To pose is defined as to place in an attitude or fixed position, for the sake of effect, and the poseur as a person who inauthentically adopts a certain attitude playing a role, a fake, or an imposter. To cover their incompetence, physicians in the past had to strike a pose. The posing of today's physician has become rather that of self-performance and for commercial purposes, particularly in cosmetic medicine. Because of the elective nature and the high out-of-pocket costs of the cosmetic procedures and products, the image particularly of cosmetic surgeons and dermatologists has changed from the traditional role of doctor into one of a business person who will promote unnecessary interventions among consumers and peers. "Bluffing, puffing, and spinning" are accepted marketing practices for businesses. Selfie culture has emerged as a natural result of the development of smartphones and social media. Mannerisms and instruments of pose in medicine have been the stethoscope, dermatoscope, FotoFinder® handpiece, microscope, syringe, human skull, and during the pandemic, undergoing COVID-19 vaccination, usually as selfie placed on Instagram or Facebook. Selfie culture has far-reaching implications for society as a whole. It has altered our understanding of privacy, blurring the line between public and private spaces, and breaking taboos in public, such as sexuality, religion, and private health issues. The World Medical Association has developed the International Code of Medical Ethics as a canon of ethical principles for the members of the medical profession worldwide defining the professional duties of physicians toward patients, other physicians and health professionals, and society as a whole. The primary duty of the physician is to promote the health and well-being of individual patients by providing competent, timely, and compassionate care in accordance with good medical practice and professionalism. The physician must always exercise independent professional judgment while maintaining the highest standards of professional conduct. The physician must refrain from intrusive or otherwise inappropriate advertising and marketing. The lure of money and celebrity cannot blind dermatologists to the limits of what they can do.
Currently, retrospective multicenter studies have gained particular popularity with trichologists, and become a practice of some groups of authors for cranking up the number of papers on their resumes. Multicenter collaboration can result in higher rates of patient enrolment than single-center trials, thereby generating larger studies of shorter duration, while offering the opportunity for networking. A single-center trial is conducted according to a single protocol and at a single site, while multicenter trials are conducted according to a single protocol but at different locations, and conducted by various researchers. Differences between the two include variations in sample size, time of patient recruitment, costs, presence of bias, validity, and center and investigator characteristics. However, the validity of multicenter research can be questioned. A single center with a high number of patients, interventions, and large experience is superior to a collective of a large number of centers with low number of patients, interventions, and little experience at each center. Multicenter studies are at risk of inconsistent diagnosis and heterogeneity among centers and populations. Finally, by their nature, multicenter studies rely purely on local expert opinion to generate findings. If the centers participating in the study can be shown to be representative of the group or area of knowledge under study then content validity can be assumed. The practice though of selecting centers based on networking means there is a responsibility to prove and justify the selection procedures used. Hence, how a center is chosen for its competence is defined must be somewhat arbitrary, and the results would then represent that particular group's opinions at a given point in time. In conclusion, when interpreting results from retrospective multicenter clinical research, bias and traps among the result should be detected according to who performs it, which inclusion indication criteria is involved, what the target is, and how it is carried out.
