Introduction: Alopecia areata (AA) manifests as patchy hair loss and intralesional corticosteroid (ILCS) is usual therapeutic choice in limited disease. Microneedling is used for uniform delivery of topical agent to relatively larger areas may prove to be more efficacious than traditional ILCS. The present study prospectively compared microneedling to traditional intralesional delivery of triamcinolone acetonide (TA). Materials and Methods: Prospective randomized comparative study in 60 patients of AA restricted to scalp not requiring systemic treatment randomly divided into two equal groups. Group 1 patients underwent microneedling with local application of injectable TA and Group 2 patients were given injectable TA intradermally for a total of three sessions at 3 weeks interval. Results: A mean regrowth of 66.36% in Group 1 and 69.75% in Group 2 at week 9 was seen which was comparative with no significant statistical difference between the two groups (P = 0.664). Thirteen patients achieved 100% regrowth at week 9 in Group 1 and 16 patients achieved 50%–99% regrowth in Group 2. Discussion and Conclusions: ILCSs have been cornerstone in the treatment of limited AA, but depth of injecting drug cannot be controlled, microneedling whereas is an effective drug delivery system and also causes release of growth factors. In this study, injectable TA used intralesionally and topically with microneedling had nearly similar efficacy in causing regrowth of hair with microneedling resulting in a more uniform but less dense regrowth of hair with lesser adverse effects.

Context: Hair loss is a common complaint among Indian women. For female pattern hair loss (FPHL), diagnosis is primarily clinical. In the early stages, it can be confused with other conditions. Histopathology is the diagnostic method of choice but requires multiple biopsies and can be disfiguring. Trichoscopy is an alternative noninvasive, rapid tool. Aim: The aim of this study is to study the hair density and hair diameter variance in relation with severity grading of FPHL. Settings and Design: Cross-sectional study. Materials and Methods: Ninety women aged 18 years and above were included in this cross-sectional study conducted at the dermatology department of Bangalore Medical College and Research Institute. Trichoscopic examination was done with a videodermoscope (Firefly DE300) at 20 and 70-fold magnification. Only those patients who met the trichoscopic diagnostic criteria for FPHL were included. Statistical Analysis Used: Descriptive statistics, ANOVA, and Spearman's correlation test for fitness of good, using Microsoft Excel data analysis tools. Results: Increase in disease severity from grade one to grade three positively correlated with a decrease in hair density over the frontal scalp (P < 0.001) and the occipital scalp (P < 0.001), decrease in average hair shaft diameter over both frontal and occipital scalp (P < 0.001). Conclusion: Trichoscopic tools, particularly hair density and hair diameter variance over both frontal and occipital scalp can be useful to help determine FPHL disease severity and its progression.

Background: Tiger tail hairs, Morse hairs or pili annulati is a nonsyndromic hair shaft disorder, characterized by alternating light and dark bands along the hair shaft. Methods: The outer surface and the inner structure of longitudinally cut tiger tail hairs were examined with scanning electron microscopy. Results: Hair specimens of five affected individuals showed small surface undulations with “curtain-like” folding of the hair cuticula (microcanaliculi). In the inner surface cord-like linear structures with serpiginous, tortuous traject were seen, associated with some cavities. Conclusions: These findings suggest that this condition is due to some deficient protein synthesis/arrangement, not only due to cavities in the hair cortex. The term Tiger tail hair is a descriptive clinical term of little scientific rigor. This disorder has been reported mainly as pili annulati; however, rings are not observed. In analogy to pili canaliculi, in which well-formed grooving is observed in the hair surface, we suggest the term pili microcanaliculi to describe this condition, based in the ultrastructural findings.

Recent research has associated alopecia areata (AA), an autoimmune disorder, with deficiency of Vitamin D, which regulates immune processes. This retrospective study compared Vitamin D levels in AA patients to those of other alopecia diagnoses and nonalopecia controls. When compared to controls, patients with AA or other alopecia diagnoses did not demonstrate lower Vitamin D levels. However, when compared to other alopecia diagnoses, AA patients had a statistically significantly higher proportion of patients with Vitamin D deficiency and a lower mean Vitamin D level. Our findings suggest a greater association between lower Vitamin D levels and AA compared to other alopecia diagnoses. Further prospective studies investigating Vitamin D levels and supplementation in AA patients are needed to further elucidate this association and its potential relevance.

Erosive pustular dermatosis of the scalp is a chronic cutaneous condition presenting with areas of erosions and pustules, healing with scarring and alopecia. We report three such cases presenting with pus-filled lesions of the scalp with nonspecific pathological changes. This condition is often misdiagnosed and shows a poor response to antibiotics. Clinical suspicion is of primary importance for early diagnosis and proper treatment.

Several reports more so from western countries present recovery for alopecia areata (AA) with tofacitinib. In this report, we present the case of a young adult male diagnosed with resistant AA with failed treatment to oral as well topical steroids, minoxidil, and oral troxasalen. He was treated with tofacitinib 5 mg twice a day along with biotin supplement. Hair regrowth was observed at 1 month. After 3 months, nearly more than 90% hair regrowth was observed. No associated side effects were noted.

Plica neuropathica is a rare scalp condition, which is manifested as a compact mass of scalp hair. Previously, it has been found to be associated with a variety of dermatological disorders. We report a case of 15-year-old female presenting with alopecia areata associated with plica neuropathica.