Hair Shaft Abnormalities as a Dermoscopic Feature of Mycosis Fungoides: Pilot Results.

INTRODUCTION: Diagnosis of persistent erythematous, scaly patches, or plaques can be complex since psoriasis (Ps), eczematous dermatitis (ED), and mycosis fungoides (MF) can be considered. Dermoscopy, which is a noninvasive diagnostic tool, is commonly used to examine blood vessels, scales, and background color; however, research on hair shaft evaluation in inflammatory dermatoses remains scarce. The aim of the study was dermoscopic evaluation of hair shafts in skin lesions localized on the non-scalp skin areas in patients diagnosed with MF, Ps, and ED. METHODS: This was a retrospective evaluation of 55 patients diagnosed with MF, Ps, and ED. Photographic and dermoscopic documentation of these patients and detailed medical history were evaluated. RESULTS: A total of 21 patients with MF, 21 patients with Ps, and 13 patients with ED were evaluated. The examination revealed the presence of various abnormalities of hair shafts (e.g., numerous pili torti, single pili torti, 8-shaped hairs, pigtail hairs, broken hairs, hair shafts rapidly tapered over long sections, hair shafts irregular in thickness, angulated hairs, branched hairs, the presence of trichorrhexis nodosa, and monilethrix-like hairs), yellow dots, and black dots. The presence of pili torti was found in 80% of patients with MF, compared with 16% of patients with Ps and 8% of patients with ED (p < 0.005), with multiple pili torti found only in MF patients (67%) (p < 0.005). Statistically significant differences also applied to hair shafts rapidly tapering over long sections and 8-shaped hairs, which occurred only in MF patients (p < 0.005 and p = 0.035, respectively). CONCLUSIONS: The presence of hair shaft abnormalities such as numerous pili torti, 8-shaped hairs, and hair shafts rapidly tapering over long sections is an important criterion that should be considered in the dermoscopic differentiation of the patchy/plaque mycosis fungoides and inflammatory dermatoses, such as psoriasis and eczematous dermatitis localized on the non-scalp skin areas.

Risk Factors and Hazards of Recipient-Area Perifollicular Erythema After Hair Transplantation: A Multicenter Retrospective Cohort Study.

BACKGROUND: Recipient-area perifollicular erythema (RPE) may delay graft growth after hair transplantation. However, there is currently a lack of observational clinical studies of RPE. OBJECTIVE: To study the clinical features and risk factors associated with RPE while analyzing its correlation with graft growth. METHODS: We conducted a multicenter retrospective cohort study between June 2020 and January 2023. RESULTS: A total of 1090 participants were included, 178 (16.33%) showed mild RPE, 56 (5.14%) showed moderate RPE, and 10 (0.92%) showed severe RPE. Patients with RPE had severe hair shaft shedding (P < 0.001) and a lower survival rate (P < 0.001) of grafts. Logistic regression analysis showed that folliculitis is a significant risk factor for mild RPE (OR 6.061, 95% CI 3.343-10.991, P < 0.001) and moderate RPE (OR 3.397, 95% CI 1.299-8.882, P = 0.013). Besides, untimely first postoperative hair washing was associated with the development of moderate RPE (OR 0.724, 95% CI 0.553-0.947, P = 0.018) and severe RPE (OR 1.553, 95% CI 1.156-2.086, P = 0.003). CONCLUSION: RPE is a postoperative complication closely related to high hair shaft shedding proportion and low graft survival rate. Both postoperative folliculitis and untimely first postoperative hair washing may induce the occurrence of RPE. LEVEL OF EVIDENCE III: 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 .

Quantitative Analysis of Hair Luster in a Novel Ultraviolet-Irradiated Mouse Model.