Patchy/focal alopecia can be noncicatricial or cicatricial. Trichopathology may play an important role in confirming and/or establishing the diagnosis of cicatricial alopecia. The aim of this study was to study the trichopathologic features of common cicatricial conditions presenting with patchy scalp alopecia. This cross-sectional study was conducted over a period of 1 year in the department of dermatology and pathology in a tertiary care hospital in North India. Adult patients (age >18 years) presenting with patchy cicatricial alopecia as well as clinically doubtful noncicatricial conditions over the scalp were included in this study. In doubtful cases of noncicatricial alopecia, a single 4-mm punch biopsy was performed for transverse sectioning with hematoxylin and eosin stain. In all cases of cicatricial alopecia, two 4-mm punch biopsies were performed, one for transverse sectioning and the second for vertical sectioning and direct immunofluorescence (DIF). The final diagnosis was made on the basis of the trichopathologic findings. A total of 23 cases were included in our study with the majority (52.2%) being in the age group of 20-30 years. The mean age at diagnosis was 30.5 ± 11.38 years. On the basis of trichopathologic findings, a final diagnosis was made in 18 (78.3%) cases. However, 5 (21.7%) cases remained undiagnosed and were labeled as nonspecific. According to the final diagnosis based on the trichopathologic findings, maximum cases were of discoid lupus erythematosus (DLE) (26.1%), followed by lichen planopilaris (21.7%), pseudopelade of Brocq (13%), alopecia areata (8.7%), folliculitis decalvans (4.3%), and traction alopecia (4.3%). Trichopathologic examination revealed hyperkeratosis (60%), basal cell vacuolization (55%), epidermal atrophy (55%,) perifollicular lymphocytic infiltrate (30%), pigment incontinence (30%), perifollicular fibrosis (25%), and thickened basement membrane (25%). Only four cases showed deposits of immunoreactants in DIF and all four were finally diagnosed as DLE. Trichopathology along with special stain is a useful tool in the diagnosis of patchy alopecia and must be carried out in cases where diagnosis is in doubt clinically, particularly in cases of cicatricial alopecia. DIF may have a supportive role in histopathologically inconclusive cases and should be carried out, particularly when DLE is suspected. Trichopathology in combination with DIF is an important tool in the diagnosis of the majority of cases of cicatricial as well as clinically doubtful cases of noncicatricial alopecia.
Androgenetic alopecia (AGA) is a disease of polygenic etiology. Androgens play a vital role in the development of patterned hair loss. Dutasteride is an anti-androgen that acts by competitively inhibiting both type 1 and type 2 isoenzymes of 5α reductase. The intradermal deposition of dutasteride has the advantage of negligible systemic absorption. Although dutasteride mesotherapy has not been approved by the Food and Drug Administration, it has been used off-label in the treatment of AGA. Here, we report 4 case series of nonscarring alopecia that developed following a single session of mesotherapy injection. A total of 15 cases with patterned hair loss were enrolled (13 males and 2 females). The grade of patterned hair loss was between Norwood Hamilton grade 3-6, and in Ludwig pattern between 2 and 3. Once a month intradermal injection of dutasteride mesotherapy was administered in all cases. To standardize the drug administration and for uniform delivery of the drug, 1 cm2 grids were created and 2 units at each point was administered at an angle of 60°, a total of 2 ml of 0.01% of dutasteride was administered in each session. Mean age of 31.53. The most common adverse effect noted was noncicatricial alopecia was noted in four cases, (3 males and 1 female), followed by pain, itching 1 case each, respectively. The grade of alopecia was AGA grade 5-6, 1 male with Ludwig grade 2 pattern of hair loss and a female with Ludwig grade 2. They developed patchy alopecia involving the mesotherapy site following a single session of dutasteride mesotherapy. There is a need for stringent monitoring of manufacturing guidelines of mesotherapeutic cocktails by governing bodies. It should primarily address the optimal concertation of the active ingredients and preservative usage to avoid untoward side effects. The benzyl alcohol and polysiloxane in the cocktail could be the key players having cytotoxic effects, contributing to the development of alopecia. The knowledge of potential adverse effects caused by a drug should always be in the mind of the treating physician.
Androgenetic alopecia (AGA) or pattern hair loss is a non-scarring hair condition defined by gradually reduced, miniaturized hair follicles. It is a multifactorial disorder primarily triggered by dysregulation of the hair cycle due to alterations between the crosstalk of numerous cell subpopulations. To provide a focus on existing and novel management options, preceded by a short overview of the current knowledge about AGA. A group of international experts in AGA analysed 85 literature sources about AGA (retrieved from PubMed and Google Scholar and published between 2000 and 2025) and discuss current and novel treatment options. Recent research evidenced that targeting the hair follicle and the surrounding tissue, rather than solely relying on solutions offered by minoxidil, finasteride, or other products, provides a safe and highly beneficial improvement of AGA. The authors underscore the significant scientific value and crucial role of advanced dermocosmetics with proven clinical efficacy in the long-term management of AGA, in addition to pharmacological active ingredients or other treatment options. These innovations offer compelling early intervention strategies, potentially delaying reliance on lifelong pharmaceutical regimens and optimizing the overall patient journey and quality of life. In addition to current treatment options of AGA, novel topical non-pharmacological therapeutic options are available, helping to safely and efficiently treat this multifactorial hair condition.
