Aplasia cutis congenita in dizygotic twin infants

Aplasia cutis congenita (ACC) is often sporadic, but familial cases have been reported. We report a case of a dichorionic diamniotic twin pregnancy in which both the male and female twins had matching areas of aplasia cutis on their scalps. An Irish couple sought fertility treatment using a donor egg and paternal sperm. Successful in vitro fertilization (IVF) and the transfer of two embryos resulted in a diamniotic dichorionic twin pregnancy. Two fetal poles were noted at the 12-week ultrasound (US) scans. The mother suffered from a minor urinary tract infection during the first trimester but had no other history of infection, including herpes simplex virus or COVID- 19. She was known to be varicella immune prior to pregnancy. The twins were born by elective caesarean section owing to breech presentation. Twin one was female and twin two was male. Both infants were born with scarring on the crown of their head, which was consistent with ACC. Cranial US showed no underlying bony abnormality. The rest of the cutaneous examination was normal and there were no other congenital anomalies. ACC is a rare, heterogeneous group of disorders characterized by the congenital absence of skin, which can be focal or widespread. It is thought to affect 1-3 per 10 000 live births. The exact cause of ACC is unclear. Various hypotheses have been suggested, including defective closure of the neural tube or embryonic fusion lines, intrauterine trauma, placental insufficiency, fetus papyraceus, amniotic membrane adhesions, intrauterine infections, teratogens and genetic mutations. The classification of ACC is based on the area affected, type of skin irregularity, associated congenital defects and mode of inheritance. Scalp ACC without multiple anomalies (category 1) is generally associated with an autosomal dominant or sporadic pattern of inheritance. These twins may have an autosomal dominant mutation that led to this phenotype. ACC can also be associated with fetus papyraceus or placental infarct. This is less likely in this case as only two embryos were transferred, and the pregnancy was dichorionic. Most cases of ACC associated with fetus papyraceus occur in monozygotic pregnancies. ACC lesions often heal spontaneously by re-epithelialization resulting in a hairless superficial scar. Twin one had a slightly smaller area affected by ACC and overlying eschar resolved several weeks after birth. Twin two has had no hair growth in the area. This case highlights the difficulties in ascertaining the aetiology of this rare condition in twin pregnancies.

Hydroxychloroquine for granuloma annulare: A case report on secondary hair growth in alopecia universalis.

Alopecia areata is an autoimmune disease resulting in non-scarring hair loss. Alopecia areata can progress to become alopecia totalis (loss of hair from the entire scalp) or alopecia universalis (loss of hair form the entire body), with the progression estimated to range from 7% to 30%. There are no universally proven therapies that both induce and sustain remission, and furthermore, the course of alopecia areata tends to be unpredictable, with ~80% of patients achieving spontaneous remission within 1 year. We herein present the case of a 61-year-old female who presented with a 20-year history of alopecia universalis, and biopsy confirmed widespread granuloma annulare. Hydroxychloroquine was initiated to treat her granuloma annulare, with subsequent significant hair regrowth on her scalp, eyebrows, eyelashes, and arms. A review of the literature is presented showing that hydroxychloroquine has variable success in treatment of alopecia areata, alopecia totalis, and alopecia universalis.

Current status and development potential of scalp healthcare in the COVID-19 blue era: A critical review focused on Republic of Korea.

AIMS: The purpose of this paper was to review the literature focusing on the scalp health of the Korean people in the COVID-19 blue era and the possibility of significant development as an academic. METHODS: This review paper is a literature review, and the method is a narrative review. RESULTS: It was found that the higher the awareness of hair loss, the better the scalp and hair management behavior. South Korea needs to develop systematic customized management methods, scalp programs, and products due to the development of the COVID-19 era and the development of the 4th industry. CONCLUSION: South Korea still needs to improve the expertise of tricolologists and national social security insurance and research along with the growth of the beauty and healthcare service industry in the COVID-19 blue era.

Complementary Strategies to Promote Hair Regrowth in Post-COVID-19 Telogen Effluvium.

Post-COVID-19 telogen effluvium has been largely reported as a sequela in the post-acute phase of COVID-19, causing major emotional distress among the affected patients. The affected individuals are further exposed to a vast amount of misinformation from the internet and social media and it is important for physicians to be familiar with the phenomenon and provide appropriate counselling to their patients regarding this condition. This article aims to review the evidence-based complementary strategies that can help enhance hair regrowth after post-COVID-19 hair loss, from psychological support and patient education to the importance of optimal nutrition and potential indications and benefits of oral nutritional supplementation, as well as the role of both topical and injectable hair growth stimulators.

