Guidelines for clinical trials of frontal fibrosing alopecia: consensus recommendations from the International FFA Cooperative Group (IFFACG).

BACKGROUND: Frontal fibrosing alopecia (FFA) has become one of the most common causes of cicatricial alopecia worldwide. However, there is a lack of clear aetiology and robust clinical trial evidence for the efficacy and safety of agents currently used for treatment. OBJECTIVES: To enable data to be collected worldwide on FFA using common criteria and assessment methods. METHODS: A multicentre, international group of experts in hair loss was convened by email to create consensus recommendations for clinical trials. Consensus was defined at > 90% agreement on each recommended part of these guidelines. RESULTS: Standardized diagnostic criteria, severity rating, staging, and investigator and patient assessment of scalp hair loss and other clinical features of FFA were created. CONCLUSIONS: These guidelines should allow the collection of reliable aggregate data on FFA and advance efforts in both clinical and basic research to close knowledge gaps in this condition.

Partial congenital arrhinia: never seen before adult presentation.

BACKGROUND: Arrhinia is defined as the partial or complete absence of the nasal structures. It is a defect of embryonal origin and can be seen in association with other craniofacial anomalies, central nervous system anomalies, absence of paranasal sinuses, and other palatal and ocular abnormalities. Very few patients with arrhinia have been reported so far in the history of modern medicine. CASE REPORT: This study reports an adult patient with congenital partial arrhinia and reviews the literature along with the embryological basis of such a rare disease. CONCLUSION: Arrhinia is a medical condition with scarce documentation in the literature. This article presents the clinical as well as radiological features of this rare entity.

Crushing assisted shave excision and electrodesiccation: A novel approach to treat granuloma pyogenicum.

BACKGROUND: Granuloma pyogenicum (GP) is a common vascular lesion which often bleeds easily during most of the treatment modalities. A number of pyogenic granulomas often recur after such treatment. OBJECTIVE: The aim of this study was to establish a surgical procedure which is easy to operate, less invasive, minimal bleeding at the operation site and without any recurrence of the lesion. METHODS: Twenty-three patients (15males, and 8females) suffering from granuloma pyogenicum at different stages (ulcerated, reepithelialized and resolving) and at various sites of the body constituted the sample population. In all the patients, crushing of the base of the lesions followed by shave excision and electrodesiccation of the shaved base were carried out. The patients were followed up for six months to observe recurrence, scar formation and any other complications. RESULTS: Bleeding was practically nil during the surgical procedure in all the cases. There was no recurrence and cosmetic outcome was excellent. No complications were encountered. CONCLUSION: The technique is not only an alternative modality but can also be the treatment of choice in all stages of granuloma pyogenicum.

Treatment of stable and recalcitrant vitiligo by autologous miniature punch grafting: a prospective study of 1,000 patients.

BACKGROUND: Stable and refractory vitiligo may be unresponsive to medical therapy. Melanocyte transplantation by punch grafting (PG) can restore the normal pigmentation. OBJECTIVE: To evaluate the efficacy of PG on repigmentation of vitiligo patches. METHODS: Autologous miniature PG was undertaken in 1,000 patients with stable and recalcitrant vitiligo. Test grafting (TG) was done in all the patients. Those who showed negative TG results were excluded from the study. RESULTS: Of the 1,000 patients, 880 (88%) showed positive TG results. In 656 (74.55%) patients, 90-100% repigmentation was achieved. In 93 (10.57%) patients, there was no spread of pigment, while in 21 (2.39%) patients depigmentation of the graft(s) was notices. Of various complications, polka dot appearance (43.98%) and colour mismatch (34.32%) were most frequent. CONCLUSION: Partial to near-total repigmentation of a vitiligo patch can be achieved by PG.