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Folliculotropic Mycosis Fungoides (FMF) is a rare variant of Mycosis Fungoides involving the scalp leading to alopecia. The clinical and trichoscopic features in 18 patients were analyzed and compared with the reports in the literature. Gender, age, disease stage, site of onset were taken into consideration. Clinical and trichoscopic analyses were performed on each patient. From a clinical point of view, Folliculotropic Mycosis Fungoides lesions involving the scalp presented as generalized alopecia (27.8%) or patchy-plaque alopecia (72.2%). Trichoscopic analysis revealed six most frequent features: single hair (83.3%), dotted dilated vessels (77.8%), broken-dystrophic hairs (66.7%), vellus hairs (61.1%), spermatozoa-like pattern vessels (55.6%), and yellow dots (55.6%). Additional identified trichoscopic patterns were dilation of follicular openings, scales-crusts, purpuric dots, short hair with split-end, pigtail hairs, perifollicular hyperkeratosis, milky-white globules, black dots, white dots/lines and absence of follicular dots. These trichoscopic features were further correlated to clinical presentations and stage of the disease. The rarity of the disease is a limitation. The relatively high number of patients allowed to identify several clinical and trichoscopic patterns that could be featured as specific or highly suspicious for FMF in order to consider trichoscopy as a complementary diagnostic approach and improve the differential diagnoses between FMF and other scalp disorders.

Background: Androgenetic alopecia [AGA] one of the common scalp hair loss disorders affecting males. Androgenetic alopecia is characterized by progressive miniaturization of hair follicles in the scalp and gradual transformation of terminal hairs into vellus hairs leading to progressive decrease in hair density. The pattern of loss follows the scale developed by Hamilton and later extended by Norwood. Aim of Work: Evaluation of the efficacy of topical cetirizine 1% for the treatment of androgenetic alopecia in male patients. Patients and methods: This case-controlled study included 30 male patients treated by topical cetirizine1%and 30 male patients as a control group treated by placebo for 6 months recruited from dermatology outpatient clinic of Damietta Hospital and Al-Sarou hospital during the period from September 2018 to August 2019. For each patient, the trichoscopic evaluation was performed before the beginning of treatment and after 6 months of treatment. Results: Treatment with topical cetirizine 1% in male patients with AGA showed that according to number of new up growing hairs, the majority [56.7%] of cases had no new growing hair, 20.0%, 16.7% &6.7% had one, two and three new hair respectively. On the other hands, all control had no new hair after 6 months of treatment. Conclusion: Topical cetirizine is effective in the treatment of Androgenetic alopecia in men.

Abstract Androgens have an intense consequence on the human scalp and body hair. Scalp hair sprouts fundamentally in awol of androgens whereas the body hair hike is vulnerable to the activity of androgens. Androgenetic alopecia (AGA) invoked as males emulate Alopecia due to the cause of the dynamic reduction of scalp hair. Androgens are medium of terminus growth of hair although the body. Local and system androgens convert the extensive terminal follicles into lesser vellus like structure. The out start of this type of alopecia is intensely irregular and the reason behind this existence of enough circulating steroidal hormones androgens and due to genetic predisposition. Effective treatments are available in the market as well as under clinical and preclinical testing. Many herbal formulations are also available but not FDA approved. Different conventional and NDDS formulations are already available in the market. To avoid various systemic side effects of both Finasteride and Minoxidil, topical formulations and natural products (nutrients, minerals, vitamins) now a days are being widely used to treat Androgenic alopecia. CAM (complementary and alternative medicine) provides the option to elect favorable, low-risk, adjuvant and alternative therapies. Herein, we offer a widespread review of topical marketed formulations, natural products, and CAM treatment options for AGA. Graphic Abstract

