Practical Approach to Hair Loss Diagnosis.

Hair loss is one of the common complaints encountered in a cosmetic practice. Evaluating a patient with hair loss requires a thorough understanding of the various causes of hair loss and practical knowledge in hair cosmetics and hair styling procedures. A systematic approach in hair loss evaluation helps the treating physician in arriving at a diagnosis. Various bedside tests and advent of trichoscopy has empowered the physician in arriving at a diagnosis. This article aims to provide the physician a systematic approach in evaluating a patient with hair loss.

Role of Hair Transplantation in Scarring Alopecia-To Do or Not to Do.

Alopecia in the scalp region leads to psychosocial embarrassment for an individual. Alopecia could be due to several reasons, including genetic, hormonal, traumatic and infections. Cicatricial alopecias (CAs) are considered as trichological emergency, since their progression is rapid and always results in permanent hair loss. The pathogenesis, disease progression and prognosis of CA are poorly understood, and the treatment process is still evolving. An early diagnosis must be established, and aggressive treatment protocol should be followed in the management of scarring alopecia. This article presents various aspects of CA and determines whether hair transplant (HT) should be done in this condition.

DRESS Syndrome Secondary to Carbamazepine Therapy Presenting with Bilateral Acute Anterior Uveitis and Angle Closure Glaucoma.

PURPOSE: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare, life-threatening multi-system adverse drug reaction characterized by febrile skin rash, hematologic abnormalities, and involvement of internal organs. We report a case of DRESS syndrome in a child presenting with primary ophthalmic manifestations. CASE REPORT: An 11-year-old boy presented with severe pain and diminished vision in both eyes six weeks after starting carbamazepine therapy for seizure disorder. Ocular examination revealed features of bilateral acute anterior uveitis, acute onset myopia, and angle closure glaucoma secondary to uveal effusion. Additionally, the patient was febrile with a generalized maculopapular rash, and blood investigations revealed eosinophilic leukocytosis. A diagnosis of carbamazepine-induced DRESS syndrome was made, and carbamazepine therapy was discontinued. Treatment with cycloplegics, topical, and systemic steroids resulted in prompt clinical recovery. CONCLUSION: Ophthalmologists should be aware that hypersensitivity to anticonvulsants, such as carbamazepine, can present with bilateral uveitis and uveal effusion along with systemic symptoms. Prompt diagnosis and treatment can prevent vision loss and life-threatening complications. Patients should be counselled about potential adverse effects of anticonvulsants before therapy.

Assembling a Hand-Held Trichotillometer and Determination of Epilation Force in Normal Individuals.

AIM: To assemble a simple, inexpensive hand-held trichotillometer and to determine the epilation force (EF) required to pluck the anagen hair and telogen hair from four regions of the scalp in healthy volunteers. MATERIALS AND METHODS: A simple hand-held trichotillometer was assembled by modifying a laboratory spring balance, and the instrument was calibrated after attachments. EF was measured in 30 healthy individuals on four regions of the scalp. RESULTS: A total of 30 volunteers were included in the study, among them 15 were males and 15 were females. A total of 1200 hairs were examined. The mean EF in our study was 70.15 grams (g). The mean EF required to pluck the anagen hair was 86.61 g and telogen hair was 53.69 g. CONCLUSION: The assembled- hand held trichotillometer is a simple and reliable device. Tricotillometer is a useful device to measure the EF in various physiological and pathological conditions and may have diagnostic, prognostic, and therapeutic value in various hair diseases.

Outcomes of staple closure of the donor area during hair transplant by follicular unit transfer.

BACKGROUND: Donor area closure in hair transplantation by follicular unit transfer (FUT) is being done by various techniques. This study aims to assess the outcomes of staple closure for donor area in FUT. AIM: To study the outcome, efficacy and complications of staples in donor area closure for FUT. MATERIALS AND METHODS: A total of 50 consecutive patients who underwent staple closure for donor area in FUT were included in the study and their data were collected retrospectively. Patients were followed up one year after the surgery and photographic documentation of the scar at the donor site was done. Objective measurement of the width of the scar was done for all the patients. RESULTS: The average length of the donor area was 22 cm. The average width of the scar was 1.82 mm. There was no infection or tissue necrosis at the staple closure site in any of the patients. CONCLUSION: Staple closure resulted in cosmetically acceptable scar, but post operative discomfort was the major limitation. The potential to conserve the hair follicles along the line of closure makes using staples worthwhile if conservation of follicles is the goal.

Practicality in using diphenyl cyclo propenone for alopecia areata.

Diphenyl cyclo propenone (DPCP) is used as a topical immunomodulator in alopecia areata. It is a potent allergen. The process of procuring, dilution and application limits its wider use. This short communication aims to make the DPCP application easy to use.