Nataraja is a well-known sculptural symbol in India and popularly used as a symbol of Indian culture. It is a depiction of Lord Shiva as the cosmic dancer who performs his divine dance as creator, preserver, and destroyer of the universe and conveys the Indian conception of the never-ending cycle of time. The same principle manifests in the hair cycle. Nataraja's right foot is planted squarely on the demon Apasmara. A dwarf, immensely powerful in his malignity, Apasmara is the embodiment of ignorance, and the manifestation of greedy, possessive selfhood. We have recently drawn attention to a practice of dishonesty in academic medicine, the deliberate act of ignoring the scientific work of others where it would be appropriate to acknowledge. Unless due to poor literacy or intellectual failure, this is usually deliberately practiced in an atmosphere of hostility or coterie, especially one that is exclusive of peers. Eponyms have a historical tradition in Western medical terminology. At a time when medicine did not command the means to investigate underlying causes, the eponym was a convenient way to label a disease condition. Conventionally, diseases have been named after the individual who originally described the condition. Being awarded an eponym has always been regarded as an honor, while the scientific community considers it as bad form to attempt to eponymize oneself. In an age, in which the person cult of the distinguished personalities of the past has become obsolete, the social media have created a new cult of the self. This cult has within it traits of narcissism: superficial charm, grandiosity and self-importance, a penchant for deception, and manipulation, and incapacity for remorse or guilt. In this atmosphere lure, the risks in the creation of personal eponyms: history sometimes shows credit should have gone to a different person. The possessive use of an eponym should be discontinued, since the author neither had nor owned the disorder. Finally, eponyms with derogative connotations should be omitted. There is a need to refrain from using inappropriate and controversial eponyms. Further academic and scientific efforts should be addressed to provide a structural systematization, semantic classification, and etymological categorization in medical nomenclature.
Artificial intelligence (AI) is intelligence exhibited by computation, as opposed to natural human intelligence. Founded as an academic discipline in 1956, AI went through cycles of optimism, followed by periods of disappointment. The growing use of AI in our century is influencing a shift toward increased automation, data-driven decision-making, and the integration of AI systems into various areas of life, including health care. On the occasion of the European Academy of Dermatology and Venereology Spring Symposium 2024, reference was made to AI in dermatology, specifically trichology. Particularly in the domain of trichoscopy, AI's contribution to automated image analysis stands out. Due to the fairly standardized imaging and a limited amount of diagnoses, trichoscopic images have become a center of interest for automated medical image analysis and its commercial utilization. Yet, costly, multi-parameter computer-assisted trichoscopic image analysis is the least effective in medical practice. Using dermoscopy, signature patterns are seen in a range of scalp and hair conditions that have provided the foundation for diagnostic algorithms. Algorithms discourage physicians from thinking independently and with creativity. Doctors are trained to romance with technology. However, healing is replaced with treating, caring is supplanted by managing, and the art of listening is taken over by technology. The power of technology, particularly computer-based, may shake the confidence of a specialist in his initial diagnosis. Nevertheless, machines cannot replace the doctor's mind, and his thinking about what he sees and what he does not see. Ultimately, common AI mistakes are often not too different from mistakes born out of natural human error. Taking all of this into account, it does not seem wise to precociously hail an evolving technology in public without the respective experimentation and experience to back up its factual utility in our practice.