Background: Hair loss (alopecia) is a common problem and is a major cause of psychological stress and anxiety among affected individuals. It is of utmost importance to diagnose these cases at the earliest and treat them accordingly. Trichoscopy provides a noninvasive option that can be used for early diagnosis and monitoring the progression of the hair disorders. Aims and Objectives: To perform trichoscopy and document the findings in patients with nonscarring alopecia's. Materials and Methods: A total of 100 cases satisfying the inclusion criteria were screened for general physical examination and scalp examination including hair shaft and root, and tests for hair anchorage and fragility were also done. The lesions were examined through dermoscope, photographs were taken, and findings were documented. Results: Among the total of 100 cases screened, 57 were female and 43 were male. The mean age of the study group was 26 ± 14.8 years. Females were affected by alopecia areata (AA) and female pattern hair loss (29.8%) equally, whereas males were most commonly affected by AA (41.8%). The common trichoscopic follicular features noted were broken hair (48%), black dots (48%), single hair follicle unit (45%), short vellus hair (44%), upright hair (41%), and yellow dots (40%). The common interfollicular features seen were honeycomb pigmentation (26%) and arborizing red lines (12%). Conclusion: The emergence of newer hair signs on trichoscopic studies aids in identification and has a definitive role in the diagnosis of clinically difficult cases, so it is recommended to use trichoscopy in the routine examination of nonscarring alopecia's.

Introduction Recently, dermoscopy of the hair and scalp, also known as trichoscopy, has become an important diagnostic tool in the diagnosis of hair diseases. There are few studies describing trichoscopic findings of trichotillomania (TTM). Aim To evaluate and identify specific trichoscopic features of TTM. Material and methods The study included 20 patients diagnosed with TTM on the basis of the clinical history, physical examination and trichoscopic findings. All of the trichoscopic images of the patients were retrospectively reviewed and the findings identified were recorded. Descriptive statistical analysis was performed. Results The findings detected were broken hairs at different levels (100%), short vellus hairs ( 90%), black dots (85%), trichoptilosis (75%), V hair (70%), hair powder (65%), yellow dots (55%), Mace hair (45%), coiled hairs (45%), exclamation mark hair (40%), blood spots (40%), branched hair (40%), angulated hair (40%), concentric hair (35%), flame hair (30%), and tulip hair (25%). Conclusions Here we have documented trichoscopic findings of TTM retrospectively. Trichoptilosis, V hair and hair powder were the most frequent relatively specific findings. We tried to define novel findings that we named branched hair and concentric hair. We also detected Mace hair in 9 cases. Mace hair was previously described just in 3 cases of TTM in a case study. Angulated hairs, to the best of our knowledge, were also firstly described for TTM in the present study. Lack of a comparison group is the main limitation of the study.

Congenital triangular alopecia also known as temporal triangular alopecia or Brauer nevus may be present at birth or acquired during the first decade of life. It can present as triangular, oval, or lancet-shaped patch of alopecia. It may be misdiagnosed as alopecia areata, traction alopecia, trichotillomania, tinea capitis, and aplasia cutis congenita. Histopathological features and dermoscopic features help in its diagnosis. There is no effective treatment for it and, in most cases, there is no need for therapeutic intervention. Therapeutic modalities include topical minoxidil, surgical excision, and hair transplantation.

Background: Androgenetic alopecia (AGA) is the most common hair loss disorder seen in men. It can have an early onset but has also been associated with ageing and senescence. It often induces pronounced psychological impact. ALRV5XR, a new hair loss treatment herein evaluated, was designed to target multiple molecular pathways involved in hair growth and hair follicle stem cell biology. The main objectives of the study were the assessment of safety and efficacy profiles of ALRV5XR in men.Methods: This 24-week, parallel randomised, placebo-controlled, double-blinded clinical trial was performed in a USA community clinic. Healthy men (age 22-65) with AGA and belonging to the Hamilton-Norwood (HN) classification I-VII and Fitzpatrick skin type (FST) I-VI, were randomly allocated in a 1:1 ratio into ALRV5XR or placebo treatment groups. Dermatologist assessment, phototrichograms, and blood samples were obtained in a blinded fashion at baseline, 12 and 24 weeks. Subjects were given a masked treatment consisting of oral capsules, shampoo, conditioner, and follicle serum, which was intended for daily use. Efficacy was assessed via absolute and per cent changes in terminal hair (TH) density, and response rates. The trial was registered with clinicaltrials.gov (NCT04450589) and is completed.Findings: Forty-six subjects were enroled in the study, 23 allocated to the ALRV5XR treatment and 23 to the placebo group. Enrolment occurred from April 11 to October 23, 2018. Thirty-six subjects completed the trial (17 ALRV5XR, 19 placebo) and 11 subjects in each group were evaluable for TH outcomes. At 24 weeks, the absolute change in TH density improved by 21.0 THs/cm(2) (95% CI: 9.2-32.8; p = 0.0014), and the relative density increased by 16.4% (95% CI: 7.4%-25.5%; p = 0.0012). The odds ratio for being a responder ( >= 0 change) was 87.4. TH density increased linearly and was not affected by HN, FST, ethnicity, age, or body mass index. All subjects in the ALRV5XR group responded to treatment while 81.8% of the placebo group decreased TH density. ALRV5XR induced statistically significant changes in both decrease in vellus hair (VH) density as well as in concomitant increase of the TH/VH ratio when compared to placebo. ALRV5XR was well tolerated, and no adverse events were observed.Interpretation: ALRV5XR treatment resulted in clinically significant TH regrowth in men with AGA. Furthermore, it appeared to reverse the characteristic hair miniaturisation seen in this condition. When compared to results of published trials of standard therapy, ALRV5XR showed a multi-fold increase both in efficacy and in response rates. In addition, the continuance of TH regrowth from 12 to 24 weeks suggests that the normal structure and function of non-productive telogen follicles is restored and that a normal hair phenotype may be attained by extended ALRV5XR treatment. (C) 2021 The Author(s). Published by Elsevier Ltd.

