{"title":"Scalp Microinfusion with Dutasteride Using the MMP® Technique for Male Androgenetic Alopecia: A 12-Month Real-World Observational Case Series.","authors":"Nicolò Rivetti","doi":"10.1159/000550858","DOIUrl":"10.1159/000550858","url":null,"abstract":"<p><strong>Introduction: </strong>Microinfusion of drugs into the skin (MMP®) is an intradermal drug delivery technique combining microneedling with controlled microinfusion using professional tattoo devices. In androgenetic alopecia (AGA), MMP has been proposed to enhance local follicular drug exposure while potentially minimizing systemic absorption, although evidence remains limited.</p><p><strong>Methods: </strong>Thirty male patients (20-45 years) with AGA (Hamilton-Norwood stages I-IV) were treated in strict monotherapy with scalp microinfusion of dutasteride 0.05%. Treatments were performed using a rotary tattoo device with sterile 49-needle cartridges (0.30-mm diameter), delivering 1 mL per session at a depth of 1.0 mm. Four monthly sessions were followed by bimonthly maintenance. Outcomes were assessed using physician global assessment, standardized photography, and patient self-assessment over 12 months.</p><p><strong>Results: </strong>At 12 months, stabilization or improvement was observed in 96.7% of patients, with clinical improvement in 76.7%. Patient-reported improvement occurred in 80.0%. Responses were more consistent in early to intermediate AGA. Treatment was well tolerated, with only mild transient local reactions.</p><p><strong>Conclusion: </strong>Scalp microinfusion with dutasteride using MMP® appears to be a safe and promising adjunctive treatment for male AGA. Further controlled studies are needed.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13021238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
İlayda Muslu Camcıoğlu, Ceyda Tetik Aydoğdu, Aslan Yürekli, Suzan Demir Pektaş, Emine Tuğba Alataş, Dilek Daşgın, Havva Solak Özşeker
{"title":"Case Series of Eosinophilic Pustular Folliculitis with Exclusive Scalp and Facial Involvement: A Distinct Entity?","authors":"İlayda Muslu Camcıoğlu, Ceyda Tetik Aydoğdu, Aslan Yürekli, Suzan Demir Pektaş, Emine Tuğba Alataş, Dilek Daşgın, Havva Solak Özşeker","doi":"10.1159/000550808","DOIUrl":"10.1159/000550808","url":null,"abstract":"<p><strong>Introduction: </strong>Eosinophilic pustular folliculitis (EPF) is a rare, non-infectious dermatosis characterized by pruritic, recurrent episodes of follicular papulopustules. Three main forms have been described: classic EPF (Ofuji disease), immunosuppression- or HIV-associated EPF, and infantile EPF. Histopathologically, eosinophilic infiltration within and around the follicular epithelium is a typical finding.</p><p><strong>Case presentation: </strong>We report four non-infant patients with negative anti-HIV antibody results who presented with pruritic follicular papulopustules exclusively involving the scalp and face. Histopathological examination in all cases confirmed the diagnosis of EPF.</p><p><strong>Conclusion: </strong>This case series highlights a clinical presentation of EPF with isolated scalp and facial involvement in immunocompetent adults. Although longer follow-up is required, these findings may suggest a distinct clinical pattern within the spectrum of EPF.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13008414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Episodes of Keratitis during Treatment with Baricitinib for Alopecia Areata.","authors":"Dorottya Godor, Anastasia Therianou","doi":"10.1159/000544920","DOIUrl":"10.1159/000544920","url":null,"abstract":"<p><strong>Introduction: </strong>There is scarce evidence in the literature regarding the association of JAK inhibitors and keratitis.</p><p><strong>Case presentation: </strong>We present the case of a 33-year-old woman with alopecia areata who developed 3 episodes of keratitis within 2 months of treatment with baricitinib, a JAK1/JAK2 inhibitor, and had to therefore stop treatment with baricitinib.</p><p><strong>Conclusion: </strong>On review of the literature regarding ocular side effects with JAK inhibitors, these seem rare but not exceptional. At this time, a casual link cannot be established. To exercise caution, clinicians should be aware of possible ocular adverse events in patients using JAK inhibitors and should also report these cases to the relevant drug safety agencies. Discontinuing the drug and switching to an alternative agent may also be necessary.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":" ","pages":"60-64"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12511536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hair Loss Treatments: A Google Trends Analysis Worldwide of the Past 5 Years (2018-2023).","authors":"Lidiya Todorova, Nicolas Kluger","doi":"10.1159/000547418","DOIUrl":"https://doi.org/10.1159/000547418","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to evaluate the recent trends in public interest regarding various alopecia-related treatments using Google Trends (GT).</p><p><strong>Method: </strong>Data generated through GT for the relative search volumes (RSVs) of the treatments-related terms were analysed: \"hair loss treatment\"; \"minoxidil\"; \"oral minoxidil\"; \"finasteride\"; \"dutasteride\"; \"hair transplant.\" Analysis has been performed worldwide from July 29, 2018, to July 16, 2023.