Hair transplantation update.

Contemporary hair transplant surgery offers results that are natural and undetectable. It is an excellent treatment option for male and female pattern hair loss. Patients are encouraged to also use medical therapy to help protect their surgical results and prevent ongoing thinning of the surrounding hairs. The two major techniques of donor elliptical harvesting and follicular unit extraction are discussed here.

Anal Pap smears and anal cancer: what dermatologists should know.

Squamous epithelial cells are susceptible to infection by the human papillomavirus. Infection of squamous epithelium with oncogenic human papillomavirus types is associated with development of dysplasia and potential malignant transformation. Historically, cervical cancer has been the most prevalent human papillomavirus-induced squamous neoplasia. However, because of widespread screening via Pap smear testing, rates of cervical cancer in the United States have decreased dramatically during the past 50 years. Rates of anal cancer, in contrast, have doubled during the past 30 years. The groups at highest risk for development of anal cancer are men who have sex with men, HIV-positive patients, and patients immunosuppressed as a result of solid-organ transplantation. By detecting dysplasia before it develops into invasive cancer, anal Pap smears may be a potentially useful screening tool for anal cancer, particularly in individuals known to be at increased risk. However, at this time, sufficient data supporting the benefit of anal Pap smear screening are lacking. With insufficient evidence, no national health care organizations currently recommend the use of anal Pap smears as a routine screening test, even among high-risk groups.

Advances and challenges in hair restoration of curly Afrocentric hair.

Although the biochemical composition of hair is similar among racial and ethnic groups, the hair structure between them varies, and individuals with curly hair pose specific challenges and special considerations when a surgical option for alopecia is considered. Hair restoration in this population should therefore be approached with knowledge on the clinical characteristics of curly hair, hair grooming techniques that may influence the management, unique indications for the procedure, surgical instrumentation used, and the complications that may arise.

Scoping scalp disorders: practical use of a novel dermatoscope to diagnose hair and scalp conditions.

BACKGROUND: Dermoscopy has been widely implemented to diagnose various skin and scalp disorders. However, existing devices that call for direct scalp contact may alter the appearance of hair features or perifollicular structures. OBJECTIVE: This paper will show how the Canfield DermScope can quickly and easily identify various nonscarring and scarring scalp disorders. Its open design does not change the direction of affected hairs or blanch certain features such as erythema. Features like perifollicular hyperkeratosis and loss of follicular orifices are still easily visible. METHODS AND MATERIALS: The author prospectively photographed patients with hair and scalp disorders in private practice between 2011 to 2012 using the handheld Canfield DermScope device. RESULTS: The presence of scale, erythema, tufting, miniaturized or broken hairs, and loss of follicular orifices were quickly identified to make a diagnosis. CONCLUSION: The diagnosis of hair and scalp disorders can be greatly facilitated by the use of the DermScope device.

The use of low-level light for hair growth: part I.

BACKGROUND AND OBJECTIVE: Low-level laser therapy (LLLT) is a new therapy for the treatment of hair loss. It has received enormous media attention and tremendous marketing budgets from companies that sell the devices, but no independent, peer-reviewed studies have demonstrated its efficacy in this application. Here we investigate the efficacy of LLLT in enhancing hair growth. METHODS: A total of seven patients were exposed to LLLT twice weekly for 20 minutes each time over a period of 3-6 months. Five patients were treated for a total of 3 months and two were treated for 6 months. Videomicroscopic images were taken at baseline, 3 months, and 6 months, and analyzed for changes in vellus hair counts, terminal hair counts, and shaft diameter. Both videomicroscopic and global images underwent blinded review for evidence of subjective improvement. Patients also answered questionnaires assessing hair growth throughout the study. Neither patients nor physicians conducting the study received any financial compensation. RESULTS: The results indicate that on average patients had a decrease in the number of vellus hairs, an increase in the number of terminal hairs, and an increase in shaft diameter. However, paired i-testing indicated that none of these changes was statistically significant. Also, blinded evaluation of global images did not support an improvement in hair density or caliber. CONCLUSIONS: LLLT may be a promising treatment option for patients who do not respond to either finasteride or minoxidil, and who do not want to undergo hair transplantation. This technology appears to work better for some people than for others. Factors predicting who will most benefit are yet to be determined. Larger, longer-term placebo-controlled studies are needed to confirm these findings, and demonstrate statistical significance, or refute them altogether.

Medical treatments for male and female pattern hair loss.

UNLABELLED: Male and female pattern hair loss affects a large percentage of the population, and patients frequently present for treatment of this to their dermatologist. Here we review the many treatments available for hair loss. We review the evidence for each, and outline the most effective treatment strategies for both men and women. LEARNING OBJECTIVE: At the conclusion of this article, the reader should be able to describe the most effective treatments for hair loss, understand their mechanism(s) of action, and explain which treatments are the best in different settings.

Hair transplantation for men.

Men throughout history have suffered from various degrees of hair loss. Modern techniques for hair transplantation give rise to natural and long-lasting results. In this paper we provide an overview of the procedure, including the harvesting of donor hair in the occipital scalp, and its redistribution along the frontal- and mid-scalp areas. Special consideration must be made to choosing the candidates carefully and to performing their surgery in a manner that looks appropriate for all ages. We describe the role of medications for male pattern hair loss and with hair transplantation.

Juvenile chondrodermatitis nodularis helicis: a case report and literature review.

Chondrodermatitis nodularis helicis (CNH) is a disorder that affects adults. Only one case of juvenile CNH has been reported, in an 8-year-old child who suffered from dermatomyositis. We report another child with juvenile CNH who was not afflicted with dermatomyositis or other systemic disorders. The clinical and histologic evaluations demonstrated CNH on the helix of the right ear in a 16-year-old Caucasian girl who was otherwise healthy. Serologic analysis ruled out an underlying autoimmune disorder. We conclude that juvenile CNH is extremely rare and may occur in patients without dermatomyositis or other systemic disorders.

Radiation effects on breast reconstruction with the deep inferior epigastric perforator flap.

Immediate breast reconstruction has important advantages over delayed reconstruction, including a shorter operative time and decreased psychological distress for the patient. However, the authors' experiences with the deep inferior epigastric perforator flap demonstrate variable aesthetic outcomes among patients who undergo radiation postoperatively. To establish an association between radiation and poor postoperative results, a matched-pairs analysis was conducted. Thirty irradiated patients were paired with 30 nonirradiated patients, according to age and body mass index. For each group, the incidence of fat necrosis, fibrosis/shrinkage, and flap contracture was recorded. In addition, an aesthetic evaluation was conducted to compare before-and-after images of 10 irradiated patients with those of 10 nonirradiated patients from similar time periods. The images were randomized and blindly evaluated by a panel of eight judges. A five-point scale was used to evaluate symmetry, aesthetic proportion, and the appearance of the superior pole. Statistical analysis demonstrated a significant difference in the score changes for irradiated and nonirradiated patients, according to all three criteria. Nonirradiated patient scores increased by one-half point, and irradiated patient scores decreased by one-half point. In addition, the incidences of fat necrosis, fibrosis, and flap contracture were all significantly higher among the irradiated group. These results suggest that when possible, reconstruction should be delayed until after radiation therapy is complete. Persons who smoke or are obese may be at particular risk for complications following radiation therapy.