Made available in DSpace on 2020-12-10T20:04:23Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-07-01. Added 1 bitstream(s) on 2021-07-15T15:06:55Z : No. of bitstreams: 1 S0365-05962020000400018.pdf: 984398 bytes, checksum: 4ef524b3e23118aac8ba36febf70835f (MD5) Syphilis is an infectious disease that has afflicted mankind for centuries, but a recent increase in worldwide incidence has been evidenced. The authors describe a patient with typical lesions of secondary syphilis and moth-eaten alopecia, whose dermoscopic examination demonstrated empty hair follicles, vellus hair, follicular hyperkeratosis, peripheral black dots, dilated and tortuous vessels, reddish brown background, and hypopigmentation of the hair shafts. Furthermore, this case presented an erythematous background more evident than previously described cases. (C) 2020 Sociedade Brasileira de Dermatologia. Published by Elsevier Espana, S.L.U. Hosp Doencas Trop Dr Anuar Auad, Dept Dermatol, Goiania, Go, Brazil Univ Fed Goias, Hosp Clin, Dept Trop Med & Dermatol, Goiania, Go, Brazil Hosp Doencas Trop Dr Anuar Auad, Sect Psoriasis & Pediat Dermatol, Goiania, Go, Brazil Univ Estadual Paulista, Fac Med Botucatu, Dept Dermatol & Radiotherapy, Sao Paulo, SP, Brazil Hosp Doencas Trop Dr Anuar Auad, Goiania, Go, Brazil Univ Estadual Paulista, Fac Med Botucatu, Dept Dermatol & Radiotherapy, Sao Paulo, SP, Brazil

Introduction Clinical diagnosis of primary cicatricial alopecias presents difficulties. Studies regarding their trichoscopic features are scarce and mostly not comprehensive. The aim of this study is to evaluate the potential benefit of a handheld dermatoscope in clinical diagnosis of primary cicatricial alopecias. Methods In all, 69 patients with primary cicatricial alopecias were included in this prospective study. Preliminary diagnoses were established clinically, and confirmed by scalp biopsy in all cases. Trichoscopic examination was performed using a polarized-light handheld dermatoscope with tenfold magnification. The images were taken using a digital camera with threefold optical zoom. Results The following findings were significantly more common, or noted only, in particular types of primary cicatricial alopecias: “target” pattern blue-grey dots, perifollicular scaling, perifollicular cast in lichen planopilaris (n = 27); short vellus hairs, tufted hairs, crust formation, yellowish tubular scaling, pustule, red dots in folliculitis decalvans (n = 17); large keratotic yellow dots in discoid lupus erythematosus (n = 7); yellow dots, yellow dots with “three-dimensional” structure, black dots in dissecting cellulitis of the scalp (n = 6). Absence of vellus hairs was observed in patients with lichen planopilaris, frontal fibrosing alopecia, and discoid lupus erythematosus without a significant difference between the groups. Short vellus hairs were detected in all types, including frontal fibrosing alopecia (n = 7). Conclusion We suggest that a polarized-light handheld dermatoscope is useful for revealing several typical trichoscopic features of primary cicatricial alopecias that guide clinical diagnosis. As a novel observation, our data indicate that absence of vellus hairs is not an identifying feature for frontal fibrosing alopecia.

