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Biomedical subjects

Antonella Tosti

Publications and source records attributed to Antonella Tosti.

At least 37 records · Page 2Linked to original sources

The psychosocial impact of hair loss among men: a multinational European study.

OBJECTIVE: Hair plays an important role in determining self-image, social perceptions, and psychosocial functioning. The objectives of this survey were to identify the impact of hair loss on the self-image of men in five European countries and their level of concern about hair loss with regard to image and personal attractiveness. Moreover, we evaluated participants' use of treatments for hair loss and whether treatment success was associated with psychological benefit. RESEARCH DESIGN AND METHODS: A structured questionnaire of closed-ended questions was administered by telephone in major cities in Germany, France, Italy, Spain, and the United Kingdom. Random sampling was used, and eligible respondents were men from 18 to 45 years old. RESULTS: Of the 1536 men responding to the telephone survey, 729 (47%) reported hair loss; these men are the subject of this report. Over 70% of these men reported hair to be an important feature of image, and 62% agreed that hair loss could affect self-esteem. The realization that they were losing hair was linked to concern about losing an important part of personal attractiveness (43% of men), fear of becoming bald (42%), concern about getting older (37%), negative effects on social life (22%), and feelings of depression (21%). Reduced self-confidence in personal attractiveness was also reported by 38% of men who were not in stable romantic relationships. Less than 10% of men were currently pursuing treatment for hair loss, and three out of four had never pursued treatment for hair loss, either at present or in the past. Those few men who pursued treatment and reported success (n = 73) also reported psychosocial benefits as a result: from 43% to 59% experienced improvements in parameters of self-esteem and perception of personal attractiveness. Reliance on self-reporting of hair loss and use of nonvalidated instruments to measure psychological outcomes are important study limitations. CONCLUSIONS: The results of this survey indicate a gap between the need for treatment of hair loss and initiation of such treatment among men in five European countries. Further research is needed into the factors affecting men's willingness to seek treatment for hair loss.

Adolescent↗

Treatment of onychomycosis with oral antifungal agents.

Onychomycosis is the most common nail disease and describes the invasion of the nail by fungi. Different clinical patterns of infection depend on the way and the extent by which fungi colonise the nail: distal subungual onychomycosis, proximal subungual onychomycosis, white superficial onychomycosis, endonyx onychomycosis and total dystropic onychomycosis. The type of nail invasion depends on both the fungus responsible and on host susceptibility. Treatment of onychomycosis depends on the clinical type of the onychomycosis, the number of affected nails and the severity of nail involvement. The goals for antifungal therapy are mycological cure and a normal looking nail. In this paper the treatment of onychomycosis with oral antifungal agents will be reviewed.

Administration, Oral↗

The disappearing nail bed: a possible outcome of onycholysis.

Onycholysis is a separation of the nail plate from the underlying and/or lateral supporting structures (hyponychium, nail bed, lateral nail folds). It is a commonly seen disorder that is usually asymptomatic. We have observed a number of cases of onycholysis in which the distal nail bed appeared to shrink. The nail bed becomes keratinized and produces dermatoglyphics like the normal tip of a digit. This may explain why it is difficult to promote reattachment. If onycholysis persists, the condition is more likely to become irreversible and form the "disappearing nail bed." The best chance of resolving onycholysis is to try to identify the causative agent and institute early therapy.

Epidermis↗

Histological features of peripilar signs associated with androgenetic alopecia.

BACKGROUND: A study of the scalp in a large cohort of volunteers with androgenetic alopecia using macrophotographs showed the presence of peripilar signs (PPS) around the hair ostia. OBJECTIVE: The aim of the present study was to establish the histopathological features related to PPS. DESIGN: Prospective clinicopathological study. SETTING. Department of Dermatology, University Hospital of Bologna. PATIENTS: A group of 40 patients (21 males and 19 females) participated in the study. Macrophotographs of the scalp were taken using a Dermaphot camera and PPS were scored using a three-point scale. Hair density and PPS were clinically scored according to reference scales. Two punch biopsies from the photographed area were obtained from each subject and histological analysis was performed on vertical and horizontal sections. OBSERVATIONS: Clinical parameters indicated that PPS were already detectable on scalp with high hair density. Moreover, in patients with high hair density (score >4), a significant relationship was found between the PPS score and the global score for perifollicular infiltrates. Thus PPS are linked to superficial perifollicular lymphocytic infiltrates in early androgenetic alopecia. CONCLUSIONS: PPS could be the clinical signs reflecting the presence of perifollicular infiltrates.

