Background: Pressure-induced alopecia is an uncommon type of alopecia. It can occur in both scarring as well as non-scarring form and occurs due to ischemia resulting from prolonged head immobilisation during surgery or hospitalisation. The patchy hair loss generally involves convexities of scalp specially vertex and occiput. The hair loss is usually noticed 3 -28 days after the inciting event and regrowth of hair occurs between 1 – 4 months. Objective: To describe trichoscopic features of pressure alopecia and compare it with the closest differential, alopecia areata. Methodology: It is a retrospective observational study. Trichoscopic features of six cases of pressure alopecia seen during the study period were compared with alopecia areata and analyzed using appropriate statistical methods. Results: The study had 30 cases, six cases of pressure alopecia and 24 cases of alopecia areata. The mean age of patients with pressure alopecia and alopecia areata was 45.16 and 29.08 years respectively. Comedone- like black dots, black dots and area of scarring were statistically significant for pressure alopecia while exclamation mark hairs were significant for alopecia areata. Conclusion: Trichoscopy is a non-invasive test for diagnosis of alopecia and “Comedone-like black dots” are unique trichoscopic feature of pressure alopecia.

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Importance: Little is known about cannabis use among patients with alopecia areata (AA). These patients often experience significant psychosocial burden and may seek alternative therapies beyond that of traditional medical treatments, such as cannabis. Objective: To characterize cannabis use among patients with AA. Design: This was a cross-sectional study conducted from March 9, 2021, to March 22, 2021, using a web-based survey distributed to adult patients with AA using the National AA Foundation's email listserv and social media platforms. Results: 1,087 participants completed the survey (completion rate: 88.1%). Most participants were female (n = 870, 83.3%) and Caucasian (n = 771, 73.8%), with a mean age of 47.6 ± 15.5 years. 65.9% (n = 689) of participants with AA had a history of cannabis use and among those, 51.8% (n = 357) were current cannabis users. The most common reason for cannabis use among current users was for AA-related symptoms (n = 199, 55.7%), with the greatest perceived improvement in symptoms of stress (n = 261, 73.1%) and anxiety, sadness, and depression (n = 234, 65.6%). 80.4% (n = 287) indicated that cannabis had no impact on their hair loss. Conclusion: Cannabis use is common among patients with AA and is often used to alleviate the psychosocial symptoms related to AA, despite the lack of perceived improvement in hair regrowth.

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Porokeratosis (PK) is an epidermal disorder of keratinization, caused by a clone expansion of a mutated keratinocyte that generates a thin parakeratotic column: the cornoid lamella (CL). Depending on the clinical presentation, we differentiate up to 6 different types of PK. Most frequent locations for the lesions are limbs and trunk, while scalp is rarely affected. The possible origin of the CL in the epidermal appendages has been proposed (ostia of the eccrine glands and infundibulum of the follicle). The first case of PK limited to the scalp with exclusive involvement of the hair follicles is presented in this manuscript. It helps identify the clinical description and especially the trichoscopy as a diagnostic key in follicular PK and also to elucidate if it is an incidental histological finding or a new different clinical variant of PK.

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We present the youngest case of trichotillomania and trichophagia in a 3-year-old African-American boy who resulted in bowel obstruction. Trichophagia should be taken into consideration in a young child presenting with abdominal pain, especially with no obvious source. Although rare, undiagnosed trichobezoar has a high complication rate. However, if diagnosed and treated promptly, with appropriate psychiatric follow-up, recovery is nearly 100% with very low recurrence rate and ultimately an excellent prognosis.

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Eruptive vellus hair cyst (EVHC) is a rare follicular developmental abnormality of the vellus hair follicles. The usual onset is between 17 and 24 years but may be congenital. It can arise sporadically or may be inherited in an autosomal dominant fashion. They are caused by an abnormality at the infundibular level of vellus hairs. They usually appear as yellow to reddish-brown papules over the chest, limbs, and abdomen. Histologically, cyst has a stratified squamous epithelium and it contains lamellated keratin and several vellus hairs. We present this rare case of a 12-year-old male because of its unusual morphology and distribution and also to generate awareness about this rarely diagnosed condition. To the best of our knowledge, no case of an axillary variant of EVHC has been reported till date.