Background: Transverse sections of scalp biopsies are performed for the assessment of alopecias and are considered advantageous over vertical sections. Aim: The aim was to study the histopathological features of alopecias on transverse sections of scalp biopsies. Methods: It was a descriptive study. Clinically confirmed cases of noncicatricial and cicatricial alopecias were subjected to 4 mm scalp biopsies, which were sectioned transversely and analyzed. Biopsies obtained from occipital region of androgenetic alopecia (AGA) cases were taken as controls. Results: Biopsies from 41 cases were assessed, including male and female AGA, alopecia areata (AA), trichotillomania, lichen planopilaris (LPP), discoid lupus erythematosus (DLE), and folliculitis decalvans (FD). Normal scalp (control) biopsies showed the median total number of hair follicles of 35 (32–37), anagen:telogen/catagen ratio of 17.5 (16.5–31), and terminal:vellus ratio of 15 (10.7–17.5). In AGA and AA, miniaturization and shift toward telogen and catagen hair were consistently observed. Peribulbar inflammation was seen in two-third of AA. Trichotillomania showed increased catagen hair and numerous pigment casts. In DLE, besides perifollicular inflammation, prominent peri-arrector pili and peri-eccrine inflammation were observed. Type of inflammatory infiltrate was similar in DLE and LPP (lymphocytic), whereas FD showed neutrophilic and plasma cell infiltrate, both around follicles and interstitially. Basal cell damage in the follicles and pigment incontinence were seen in majority of DLE and LPP patients. DLE also showed basement membrane thickening, mucin deposition, and telangiectasia. Reduction/absence of sebaceous glands and perifollicular fibrosis were observed in almost all cicatricial alopecias. Conclusion: Transverse sectioning may be a useful tool in the diagnosis of alopecias.

Background: Dermoscopy has been shown to be a useful tool in assisting the noninvasive diagnosis of various general dermatological disorders. Aim: The purpose of the study was to describe the dermoscopic findings in various dermatophytosis. Materials and Methods: This cross-sectional study included 100 clinically diagnosed tinea infections of skin, hair, and nails, which were evaluated using a dermoscope (Dermlite 3 gen DL3N, California USA, 10x). Results: Among 100 patients of dermatophytosis, 69 were males and 31 females. The maximum number of patients had tinea corporis, followed by tinea cruris and tinea capitis. Dermoscopic findings noted in cases of tinea corporis included diffuse erythema, follicular micropustules, and brown spots surrounded by a white-yellowish halo, broken hair, wavy hair, and rare, morse code hair. Dermoscopy of tinea capitis depicted comma hairs, corkscrew hairs, zigzag hairs, and morse code hairs. Proximal jagged edge, spikes, and longitudinal striations were present in the cases of onychomycosis. Dermoscopy of tinea incognito yielded morse code hairs, follicular micropustules, and easily deformable hairs that look weakened and transparent and show unusual bends. Limitations: Dermoscopic findings were not correlated to fungal culture. Conclusion: Dermoscopy can be used as a fast, inexpensive, and noninvasive diagnostic tool to enhance diagnosis of cutaneous fungal infections.

Background: Congenital triangular alopecia (CTA) is a benign, asymptomatic, nonprogressive, localized and noncicatricial type of alopecia that is usually first noted during infancy or childhood. The pattern of hair loss is traditionally described as triangular, oval or lancet shaped with apex toward the vertex. Objectives: We present a case series of CTA located in unusual sites. Patients and Methods: We performed trichoscopy in 78 patients with CTA. From this group, we selected 10 individuals (4 males and 6 females) whose disease was not localized on the typical scalp area. Results: The alopecic area was located on the occipital region in 5 patients, the parietal region in 4 patients, at the vertex in 1. With trichoscopy, vellus hairs were detected in all patients, and evidence of empty follicles was noticed only in 3 patients. Conclusions: In contrast with the preconceived notion that all CTAs are frontotemporal, our case series points out that this disease could be localized in other scalp sites.