Hair luster is a key attribute of healthy hair and a crucial aspect of cosmetic appeal, reflecting the overall health and vitality of hair. Despite its significance, the advancement of therapeutic strategies for hair luster enhancement have been limited due to the absence of an effective experimental model. This study aimed to establish a novel animal model to assess hair gloss, employing ultraviolet (UV) irradiation on C57BL/6 mice. Specifically, UVB irradiation was meticulously applied to the shaved skin of these mice, simulating conditions that typically lead to hair luster loss in humans. The regrowth and characteristics of the hair were evaluated using a dual approach: an Investigator's Global Assessment (IGA) scale for subjective assessment and an image-based pixel-count method for objective quantification. These methods provided a comprehensive understanding of the changes in hair quality post-irradiation. To explore the potential reversibility of hair luster changes, oral minoxidil was administered, a treatment known for its effects on hair growth and texture. Further, to gain insights into the underlying biological mechanisms, bulk RNA transcriptomic analysis of skin tissue was conducted. This analysis revealed significant alterations in the expression of keratin-associated protein (KRTAP) genes, suggesting modifications in hair keratin crosslinking due to UV exposure. These changes are crucial in understanding the molecular dynamics affecting hair luster. The development of this new mouse model is a significant advancement in hair care research. It not only facilitates the evaluation of hair luster in a controlled setting but also opens avenues for the research and development of innovative therapeutic strategies. This model holds promise for the formulation of more effective hair care products and treatments, potentially revolutionizing the approach towards managing and enhancing hair luster.

Lacrimal gland sinus generated by a retained cilium: case report and literature review.

Lacrimal gland stone(s) (LGSs) are rare and usually asymptomatic. LGSs should be distinguished from dacryoliths, as the former arise in the lacrimal gland. The aetiology of LGSs in many cases is likely related to a reaction to a hair within the palpebral lobe of lacrimal gland. Eye rubbing may contribute to the migration of the hair into the lacrimal gland. This case report describes the rare occurrence of an LGS with a central hair shaft (cilium) and associated sinus formation in a 39-year-old male presenting with persistent redness of, and discharge from the right eye for 4 weeks. Examination revealed a sinus opening onto the inferonasal surface of the palpebral lobe of the right lacrimal gland. The patient was treated with surgical excision of the sinus, with rapid and complete resolution of his symptoms.

A Unique Case of Pili Multigemini Complicated by Folliculitis: Unveiling the Intricacies of a Rare Hair-Follicle Disorder.

Pili multigemini is defined as the presence of two or more hair shafts in one hair follicle. It has mostly been reported to occur in the beard of men; however, it has been reported to occur uncommonly at other locations of the body as well. We present a rare case of a patient who presented with folliculitis on the abdomen which was incidentally detected as pili multigemini.

Profiling of hair proteome revealed individual demographics.

Human hair is often found at crime scenes, persists for a long time, and is a valuable biological specimen in forensic investigations. Hair contains minimal intact nuclear DNA for the discrimination of individual identity. In such cases, proteomics evaluation of hair proteins could provide an attractive alternative for protein-based human identification. Therefore, this study adopted a proteomic approach to profile hair shafts from both males and females across different ethnic populations including Chinese, Indians, Malays, and Filipinos in their 20-80 s. First, hair proteins were extracted by different methods to adopt the most suitable protocol that produced the highest extraction efficiency based on most significant enrichment of keratins and keratin-associated proteins. Abundance of hair keratins including both types I and II, and keratin-associated proteins, estimated using label-free quantification, showed distinguishable profiles, and the possibilities of distinguishing individuals within each ethnic origin. Similarly, several protein candidates and their abundances could be used to distinguish sex and age of individuals. This study explored the possibility of utilizing hair proteomics phenotyping in forensic science to differentiate individuals across various ethnic groups, sex and age.

Hair Shaft Disorders in Children - An Update.

Disorders of hair shaft are a diverse group of congenital and acquired abnormalities of the hair that can pose a diagnostic and therapeutic challenge to the dermatologists. Hair shaft abnormalities can occur as an isolated phenomenon or can be associated with an underlying genetic syndrome. Any change in the texture, appearance, and growth of the hair should prompt evaluation of the patient for the presence of any hair shaft anomaly. The diagnosis can be suggested by a complete history and physical examination of the hair-bearing areas as well as other ectodermal structures (nails and teeth). A key feature in the evaluation of hair shaft defects is to determine the fragility of the hair shaft that can be elucidated by performing the "tug test." Trichoscopy and light microscopy serve as valuable tools in establishing the specific type of hair shaft disorder. An update of the approach for the diagnosis and management is included in this review.

