{"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}
Lauren Fleshner, Mehmet Fatih Atak, Katie Roster, Banu Farabi
{"title":"Racial Disparities in Healthcare Resource Utilization among Patients with Hidradenitis Suppurativa: An All of Us Database Analysis.","authors":"Lauren Fleshner, Mehmet Fatih Atak, Katie Roster, Banu Farabi","doi":"10.1159/000547793","DOIUrl":"10.1159/000547793","url":null,"abstract":"<p><strong>Introduction: </strong>Hidradenitis suppurativa (HS) disproportionately affects historically underrepresented populations, with social determinants of health (SDoH) contributing to disparities in access to care, specialty services, and medication access. This study aimed to evaluate healthcare utilization in HS, stratified by race, to better understand the role of SDoH.</p><p><strong>Methods: </strong>A cross-sectional analysis using the All of Us database was conducted using variables including surgical procedures, healthcare utilization, biologic use, and pertinent comorbidities (diabetes, obesity, smoking, sepsis). Survey data assessed socioeconomic factors and healthcare access. Chi-square tests were used (<i>p</i> < 0.005); analyses were performed in RStudio 4.1.2.</p><p><strong>Results: </strong>Among 2,265 patients with HS (40.26% African American, 77.48% female), African American patients had higher rates of emergency department visits, diabetes, complex surgeries, and inability to afford medications (all <i>p</i> < 0.01). White patients had more outpatient visits and delays in care due to anxiety (<i>p</i> < 0.0005 and <i>p</i> < 0.026, respectively).</p><p><strong>Conclusions: </strong>Racial disparities in HS healthcare utilization reflect the impact of SDoH, with African American patients experiencing greater disease burden. Early identification of high-risk patients and targeted interventions are essential to promote equitable care.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":" ","pages":"50-54"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252878","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":"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}
Elen Deng, Meaghan C Dougher, Julia O Baltz, Nathaniel J Jellinek, Adam I Rubin, Kimberly M Ken
{"title":"Novel Clinicopathologic Subungual Angiokeratoma Series Demonstrating Clinical Features Mimicking Nail Unit Melanoma.","authors":"Elen Deng, Meaghan C Dougher, Julia O Baltz, Nathaniel J Jellinek, Adam I Rubin, Kimberly M Ken","doi":"10.1159/000547969","DOIUrl":"10.1159/000547969","url":null,"abstract":"<p><strong>Introduction: </strong>Angiokeratomas are benign vascular tumors that typically present as a hyperkeratotic, red-brown to black papule on the lower extremities. Angiokeratomas in the subungual location are rare, with few reported cases in the literature.</p><p><strong>Case presentation: </strong>We present three biopsy-proven cases of subungual angiokeratomas with novel clinical features: involvement of the nail bed, clinically mimicking nodular melanoma, and involving a broad age range, with the youngest patient reported at 25 years old. Symptoms included tenderness and bleeding, while the clinical presentations ranged from evenly to irregularly pigmented nodule(s). Histopathology revealed morphologic findings; characteristics of angiokeratoma include multiple dilated vascular spaces within the superficial dermis and overlying epidermal hyperplasia.</p><p><strong>Conclusion: </strong>This case series expands the known clinical presentations of nail unit angiokeratomas and emphasizes the importance of including subungual angiokeratoma in the differential diagnosis of pigmented, nodular lesions of the nail unit.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":" ","pages":"75-80"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252835","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}
Christian Bailey-Burke, Jennifer Panara, Guanlin Guo, Lorrie Schmid, Jane Bellet, Erin Lesesky
{"title":"Efficacy of a Nail Cadaver Lab as a Teaching Tool for Dermatology Residents.","authors":"Christian Bailey-Burke, Jennifer Panara, Guanlin Guo, Lorrie Schmid, Jane Bellet, Erin Lesesky","doi":"10.1159/000548023","DOIUrl":"10.1159/000548023","url":null,"abstract":"<p><strong>Introduction: </strong>Instruction in nail procedures is limited in dermatology residency programs. Cadaveric-based educational sessions can help bridge the gap in nail procedure knowledge and confidence in residency education. This study evaluates a combined didactic and hands-on cadaveric workshop for two cohorts of second- and third-year dermatology residents at a single institution (2023 and 2025).</p><p><strong>Methods: </strong>Second- and third-year dermatology residents completed a pre-survey prior to the session to assess their comfort and confidence with nail procedures prior to completing a didactic nail surgery lecture and subsequent nail procedure cadaveric training. Participants completed a post-survey within a week after the nail cadaver lab training to re-assess their experience and confidence.</p><p><strong>Results: </strong>Participants demonstrated significant post-intervention improvements in comfort with nail procedures, including instruments needed to perform nail procedures, postoperative care, nail matrix biopsies, and nail avulsions, with confidence in complete and partial nail avulsions doubling. All residents endorsed the session's effectiveness and recommended repeating it for future dermatology residents.</p><p><strong>Conclusion: </strong>These findings highlight nail procedure cadaveric training as a reproducible, scalable intervention to address gaps in procedural dermatology education and enhance residents' skills in nail surgery.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":" ","pages":"17-21"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252738","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}