The hair cycle and hair follicle structure are highly affected by various hormones. Androgens—such as testosterone (T); dihydrotestosterone (DHT); and their prohormones, dehydroepiandrosterone sulfate (DHEAS) and androstendione (A)—are the key factors in terminal hair growth. They act on sex-specific areas of the body, converting small, straight, fair vellus hairs into larger darker terminal hairs. They bind to intracellular androgen receptors in the dermal papilla cells of the hair follicle. The majority of hair follicles also require the intracellular enzyme 5-alpha reductase to convert testosterone into DHT. Apart from androgens, the role of other hormones is also currently being researched—e.g., estradiol can significantly alter the hair follicle growth and cycle by binding to estrogen receptors and influencing aromatase activity, which is responsible for converting androgen into estrogen (E2). Progesterone, at the level of the hair follicle, decreases the conversion of testosterone into DHT. The influence of prolactin (PRL) on hair growth has also been intensively investigated, and PRL and PRL receptors were detected in human scalp skin. Our review includes results from many analyses and provides a comprehensive up-to-date understanding of the subject of the effects of hormonal changes on the hair follicle.

Recently, the hair loss population, alopecia areata patients, is increasing due to various unconfirmed reasons such as environmental pollution and irregular eating habits. In this paper, we introduce an algorithm for preventing hair loss and scalp self-diagnosis by extracting HLF (hair loss feature) based on the scalp image using a microscope that can be mounted on a smart device. We extract the HLF by combining a scalp image taken from the microscope using grid line selection and eigenvalue. First, we preprocess the photographed scalp images using image processing to adjust the contrast of microscopy input and minimize the light reflection. Second, HLF is extracted through each distinct algorithm to determine the progress degree of hair loss based on the preprocessed scalp image. We define HLF as the number of hair, hair follicles, and thickness of hair that integrate broken hairs, short vellus hairs, and tapering hairs.

Background Dermoscopy devices can overcome the refractive properties of stratum corneum by interface medium or cross polarization such that the lesion can be easily seen. Aim To examine the dermoscopic feature in alopecia areata and correlate the severity of disease with dermoscopic features. Materials and methods Retrospective analysis of 72 patients suffering from alopecia areata (AA), irrespective of age and sex, who visited the dermatology outpatient department of a tertiary care center in Eastern India was carried out. The most recently developed cases of AA were examined dermoscopically. Variables included yellow dots (YDs), black dots (BDs), broken hair (BH), short vellus hair (SVH), and exclamation mark hair (EMH) on the basis of available literature and expertise. Results Yellow dots was the most common finding seen in 57 cases (79.16%), black dots in 51 cases (70.8%). Short vellus hair was seen in 32 cases (44.44%), broken hair was seen in 31 cases (43.05%), and exclamation mark hair in 23 cases (31.9%). YDs per field of vision was considered as the most common finding with increased severity of AA. Conclusion YDS, in increased number per field of vision, is the most consistent finding seen in severe cases of AA, as they are in progressive AA and alopecia universalis. An increased number of SVH and terminal hairs were seen in patients who were being treated.

Eruptive vellus hair cyst (EVHC) is a rare follicular developmental abnormality of the vellus hair follicles. They are usually seen in children, adolescents, or young adults and manifest as reddish-brown smooth papules most commonly involving the chest, limbs, and abdomen. An 18-year-old male presented with asymptomatic papules on the trunk and flexor aspect of both forearms for the past 2 years. There was no family history of similar lesions. His medical history was also not contributory. A clinical diagnosis of steatocystoma multiplex and chronic folliculitis was given, and a punch biopsy from the papule was performed and sent for histopathological examination. On microscopic examination, a final diagnosis of EVHC was rendered. The patient was advised topical treatment of retinoic acid cream (0.05%) for 6 months, and he is currently under follow-up period. Due to its rarity and resemblance to many similar entities, histopathological examination plays a major role in establishing a definite diagnosis and further proper management of the patient. We report this unusual case to generate awareness about this rarely diagnosed condition.

