Background: Teledermatology is the application of information and telecommunication technologies in the field of dermatology to provide remote care services based on the exchange of clinical information within a network of professionals or between professionals and patients. Tele-trichoscopy is a non-invasive, inexpensive, and easy-to-use method that applies the principle of surface microscopy at different magnifications. Alopecia areata is a non-scarring alopecia with a chronic evolution, which often needs a close follow-up. Objectives: The aim of our work was to analyze the possible benefits of telemedicine for the follow-up of patients with alopecia areata. Materials and Methods: We enrolled patients with alopecia areata, identified during the first trichological evaluation, and we divided the patients into two groups. One group was provided with the devices necessary for a telemedicine follow-up. The other group had a conventional follow-up. The total follow-up time was one year. All of the patients’ photos were blindly evaluated by a team of expert dermatologists who were asked to indicate the quality of the images. The photos were also evaluated to identify disease markers. During the follow-up period, questionnaires were administered to both groups of patients to assess the quality of the visit, the level of patient satisfaction, and to identify any issues encountered by the patients. Results: There was a high degree of concordance between the images obtained by outpatient trichoscopy and those obtained by telemedicine. The satisfaction levels were the same between the patients followed via telemedicine and those seen in the outpatient clinic. Conclusions: Telemedicine applied to trichology using trichoscopy was proven to be a valid system for managing the follow-up of patients suffering from chronic recurrent scalp diseases and, above all, for maintaining continuity of care.

Background and Objectives: Ritlecitinib is a selective Janus kinase 3 and TEC family kinase inhibitor approved for the treatment of severe alopecia areata (AA). Real‐world prospective data remain limited, particularly regarding response dynamics beyond mean severity scores. The objective of this study was to evaluate the real‐world effectiveness and safety of ritlecitinib in patients with severe AA and to characterize patterns of treatment response by integrating clinical severity metrics and trichoscopic findings. Methods: This prospective single‐center cohort study included adults with severe AA (baseline Severity of Alopecia Tool [SALT] ≥ 50) treated with ritlecitinib 50 mg once daily. Clinical assessments were performed at baseline and Weeks 4, 12, and 24. Outcomes included longitudinal changes in the SALT score, achievement of SALT ≤ 20, transitions across severity categories, and trichoscopic markers of disease activity and regrowth. Safety and laboratory parameters were monitored through Week 24. Results: Thirty patients completed follow‐up through Week 24. Mean SALT decreased from 79.7 ± 22.0 at baseline to 44.5 ± 37.2 at Week 24. Thirteen of 30 patients (43.3%; 95% CI: 27.4–60.8) achieved SALT ≤ 20 by Week 24. Distribution‐based analyses demonstrated a progressive shift toward lower SALT values and transitions from severe to milder disease categories in a subset of patients. Trichoscopic evaluation showed an early and progressive increase in regrowth hairs from Week 4 onward, while traditional activity markers remained frequently detectable. Patient‐reported outcomes also improved over follow‐up, with significant reductions in Skindex‐16 and HADS anxiety and depression scores. No serious adverse events or treatment discontinuations occurred; laboratory parameters remained largely stable. Conclusions: In this prospective real‐world cohort, ritlecitinib demonstrated clinically meaningful effectiveness and a favorable midterm safety profile in severe AA. Integrating continuous, categorical, and trichoscopic outcomes provides a nuanced characterization of treatment response beyond mean severity measures alone.

Background/Objectives: Alopecia areata (AA) and psoriasis are immune-mediated diseases that can coexist, suggesting shared pathogenic mechanisms. While Janus kinase inhibitors (JAKi) are approved for AA treatment, their role in managing concomitant psoriasis and psoriatic arthritis (PsA) remains unclear. This study evaluates the efficacy and safety of baricitinib in patients with severe AA and coexisting psoriasis and/or PsA. Materials and Methods: A retrospective case series of five patients (mean age 53.2 years) with severe AA (SALT > 80) or alopecia universalis (AU) and concomitant psoriasis (n = 2) and/or PsA (n = 3) was conducted in the Dermatology Unit of Policlinico of Tor Vergata, Catholic University of the Sacred Heart and La Sapienza University of Rome, Italy. Patients received baricitinib 4 mg/day and were assessed at weeks 4, 24, and 52 using SALT, PASI, and pVAS scores. Results: At week 52, one patient achieved complete AA remission, while two improved to SALT < 20 (mean SALT 83 to 8.75). Psoriasis remained stable (mean PASI 1.4 to 0.5). However, one PsA patient worsened (pVAS 9) and discontinued the treatment. Conclusions: Baricitinib was effective for AA, with potential benefits for psoriasis, but it may not be optimal for PsA. Further studies are needed to define its role in multiple immune diseases.

Background: Male pattern hair loss is the most common form of hair loss in men, occurring in specific patterns. Contributing factors include hormonal changes, stress, malnutrition, and insufficient blood microcirculation.Objective: Topical applied dimethylglycine sodium salt (DMG‐Na) has been identified to increase skin microcirculation by activating endothelial nitric oxide synthase and inducing nitric oxide production. Given the importance of sufficient microcirculation on hair growth, the goal of this study was to evaluate the effectiveness of topically applied DMG‐Na in combination with caffeine against male pattern hair loss.Methods: A 24‐week, double‐blind, randomized, placebo‐controlled trial was conducted on 154 men with male pattern hair loss, treated with a DMG‐Na and caffeine‐containing shampoo or the corresponding placebo. The primary efficacy parameter was the change in the number of hairs pulled via hair pull test from baseline to 6 months of daily product application. Clinical efficacy was further evaluated via phototrichogram analysis on a subgroup of 30 subjects.Results: The decreased number of hairs pulled during the hair pull test after 6 months of active shampoo application was significantly higher compared to the placebo (−2.8 ± 1.6 vs. 0.6 ± 2.2; p < 0.001), with no reported adverse events. Phototrichogram results showed an increase in the number of hairs, hair density, and percentage of anagen hairs after 6 months of active shampoo usage (p < 0.001).Conclusion: The clinical efficacy of this novel DMG‐Na and caffeine‐containing shampoo demonstrates significant potential against male pattern hair loss, offering promising results without any undesirable side effects.