Anna L Brinks, Caitlin A Kearney, Carli D Needle, Akshay Pulavarty, Archie Spindler, Derek Maas, Loren D Krueger, Kristen I Lo Sicco, Jerry Shapiro
{"title":"Topical Tacrolimus, Clobetasol, and Minoxidil for Primary Cicatricial Alopecias: A Retrospective Analysis of Clinical Outcomes and Safety.","authors":"Anna L Brinks, Caitlin A Kearney, Carli D Needle, Akshay Pulavarty, Archie Spindler, Derek Maas, Loren D Krueger, Kristen I Lo Sicco, Jerry Shapiro","doi":"10.1159/000548130","DOIUrl":"10.1159/000548130","url":null,"abstract":"<p><strong>Introduction: </strong>Primary cicatricial alopecias (PCAs) cause permanent hair loss and psychosocial distress. Management involves anti-inflammatory and hair growth-promoting therapies. A combination of tacrolimus, clobetasol, and minoxidil (TCM) may offer synergistic benefits by targeting distinct inflammatory pathways while increasing background hair density for improved camouflage. This study evaluates the safety and efficacy of TCM use in PCA patients.</p><p><strong>Methods: </strong>We conducted a retrospective chart review of PCA patients aged 18+ years treated with TCM between January 1, 2009, and May 31, 2025. Outcomes included inflammatory activity on trichoscopy, scalp symptoms, provider- and patient-reported disease status, and objective hair measurements. Descriptive statistics were performed using SAS v9.4.</p><p><strong>Results: </strong>Eighty-two patients (80.5% female, mean age 61.5) were included, most commonly with frontal fibrosing alopecia or lichen planopilaris. TCM was typically prescribed as a compounded solution used 1-2 times/day for an average of 24.5 months. Adverse effects included worsened itch/burning (6.1%), hypertrichosis (4.9%), scalp irritation/dryness (4.8%), and atrophy (3.7%); most (62.2%) experienced no adverse effects. Provider-assessed inflammation and disease status improved or stabilized in 69.5% and 76.9%, respectively. Objective hair measurements also improved.</p><p><strong>Conclusions: </strong>TCM is well tolerated and, used alone or in conjunction with other therapies, appears to be effective. Improvements were seen in provider-reported outcomes and objective hair measurements.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":" ","pages":"55-59"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252800","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":"Trichonodosis: A Case Report and Literature Review.","authors":"Pattarada Chantanakul, Chinmanat Lekhavat","doi":"10.1159/000547816","DOIUrl":"10.1159/000547816","url":null,"abstract":"<p><strong>Introduction: </strong>Hair shaft disorders include congenital or acquired conditions characterized by structural abnormalities of the hair. Trichonodosis, or knotted hair, is a rare disorder characterized by the presence of knots along the hair shaft. It can occur spontaneously or be induced by mechanical forces.</p><p><strong>Case presentation: </strong>An 8-year-old girl presented with short, fine, curly hair since birth. Physical examination revealed diffusely curly scalp hair with visible breakage. Trichoscopy and light microscopy showed knotted hair segments, cortical fractures, and variation in hair shaft thickness. A diagnosis of spontaneous trichonodosis was made. Treatment with topical minoxidil and gentle hair care led to improved hair length and strength over 2 years.</p><p><strong>Conclusion: </strong>We propose that spontaneous trichonodosis with congenital onset and no mechanical triggers suggest a genetic predisposition. Although treatment options are limited, topical minoxidil may provide therapeutic benefit.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":" ","pages":"71-74"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252883","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":"An Unusual Compulsive Behavior Related to Scalp Psoriasis and Hair Follicle Anxiety in Young Men.","authors":"Ramon Grimalt","doi":"10.1159/000547907","DOIUrl":"10.1159/000547907","url":null,"abstract":"<p><strong>Introduction: </strong>Patients suffering from androgenetic alopecia may experience obsessive behaviors on observing their own scalp.</p><p><strong>Case presentation: </strong>This article describes a series of three cases of young men presenting with an unusual, seemingly compulsive behavior related to mild scalp psoriasis and a family history of androgenetic alopecia. Contrary to the typical goal of psoriasis treatment, these patients exhibit an intense fixation on scalp scales containing embedded hairs. They actively avoid dislodging these scales during routine hygiene or therapeutic efforts, fearing that their removal might accelerate hair loss. The cases involve young men (aged 24, 19, and 22) with significant anxiety about hair loss, which manifests as a meticulous and repetitive manipulation of their scalps to preserve these specific scales.</p><p><strong>Conclusion: </strong>This behavior may fall within the spectrum of body-focused repetitive behaviors. This observation underscores the importance for dermatologists to thoroughly question patients about underlying anxieties and specific scalp manipulation behaviors, especially in young men with a familial history of alopecia, to facilitate more effective clinical management.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":" ","pages":"8-11"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252795","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}