</p><p><strong>Results: </strong>Mean RSVs for \"hair loss treatment\" have increased since 2021 (23 ± 2.8 in 2018 to 70 ± 7.5 in 2023). Interest in \"minoxidil\" has been growing since 2018, with \"minoxidil oral treatment\" gaining attention since 2021. \"Finasteride\" saw a rise in 2021; \"dutasteride\" experienced consistent growth. RSVs for \"hair transplant\" have remained stable. Geographically, public interest in \"hair loss treatment\" was concentrated in Middle Eastern countries and Japan. Interest in oral treatments was prominent in Latin American and Spanish-speaking countries; Ireland and the UK showed strong focus on hair transplants.</p><p><strong>Conclusion: </strong>GT is not a real epidemiological tool and can be only used by individuals who have access to the Internet. We observed temporal and geographical variations in public interest in hair loss treatments. COVID-19 pandemic, differences in the prevalence of alopecia-related conditions, cultural, social influences impact search trends across countries.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":"12 1","pages":"46-49"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Chronic Onychodystrophy Revealing Amelanotic Nail Unit Melanoma in a Moroccan Patient: A Case Report.","authors":"Bouchra Baghad, Fouzia Hali, Yousra Habibi, Fatima Anejjar, Bahija Lemrhari, Bouchra Mouaouya, Meriem Regragui, Mounia Diouri, Soumiya Chiheb","doi":"10.1159/000546886","DOIUrl":"10.1159/000546886","url":null,"abstract":"<p><strong>Introduction: </strong>Nail unit melanoma is a rare and potentially aggressive variant of acral lentiginous melanoma. Diagnosing amelanotic variants can be particularly challenging due to the absence of typical pigmentation. Here, we report a case of chronic onychodystrophy revealing amelanotic nail unit melanoma.</p><p><strong>Case presentation: </strong>A 48-year-old Moroccan patient presented with chronic persistent monodactylic nail dystrophy. Dermoscopy showed subungual hyperkeratosis with an atypical vascular pattern but no pigmented structures. A biopsy of the nail unit confirmed amelanotic melanoma. Staging (PET scan, lymph node ultrasound, and bone CT) excluded metastases. Surgical management led to metacarpophalangeal amputation of the thumb.</p><p><strong>Conclusion: </strong>This case underscores the need to consider amelanotic melanoma in patients with atypical or persistent nail lesions. Early recognition and prompt treatment can significantly affect prognosis. Monodactylous involvement with nail dystrophy, including nail plate destruction, should lead to a nail biopsy for an early and accurate diagnosis.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":" ","pages":"22-28"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Archie Spindler, Derek Maas, Isabella Zappi, Anna L Brinks, Carli Needle Lawrence, Caitlin A Kearney, Jean Pickford, Itisha S Jefferson, Morinola Shobajo, Maryanne M Senna, Jerry Shapiro, Kristen I Lo Sicco
{"title":"Financial Burden of Scarring Alopecia: Insights from the Cicatricial Alopecia Patient Assessment and Impact Report-Scarring Alopecia Foundation Survey Study on Economic and Psychosocial Impact.","authors":"Archie Spindler, Derek Maas, Isabella Zappi, Anna L Brinks, Carli Needle Lawrence, Caitlin A Kearney, Jean Pickford, Itisha S Jefferson, Morinola Shobajo, Maryanne M Senna, Jerry Shapiro, Kristen I Lo Sicco","doi":"10.1159/000550749","DOIUrl":"10.1159/000550749","url":null,"abstract":"<p><strong>Introduction: </strong>Alopecia treatments can incur significant patient costs; however, this monetary impact has yet to be characterized in scarring alopecia (SA) patients. Our study aims to characterize the financial burden of SA and its psychosocial impact.</p><p><strong>Methods: </strong>We conducted a cross-sectional study using survey data collected by the Scarring Alopecia Foundation between December 2, 2022, and December 16, 2022. Financial burden metrics and quality of life impacts were analyzed using RStudio.</p><p><strong>Results: </strong>A total of 1,047 individuals (97.4% female, mean age 57.8 years) completed the survey. Most patients (51.4%) spent USD 1-100 monthly on medical treatments, followed by USD 101-250 (22.8%). Annual costs for nonprescription treatments were most commonly <USD 100 (37%), followed by USD 101-500 (26.5%). Annual costs for nonmedical items were more evenly distributed, yet nearly one in five patients spent >USD 1,000. No differences were seen between general dermatologist and hair loss specialist patients. Most patients felt only somewhat supported or not supported by insurance with no difference between public and private coverage. Additionally, no financial metrics were significantly associated with differences in quality of life.</p><p><strong>Conclusion: </strong>Regardless of provider type, patients with SA face substantial out-of-pocket costs for nonmedical items with limited insurance support. Further advocacy is needed to lessen the financial burden faced by SA patients.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Alcohol Use and Hidradenitis Suppurativa: An Unclear Relationship.","authors":"Miriam Motlak, Connor Gill, Emily Guzzardi, Sydney Barlow, Gerardo Guilarte, Sonal Choudhary","doi":"10.1159/000550645","DOIUrl":"10.1159/000550645","url":null,"abstract":"<p><strong>Background: </strong>Hidradenitis suppurativa (HS) may be linked to behavioral factors that exacerbate inflammation, gut microbiome, and healing.