A review of bubble hair deformity.

Bubble hair deformity is an acquired abnormality characterized by air-filled cavity formations within the hair shaft, usually because of heat damage. Traditionally, bubble hair is diagnosed by visualization of characteristic bubbles under light microscopy. The increased utilization of trichoscopy (scalp dermoscopy) has led to its adoption in the diagnosis of many hair and scalp conditions, including bubble hair deformity. We sought to review clinical reports evaluating the patient profile, use of diagnostic imaging, and treatment options for bubble hair deformity. A systematic search of PubMed was performed in February 2021 using various keywords. Titles and abstracts were screened, leading to the selection of 11 case reports or series. The majority of patients were middle-aged Caucasian women who had used a heated tool to dry or style wet hair. Treatment consisted of cessation of heated tool usage. Light microscopy visualization of characteristic hair shaft cavities was used for diagnosis of bubble hair deformity in reports published prior to 2012. Diagnosis by trichoscopy was used in more recent reports. Our findings support the use of trichoscopy as a convenient and noninvasive method of diagnosing bubble hair deformity. More clinical studies are needed to evaluate the development of bubble hair deformity in ethnic hair.

Trichoscopic Diagnosis of Structural Hair Defects in a Clinical Setting: A Cross-Sectional Analytical Study.

BACKGROUND: Trichoscopy is a simple, noninvasive procedure practiced in the diagnosis of a multitude of scalp and hair disorders. Hair shaft abnormalities usually represent a diagnostic challenge to dermatologists. OBJECTIVES: The aim of the study was to determine the practicality, versatility, and value of using the handheld dermoscope in the assessment of hair shaft abnormalities and the diagnosis of different hair/scalp disorders. METHODS: Eight hundred and seven patients of both sexes, aged from 1 to 76 years, with complaints pertaining to scalp and hair, were the subjects of the study. All patients were examined by the handheld dermoscope, and 400 were additionally examined by the folliscope, digital dermoscope, or their hairs mounted for light microscopy. RESULTS: Based on trichoscopic findings, more than half the patients demonstrated thinned terminal hairs and a predominance of single-haired scalp pilosebaceous units (57% and 55.5%, respectively). Over a quarter of the patients showed hair diameter heterogeneity, upright regrowing hairs, and increased vellus hairs (37%, 31%, and 25%, respectively). Other trichoscopic findings included scalp scaling (19%), hair weathering (12%), thinned wavy hairs (10.5%), brush-like hair fractures (9%), exclamation mark hairs (9%), and longitudinal cleavage (trichoptilosis) (8%). The clinical diagnostic spectrum was topped by the following diagnoses in order of frequency: female pattern hair loss, telogen effluvium, traction alopecia, and trichotillomania. Trichodynia appeared to be significantly associated with numerous hair shaft abnormalities. CONCLUSION: Most hair shaft abnormalities can be reliably diagnosed with high accuracy using a handheld dermoscope in an office setting. Skillful knowledge of dermoscopy is an important aid in the diagnosis of hair and scalp disorders.

[Morphologial changes in the hair follicle and hair shaft in old age.]

The work is based on the results of a microscopic examination of 46 men and 50 women who were examined at the medical center for the treatment of hair and skin in the period 2022-2023. Depending on the age of the subjects, they were divided into two groups. The first group included 52 people (25 men and 27 women) of young age (21-35 years old). The second group consisted of 44 people (21 men and 23 women) of senile age (75-86 years old). Hair sampling was performed in the temporal region of the head by combing out the hair that had already fallen out with a comb (they did not pull it out of the skin!). The sample of this study consisted of conditionally healthy individuals of the Slavic phenotype. The width of the hair follicle and the hair shaft were calculated. The results of this lifetime comparative analysis of the linear dimensions of the hair follicle and the hair shaft in the temporal region in persons of both sexes of young and old age allow us to expand the understanding of the features of their age-related changes, and further continue detailed study, since new knowledge is necessary for the development of modern methods for the prevention of age-associated pathologies of the scalp.

