Background
Female Pattern Hair Loss (FPHL) is one of the most common types of hair loss in women. It is characterized by progressive follicular miniaturization leading to diffuse hair thinning over the midfrontal scalp with a negative impact on quality of life. Pharmacological treatments are commonly used, and hair follicle transplantation is an option for those cases with adequate donor area. Minimally invasive procedures, such as microneedling, mesotherapy, microinfusion of drugs into the scalp with tattoo machines (MMP®), and platelet‐rich plasma (PRP) have been reported as adjuvant treatments.
Aims
This study aims to summarize and discuss the efficacy of minimally invasive procedures described for the management of FPHL.
Methods
Published articles indexed on the Pubmed database and Scopus that described minimally invasive procedures for the management of FPHL in humans were considered. Citations were reviewed and added for completeness. The search was for articles in English only. After excluding duplicate titles, 23 relevant articles were considered.
Conclusion
Minimally invasive procedures are promising options and may play a role in FPHL treatment. They can be used as adjunctive therapy for FPHL, in case of poor response to clinical therapy, or when patients prefer other care than the standard. We reinforce that these methods should be performed by an experienced medical professional following strict aseptic techniques. However, microneedling, mesotherapy, MMP, and PRP lack standardization and are supported by a low level of evidence yet. For the future, larger randomized clinical trials are essential to determine the efficacy and optimal protocols for these treatments.
Scalp seborrheic dermatitis (SSD) is a prevalent chronic, relapsing inflammatory skin disease. The etiology is related to sebum production, bacterial proliferation – <i>Staphylococcus</i> sp., <i>Streptococcus</i>, and <i>M. restricta</i> – and host immunity factors – NK1+, CD16+ cells, IL-1, and IL-8. Trichoscopy features include mostly arborizing vessels and yellowish scales. New trichoscopic findings were described to guide the diagnosis as dandelion vascular conglomerate, “cherry blossom” vascular pattern, and intrafollicular oily material. Antifungals and corticosteroids constitute the essential therapy, but new treatments have been described. This article aims to review and discuss the etiology, pathophysiology, trichoscopy, histopathologic findings, main differential diagnoses, and therapeutic options of SSD.
Dowling-Degos disease (DDD) is a rare autosomal-dominant genodermatosis and it has been associated with hidradenitis suppurativa (HS). Deregulation of NOTCH pathway has been linked to the development of HS in DDD context (DDD-HS). However, molecular alterations in DDD-HS, including altered gene expression of NOTCH and downstream effectors that are involved in the follicular differentiation and inflammatory response, are poorly defined. We report two cases of patients diagnosed with DDD-HS, one of those, under Adalimumab treatment. Our results have shown downregulation of NOTCH1/ NCSTN pathway, distinct molecular profiles of inflammatory cytokines (IL23A and TNF), and a novel aberrant upregulation of genes involved in the cornified envelope (CE) formation (SPRR1B, SPRR2D, SPRR3, and IVL) in paired HS lesions of two DDD patients.
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