Type of publication:

Conference abstract

Author(s):

*Mehra S.

Citation:

British Journal of Dermatology. Conference: 105th Annual Meeting of the British Association of Dermatologists, BAD 2025. Glasgow United Kingdom. 193(Supplement 1) (pp i54), 2025. Date of Publication: 01 Jul 2025.

Abstract:

Trichoscopy has emerged as a pivotal diagnostic tool for evaluating scalp disorders. This systematic review assesses its diagnostic sensitivity, specificity and accuracy for various scalp conditions, proposing refinements to clinical protocols based on National Institute for Health and Care Excellence (NICE) and British Association of Dermatologists (BAD) guidelines. The aim is to provide recommendations for integrating trichoscopy into routine dermatology practice to optimize patient outcomes and diagnostic pathways. A systematic review was conducted following the PRISMA guidelines. The PubMed, MEDLINE and Embase databases were searched for studies published between 2010 and 2023. Keywords included 'trichoscopy', 'scalp disorders', 'diagnostic accuracy', 'sensitivity' and 'specificity'. Inclusion criteria encompassed studies evaluating the diagnostic performance of trichoscopy for common scalp conditions such as alopecia areata, androgenetic alopecia, telogen effluvium, scalp psoriasis, seborrhoeic dermatitis and tinea capitis. Only multicentre or single-centre studies with quantitative data were included. Exclusions included case reports and studies lacking statistical metrics. Data were analysed within the framework of the BAD and NICE recommendations to assess real-world applicability. Thirty-six studies involving 11 250 patients were included. Trichoscopy consistently demonstrated high diagnostic accuracy, surpassing traditional methods. (i) In alopecia areata, exclamation-mark hairs and black dots yielded 94% sensitivity and 92% specificity, aligning with BAD recommendations. (ii) In androgenetic alopecia, hair shaft diameter variability and perifollicular pigmentation showed 91% sensitivity and 89% specificity, supporting diagnostic integration. (iii) In telogen effluvium, empty follicles and short regrowth hairs demonstrated 86% sensitivity and 84% specificity, enabling earlier interventions. (iv) In tinea capitis, comma hairs and corkscrew hairs achieved 95% diagnostic accuracy, emphasizing the superiority of trichoscopy. (v) In scalp psoriasis and seborrhoeic dermatitis, differentiation was achieved using red dots, diffuse white scales and arborizing vessels, with 92% sensitivity. Reproducibility across centres was evident. Artificial intelligence (AI)-based algorithms were highlighted for enhancing diagnostic standardization, clinician training and accessibility. A national registry of trichoscopic images is proposed to improve data sharing and compliance with guidelines. In conclusion, trichoscopy is indispensable for diagnosing scalp disorders, offering a noninvasive, accurate alternative to biopsies. It enables earlier diagnosis, precise differentiation and improved outcomes, aligning with NICE and BAD guidelines. The results support the following recommendations. (i) Develop standardized trichoscopic criteria for scalp disorders. (ii) Include trichoscopic education in dermatology training. (iii) Invest in AI-based tools for image standardization. (iv) Establish a national trichoscopy registry for collaborative research. For application to clinical practice, this review provides actionable insights for enhancing diagnostic pathways and advancing the role in dermatology in trichoscopy, offering a foundation for improved patient care.

DOI: 10.1093/bjd/ljaf085.105

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Type of publication:

Conference abstract

Author(s):

*Mehra S.

Citation:

British Journal of Dermatology. Conference: 105th Annual Meeting of the British Association of Dermatologists, BAD 2025. Glasgow United Kingdom. 193(Supplement 1) (pp i34), 2025. Date of Publication: 01 Jul 2025.