Vitamins and their derivatives synergistically promote hair shaft elongation ex vivo via PlGF/VEGFR-1 signalling activation.

BACKGROUND: Although vitamins or their derivatives (Vits), such as panthenyl ethyl ether, tocopherol acetate, and pyridoxine, have been widely used in topical hair care products, their efficacy and mode of action have been insufficiently studied. OBJECTIVE: To elucidate the biological influence of Vits on hair follicles and determine the underlying mechanisms. METHODS: A mouse vibrissa hair follicle organ culture model was utilized to evaluate the effects of Vits on hair shaft elongation. Gene and protein expression analyses and histological investigations were conducted to elucidate the responsible mechanisms. A human hair follicle cell culture was used to assess the clinical relevance. RESULTS: In organ culture models, the combination of panthenyl ethyl ether, tocopherol acetate, and pyridoxine (namely, PPT) supplementation significantly promoted hair shaft elongation. PPT treatment enhanced hair matrix cell proliferation by 1.9-fold compared to controls, as demonstrated by Ki67-positive immunoreactivity. PPT-treated mouse dermal papillae exhibited upregulated Placental growth factor (Plgf) by 1.6-fold compared to controls. Importantly, the addition of PlGF neutralizing antibodies to the ex vivo culture diminished the promotive effect on hair growth and increase in VEGFR-1 phosphorylation achieved by PPT. A VEGFR-1 inhibitor also inhibited the promotion of hair growth. Microarray analysis suggested synergistic summation of individual Vits' bioactivity, putatively explaining the effect of PPT. Moreover, PPT increased PlGF secretion in cultured human dermal papilla cells. CONCLUSION: Our findings suggested that PPT promoted hair shaft elongation by activating PlGF/VEGFR-1 signalling. The current study can shed light on the previously underrepresented advantage of utilizing Vits in hair care products.

Deep coverage proteome analysis of hair shaft for forensic individual identification.

Hair shaft is one of the most common biological evidence found at crime scenes. However, due to the biogenic degradation of nuclear DNA in hair shaft, it is difficult to achieve individual identification through routine DNA analysis. In contrast, the proteins in hair shaft are stable and contain genetic polymorphisms in the form of single amino acid polymorphisms (SAPs), translated from non-synonymous single nucleotide polymorphisms (nsSNPs) in the genome. However, the number of SAPs detected still cannot meet the requirements of practical applications. This paper developed a deep coverage proteome analysis method by combining a three-step sequential ionic liquid-based protein extraction and 2D-RPLC-MS/MS with high and low pH to identify both variant and reference SAPs from 2-cm-long hair shafts. We identified 632 ± 243 protein groups from 10 individuals, with the average number of SAPs reaching 167 ± 21/person. These were further used to calculate random match probabilities (RMPs), a widely accepted forensic statistical term for human identification. The RMPs ranged from 6.53 × 10-4 to 3.10 × 10-14 (median = 2.62 × 10-8) when calculated with frequency of matching nsSNP genotype data from exomes, and ranged from 2.62 × 10-3 to 2.07 × 10-10 (median = 4.88 × 10-6) with SAP genotype frequency. All these results indicate that the deep coverage proteomics method is beneficial for improving SAP-based forensic individual identification in hair shaft, with great potential in crime investigation.

Advances in nanotechnology-based hair care products applied to hair shaft and hair scalp disorders.

OBJECTIVE: Nanotechnology has been intensively applied to the development of novel cosmetic products for hair and scalp care during the last decades. Such a trend is corroborated by the fact that about 19% of the total nanocosmetics registered in the StatNano database are intended for hair and scalp care. Nanotechnology-enabled formulations based on nanoparticles, cyclodextrins, liposomes and nanoemulsions have emerged as novel approaches due to chemical stability and their controlled release. Regarding hair care formulations, nanocarriers can target the hair shaft, hair follicle and scalp. Therefore, they have been used to treat several hair disorders, including dandruff and other hair-damaging conditions. METHODS: This review addressed the most important nanocarriers applied to hair-related disorders improvement. Furthermore, the application for hair photoprotection and improvement of hair colour duration by nanotechnological formulations is also approached. Besides, we provided an overview of the current scenario of available nano-based commercial hair products and novel patented inventions. RESULTS: From the patent search, the Patent Cooperation Treaty was pointed as the most important depositing agency while the United States of America has been the most depositing country. On the contrary, according to the StatNano database, Brazil stands out in the hair care worldwide market, and it is also the main producer of hair cosmetics based on nanotechnology. CONCLUSION: As nano-based products offer several advantages over conventional cosmetics, it is expected that in future, there will be more research on nanocarriers applied to hair disorders, as well as commercial products and patent applications.