We have read Ramos Costa et al.'s publication "Trichoteiromania: A multicentre retrospective descriptive and analytical study of 129 cases" in the Journal of the European Academy of Dermatology, and comment on some critical issues related to the nosology, nomenclature, and methodology. The term trichoteiromania was originally coined for the rubbing of the hair due to an underlying psychiatric disorder without further specifications. Based on case observations of patients with trichoteiromania, it was later reported that in contrast to trichotillomania that represents an obsessive-compulsive disorder, the underlying disorder in trichoteiromania varies among patients. Histopathological features are unspecific, while the traumatic changes to the hair shaft are more conspicuous, and 15 min of rubbing the hair is sufficient for hair breakage. Therefore, a clear distinction must be made between trichotillomania, trichoteiromania, neurotic excoriations, factitious dermatitis, lichen simplex chronicus, and nodular prurigo of the scalp, while the dermoscopic findings provided by Ramos Costa et al. showed the mechanics of hair damage without a deeper insight into its etiology. Trichoscopy has gained disproportionate popularity for the differential diagnosis of the hair and scalp disorders since its introduction into dermatologic practice, and as a self-reliant examination technique, it can even be misleading. As a diagnostic procedure, trichoscopy is to be understood as representing an integral part of a more comprehensive dermatological learning, to include a stringent nosological classification and nomenclature of diseases, based on a pathogenic understanding. Specifically, in trichoteiromania studies with a more detailed assessment of the psychopathological status will be of more value to determine disease management strategies, specifically approaches to psychotherapeutic, behavioral, and pharmacological interventions aimed at reducing or eliminating the hair-rubbing behavior. Regrettably, the majority of recent publications on trichoteiromania have been based on trichoscopy without any disease-relevant insights, and obviously, the editors and reviewers of the respective publishing journals have so far failed to acknowledge this major shortcoming.
Oral minoxidil (OM) is approved by the US Food and Drug Administration for the treatment of hypertension. It has also been off-label used increasingly for hair disorders like androgenetic alopecia (AGA). Hypertrichosis is known as the most commonly found adverse effect of oral minoxidil (LDOM) at low dose of 0.25-5 mg. This study aims to describe the characteristics of hypertrichosis induced by 5 mg daily oral low-dose minoxidil for 24 weeks in male AGA treatment. This prospective study included 30 male AGA patients who received treatment with 5 mg daily oral low-dose minoxidil. The modified Ferriman-Gallwey scoring system was used for the assessment of hypertrichosis by physicians in the forearm area at baseline, 12 and 24 weeks. The Dermatology Life Quality Index was applied to assess the impact of hypertrichosis on quality of life. Patients were divided into two age groups: under 41 and 41 or older. Hypertrichosis was prevalent in 93% of patients, especially the younger group with a higher incidence and variation of severity. Most patients indicated a general tolerance with minimal impact on their quality of life. Notably, hypertrichosis seldom led to drug discontinuation despite a widespread occurrence. The 24-week treatment of low-dose 5 mg daily OM induces a high prevalence of hypertrichosis in male AGA patients. Further study is recommended for long-term implications and safety profiles of low-dose oral minoxidil.
A Saint is a person who is recognized as having an exceptional degree of Holiness, likeness, or closeness to the Godhead. Many religions use similar concepts, albeit different terminologies, to venerate persons worthy of some honor. Saints across various cultures and religions have the following family resemblances: exemplary model, extraordinary teacher, wonder worker or source of benevolent power, intercessor, life often refusing material attachments or comforts, and possession of a special and revelatory relation to the Holy. From the beginning of civilization, man has placed importance on the appearance and symbolism of hair. Peculiarities relating to the hair of Saints are the miracle of hair growth (St. Agnes of Rome), long and beautiful hair (St. Mary Magdalene), long and disheveled hair (St. Mary of Egypt), generalized hypertrichosis (St. Onuphrius), facial hirsutism (St. Wilgefortis), and overnight whitening of hair (St. Thomas More). Therefore, the Saints whose attributes relate to the hair have proven suitable candidates for a number of varied trichological issues. Finally, in challenging times with capitalist technocracy changing the face of our practice at the cost of our spirituality, it is wise to get back to the basics and reflect on the examples of the Saints. Saint Josemaría Escrivá taught that everyone is called to Holiness and to discover Sanctity in their ordinary lives. The role of the Saints is to act as spiritual guides, mentors, and examples of faith. In many religions, there are individuals who have been recognized within their tradition as having fulfilled the highest aspirations of religious teaching. In English, the term Saint is often used to translate this idea from many world religions, which proves the universality of Sainthood.
