Folliculitis decalvans (FD) is a primary cicatricial alopecia characterised by recurrent pustulation, tufting and progressive scarring hair loss. Familial clustering is rarely reported, limiting understanding of potential genetic susceptibility. We describe five cases of FD occurring in two unrelated families: three sisters with adolescent-onset disease and a mother-daughter pair with adult-onset disease, with a possible history in a preceding generation. Clinical and histopathological findings were consistent with FD in all cases. Staphylococcus aureus was identified in three of the affected individuals. Compared with previously reported familial cases, which predominantly involve male relatives or twins, this series represents the largest female-predominant familial cluster and the first clear mother-daughter occurrence. These findings support a potential heritable component in FD and highlight the need for further genomic and mechanistic studies.

Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disorder characterised by pruritus, epidermal barrier dysfunction, and immune dysregulation, significantly impacting quality of life. Conventional therapies, including corticosteroids, calcineurin inhibitors, and systemic immunosuppressants, provide mainly symptomatic relief with limited long-term efficacy and potential adverse effects. Additionally, Janus kinase (JAK) inhibitors such as Ruxolitinib (RUX) (Opzelura® 1.5 % w/w) have improved treatment outcomes, but their prolonged use causes folliculitis and increased risk of infections. To solve this existing problem, we developed a RUX-NEG to enhance the localised epidermal delivery, along with reducing systemic exposure by employing a low-dose NEG, which has a prolonged release profile and better therapeutic efficacy. Nanoemulsions containing 0.5, 0.75 and 1 % w/w RUX were optimised using a BOX-Behnken design, yielding nanosized droplets (∼16 nm) with a narrow size distribution. Incorporation of 1.5 % w/w high-molecular-weight hyaluronic acid provided suitable rheological characteristics, including pseudoplastic and thixotropic behaviour for improved topical application. The developed RUX-NEG exhibited notable antioxidant potential and significantly attenuated reactive oxygen species generation, mitochondrial membrane depolarisation, and cell death in LPS-stimulated HaCaT cells. Additionally, it suppressed pro-inflammatory mediators (TNF-α, IL-6, IL-8, IL-1β) and modulated NF- κB signalling pathways. Dermatokinetic evaluation demonstrated enhanced drug retention within AD lesions. Furthermore, in a 2,4-DNCB-induced AD mouse model, RUX-NEG effectively reduced inflammatory cytokines (TNF-α, IL-4, IL-6, IL-13) (ELISA), inhibited JAK1/JAK2 signalling (western blot) and improved histopathological alterations. Collectively, these findings highlight the potential of RUX-NEG as an effective topical delivery system for improving therapeutic outcomes and safety in the management of AD.

Hair loss is common and can markedly impair quality of life, yet the contribution of the scalp microbiome to alopecia remains fragmented across disease subtypes and mechanistic levels. This review aims to construct a clinically relevant and mechanistically coherent framework for the scalp microbiome-hair axis. We first summarize the composition and physiological functions of the scalp microbiome, including its roles in barrier integrity, immune regulation, and nutrient metabolism. We then compare dysbiosis patterns across androgenetic alopecia, alopecia areata, seborrheic dermatitis-associated hair loss, and folliculitis/scarring alopecia. This comparison identifies a shared pathogenic layer-barrier disruption, innate immune activation, altered lipid or metabolite processing, and impaired anagen support-together with subtype-selective mechanisms, including immune-privilege collapse in alopecia areata, androgen-lipid-microbiome coupling in androgenetic alopecia, Malassezia-centered inflammatory ecology in seborrheic dermatitis, and infection/biofilm-driven injury with fibrosis in scarring disease. We further organize the available evidence into a 3-tier signaling cascade linking upstream microbial triggers to midstream NF-κB, JAK-STAT, PI3K/AKT, and Wnt/β-catenin integration and downstream outcomes such as stem-cell quiescence, dermal papilla dysfunction, vascular regression, immune-privilege loss, and fibrosis. We also evaluate probiotics, postbiotics, and engineered microbial systems, whose potential benefits may arise from coordinated anti-inflammatory, ecological, regenerative, and pro-angiogenic effects. However, translation is limited by methodological heterogeneity, weak causal evidence, strain stability, targeted delivery, manufacturing quality control, and regulatory uncertainty. Overall, this framework clarifies shared and subtype-specific roles of scalp dysbiosis and defines priorities for precision, microbiome-guided alopecia therapy.

Seborrheic dermatitis (SD) is a chronic inflammatory skin condition likely caused by several factors, including overgrowth of the lipophilic yeast Malassezia, increased sebaceous gland activity, and a potential genetic predisposition, whereas Malassezia folliculitis (MF) is a fungal infection of hair follicles. In this case, a 22-year-old male initially presented with erythematous papules on the malar region and was clinically diagnosed with SD. Following partial improvement with topical and oral antifungals, the patient developed new pustular lesions involving the malar and chin regions, raising suspicion of MF. The absence of comedones and cysts helped rule out Acne vulgaris. Potassium hydroxide mount from pustular swabs revealed numerous fungal spores, prompting further investigation. Culture on modified Leeming and Notman agar yielded yeast colonies, which appeared as budding yeast cells under light and fluorescence microscopy with Calcofluor white stain. Molecular identification using PCR for the ITS regions and RFLP analysis confirmed the isolate as Malassezia furfur. This case highlights the clinical progression from SD to MF, underscoring the pathogenic potential of Malassezia and the importance of integrating clinical, microscopic, and culture-based molecular diagnostic approaches for accurate diagnosis and targeted treatment in dermatological mycoses.

The combination of sophorolipids and copaiba essential oil in a multifunctional facial formulation aimed at the treatment of conditions such as acne and herpetic folliculitis was evaluated. Sophorolipids produced by Starmerella bombicola reached 38.37 g/l, predominantly in the lactonic form. Their antimicrobial activity, alone and combined with copaiba oil, was evaluated against Cutibacterium acnes, Staphylococcus aureus, and Staphylococcus epidermidis. The combination reduced the minimum inhibitory concentration against C. acnes from 62.50 to 31.25 μg/ml, demonstrating an additive effect. Antiviral assays showed strong anti-HSV-1 activity, with 95.58% inhibition in the virucidal test and 63.99% in the antiviral assay. Three dermocosmetic formulations were developed, and the optimized formulation achieved 91.45% inhibition of C. acnes and 26.17% antioxidant activity, confirming its multifunctional potential. The application of a formulation combining sophorolipids and copaiba oil shows promising potential for the treatment of skin conditions, demonstrating significant antimicrobial activity against C. acnes as well as adequate physicochemical stability.