Frontal fibrosing alopecia (FFA) represents a distinctive condition with a marginal scarring alopecia along the frontal and temporal hairline. Since its original description, the condition has been recognized to represent a more generalized than localized process, with extension beyond the frontotemporal hairline to include the parieto-occipital hairline and involve peculiar facial papules as evidence of facial vellus hair involvement and loss of peripheral body hair. Finally, the association of FFA with oral lichen planus, nail involvement, and concomitant lichen planopilaris (LPP) points to a close relationship to lichen planus. The Koebner phenomenon or isomorphic reaction has been described in lichen planus, LPP, and ultimately FFA, with face-lift procedures and hair restoration surgery having been implicated as the culprits in the latter. We report the first case of FFA in whom LPP developed at the sites of wig attachments, providing the evidence for Koebner phenomenon. Therefore, wigs are to be included to the list of procedures for hair restoration at risk of eliciting an isomorphic reaction in patients with FFA. Ultimately, the association of Koebner phenomenon with LPP-type lesions in FFA may provide further insight into the underlying pathology and nosology of the condition.

Background: Fibrosing alopecia in a pattern distribution (FAPD) has only been described in Caucasian patients, and it is not clear whether it can develop in dark-skin ethnicities. Materials and Methods: Sixteen Brazilian female patients, 12 of African descent and 4 Hispanic, with progressive scarring alopecia in a pattern distribution were analyzed. Results: Dermatoscopic features showed perifollicular erythema and scaling (14/16), hair fiber diameter diversity (16/16), loss of follicular ostia (16/16), and follicular keratosis (3/16). Late stages showed a honeycomb pigmented network (12/16), a hyperpigmented perifollicular halo (12/16), and small white patches (12/16). Histopathological features showed lichenoid perifollicular infiltrate (14/16), follicular miniaturization (16/16), concentric fibrosis (16/16), perifollicular lymphocytic infiltrate (16/16), and vellus hair involvement (10/16). Premature desquamation of the inner root sheath was found in 11 patients. Conclusions: The concomitant findings of cicatricial pattern hair loss (with or without the recess of the front hair line), hair fiber diversity, perifollicular erythema and scaling, a whitish perifollicular halo, and histological findings of androgenetic alopecia, with vacuolar interface alteration of the upper portion of the follicular epithelium, are the main key features to suggest the diagnosis of FAPD. FAPD is a possible diagnosis in patients of color with cicatricial pattern hair loss. Clinical, dermatoscopic, and histopathological examination allow a proper final differential diagnosis.

WOS: 000468038000032, PubMed: 30350907, Background/ ObjectivesIsotretinoin is a synthetic vitamin A agent that affects all of the pathogenic factors that suppress sebum production and play a role in the formation of acne. It is frequently used in the treatment of moderate-severe acne vulgaris. However, there are some mucocutaneous and systemic side effects that limit the use of isotretinoin. In this study, we aimed to determine the effect of isotretinoin on hair growth parameters. Material and MethodsIsotretinoin treatment at 0.5mg/kg per day dose was started to patients with moderate-severe acne vulgaris, and hair growth parameters were evaluated before treatment and after 3months of treatment. Parameters were measured by Fotofinder dermatoscopy device using the TrichoScan Professional program. ResultsIn the TrichoScan analysis, the total hair count, hair density, percentage of anagen and telogen hair, density, count, and ratio of vellus and terminal hairs in the 0.73 area were calculated. As a result, there were differences in some values between the first analysis and the second analysis. However, these differences were not statistically significant. ConclusionOur study was based on the mucocutaneous side effects of isotretinoin which are telogen effluvium and thinning hair. Our results support that the drug does not alter hair growth parameters in the short term and when very high doses are not used.

Background: Alopecia areata is a nonscarring hair loss that usually causes round patches of baldness, but alopecia areata incognita (AAI) and diffuse alopecia areata (DAA) can cause a diffuse and acute pattern of hair loss. Objective: To analyze the clinical, trichoscopic, histological, and therapeutic features of AAI and DAA. Methods: The study was designed to include data of patients with histological diagnosis of AAI and DAA enrolled in our Hair Disease Outpatient Consultations. Results: DAA had a greater involvement of the parietal and anterior-temporal regions, while AAI manifested itself mainly in the occipital-parietal regions. The most frequent pattern was empty yellow dots, yellow dots with vellus hairs, and small hair in regrowth, but the presence of pigtail hair was found almost exclusively in those with AAI. In cases of DDA, the finding of dystrophic hair and black dots was more frequent. The most frequent trichoscopic sign in both diseases was the presence of empty yellow dots, which, however, were described in a higher percentage in cases of DAA. The diseases have a benign course and are responsive to topical steroid therapy. Conclusions: Trichoscopy is very important for the differential diagnosis between the 2 diseases and to select the best site for biopsy. In the presence of diffuse hair thinning, these entities must be considered.

