This is a review of psychiatric problems in patients with alopecia areata (AA). The electronic database of MedLine/PubMed was searched using the determined keywords. The rate of depression in children and adolescents with AA is up to 50%. Stressful life events are associated with AA. A rate of 39% for generalized anxiety disorders was reported. AA is highly associated with obsessive compulsive disorder (35.7%) in children and adolescents. Schizophrenia tended to be less seen in AA patients.

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Background: Although alopecia areata (AA) is typically seen by medical staff as a benign, not life-threatening cosmetic disease, some studies have found significant impairment in quality of life (QL) in AA patients. There are no studies that assess QL in Brazilian AA patients. Objectives: To evaluate QL in AA patients, using the 36-item Short-Form Health Survey (SF-36). The most affected SF-36 dimensions were compared to two culturally different AA QL studies. Materials and Methods: We performed a case-control study with 37 AA patients and 49 age- and sex-matched volunteer blood donors. The results of a Turkish and a French study were compared to our results. Results: The dimensions social functioning ( P = 0,001), role emotional ( P = 0,019), and mental health ( P = 0,000) scored statistically lower in the AA group in relation to controls, suggesting a worse QL. Incomparison to the Turkish and French studies, we found: (1) On the dimension role emotional, QL was equally impaired; (2) on the dimension social functioning, it was not different than the Turkish study; (3) social life of French AA patients was more affected; and (4) vitality and mental health dimensions were significantly more affected in French and Turkish patients. Conclusions: Impairment in QL in AA patients affected psychological, emotional, and social aspects of theirlives. Despite the scores of SF-36 dimensions varied significantly among different cultural groups, impairment of QL was found in all three studies; thus, we can suppose that these findings are not linked to a specific culture.

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Background: Several studies have demonstrated an association between androgenetic alopecia (AGA) and cardiovascular disease. Still controversies exist regarding the association. Are they truly associated? Objective: The purpose of the present study was to assess the prevalence of AGA and establish its association in young (<45 years) Asian Indian Gujarati male patients having coronary artery disease (CAD). Materials and Methods: Case-control prospective multicentric study was carried out on 424 men. Case group consisted of 212 male subjects having CAD (Group 1) and another 212, either sibling or first degree male relative of the case subjects (having no evidence of CAD) were considered as the control group (Group 2). Age, total cholesterol, incidence of diabetes mellitus, and hypertension were similar in both groups. The degree of alopecia was assessed using the Norwood-Hamilton scale for men. Statistical analysis was performed using Chi-square test. Results: AGA was found in 80 (37.73%) young CAD patients (Group 1), whereas 44 (20.7%) of patients had alopecia in the control group (Group 2). There was statistically significant association between male AGA and CAD ( P = 0.001). Odds ratio was 2.70 (95% confidence interval [CI], 1.72 ± 4.26). Statistically significant association was found between high grade baldness (Grades IV-VII) and CAD in young men ( P < 0.05). Odds ratio = 2.36 (95% CI, 1.108 ± 5.033). There is statistically significant association of AGA in young Asian Gujarati male with CAD and the prevalence of AGA in young CAD patient is 37.73%. Conclusion: This study implies early onset AGA in male is independently associated with CAD, though mechanisms need to be investigated.

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Trichonodosis is characterized by knotted hair on the distal portion of the hair shaft. This may be spontaneous or secondary to mechanical factors like vigorous scratching or combing the hair. We report a case of spontaneous trichonodosis with abnormal scalp and body hair.

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Background: Different studies have been done on this topic, most of the older studies on the vertical section confirm that peribulbar infiltrate is an important finding, however the newer studies on the horizontal section, mention decreased anagen to telogen ratio, decreased terminal to vellus hair ratio and a decreased follicular count. These studies on horizontal (transverse sections) have shown that transverse sectioning is superior and more diagnostic in studying alopecias. However, these studies are based on multiple cut sections, because in a single cut section, we may miss a few hair bulbs above or below, depending on where the section is taken. Hence this makes it a time consuming, technically challenging and expensive procedure. Objectives: 1. To compare the histopathological features of single vertical section versus a single horizontal section cut in the reticular dermis. 2. To determine if a single horizontal section is sufficient to report a biopsy of alopecia areata compared to multiple sections. Materials and Methods: To compare the findings, in 50 patients with localized alopecia areata, 25 sectioned horizontally and 25 vertically, single section. Only three of the common findings, peribulbar infiltrate, intrabulbar infiltrate and perifollicular microscarring was considered and reported. Results: Once the anagen to telogen ratio is excluded from the comparison, diagnosis made on the basis of a single horizontal section is considered sufficient to give us an aid toward the prognosis.

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Trichofolliculoma represents abortive differentiation of pluripotent skin cells toward hair follicles. We present a case of an adult female with lobulated mass involving the tip and dorsum of the nose for the last 15 years. The systemic and radiological examinations were noncontributory. The clinical diagnosis was thought to be dermoid cyst. The fine-needle aspiration cytology of the lobulated mass was performed, and the cytology smears showed anucleate squames admixed with sebaceous cells. The possibility of a benign skin adnexal lesion was suggested. The biopsy was done, and the final diagnosis of trichofolliculoma was made. The wide local excision of the mass was performed, and no recurrence was noted during the follow-up of 1 year.

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Pilomatrixoma is a benign soft tissue neoplasm originated from follicular matrix of hair and is also known as Malherbe's calcified epithelioma. Some lesions are located on the skin and are usually misdiagnosed. A small number of patients had been dermoscopically examined. In this article, three patients of pilomatrixoma who had three different dermoscopic views were evaluated and discussed in concordance with the literature.

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Pachydermoperiostosis or primary hypertropic osteoarthropathy is a rare hereditary disorder that was first described in 1868. It is characterized by digital clubbing, pachydermia (thickening of the facial skin and/or scalp), and periostosis (swelling of periarticular tissue and subperiosteal new bone formation). We report a case of a patient with the complete form of the disease, and with a unique appearance of the hair shaft and eyelashes. The authors propose a possible mechanism to justify the abnormalities observed in the patient's hair shafts regarding the metabolism of prostaglandins and its relationship with the hair follicle physiological cycle.

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Pseudopelade of Brocq (PPB) is a rare, idiopathic self-limiting hair disorder resulting in progressive cicatricial alopecia primarily involving the parietal scalp and vertex. The general pathogenesis of scarring alopecias has been focused on theories of stem cell failure and sebaceous gland destruction. Acquired immunity, Borrelia infection and senescence of follicular stem cell reservoir plays suspected role. It classically presents as porcelain white hypopigmented and slightly depressed atrophic plaque. There is no standard treatment for PPB. Here, we present five cases which were labeled as primary idiopathic PPB, as on histopathology no specific changes of any cicatricial alopecia were seen.

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Epidermal growth factor receptor (EGFR) inhibitors have been widely used for the treatment of epithelial malignancies. A wide spectrum of skin toxicities have been described in patients receiving EGFR inhibitors. Trichomegaly, especially of the eyelashes is a rare side effect of this therapy. We report a case of trichomegaly of eyelashes in a 39-year-old male, a case of carcinoma pancreas. This side-effect of these medications gives prospects as a therapy to stimulate the growth of hair.

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