Overview and Algorithmic Approach to Management of Male and Female Pattern Hair Loss

Male and female pattern hair loss (PHL) is an innocuous condition, but it has a major psychological impact on the sufferer. This paper aims to provide a simple algorithmic approach toward diagnosis, staging, and treatment of PHL in males and females. It also aims at simplifying the decision-making process for the surgeon with regard to timing and extent of procedure for hair transplant surgeries. Various treatment options, their merits and demerits, along with scientific evidence supporting or not supporting the treatment options are discussed in detail.     

Guidelines for Pubic Hair Restoration

Background Although the loss of pubic hair is a relatively frequent condition, there have been few reports about pubic hair restoration. This report aims to describe the demarcation and technical guidelines for pubic hair restoration using follicular micrografts. Methods Demarcation is described and based on anatomic parameters such as the level of the greater trochanters and the labium majus. The angle of micrograft insertion and direction also are described. Results The use of micrografts for pubic hair restoration is a procedure that promotes very natural results. Conclusions The described parameters of demarcation and technical details are important issues that should be considered to obtain a natural result in pubic hair restoration.     

肝移植术前影像学检查的综合评价

目的 综述肝脏移植术前各种影像学检查方法的综合应用价值。方法 介绍适用于肝移植术前供、受体影像学检查的各种方法。通过影像学检查评估活体供肝和受体的肝脏体积、肝实质、肝脏血管系统、胆道系统及肝外情况,并根据相关影像学表现,综合评述各种方法的优缺点。结果 传统影像学方法仍有部分应用价值。但断面影像学手段(超声、CT和MR1)正在发挥着越来越重要的作用。CT检查能提供各种丰富、准确的信息,“一站性”MR1综合检查极具优势。结论 各种影像学检查方法都有其优势和局限。能够同时反映多种所需信息的现代影像学检查方法在肝移植术前具有较大的应用前景。     

Bitemporal Scalp Hair Loss: Differential Diagnosis of Nonscarring and Scarring Conditions

BACKGROUND: Bitemporal hair loss can be a diagnostic challenge because several entities may affect this region of the scalp, including both scarring and nonscarring conditions. Although traction alopecia is the most common cause of bitemporal hair loss, no studies to date have outlined all of the potential causes. OBJECTIVE: We sought to review nonscarring and scarring conditions that have a clinical presentation of bitemporal hair loss, including traction alopecia, telogen effluvium, female pattern hair loss, frontal fibrosing alopecia, central centrifugal cicatricial alopecia, and seborrheic dermatitis. METHODS: A Google Scholar and PubMed literature search were conducted for this review. The keywords used in the search included the following: “traction alopecia”, “telogen effluvium”, “androgenic alopecia”, “androgenetic alopecia”, “female pattern hair loss”, “alopecia areata”, “frontal fibrosing alopecia”, “central centrifugal cicatricial alopecia”, and “seborrheic dermatitis”. The scope of our search included all research articles published from 1957 to February 2019. In total, 94 articles regarding non-scarring and scarring hair loss were selected and included according to topic relevance. Exclusion criteria included articles that did not address the epidemiology and/or clinicopathologic or dermatoscopic findings of non-scarring and scarring forms of alopecia. Inclusion criteria included articles that addressed a clinical presentation of bitemporal hair loss; or addressed epidemiology, clinical presentation, dermatoscopic findings, and/or treatment. RESULTS: Bitemporal hair loss is a common and often distressing condition with a broad differential. CONCLUSION: Clinicians must be aware of the potential causes of bitemporal hair loss. Prompt diagnosis is essential to prevent further hair loss, especially in scarring conditions.     

The scalp as a favorable donor site for limited-sized split-thickness skin grafts in comparison to the thigh donor site

We compared the split-thickness skin graft donor sites of hair bearing scalp (n=86) and thigh (n=27) in 113 patients, predominantly adults over a 6-month period. Donor site morbidity (pain, epithelialization, scars) was evaluated, including intensity and duration of pain, number of dressing changes, and duration of epithelialization of the wound. Graft thickness and quality was identical in the two groups. Patients with grafts from the scalp had fewer complaints than those with grafts from the thigh; they also had faster reepithelialization. Costs for staff and material related to the frequency and duration of dressing changes were significantly lower in patients with scalp grafts. The limited size of these grafts must be considered. The scalp as a donor site has the advantage of lower donor site morbidity with minimal pain and fast epithelialization. There was no scarring or alopecia in any of the patients.     

