Frontal fibrosing alopecia (FFA) and lichen planus pigmentosus (LPP) frequently coexist. 1 The umbrella term "acquired dermal macular hyperpigmentation (ADMH)" encompasses disorders with clinicopathological overlap such as LPP and pigmented contact dermatitis. 2 Contact sensitization has been described in the contexts of both FFA and ADMH. [2][3][4] CASE REPORTA woman with Fitzpatrick skin phototype IV and hypothyroidism developed pruritic macular hyperpigmentation with punctate hypopigmentation symmetrically on her forehead (Figure 1A) at age 45 which she related to hair dyes. Gradually, the hyperpigmentation spread to the temples, preauricular areas, and upper lip. Melasma was suspected and treated with hydroquinone plus sunscreens. Pigmentation, however, progressively darkened and spread to the armpits, groin, retroauricular areas, and dorsal aspects of hands and feet. A biopsy showed lichenoid infiltrates around pilosebaceous units with Civatte bodies and melanophages, features compatible with LPP. Topical depigmenting agents (glycolic acid and kojic acid), calcipotriol, topical and oral corticosteroids, griseofulvin, laser, and hydroxychloroquine were applied without success and were suspended.Four years later, she experienced frontotemporal hairline recession associated with eyebrow, forearm, pubic, leg and axillary hair loss clinically compatible with FFA. Hyperpigmentation thereafter spontaneously improved in the face and completely resolved elsewhere. Subsequently, at the age of 58, she presented with acute facial eczema (Figure 1B). Patch tests showed positive reactions to nickel sulfate, cobalt chloride, propolis, gallates mix, dodecyl gallate, ethylhexyl salicylate, and two personal cosmetics "as is" (Eucerin Hyaluron-Filler +

styler/treatment. Products not categorized as conditioners or shampoos on the Target, CVS Pharmacy, and Ulta Beauty websites were included in the "hair styler/treatment" category.Of the 1,960 HCPs (including shampoos, conditioners, styling products/treatments) in the CAMP, 287 (14.6%) were considered "textured HCPs," including 17.3% of conditioners, 15.4% of hair stylers/treatments, and 11.6% of shampoos. Of the 240 HCP brands participating in the CAMP, 55 (22.9%) matched those in the Target, CVS Pharmacy, or Ulta Beauty "textured hair" categories.Fragrance allergy is seen in almost a quarter of patch-tested patients 4 and can be one of the difficult allergens to avoid given its high prevalence in personal care products. 5 Fragrance-free hair products are even more difficult to find. In the CAMP, 5.6% of the HCPs are considered fragrance-free, whereas 29.1% of the moisturizers/lotions are fragrance-free. Of the HCPs for textured hair in the CAMP, we found 0 of 18 conditioners, 3 (7.1%) of 42 shampoos, and 7 (13.7%) of 51 styling products/treatments to be fragrance-free.From this investigation, we concluded that less than 15% of the HCPs within the CAMP are marketed specifically for textured hair, and fragrance-free options are limited. We have included a list of fragrance-free textured HCPs to better enable patients and clinicians to identify safe and appropriate options (Table 1). The lack of fragrance-free textured HCPs commercially available underscores a deficit in the hair care market and illustrates the importance of creating more hypoallergenic HCPs for individuals with textured hair.

suppressing calcineurin phosphatase required for IL-2 synthesis. 8 It also inhibits the release of other inflammatory cytokines, including the ones secreted by various antigen-presenting cells, mast cells, and cells involved in the inflammatory cascade. 9 Therefore, it has been shown to be beneficial in patients of Parthenium dermatitis. In our study, a rapid response to dermatitis with disease remission was achieved in all the patients with ciclosporin and there were no clinical or biochemical adverse effects. Thus, ciclosporin appears to be an effective drug in treatment of patients with Parthenium dermatitis, particularly when corticosteroids and azathioprine are contraindicated. However, further controlled trials with a larger sample size are required to establish its effectiveness and safety in these patients.