Economic Impact of Home-Use versus Office-Use Diphenylcyclopropenone in Extensive Alopecia Areata.

Introduction: Diphenylcyclopropenone (DPCP) is the medication of choice for the treatment of severe alopecia areata (AA) according to AA treatment guidelines. Precise initiation and application are important factors for successful treatment. However, it is difficult for patients who live far away to visit their doctor weekly. Methods: We conducted a retrospective cohort study to assess the cost, effectiveness, and side effects of DPCP treatment between office-use DPCP (O-DPCP) and home-use DPCP (H-DPCP) in severe AA patients. A cost-effectiveness analysis was performed from the perspective of healthcare providers and patients using real-world data and the national cost statistics for hospital services comparing O-DPCP and H-DPCP in patients with severe AA at 24, 36, and 48 weeks. Results: Two groups of 41 patients treated with O-DPCP and H-DPCP were enrolled. There was no significant difference in the proportion of patients who showed a favorable outcome (≥50% improvement) with minimal side effects between both groups at 24 (O-DPCP 43.9% vs. H-DPCP 26.8%, p = 0.11), 36 (O-DPCP 58.5% vs. H-DPCP 43.9%, p = 0.19), or 48 weeks (O-DPCP 63.4% vs. H-DPCP 56.1%, p = 0.49). The cost of H-DPCP was half of the cost of O-DPCP. Discussion/Conclusion: H-DPCP is a cost-effective and time-efficient alternative treatment option for severe AA patients.

New Donor Excision Design for Better Hair Alignment in Hair Restoration Surgery.

BACKGROUND: The linear scar and misalignment of hair follicles are disadvantages of the follicular unit transplantation (FUT) or strip technique. The most common misalignment is at the end of the strip. Although most surgeons try to match hair direction to achieve optimal hair alignment, their attempts are often unsuccessful. OBJECTIVES: We aimed to assess strip designs to improve hair alignment during hair transplantation. METHODS: We conducted a retrospective study of 157 patients who underwent hair transplantation with either the commonly used elliptical incision or our novel triangular flag-shaped designed incision on the donor strip tip. Two blind evaluators assessed the outcome of hair alignment using a 5-point visual analog scale. RESULTS: In total, 303 wounds on 157 patients were assessed. Overall, our triangular flag-shaped design (TFD) achieved better hair alignment than the common elliptical design (CED) (p=0.01). Patients with hair direction straight on the upper wound edge and hair direction inward on the lower wound edge showed improved outcomes with TFD, whereas patients with hair direction inward on both upper and lower wound edges showed better outcomes with CED. CONCLUSIONS: The TFD tip of donor strips achieved proper hair alignment for most hair transplant patients. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Postsurgical Transient Hypertrichosis Around Healing Wound After Total Knee Arthroplasty: A Case Report.

Hypertrichosis is a condition characterized by the presence of an abnormal increase in the number of hairs and either occurs in a localized pattern or a generalized pattern. Localized hypertrichosis around a healing wound is an infrequent postsurgical complication. A 60-year-old Asian man came for a consultation because of an increase in the amount of hair around his 2-month postsurgical wound of right knee arthroplasty. Neither history of topical medications nor systemic medications, which can cause hypertrichosis, were presented. A diagnosis of postsurgical hypertrichosis was made clinically without any laboratory investigations. The patient was reassured that the medication was not necessary and he was appointed for follow-ups. Within the next 4 months, the hypertrichosis resolved spontaneously without any treatment. The case demonstrates the correlation between wound healing and hair morphogenesis, especially as both processes involve some similar growth factors and signaling molecules. Further studies might lead to discovery and better management of hair disorders.