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Trichorrhexis nodosa (TN) is a common hair shaft defect that develops as a result of excessive physical or chemical trauma. Microscopy is considered the gold standard for its diagnosis. Outpatient diagnosis thus becomes difficult in the absence of availability of microscope. Trichoscopy is emerging as an excellent tool in outpatient diagnosis of hair shaft defects. Here, we report a young girl with localized TN secondary to trichoteiromania where trichoscopy clinched the diagnosis. Classical appearance of nodes in hair shaft and transverse hair shaft fractures producing “two brooms stuck in opposite direction” was evident. This case is being reported to emphasize the advantages of trichoscopy in quick diagnosis of hair shaft defects with review of published literature.

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Background: Alopecia areata (AA) is an autoimmune disease leading to noncicatricial alopecia. Topical or intralesional corticosteroid (ILCS) is the accepted therapeutic option for mild cases; however, adverse effects are sometimes difficult to reverse. When the exposure to liquefied nitrogen is limited to a few seconds “superficial” cryotherapy, reactive vasodilation may improve microcirculation and nutritional status around hair follicles. Objective: This study aimed to evaluate and compare superficial cryotherapy and ILCS in the treatment of patchy AA. Materials and Methods: This prospective comparative study included 21 patients with patchy AA. Every patient received superficial cryotherapy on one patch, every 2 weeks for 3 months, and ILCS injection for another patch, once monthly for 3 months. Results: Clinical improvement was higher in cryotherapy group compared to ILCS group with a statistically significant difference (P = 0.002). On trichoscopic evaluation, terminal hair count was improved in lesions treated with cryotherapy more than lesions treated with ILCS but without statistical significance (P = 0.595) and vellus hair count was improved in lesions treated with cryotherapy more than lesions treated with ILCS with a statistical significance (P = 0.002). Conclusions: Cryotherapy is more effective and less painful than ILCS in the treatment of patchy AA.

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Platelet-rich plasma (PRP) therapy is a new method for the treatment of androgenetic alopecia (AGA), the effectiveness and safety of which continues to be studied. Information on comparative efficacy when combining PRP with other methods of treatment is limited. The aim of the study was a comparative evaluation of the clinical efficacy of minoxidil, PRP therapy, and their combination in the treatment of men with AGA. Materials and Methods: The study included 69 men. The patients were divided into three observation groups: the main group (25 people, received applications of a 5% solution of minoxidil in combination with PRP injections), the comparison group (22 people, received intradermal injections of PRP), and the control group (22 people, received applications of a 5% solution of minoxidil). The clinical efficacy of the therapy was evaluated by the dynamics of morphometric indicators of hair growth using a digital camera and the software. Results: It was established that after complex therapy in the form of minoxidil applications and injections of PRP, the hair density increased by 32% (P = 0.00004), the diameter of the hair shafts by 26% (P = 0.00004), the share of vellus hair decreased by 30% (P = 0.00082), and the proportion of telogen hair decreased by 39% (P = 0.00008). The results of using complex therapy significantly exceeded the clinical effect of platelet-rich plasma and topical applications of a 5% solution of minoxidil. Conclusions: The data obtained allows suggesting that PRP and minoxidil potentiate each other's action when used together and their complex application seems promising for the treatment of androgenetic alopecia.

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Background: The use of light-based home-use hair removal devices has seen a significant increase in the last decade all over the world. Home-based devices would be especially more relevant in the context of the COVID-19 pandemic, with patients having less access to laser hair removal in clinics. This survey attempted to evaluate the practices-related use of light-based home-use hair removal devices in our region and also to assess patient satisfaction related to the same. Materials and Methods: This was a cross-sectional survey using an electronic questionnaire. Results: Out of a total of 111 valid responses, 39 had used light-based home-use hair removal devices. The most common type used was intense pulse light-based devices. On a scale of 1–10, the average satisfaction with the product for hair removal was 6.07. Incidence of side effects was very low (only 4 out of 39 mentioned side effects), and the most common side effects mentioned were redness, “bumps,” burns, and discoloration on the lased sites. Conclusions: The frequency of use of light-based home hair removal devices is quite high in our region. Patients seem to be satisfied with the same, and the incidence of side effects is low in our population.

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