Acquired progressive kinking of the hair (APKH) is a rare condition in which the hair of the scalp changes in appearance. This disorder has been described infrequently over the years, so it is believed that it is being diagnosed late by physicians. We present a case of a patient with APKH. A 13-year-old woman consulted for 8 months of evolution of changes on the appearance of her hair, being darker, thicker, and more brittle than usual. The physical examination reveals the presence of thick short hair and isolated long dark hair in the coronal area. Trichoscopy showed periodic reductions on the diameter of the hair shaft and no areas of alopecia suggestive of APKH. APKH is an extremely rare condition in which hair of the scalp changes in appearance. It is very important to know the physical changes produced on the hair to avoid misdiagnosis. We report the case to make this pathology more widely known among professionals and encourage the reporting of this unusual disorder.
The introduction of three-dimensional (3D) printing technology has transformed several disciplines, including therapeutic approaches, by offering novel alternatives for hair regrowth and scalp therapy. This brief overview looks at 3D printing's existing applications in neurology, with a focus on its ability to manufacture personalized hair follicles, prostheses, and surgical templates that will improve the efficiency of hair restoration surgeries. It investigates the materials used in 3D printing, including as biocompatible polymers and bioinks, which enable the creation of patient-specific solutions. Furthermore, this study emphasizes the constraints and limitations of incorporating 3D printing into clinical practice, such as regulatory issues and the need for additional research to investigate long-term effects. This study seeks to provide insights into the transformative impact of 3D printing in enhancing trigeminal therapeutics and improving patient outcomes by combining existing literature.
Waardenburg syndrome (WS) is an autosomal dominant genetic disease with an estimated prevalence of 1 in 20,000-40,000. An 8-year-old boy, born to nonconsanguineous parents, presented with complaints of areas of depigmentation on the forehead and right leg since birth. On examination, there was a well-defined amelanotic macule on the center of the forehead of size 5 cm × 2.5 cm with a few spots of normal pigmentation, a forelock of white hair on the frontal area of the scalp, and a well-defined amelanotic macule of size 6 cm × 4 cm with a small central area of normal pigmentation on the posterior part of the right leg. He had scoliosis of the spine in the thoracic region. The nasal root was broad with widely separated inner canthi. There was exotropia and microcornea of the right eye with a visual acuity of 6/24. Fundus examination of the right eye showed a large disc, disc coloboma, peripapillary atrophy, and pigmentary changes in the fovea. The left eye was normal. There was no hearing defect. His father and two siblings too had patchy amelanosis in a similar distribution. They probably represent a limited expression of the same disease. All of them meet the diagnostic criteria for WS. WS is rare with only <100 cases reported worldwide.
Morgellons disease remains a poorly understood condition, while the general medical consensus is that it is a form of delusional parasitosis in which individuals have sores they believe contain fibers. In fact, Morgellons disease may represent a culture-bound syndrome, i.e., a combination of psychiatric and somatic symptoms that are considered to be a recognizable disease within a specific society or culture. We present a case of Morgellons-like disease of the scalp and discuss its relationship to psychopathology and specific features of the scalp microenvironment. The propositus suffered from an obsessive-compulsive disorder with a delusional overlay or rather belief system. Lesions were successfully treated with lesional botulinum toxin injections. The particular features of the hair and scalp with a microenvironment of microbes, parasites, and pollutants may contribute to the itching phenomenon and produce some debris that may be misinterpreted in its origins and pathogenicity. This case presentation exemplifies that the presence of multicolored filaments is neither specific nor of any diagnostic value. Botulinum toxin proved effective by virtue of its interference with neuropeptide substance P and acetylcholine as key players in the interaction between emotional shifts and bodily sensations, specifically of the hair and scalp.