Background: Recently, platelet-rich plasma (PRP) injection has been proposed as a potential adjuvant therapy to treat androgenetic alopecia. Aims: Investigate the efficacy, tolerability, and clinical improvement of PRP for the treatment of female AGA. Patients/Methods: A total of 10 female patients affected by AGA and not responding to treatment with minoxidil and/or oral antiandrogens were enrolled. The clinical improvement was evaluated by pull test, global photographs, and Trichoscan at weeks 9, 12, and 24, and hair measurements were performed at baseline and 12 and 24 weeks after the first session. Results: After 24 weeks, the median relative percentage change (%RC) for all the parameters of hair density was mostly positive. After 12 weeks, the medium hair diameter in frontal area showed a significant increase (%RD = 12.5, with P-value < .05), and after 24 weeks (%RD = 14.6, P-value < .05), the vellus relative change instead showed a decrease, especially in the front and the central area, while for the vertex, the decrease was mainly visible at the end (-6.6%). No adverse events were reported. Conclusion: Platelet-rich plasma injections have a positive therapeutic effect on hair density and hair diameter improvement.

Background: Alopecia areata (AA) is a common, chronic inflammatory disease characterized by nonscarring hair loss on the scalp or any hair-bearing area of the body. Recently, dermoscopy, a noninvasive diagnostic procedure, has been employed for the diagnosis of AA. Aim: To evaluate various dermoscopic patterns in AA and correlate these patterns with the disease activity and severity. Materials and Methods: Dermoscopy was performed on AA patients using DL1 dermoscope (magnification ×10 was used). The dermoscopic patterns recorded were analyzed to identify any correlation with the disease activity and severity. Results: A total of fifty patients of AA were recruited in the study. Female outnumbered males with the ratio being 1.173:1. Mean age of the patients was 25.06 years. Mean duration of disease was 14 months. The most common site involved was scalp (80%) and type noted was patchy (84%). Various dermoscopic patterns noted were yellow dots (YD) (88%), short vellus hair (66%), black dots (BD) (58%), broken hairs (BHs) (56%), tapering hair (TH) (26%), Coudability hairs (14%), pigtail hair (14%), and Pohl-Pinkus constrictions (2%). Statistically significant correlation was observed between BD, BHs, THs, and disease activity. No significant correlation was found between severity and any of the dermoscopic features. Conclusion: The most common dermoscopic pattern in our study was YD. Presence of BDs, BHs, and THs indicate active disease. Dermoscopic patterns were not affected by severity of the disease.

We herein report a case of hair follicle nevus, a rare hamartoma found on the face and showing follicular differentiation, which was associated with sebaceous hyperplasia. Dermoscopy of the lesion showed yellow globules surrounded by crown vessels/telangiectasias and scattered tiny hairs. Histopathological investigation revealed hyperplasia of the sebaceous glands and proliferation of well-differentiated vellus hair follicles. These pathological findings were thought to correspond to the yellowish globules and tiny hairs observed under dermoscopy. Hair follicle nevus associated with sebaceous hyperplasia is extremely rare; however, dermoscopic examination can suggest an appropriate diagnosis. The present case proved the diagnostic usefulness of dermoscopy for cutaneous tumors with hair follicular and sebaceous glandular differentiation.

Alopecia areata is an autoimmune skin disease which is usually characterized by patchy hair loss in effected regions. Diagnosis usually based on clinical findings and main treatment options include topical, intralesional, systemic corticosteroids, and topical immunotherapy. Verruca vulgaris is an infectious disease caused by human papillomavirus which is usually characterized by well-marginated hyperkeratotic papules or plaques. There are several treatment modalities such as physical and chemical destruction and topical immunotherapy. A 23-year-old male patient presented to our outpatient clinic with multifocal noncicatrial alopecic plaques on scalp and multiple periungual verrucous papules on bilateral hands. High potent corticosteroid cream and minoxidil lotion 5% were offered for his scalp lesions, and topical 5-fluorouracil lotion was initiated for his verrucous lesions. In the 1st month visit, we detected contamination of viral warts on alopecic plaques of his scalp and all the previous therapeutics were stopped. We initiated topical diphenylcyclopropenone (DPCP) sensitization weekly. After the fourth application of DPCP, we observed that all of hyperkeratotic papules disappeared. Diphencyprone treatment was continued, and with further applications, hair growth as vellus type was observed. DPCP is relatively beneficial treatment option for both diseases although it is not a first-line therapy most times. There are case reports and series about this treatment for both of these diseases. We want to present this case to by regard of the unusual presentation and efficacy of DPCP in both indications.