Abstract:

The aim of this study was to evaluate the efficacy and safety of injectable bio-revitalizers and rejuvenative therapies licensed under Medicines and Healthcare products Regulatory Agency (MHRA) and National Institute for Health and Care Excellence (NICE) guidelines. These included platelet-rich plasma (PRP) and exosome-based treatments. This review synthesizes clinical outcomes, safety profiles and patient-reported satisfaction to provide evidence-based recommendations for advancing dermatological practice in the UK. A systematic review was conducted following the PRISMA guidelines. Databases including PubMed, MEDLINE, Embase and Cochrane Library were searched for studies published between 2010 and 2023. Keywords included 'injectable bio-revitalisers', 'hyaluronic acid', 'polynucleotides', 'platelet-rich plasma', 'exosome therapy', 'efficacy' and 'safety'. Inclusion criteria focused on licensed products approved in the UK under MHRA and NICE regulations, such as Profhilo, Restylane Skinboosters, Sunekos, Nucleofill, Juvelook, PRP and exosomebased therapies. Data extraction covered clinical efficacy (e.g. hydration, elasticity, wrinkle reduction), safety (e.g. adverse events, tolerability) and patient-reported outcomes. Twenty-six studies involving 2450 patients were included. Key findings highlighted consistent efficacy and safety across therapies. Hyaluronic acid-based bio-revitalizers (e.g. Profhilo, Restylane Skinboosters) improved hydration (20-25%), elasticity (15-18%) and wrinkle reduction, with patient satisfaction rates of 88-90%. Adverse events were limited to transient erythema and swelling. Polynucleotidebased therapies (e.g. Nucleofill, Juvelook) enhanced skin regeneration, provided antioxidant benefits and showed sustained results up to 6 months, with minimal adverse effects and improved firmness (18-22%). PRP showed moderate-to-significant improvements in skin texture and fine lines, with 76% of patients reporting enhanced skin quality. Adverse events were mild. Exosome-based therapies had emerging evidence indicating improvements in tone, texture and collagen stimulation, with high satisfaction rates (89%) and minimal adverse events. In conclusion, injectable bio-revitalizers, including PRP and exosome-based therapies, demonstrate high efficacy and safety profiles when adhering to MHRA and NICE guidelines. These therapies provide innovative, minimally invasive options for skin rejuvenation, with consistent patient satisfaction. Standardized treatment protocols, tailored patient selection criteria, and long-term studies are needed to optimize outcomes. PRP and exosome-based therapies expand regenerative dermatology and enhance patient care. Recommendations for practice are as follows: (i) incorporate PRP and exosome therapies into bio-revitalization strategies, emphasizing regenerative potential; (ii) develop national guidelines for standardized protocols; (iii) establish multicentre registries for tracking long-term outcomes and (iv) implement training programmes on appropriate use and safety considerations. This review offers a comprehensive evaluation of licensed bio-revitalizers and rejuvenate therapies, providing colleagues with evidence-based insights for improving patient care and advancing practice in aesthetic and therapeutic dermatology. The findings serve as a valuable teaching tool, fostering reflection on current practices and encouraging innovation within the field.

DOI: 10.1093/bjd/ljaf085.065

Link to full-text [no password required]

Type of publication:

Conference abstract

Author(s):

*Mehra S.

Citation:

British Journal of Dermatology. Conference: 105th Annual Meeting of the British Association of Dermatologists, BAD 2025. Glasgow United Kingdom. 193(Supplement 1) (pp i85), 2025. Date of Publication: 01 Jul 2025.

Abstract:

Hair loss in women is associated with profound psychological distress, affecting mental health, self-esteem and social functioning. This systematic review consolidates findings from qualitative studies to explore the psychological burden of hair loss and evaluate the efficacy of supportive interventions. The aim is to inform best practices for holistic, patient-centred management in dermatology clinics, aligning with National Institute for Health and Care Excellence guidelines and international protocols. This review adhered to the PRISMA guidelines, with a comprehensive search of the PubMed, MEDLINE, PsycINFO and Embase databases for qualitative studies published between 2010 and 2023. Keywords included 'psychological impact', 'hair loss', 'women', 'qualitative studies' and 'supportive interventions'. Inclusion criteria encompassed studies on the emotional and psychological burden of hair loss in women, with or without supportive interventions. Mixed-methods studies were included if qualitative data could be extracted. Singlecase studies and those without a psychological focus were excluded. Data were thematically synthesized to identify psychological impacts and assess the effectiveness of interventions such as counselling, peer support and cosmetic solutions. Twenty-six studies involving 1450 participants met the inclusion criteria. The key findings are reported here. (i) Emotional distress: hair loss caused significant emotional distress, with 78% of women reporting feelings of shame, anxiety or depression. Younger women and those with more extensive hair loss experienced greater psychological burdens. (ii) Impact on self-image: self-esteem was negatively affected in 85% of participants, with themes of loss of femininity and perceived diminished attractiveness. (iii) Social withdrawal: over 60% of women avoided social interactions due to embarrassment, compounding isolation and low selfworth. (iv) Supportive interventions: psychosocial therapies such as cognitive behavioural therapy (CBT) and peer support groups reduced anxiety and improved coping in 68%, while cosmetic solutions such as wigs, scalp micropigmentation and hairpieces enhanced confidence and social reintegration for 72%. Emerging themes underscored the importance of empathic clinician-patient communication, with patients emphasizing the need for guidance and emotional support alongside clinical care. Hair loss in women exerts a profound psychological impact on mental health, self-esteem and social functioning. Supportive interventions, including CBT, peer support and cosmetic solutions, effectively alleviate distress and enhance quality of life. A multidisciplinary approach integrating psychological support into routine care pathways is essential. Recommendations for practice are (i) to implement psychological assessments to identify at-risk patients; (ii) to develop integrated care models combining dermatological and psychological support; (iii) to create age-specific, culturally sensitive interventions and (iv) to educate patients on supportive therapies, fostering proactive engagement. This review highlights the critical need for dermatologists to address both the physical and psychological dimensions of hair loss, offering practical insights for patient-centred care. By incorporating psychological screening, empathetic communication and evidence-based supportive interventions, dermatology clinics can significantly improve patient outcomes.

DOI: 10.1093/bjd/ljaf085.164

Link to full-text [no password required]

Type of publication:

Conference abstract

Author(s):

*Mehra S.

Citation:

British Journal of Dermatology. Conference: 105th Annual Meeting of the British Association of Dermatologists, BAD 2025. Glasgow United Kingdom. 193(Supplement 1) (pp i119), 2025. Date of Publication: 01 Jul 2025.

Abstract:

This systematic review evaluates the correlation between nail changes and systemic diseases, assessing their diagnostic utility, sensitivity and specificity. The aim is to highlight the role of nail examination as a noninvasive diagnostic tool, enhancing dermatology practice and interdisciplinary care in line with National Institute for Health and Care Excellence (NICE) guidelines and clinical protocols. This practice is particularly relevant in resource-limited settings, where access to advanced diagnostics may be restricted. A systematic review was conducted following the PRISMA guidelines. The PubMed, MEDLINE and Embase databases were searched for studies published between 2010 and 2023 using keywords such as 'nail changes', 'systemic disease' and 'diagnostic indicators'. Studies were included that analysed correlations between nail abnormalities (e.g. clubbing, Beau's lines, splinter haemorrhages, leuconychia, onycholysis) and systemic diseases like cardiovascular, pulmonary, autoimmune or metabolic conditions. Case reports and studies without statistical analysis were excluded. Data extraction focused on nail abnormalities, associated systemic diseases, and diagnostic metrics such as sensitivity and specificity. Thirty-two studies involving 7250 patients were included. Key findings demonstrated significant correlations between nail changes and systemic diseases. (i) Clubbing was associated with pulmonary and cardiovascular conditions, such as bronchiectasis and congenital heart defects, with a specificity of 92%. (ii) Beau's lines were linked to systemic stressors like severe infections, chemotherapy and malnutrition, with a sensitivity of 81%. (iii) Splinter haemorrhages were observed in vasculitis, infective endocarditis and connective tissue disorders, with a sensitivity of 78%. (iv) Leukonychia was linked to hypoalbuminaemia and liver cirrhosis, with a specificity of 85%. (v) Onycholysis was indicative of thyroid dysfunction, particularly hyperthyroidism, with a diagnostic accuracy of 80%. In 30% of cases, nail changes preceded other clinical manifestations, offering opportunities for early diagnosis and intervention. While nail findings alone lacked specificity in some cases, combining them with clinical history and investigations enhanced utility. These findings are impactful in resource-limited settings, where noninvasive tools can guide early management without expensive testing. This review underscores the value of nail examination as a noninvasive tool for identifying systemic diseases, often serving as an early indicator of pathology. Nail changes such as clubbing, Beau's lines and leuconychia provide clinically significant insights, particularly when integrated with broader assessments. Increased awareness, standardized documentation and incorporation into practice can improve diagnostic accuracy and patient outcomes, especially in settings with limited access to advanced diagnostics. Nail examination is an underutilized diagnostic tool. It bridges dermatology and systemic medicine, prompting timely referrals and collaborative management. In resource-limited settings, it offers an accessible alternative, reducing reliance on costly tests. Standardized protocols should be integrated into NICE guidelines globally.

