Background: Alopecia areata (AA) is a common, non-scarring, patchy loss of hair at scalp and elsewhere. Its pathogenesis is uncertain; however, auto-immunity has been exemplified in various studies. Familial incidence of AA is 10-42%, but in monozygotic twins is 50%. Local steroids (topical / intra-lesional) are very effective in treatment of localized AA. Aim: To compare hair regrowth and side effects of topical betamethasone valerate foam, intralesional triamcinolone acetonide and tacrolimus ointment in management of localized AA. Materials and Methods: 105 patients of localized AA were initially registered but 27 were drop out. So, 78 patients allocated at random in group A (28), B (25) and C (25) were prescribed topical betamethasone valerate foam (0.1%) twice daily, intralesional triamcinolone acetonide (10mg/ml) every 3 weeks and tacrolimus ointment (0.1%) twice daily, respectively, for 12 weeks. They were followed for next12 weeks. Hair re-growth was calculated using "HRG Scale"; scale I- (0-25%), S II-(26-50%), S III - (51-75%) and S IV- (75-100%). Results: Hair re-growth started by 3 weeks in group B (Scale I: P<0.03), turned satisfactory at 6 weeks in group A and B (Scale I: P<0.005, Scale IV: P<0.001)), good at 9 weeks (Scale I: P<0.0005, Scale IV: P<0.00015), and better by 12 weeks of treatment (Scale I: P<0.000021, Scale IV: P<0.000009) in both A and B groups. At the end of 12 weeks follow-up hair re-growth (>75%, HRG IV) was the best in group B (15 of 25, 60%), followed by A (15 of 28, 53.6%) and lastly group-C (Nil of 25, 0%) patients. Few patients reported mild pain and atrophy at injection sites, pruritus and burning with betamethasone valerate foam and tacrolimus. Conclusion: Intralesional triamcinolone acetonide is the best, betamethasone valerate foam is better than tacrolimus in management of localized AA.

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Dandruff (pityriasis capitis, seborrheic dermatitis confined to the scalp) is a disease that has been around for centuries despite several treatment options. Almost every day new players are entering the market with various antidandruff products, perhaps due to an increase in the incidence of dandruff all over the world. Interestingly, clinicians, especially dermatologists, gave little attention to this problem. At the end, the dandruff sufferer is puzzled by the array of antidandruff products with varied claims entering the market day by day. Why have we not achieved complete treatment success against dandruff? Is dandruff a disease or disorder? It seems that our understanding about dandruff perfectly fits into the famous saying of Albert Einstein, "as the area of light increases, so does the circumferences of darkness." Have dermatologists left dandruff unattended, only to be exploited by the personal care industry?

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Graham Little-Piccardi-Lassueur syndrome is a type of lichen planopilaris (follicular lichen planus) characterized by the triad of patchy cicatricial alopecia of the scalp, noncicatricial alopecia of the axilla and groin, and a follicular spinous papule on the body, scalp, or both. It is four times more common in females in the age group of 30-70 years. Only a few cases have been reported in literature wherein the disease has affected males. Herein we report a young male who presented with features of Graham Little-Piccardi-Lassueur syndrome.

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Trichorrhexis nodosa is a hair shaft disorder often encountered in clinical practice. Acquired trichorrhexis is commoner of the two types and is most often due to weathering from physical or chemical causes. We report three representative cases of localized acquired trichorrhexis encountered in our clinic attributable to a specific comb, used commonly in Kerala, a Southern state of India.

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Benign calcifying epithelioma of Malherbe or pilomatrixoma or pilomatricoma is an uncommon lesion of the periocular tissues, arising from the matrix cells at the base of the hair. In the periocular area, it usually arises from the lids and eyebrows. Pilomatrixoma has certain characteristic clinical and histopathologic features, but since it is not commonly suspected preoperatively, certain distinctive clinical features of tumor should suggest clinical diagnosis followed by histopathologic confirmation.

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Clinical photography of hair disorders is an extension of photography in dermatology practice. Some points should be kept in mind while taking images of the hair and hair bearing areas in view of the reflection of light and the subsequent glare that may spoil the result. For documentation of most conditions of the hair, the same general rules of dermatological photography apply. The correct lighting is the most important aspect of clinical photography in trichology practice and can be achieved by reflected light than direct light. Special care should be taken in conditions requiring serial images to document progress/response to treatment and the most important factor in this context is consistency with respect to patient positioning, lighting, camera settings and background. Dermoscopy/trichoscopy can also be incorporated in clinical practice for image documentation.

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Lipids are an amazingly diverse group of biomolecules with an array of biological functions including protecting and maintaining key properties and structure. Oxidative insult in the form of UV, hydrothermal, or other damage leads to compromised lipid function and can be linked to a wide range of consumer complaints. This proof-of-principle study applied and evaluated redox lipidomic approaches for the characterization and profiling of selected lipids and their oxidation products in human hair. It was observed that cholesterol and cholesterol derivatives regions appeared to be the most susceptible to oxidative damage and this leads to further experiments, including the systematic characterization of oxidative products, and correlation of modifications with damage protocol.

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Adamson's fringe is located at the upper margin of the keratogenous zone of the hair follicle where the nucleated hair shaft cornifies completely and gets converted to hard anucleated keratin. It marks also the area of complete keratinization of the cuticle and Henle's layer of the inner root sheath and the beginning of the stem of the follicle. In Tinea capitis, dermatophytic infection of the hair shaft is restricted to this zone and the fungi do not penetrate further down the infected hair in the bulb of the follicle. The fungi in Adamson's words form "a fringe of mycelium surrounding the hair shaft and project below the lower margin of the sheath of spores around the root-stem." Horatio George Adamson (1865--1955), a British dermatologist first described this phenomenon, in 1895, and this article describes Adamson's fringe with a short biography of Adamson and discusses Kligman's experiments and observations on Tinea capitis which validated the observations of Adamson and the concept of Adamson's Fringe and described the pathogenesis in Tinea capitis.

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Light microscopy of the hair forms an important bedside clinical tool for the diagnosis of various disorders affecting the hair. Hair abnormalities can be seen in the primary diseases affecting the hair or as a secondary involvement of hair in diseases affecting the scalp. Hair abnormalities also form a part of various genodermatoses and syndromes. In this review, we have briefly highlighted the light microscopic appearance of various infectious and non-infectious conditions affecting the hair.

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