Au cours des dernières décennies, les nanotechnologies ont été intensivement appliquées au développement de nouveaux produits cosmétiques pour le soin des cheveux et du cuir chevelu. Cette tendance est corroborée par le fait qu'environ 19% du nombre total de nano-cosmétiques enregistrés dans la base de données StatNano sont destinés à la fois aux soins des cheveux et du cuir chevelu. Les formulations basées sur les nanoparticules, les cyclodextrines, les liposomes et les nano-émulsions sont devenues de nouvelles approches grâce à l'amélioration de la stabilité chimique des médicaments et des ingrédients actifs cosmétiques et à leur libération contrôlée. En ce qui concerne les formulations de soins capillaires, les nanocarriers peuvent cibler le follicule pileux, la tige des cheveux et du cuir chevelu. Par conséquent, ils ont été utilisés pour traiter plusieurs troubles capillaires, notamment les pellicules et d'autres affections capillaires. Dans cette revue, les nano-carriers les plus importants appliqués à l'amélioration des troubles liés aux cheveux ont été abordés. L'application pour la photoprotection des cheveux et l'amélioration de la durée de la couleur des cheveux par des formulations nanotechnologiques est également abordée. En outre, nous fournissons un aperçu du scénario actuel des produits capillaires commerciaux à base des nanotechnologies disponibles et des nouvelles inventions brevetées. D'après la recherche de brevets, le Traité de coopération en matière de brevets a été désigné comme l'agence de dépôt la plus importante, tandis que les États-Unis d'Amérique ont été le pays le plus déposant. Diversement, le Brésil se distingue sur le marché mondial des soins capillaires et il est aussi le principal producteur de cosmétiques capillaires basés sur les nanotechnologies. Par conséquent, comme les produits à base de nanotechnologies offrent plusieurs avantages par rapport aux cosmétiques conventionnels, on s'attend à ce que les recherches sur les nano-carriers appliqués aux troubles capillaires se multiplient à l'avenir, de même que les produits commerciaux et les demandes de brevets.

Keys to the diagnosis of hair shaft disorders: Part I. / Claves diagnósticas en displasias pilosas I.

Hair shaft disorders, involving dysplastic abnormalities in the shaft, may be either congenital or acquired. Two large categories have been defined according to the presence or not of hair fragility. A diagnosis can usually be made after taking a thorough medical history and performing a physical examination. Trichoscopy has become a useful, cost-effective tool in recent years, particularly for examining the hair of children, because it facilitates inspection without removal of hairs. Structural abnormalities in the hair shaft are sometimes clues to the diagnosis of more complex diseases in which early treatment can improve prognosis. This review describes key features that enable the diagnosis of the most common hair shaft disorders and discusses the various treatments currently available.

Keys to the Diagnosis of Hair Shaft Disorders: Part II. / Claves diagnósticas en displasias pilosas II.

Hair shaft disorders, involving dysplastic abnormalities in the shaft, may be caused by genetic mutations or acquired through environmental exposures. The second part of this review presents these disorders classified according to the degree of hair fragility. It is important to take a thorough medical history and examine the hair to detect changes in texture, density, quality, and whether fragility is observed or not. Trichoscopy is a useful, noninvasive tool that can suggest a diagnosis in most cases. Specific treatments for hair shaft disorders are not available at present. We recommend general care practices to prevent hair damage; examples are avoiding excessive brushing, chemical products, hairstyles that introduce tension, and exposure to excessive heat. Some hair shaft disorders improve with puberty. Others may respond to treatments such as topical applications of minoxidil.