毛发移植在修复眉缺损中的临床效果

目的 探讨实施自体毛发移植术对眉缺损的修复效果。方法 选取我院2021年1月-2022年12月收 治接受修复手术的150例眉缺损患者为研究对象。150例患者均接纳自体毛发移植术治疗,记录毛囊数量、 手术时间并发症发生率、成活率、毛发脱落率以及再植次数以及患者满意度。结果 150例患者中,所钻取 毛囊数量50~600个毛囊;35~180 min完成修复术;二次眉毛接种者有14人;受区眉毛成活率70%~90%;全 部病例的供区组织恢复效果良好,术区无并发症发生;满意度为99.33%。结论 对眉缺损患者实施自体毛 发移植术的整体修复效果良好,且具有较强的安全性,成活率较高,值得临床应用。     

针对性护理在女性不剃发植发围手术期的应用效果

目的 探讨在女性不剃发植发围手术期应用针对性护理的效果。方法 选取2021年3月-2023年5月于 我院行前发际线毛发移植手术的80例女性患者为研究对象,随机分为对照组和研究组,每组40例。对照 组实施常规护理,研究组实施针对性护理,比较两组毛囊成活率、护理满意度、心理状况、并发症发生情 况及疼痛程度。结果 研究组术后6个月毛囊成活率高于对照组（P ＜0.05）;两组术后9个月毛囊成活率比 较,差异无统计学意义（P ＞0.05）;研究组护理满意度为100.00%,高于对照组的80.00%（P ＜0.05）;两 组护理后SAS、SDS评分均低于护理前,且研究组低于对照组（P ＜0.05）;研究组并发症发生率为5.00%, 低于对照组的22.50%（P ＜0.05）;研究组术后24、48、72 h VAS评分均低于对照组（P ＜0.05）。结论 针 对性护理在女性不剃发植发围手术期的应用效果确切,可提高早期毛囊成活率,有效降低术后并发症发生 风险及疼痛程度,能够缓解患者的焦虑、抑郁情绪,提升护理满意度。     

自体头发单体毛囊移植治疗永久性秃发的疗效评价

目的采用自体枕部头发分离成单体毛囊，移植治疗永久性秃发（雄激素源性秃发及瘢痕性秃发），评价其效果。方法取患者自体枕部的头发优势区的毛发，在手术放大镜下将其分成含有1～4根毛发的单体毛囊，用小植发刀在受区根据术前设计作2mm的小切口，用显微手术镊取已分离好的单体毛囊，植入切口内。结果我科于2003年10月至2007年10月共手术163例，大部分患者术后移植的毛发均生长良好。结论自体毛发单体毛囊移植术治疗永久性秃发，手术效果好，手术创伤小，外观较满意。     

Novel skin graft donor site for the scalp transposition flap

Transposition scalp flaps are a versatile solution for soft-tissue cover in a multitude of scalp defects. They are frequently used to reconstruct larger skin cancers that involve the outer table of the cranium in addition to covering neurosurgical bony defects and hardware. The transposition flap requires the donor site to be grafted using a split-thickness graft, which results in a secondary wound elsewhere on the body, commonly the lateral thigh. Although quite routine in such surgery, this procedure does require another body area to be prepared and draped. We sought to streamline this procedure with an adjustment to the location of the donor site. In harvesting the graft from the skin of the flap itself, we localised all surgery to one area, which has a number of logistical and patient-care advantages. Our experience has shown significant benefits from this technique and this is now our chosen and recommended donor site for these reconstructions.     

自体毛囊种植修复鬓角缺损

目的:探索应用自体毛囊种植修复鬓角缺失的效果。方法:对67例患者,采用枕后安全区头皮,分离成含1～2个毛囊单位的移植物,利用针头穿刺打孔或植发器将毛发移植到缺损处以修复形态,每位患者每侧移植200～600个毛囊单位(U),植入密度为30～40U/cm2。结果:植入毛发生长良好,再造鬓角形态及方向与正常较为一致,效果满意。结论:自体毛囊移植可按设计形态种植修复鬓角形态,具有形态好,创伤小的特点,是修复小面积及形态不规则的鬓角缺损的最佳选择。     

Reconstruction of the temporal hairline

Reconstruction of the temporal hairline is usually discouraged because of unsuccessful results. A technique using punch hair grafts and micrografts is presented that has shown good cosmetic results.     

Comparison of Dermoscopic Findings in Female Androgenetic Alopecia and Telogen Effluvium and Female Controls in a Tertiary Care Center

BackgroundFemale androgenetic alopecia (FAGA) is a patterned hair loss caused by progressive miniaturization of hair follicles. This leads to reduction in the number and thickness of hairs, especially in the central, frontal, and parietal scalp regions. Telogen effluvium (TE) is characterized by diffuse hair loss within months of a significant systemic stressor because of premature follicular transition from the anagen to the telogen.ObjectiveThis article aims to highlight the dermoscopic differences between TE and FAGA compared to healthy female controls.MethodsA total of 124 female patients, which included 31 women with clinical diagnosis of FAGA, 33 with TE, and 60 controls, were enrolled. Two dermatologists independently assessed each patient clinically as well as with dermoscope, recorded the history and examination findings on a proforma, and made a diagnosis. These dermoscopic images were later revised in photographs on the computer.ResultsThere was a statistically significant difference in hair diameter diversity (HDD) between patients with FAGA versus TE and FAGA versus controls (p<0.0001). The difference in the mean percentage of single PSU in both frontal and occipital areas in FAGA versus controls and FAGA versus TE patients was statistically significant. The vellus hair were significantly higher in the FAGA patients than TE and control.ConclusionDermoscopic features of FAGA and TE will help in early detection on the basis of increased proportion of thin and vellus hairs, HDD, perifollicular discoloration, and the presence of a variable number of yellow dots.