored combination of anti-inflammatory medications, immunosuppressive agents, and/or immunomodulatory treatments. This review aims to provide a better understanding of pemphigus vulgaris nail changes and guidance for clinical treatment. Unknown etiologies, predisposing factors, discrepancies evident in the literature, and limited research warrant further investigation of pemphigus vulgaris of the nail.

Leukemias and Lymphomas can present in indolent and surprisingly unusual manners. Although uncommon, follicular lesions such as eosinophilic folliculitis have been reported in association with leukemia. However, follicular and papular mucinosis are novel associations for chronic myelomonocytic leukemia.

Electroconvulsive therapy (ECT) is an established treatment for refractory cases of major depression for over 60 years. There are many widely known and reported side effects of ECT. However, cutaneous changes post-ECT are rarely reported in the peer-reviewed literature. This report illustrates a case of post-ECT changes that consisted of petichiae. This manuscript also discusses the potential pathogenesis behind this presentation.

Electroconvulsive therapy (ECT) is an established treatment for refractory cases of major depression for over 60 years. There are many widely known and reported side effects of ECT. However, cutaneous changes post-ECT are rarely reported in the peer-reviewed literature. This report illustrates a case of post-ECT changes that consisted of petichiae. This manuscript also discusses the potential pathogenesis behind this presentation.

Ambras syndrome was described less than 20 years ago. The initial report focused on the subtle, but important distinguishing characteristics that separate this from other forms of congenital hypertrichosis. This review, we examine this fascinating syndrome, and the current scientific perspectives in discussion. This review will help increase and expand our knowledge base of this uncommon syndrome, and should encourage future dermatologic analysis and reports on Ambras syndrome.

Granuloma inguinale is common in certain regions of the world, however, it is rarely reported in the United States. It is the result of infection by Calymmatobacterium granulomati, although current literature proposes to re-classify this organism as Klebsiella granulomati. Here we report a case of granuloma inguinale, review the literature, and discuss historical context, treatment options, and differential diagnosis.

Onychomatricomas (OM) are rare subungual tumors first described just over a decade ago. Surprisingly, these lesions still rarely are reported in the literature. This may be because of a lack of awareness, understanding, or interest in these perceivably benign lesions. In this review, we discuss the current literature and understanding of OM. We attempt to ascertain predilections and patterns in an attempt to establish a stronger appreciation of OM, and to encourage future reports. We emphasize the importance of reporting such lesions; with a larger literature base, prevalence, etiology, and pathogenesis can be better determined.