The purpose of this in vitro hair graft study was to better understand how different storage media affect the survival of hair follicles at different temperatures during a hair transplant procedure. In this study, hair follicles (n = 60) were harvested from 3 healthy male volunteers. Follicles were randomly assigned to the following groups: Group A: Storage media phosphate-buffered saline (PBS), platelet-rich plasma (PRP), platelet-rich fibrin (I-PRF), and Dulbecco's Modified Eagle Medium (DMEM). Group B: Storage media were placed at the following temperatures: 4°C, 26°C (room temperature), and 37°C (body temperature). The viability of hair follicles was checked using the explant culture method. Cell outgrowth was observed after incubation at 37°C in DMEM containing 10% FBS. Explant cultures of hair follicles stored at 4°C and 26°C did not show outgrowth of the cells after 7 days of culture. Explant cultures of hair follicles stored at 37°C did show outgrowth of the cells after 7 days of culture. Furthermore, these study results indicated that 10% DMEM preserves hair follicles more effectively than PBS, PRP, and I-PRF. According to the study's findings, freezing graft storage options might not be the best option. Instead of 4°C or room temperature 26°C, 37°C has been shown to improve hair graft survival. Furthermore, these study results indicated that 10% DMEM preserves hair follicles more effectively than PBS, PRP, and I-PRF. The study concluded that maintaining hair follicles in 10% DMEM at 37°C would prolong graft life and improve therapeutic outcomes.
Woke is an adjective meaning "alert to racial prejudice and discrimination." Originally referring to an awareness of social and political issues affecting African Americans, over time, it became increasingly connected to matters beyond race, such as gender and identities perceived as marginalized, and eventually appropriated by white people to encompass a broader awareness of social inequalities beyond racial injustice, such as sexism, and denial of lesbian, gay, bisexual trans, queer, intersex (LGBTQI) rights. As its use spread internationally, woke was added to the Oxford English Dictionary in 2017. Woke has also been used as shorthand for some ideas of the American Left involving identity politics and social justice. By 2020, the political right began using the term sarcastically as a pejorative for various leftist and progressive movements and ideologies, implying that wokeness was an insincere form of performative activism. The issue of wokeness in medical practice has as yet not found the due attention both in terms of discrimination in employment or in medical care. While the former lies in the personal responsibility of the employer as an individual or an institution, the latter lies in the accountability of our profession as a group. Nevertheless, dermatology has always shown a particular interest in ethnic skin and hair and is taking gender-affirming cosmetic dermatology at heart. Dermatologists are aware of dermatologic conditions with a particular predilection for the black population in terms of frequency and severity due to peculiarities of hair anatomy and hair grooming habits. Furthermore, there are ethnic considerations in hair restoration surgery essential for hair transplant surgeons to understand so that esthetic results can be achieved. Dermatologists are experts in many of the medical treatments and minimally invasive procedures gender-diverse individuals seek. Such procedures include laser hair reduction, neurotoxins, soft-tissue augmentation, body sculpting and contouring, and alopecia management.
Low-dose oral minoxidil (LDOM) can safely and effectively treat numerous hair disorders. Reported doses range from 0.25 mg to 5 mg daily titrated against clinical effectiveness and adverse events. Some clinicians advocate routine monitoring of patients treated with LDOM. However, there is limited evidence on whether minoxidil in such small doses adversely impacts patients with normal hemodynamic and biochemical baseline profiles. The aim of the study is to evaluate the need for regular monitoring of patients treated with LDOM. This is a retrospective analysis of patients treated with LDOM in a tertiary hair clinic between April 2017 and June 2020. The clinical and laboratory parameters were assessed every 6 months. On commencing LDOM, baseline blood pressure, heart rate, and weight were recorded, and renal and liver function tests were performed. The data were analyzed using graphical exploration. The heart rate, weight, renal function, and liver function appeared stable throughout the treatment course. The weight and estimated glomerular filtration rate showed a trend to increase over time, but these findings were not statistically significant for any of the outcomes. The data support the position that routine monitoring is not required during treatment in asymptomatic patients with normal baseline values. Regular monitoring of blood pressure, heart rate, weight as well as liver and kidney function is not required during treatment with LDOM in patients with normal hemodynamic and biochemical baseline profiles. Patients with preexisting renal impairment can be prescribed oral minoxidil; however, we advocate ongoing monitoring in this subgroup, especially those with moderate-to-advanced disease. To the best of our knowledge, this is the first study that provides longitudinal monitoring data for LDOM with a follow-up period beyond 6 months and up to 36 months on treatment.