Background: Facial threading involves the removal of hairs to restore facial skin smoothness. However, its effectiveness has not been rigorously evaluated. Objective: To evaluate effects of facial threading on skin roughness, hydration, melanin index, and vellus hair on the face, complemented by a subjective evaluation of the tactile feel of the skin and improvement in skin color. Method: Participants who had not used exfoliators for two weeks before the experiment were included. Each participant underwent one session of facial threading every 21 days, for a total of 3 sessions. A three-dimensional skin roughness instrument and a multifunctional skin testing system were used to evaluate changes in roughness, hydration, and pigmentation on the forehead, cheeks, and corners of the mouth. A photomicrographic camera was used to record changes in vellus hair. Subjective reports of skin smoothness and color were recorded. Result: Eighteen participants completed the study. Facial threading produced a significant decrease in skin roughness on the forehead (22.42%, p =.013), right cheek (77%, p =.02), and left corner of the mouth (33.02%, p =.001). Subjective improvement in tactile feel of the skin and coloring were reported. Study limitations: The study did not include randomization, with further limitations of a small sample size and a single site. Conclusion: Facial threading reduced skin roughness by 26.74% after three threading sessions, with improved subjective assessment of tactile feel and coloring. Future research should include a comparison with other cosmetic products with similar beautifying effects or a control group.

Introduction: There are no reports of the density of hair follicles in the scalp of Mexican mestizo population, necessitating the determination of normal references values for this population compared with other ethnic groups. Objective: To determine the average hair follicle count on the scalp in Mexican mestizo population. Materials and Methods: A total of 50 scalp samples (25 men and 25 women) from Mexican mestizo individuals aged between 19 and 60 years, with no clinical evidence of hair disease, obtained by biopsy punch at General Hospital “Dr. Manuel Gea González” were collected over 2 years. The total follicular density, vellus and terminal hair follicles, and the percentage in anagen and catagen-telogen phase were measured. χ2 was used as the basic statistical test. Results: The mean number of total hair follicles in our Mexican mestizo population was 23.2 ± 4.2, which is lower compared with Thais, Iranians, and Caucasians. However, the ratio of terminal and vellus hair follicles was higher than in Thais, Caucasians, and African-Americans. The percentage of terminal hairs in anagen phase was lower than in the other populations, and higher in telogen, without exceeding 15%, established as the normal reference value. There was an association between sex and terminal hairs in telogen phase (p < 0.05). The average follicular density per mm2 was slightly higher compared with African-Americans and Asians. Women had more terminal hairs than men. Conclusions: The density of total follicles is lower in the Mexican mestizo population compared with Iranians, Thais, and Caucasians. However, the greater number of terminal hairs compared to vellus hairs gives the appearance of greater overall volume. The results of this study can be used as a reference for diseases of the scalp in the Mexican population.

Tinea infection is a common superficial fungal infection of the skin, hair and nails. Tinea of vellus hair is a rare form of dermatophytosis that is difficult to diagnose and treat. Herein, the authors report the case of a patient who had an itchy rash on the cheek. Microscopic and mycological studies confirmed the diagnosis of tinea of vellus hair. The patient was treated with systemic antifungal therapy with clinical improvement. This report aims to describe an infrequent subtype of common disease and review clinical clues, tools for diagnosis as well as treatment plans.

Frontal fibrosing alopecia (FFA) and fibrosing alopecia in a pattern distribution (FAPD) represent clinically distinctive conditions characterized by pattern hair loss with evidence of follicular inflammation and fibrosis. Since Kossard's original description, the condition has been recognized to represent a rather generalized than localized process, with extension well beyond the frontotemporal hairline. More recently, peculiar facial papules have been reported in FFA representing facial vellus hair involvement. We report the case of a 42-year-old woman with FAPD associated with the same facial papules, supporting that both entities belong to the same spectrum of cicatricial pattern hair loss.