Acquired Trichorrhexis Nodosa Secondary to Trichoteiromania: Prompt Diagnosis Using Trichoscopy.

Trichorrhexis nodosa (TN) is a common hair shaft defect that develops as a result of excessive physical or chemical trauma. Microscopy is considered the gold standard for its diagnosis. Outpatient diagnosis thus becomes difficult in the absence of availability of microscope. Trichoscopy is emerging as an excellent tool in outpatient diagnosis of hair shaft defects. Here, we report a young girl with localized TN secondary to trichoteiromania where trichoscopy clinched the diagnosis. Classical appearance of nodes in hair shaft and transverse hair shaft fractures producing "two brooms stuck in opposite direction" was evident. This case is being reported to emphasize the advantages of trichoscopy in quick diagnosis of hair shaft defects with review of published literature.

Claves diagnósticas en displasias pilosas I / Keys to the diagnosis of hair shaft disorders: Part I

Las displasias pilosas corresponden a alteraciones en la estructura del tallo del cabello y pueden ser congénitas o adquiridas. Se clasifican en dos grandes grupos según la presencia o no de fragilidad capilar. En la mayoría de los casos la valoración del paciente, la anamnesis y la exploración física nos llevarán al diagnóstico. En los últimos años, el uso de la tricoscopia se ha posicionado como una técnica útil y coste efectiva, sobre todo en niños, ya que permite lograr una adecuada exploración sin tener que arrancar los cabellos. En algunas ocasiones las alteraciones en la estructura del cabello serán la clave diagnóstica de enfermedades más complejas, en las que la instauración de un tratamiento precoz puede mejorar el pronóstico. El propósito de esta revisión es aportar las claves que permitan diagnosticar las displasias pilosas más frecuentes y valorar las alternativas terapéuticas disponibles en la actualidad (AU)

Hair shaft disorders, involving dysplastic abnormalities in the shaft, may be either congenital or acquired. Two large categories have been defined according to the presence or not of hair fragility. A diagnosis can usually be made after taking a thorough medical history and performing a physical examination. Trichoscopy has become a useful, cost-effective tool in recent years, particularly for examining the hair of children, because it facilitates inspection without removal of hairs. Structural abnormalities in the hair shaft are sometimes clues to the diagnosis of more complex diseases in which early treatment can improve prognosis. This review describes key features that enable the diagnosis of the most common hair shaft disorders and discusses the various treatments currently available (AU)

[Translated article] Keys to the Diagnosis of Hair Shaft Disorders: Part I / Claves diagnósticas en displasias pilosas I

Hair shaft disorders, involving dysplastic abnormalities in the shaft, may be either congenital or acquired. Two large categories have been defined according to the presence or not of hair fragility. A diagnosis can usually be made after taking a thorough medical history and performing a physical examination. Trichoscopy has become a useful, cost-effective tool in recent years, particularly for examining the hair of children, because it facilitates inspection without removal of hairs. Structural abnormalities in the hair shaft are sometimes clues to the diagnosis of more complex diseases in which early treatment can improve prognosis. This review describes key features that enable the diagnosis of the most common hair shaft disorders and discusses the various treatments currently available (AU)

Las displasias pilosas corresponden a alteraciones en la estructura del tallo del cabello y pueden ser congénitas o adquiridas. Se clasifican en dos grandes grupos según la presencia o no de fragilidad capilar. En la mayoría de los casos la valoración del paciente, la anamnesis y la exploración física nos llevarán al diagnóstico. En los últimos años, el uso de la tricoscopia se ha posicionado como una técnica útil y coste efectiva, sobre todo en niños, ya que permite lograr una adecuada exploración sin tener que arrancar los cabellos. En algunas ocasiones las alteraciones en la estructura del cabello serán la clave diagnóstica de enfermedades más complejas, en las que la instauración de un tratamiento precoz puede mejorar el pronóstico. El propósito de esta revisión es aportar las claves que permitan diagnosticar las displasias pilosas más frecuentes y valorar las alternativas terapéuticas disponibles en la actualidad (AU)