Telogen effluvium (TE) is a prevalent cause of diffuse, nonscarring hair loss, characterized by the premature entry of hair follicles into the telogen phase. Previous research from our group demonstrated the efficacy of a nutritional supplement containing hydrolyzed collagen, Group B vitamins, and zinc (Pilopeptan® Intensive) in improving the anagen/telogen ratio after a 1-month treatment. This study aimed to further assess and validate the sustained effects of this supplement in a larger cohort. A 1-month intervention with Pilopeptan® Intensive was administered to 343 TE patients, with assessments at baseline (T0), posttreatment (T1), and after a 30-day washout period (T2). Parameters evaluated included self-assessed hair thickness, hair amount, hair shedding, hair strength, hair brightness, hair softness, pull test results, subject-perceived improvement, treatment satisfaction, adherence, and side effects. Out of 343 patients, 340 completed the second visit, and 330 completed all three visits. The participants, predominantly women (92.1%), had a mean age of 43.2 years. Significant improvements in all hair parameters were observed at T1 and T2 (P < 0.001). The pull test indicated reduced hair shedding, with sustained effects during the washout period (P < 0.001). Participants reported overall improvement and satisfaction with treatment. Mild side effects were reported by ten patients, with high adherence observed. Pilopeptan® Intensive showed promising effects in improving hair parameters for TE patients, with sustained benefits posttreatment. The study supports the potential role of nutritional supplements as nonpharmacological adjuvants for TE treatment. Further research, including randomized controlled trials, is warranted to validate long-term efficacy and safety.
Telogen effluvium (TE) is self limiting diffuse hair loss occurring 3-4 months after a triggering event. There is scarcity of data on TE as possible sequelae of COVID-19. We assessed 113 cases of TE occurring after SARS-CoV-2 infection as a retrospective study. Most of the patients belonged to the age group 18-30 years and were females (85.8%). Most of the patients (92%) had acute TE. The median duration of hair loss was 2 months. Trichodynia and pruritus were the common associated complaints. Hair pull test was positive in 54.9% patients. Trichoscopy showed short regrowing hairs in 61.2% patients and empty hair follicles in 77.9% patients. Ferritin, vitamin D and Vitamin B12 deficiency was seen in 27.4%, 38.1% and 20.4% patients respectively. TE was seen more commonly with symptomatic COVID infection (93% patients). TE occurring after SARS-CoV-2 infection calls for assessment of micronutrient deficiency, as there appears to be an association between COVID-19 infection and nutritional deficiency. Although acute TE is the most common presentation, relapse in chronic TE might also occur as sequelae of COVID-19 infection.
Hair is one of the most commonly encountered trace evidence of crime scenes. The cases in which it may be found as evidence vary, ranging from those involving exotic and endangered wildlife species, hunting of which has been prohibited to various homicidal and assault cases. Besides homicide, sexual assault, and rape cases, hair is common evidence in poaching and other wildlife-related cases. The forensic examination of hair can help in personal identification (from human hair) and species identification (from nonhuman hair). Conventionally, the hair examination starts with the microscopic examination which is further extended to modern analytical methods such as DNA profiling, neutron activation analysis, inductively coupled plasma-mass spectrometry, scanning electron microscopy-electron-dispersive X-ray spectroscopy, infrared spectroscopy. However, recent years have observed significant improvement in the sensitivity, reliability, and applicability of these methods. In the present review, a critical analysis of methods of hair examination has been done.