DOI: 10.1093/bjd/ljaf085.237

Link to full-text [no password required]

Type of publication:

Conference abstract

Author(s):

*Mehra S.

Citation:

British Journal of Dermatology. Conference: 105th Annual Meeting of the British Association of Dermatologists, BAD 2025. Glasgow United Kingdom. 193(Supplement 1) (pp i117-i118), 2025. Date of Publication: 01 Jul 2025.

Abstract:

Hair gloss treatments have gained popularity for enhancing shine, hydration and overall hair health. However, their safety profiles, formulation integrity and clinical efficacy remain under scrutiny within dermatology. This systematic review evaluates the efficacy, safety and formulation of licensed hair gloss products in the UK, examining compliance with Medicines and Healthcare products Regulatory Agency (MHRA) and National Institute for Health and Care Excellence guidelines. The review bridges academic findings with practical application, offering insights for patient care and regulatory considerations. A systematic review was conducted following PRISMA guidelines, covering studies published between 2010 and 2023. Databases searched included PubMed, MEDLINE, Embase and Cochrane Library, focusing on licensed UK products. Keywords included 'hair gloss', 'safety', 'efficacy', 'formulations' and 'adverse reactions'. Products analysed were Olaplex No. 6 Bond Smoother, Redken Shades EQ Gloss, Wella Professionals Shinefinity, and L'Oreal Professional DIA Light Gloss. Data extracted included efficacy metrics (e.g. shine, hydration and smoothness), safety outcomes (e.g. adverse reactions and ingredient profiles) and adherence to regulatory standards. Twenty-two studies and regulatory reports involving 1000 participants and 150 licensed products were analysed. Key findings include the following. (i) Efficacy. Shine and smoothness improved in 85% of users, with 72% noting enhanced hydration and reduced frizz. Benefits lasted 4-6 weeks. Products with panthenol and plant-based proteins showed superior efficacy, particularly for dryness and breakage. (ii) Safety profiles. While 82% of products adhered to MHRA standards, 18% contained harmful ingredients (e.g. formaldehyde derivatives, parabens and sulfates) linked to mild scalp irritation (9%), allergic responses (3%) and transient dryness (2%). Licensed products like Wella Professionals Shinefinity and L'Oreal DIA Light Gloss exhibited excellent safety profiles due to ammonia-free, conditioning-focused formulations. (iii) Formulation integrity. 'Ammonia-free' and plant-derived hydrating products had fewer adverse reactions and higher satisfaction. Non-clinical-grade products lacked standardized labelling and ingredient reporting, challenging safety and consistency. In conclusion, licensed hair gloss treatments offer significant cosmetic benefits with acceptable safety profiles. However, harmful additives in some formulations emphasize the need for stricter regulatory oversight and clinician guidance. Dermatologists play a key role in addressing patient concerns and optimizing outcomes. Recommendations for practice are as follows. (i) Dermatologists must educate patients on choosing licensed products and highlight risks of unregulated formulations. (ii) Stricter labelling standards and transparency are essential. (iii) Hair gloss treatments should be viewed as adjuncts to address hair health concerns. This review highlights the growing relevance of product safety and efficacy in patient consultations. With academic findings and real-world application, practitioners can better navigate the intersection of cosmetic science and clinical dermatology, ensuring that patient outcomes are both aesthetically and medically optimized. The reflections herein encourage dermatologists to critically assess the safety and utility of cosmetic products in practice, fostering an evidence-based approach.

DOI: 10.1093/bjd/ljaf085.233

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