Hair cortisol concentrations in medical nurses during the COVID-19

Background: The COVID-19 pandemic is a serious and long-term stressor for healthcare workers, therefore hair cortisol concentrations (HCCs) could be used to assess this prolonged stress. Method: HCCs of 67 female nurses were measured during spring 2020, with a follow-up performed in autumn 2020 with 57 participants. Both times, HCCs were analyzed from two 3 cm hair segments corresponding to periods of hair growth before and during the spring wave of the pandemic, during the summer release, and the autumn wave of the pandemic. Results: Data from spring 2020, showed higher HCCs in hair grown during the pandemic compared to older hair (90%CI η2=0.123-0.397), while nurses reporting a high risk of infection (n=33) had higher HCCs (90%CI η2=0.002-0.176) than nurses reporting low risk (n=34). In the follow-up, hair samples corresponding to worsening of the pandemic had higher HCCs than samples from summer release (90%CI η2=0.002-0.201). Three groups were compared instead of two, as only 9 nurses reported low risk, 25 high risk, and 23 daily work with COVID-19 patients. Group differences were not significant. Conclusion: Data from the follow-up supported the findings of higher HCCs in nurses during the worsening of the pandemic.

Efficacy of QR678 Neo® hair growth factor formulation for the treatment of hair loss in Covid-19-induced persistent Telogen Effluvium-A prospective, clinical, single-blind study.

BACKGROUND: Telogen Effluvium (TE) in a post-Covid-19 patient causes excessive shedding of hair. No definite treatment is available till now. Past studies demonstrates that QR678Neo® has shown promising results in various types of Alopecia. AIM: In this study, we aim to establish efficacy of QR678 Neo® hair growth factor formulation administration in Covid-19-induced persistent TE for treatment of hair loss and for hair regrowth. MATERIAL & METHOD: Twenty adult patients (all females) presenting with persistent TE starting few weeks after recovery from Covid-19 infection, and continuing beyond 6 months were included for the study. A 1.5 mL solution of QR678 Neo® hair growth factor formulation was administered in the scalp per session. A total of 8 sessions (one session every 4 weeks) were done. The results were assessed at the baseline, after 4thsession, and 1 month after 8th session. RESULTS: Most of the patients showed significant reduction in hair fall; 89% patients showed excellent hair growth. Global photographic assessment score showed marked improvement, which maintained even post therapy. Videomicroscopic assessment showed increase in the hair count (mean =29.32) after 8th session, that further improved even post therapy. The subjective assessment scores for overall hair growth, appearance of hair, reduction in visibility of the scalp, and hair loss were 4, 4.5, 4.25, and 5, respectively. CONCLUSION: Management of Covid-19-induced persistent Telogen Effluvium has been unclear and futile so far. Intra-dermal administration of QR678 Neo® hair growth factor formulation in the scalp, reduces hair fall, improves hair regrowth, and increases the hair density.

The shifting preferences of patients and physicians in nonsurgical hair loss treatment.

BACKGROUND: There are multiple etiologies for hair thinning and loss, including genetic, hormonal, immune, scaring, and infectious. Hair loss treatment involves both surgical intervention and nonsurgical therapies such as pharmaceuticals, haircare products, vitamins, and low-level laser therapy (LLLT). While pharmaceuticals have been extensively researched, the efficacy of other therapies remains inconclusive. With so many available treatments, consumers often research their options using search engines such as Google and/or seek help from hair restoration physicians. AIMS: To identify and analyze changing trends in international consumer and physician interest in nonsurgical hair loss therapies. METHODS: Worldwide trends in Google searches of hair loss products (2004-2020) were compared with product prescription frequency surveys from members of the International Society of Hair Restoration Surgery (2004-2019, ~29% response rate). RESULTS: Minoxidil and finasteride were the most prescribed hair loss treatments, while "minoxidil" was the most "Googled" term. Generic products were searched more often than their brand counterparts. Nutritionals and haircare prescriptions increased over time. LLLT was also increasingly prescribed, with Internet searches increasing following government regulation announcements. The COVID-19 pandemic initially negatively affected hair loss treatment searches, which have since returned to, and surpassed, pre-pandemic levels. CONCLUSION: Regulations and social media have influence on consumer interest in hair loss products. A weak economy and coronavirus fears may persuade consumers to turn to cheaper hair loss treatment alternatives. Hair restoration specialists need to keep abreast of online trends to communicate effectively with their patients. Patients should be cognizant of the safety and efficacy of hair restoration treatments.