</p><p><strong>Summary: </strong>This review evaluates current evidence on the relationship between alcohol consumption and HS. Emerging studies show high incidences of alcohol and substance use disorders in HS patients. However, observational studies remain inconsistent: HS patients may experience higher alcohol-related burden, yet its association to disease progression and baseline severity remains unclear. Limitations of existing studies include self-reported exposures of alcohol, heterogeneous outcome measures, and potential confounding factors, such as stress.</p><p><strong>Key messages: </strong>Biologic plausibility remains, as alcohol can promote dysbiosis, inflammation, and oxidative stress that may influence disease activity and healing. This review highlights the need for larger, controlled trials that determine whether the reduction or elimination of alcohol may improve HS outcomes.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12999214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147487265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Diagnostic Performance of the Trichogram Compared to Histopathology of Scalp Biopsy in Horizontal Sections in Female Androgenetic Alopecia: A Retrospective Study.","authors":"Priscila Kakizaki, Vanessa Barreto Rocha, Carla Jorge Machado, Neusa Yuriko Sakai Valente","doi":"10.1159/000550541","DOIUrl":"10.1159/000550541","url":null,"abstract":"<p><strong>Introduction: </strong>Female androgenetic alopecia (FAGA) is a frequent cause of diffuse, non-scarring hair loss in women. The trichogram is a noninvasive method for assessing follicular miniaturization, but its diagnostic accuracy compared with scalp biopsy remains uncertain.</p><p><strong>Methods: </strong>In this retrospective, cross-sectional study, 49 women with suspected FAGA underwent trichogram and scalp biopsy on the same day. Hair shafts were classified using three approaches: (1) standard classification (terminal >0.03 mm; vellus ≤0.03 mm or thinner than the inner root sheath, per Headington's criteria); (2) T:(V+I) classification (terminal >0.06 mm, intermediate >0.03-0.06 mm, vellus ≤0.03 mm); and (3) relative diameter method, where hairs <50% of the thickest shaft were considered vellus. In all methods, a terminal-to-vellus ratio ≤3 indicated diagnosis.</p><p><strong>Results: </strong>Standard classification yielded a sensitivity of 65.3%. When intermediate and miniaturized hairs were combined, sensitivity increased to 96%. The relative diameter method achieved 77.6%, with no significant difference from histopathology.</p><p><strong>Conclusion: </strong>Trichogram sensitivity in FAGA improves when intermediate hairs are included or when relative shaft diameter is applied. These adaptations enhance correlation with histology and support the trichogram as a practical, noninvasive, and cost-effective diagnostic tool in clinical practice.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12928728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sarah A Alsalman, Giulia Coscarella, Antonella Tosti
{"title":"The Utility of Ultraviolet Dermoscopy in Identifying White Hairs in Children: A Diagnostic Aid.","authors":"Sarah A Alsalman, Giulia Coscarella, Antonella Tosti","doi":"10.1159/000550468","DOIUrl":"10.1159/000550468","url":null,"abstract":"","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12908965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zeynep Altan Ferhatoglu, Mirac Zengin, Gurbuz Yildirim, Burhan Engin, Server Serdaroglu, Fatih Goktay
{"title":"Impact of Nail Psoriasis on Quality of Life: A Turkish Validation Study of NPQ-10 and NAPPA.","authors":"Zeynep Altan Ferhatoglu, Mirac Zengin, Gurbuz Yildirim, Burhan Engin, Server Serdaroglu, Fatih Goktay","doi":"10.1159/000550467","DOIUrl":"10.1159/000550467","url":null,"abstract":"<p><strong>Introduction: </strong>Nail psoriasis significantly impairs quality of life (QoL). General dermatology instruments often lack sensitivity for specific nail-related burdens. This study aimed to validate the Turkish versions of the Nail Psoriasis Quality of Life Scale (NPQ-10) and the Nail Assessment in Psoriasis and Psoriatic Arthritis (NAPPA).</p><p><strong>Methods: </strong>This cross-sectional validation study included 71 patients (42 male, 29 female). The questionnaires were translated into Turkish following international guidelines. Reliability and validity were assessed by analyzing correlations with the Dermatology Life Quality Index (DLQI) and clinical parameters (PASI, NAPSI).</p><p><strong>Results: </strong>The sample showed a male predominance (59.2%). DLQI scores showed a moderate positive correlation with NPQ-10 (<i>r</i> = 0.453) and NAPPA-QoL (<i>r</i> = 0.477). Patients with toenail involvement had significantly higher QoL impairment. While men had higher clinical severity scores (PASI), women reported higher stigma-related scores.</p><p><strong>Conclusion: </strong>The Turkish versions of NPQ-10 and NAPPA are valid and reliable instruments. They capture specific physical and psychosocial burdens of nail psoriasis more accurately than general tools, particularly regarding toenail involvement and stigma. Incorporating these tools into practice is recommended.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12908964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}