Adult↗

White superficial onychomycosis: epidemiological, clinical, and pathological study of 79 patients.

OBJECTIVE: To analyze the epidemiology, responsible agents, clinical features, and outcome of white superficial onychomycosis (WSO). DESIGN: Retrospective study. SETTING: University hospital. PATIENTS: A total of 79 patients with WSO seen at the Department of Dermatology of Bologna University from 1994 to 2002. Responsible agents included Trichophyton interdigitale in 58 cases (73%), Trichophyton rubrum in 4 (5%), Fusarium species in 9 (11%), Aspergillus species in 5 (6%), and Acremonium strictum in 3 (3%). RESULTS: White superficial onychomycosis may have different clinical and epidemiological features. "Classic" WSO, characterized by superficial nail plate involvement, is usually due to Trichophyton mentagrophytes (var interdigitale), although Acremonium strictum or Onychocola canadiensis can sometimes be responsible. A deep and diffuse WSO, characterized by massive penetration of the nail plate by fungi, can be seen in nail infections by molds such as Fusarium species and Aspergillus species, or in nail infections by Trichophyton rubrum in healthy children and in patients infected with human immunodeficiency virus. CONCLUSIONS: Severity and spread of WSO is the result of complex host-parasite relationships. When dealing with a patient with WSO, we should always consider the causative organism and the host characteristics to choose the best therapeutic approach.

Acremonium↗

Evaluation of sexual function with an international index of erectile function in subjects taking finasteride for androgenetic alopecia.

OBJECTIVE: To evaluate variations in sexual and erectile function in subjects taking 1 mg of finasteride for androgenetic alopecia by administering the abridged 5-item version of the International Index of Erectile Function (IIEF-5) questionnaire before and during treatment. DESIGN: In a multicenter study, 186 patients with androgenetic alopecia were asked to complete the IIEF-5 regarding the domain of erectile function before (at baseline) and 4 to 6 months after beginning finasteride treatment. The test was self-administered. SETTING: The study was conducted in 7 institutional dermatology departments in Italy (Bologna, Rome, Genoa, Cagliari, Milan, Florence, and Bari). PATIENTS: A total of 186 patients with androgenetic alopecia were evaluated before and 4 to 6 months after the initiation of finasteride therapy (1 mg). All patients (age range, 19-43 years; mean age, 28.3 years) were followed up as outpatients. RESULTS: The score on each of the 5 domains of the IIEF-5 did not show any significant change after 4 to 6 months of treatment. CONCLUSIONS: Our results support the clinical impression that sexual side effects are actually much less common than reported in clinical trials. The sexual function of all patients remained stable during treatment with 1 mg of finasteride.

5-alpha Reductase Inhibitors↗

The nail and hair in forensic science.

Drugs, chemicals, and biological substances accumulate and are stored in hair and nails where they can be detected and measured. Advantages of analyzing hair and nail samples also include their easy and non-invasive collection, the small sample size required for analysis, and their easy storage at room temperature. We report 3 examples of heavy metal poisoning diagnosed because of the hair or nail symptoms. Drugs and toxins that can be detected in hair and nails are reviewed and the application of hair/nail analysis in general and in forensic medicine is discussed.

Adolescent↗

Hypertrichosis of the eyelashes caused by bimatoprost.

The phenyl-substituted analog of prostaglandin F 2alpha , latanoprost (Xalatan; Pfizer, Inc, New York, NY) is an intraocular pressure (IOP)-lowering drug for use in patients with glaucoma and ocular hypertension. Latanoprost has been shown to stimulate eyelash hypertrichosis and has recently been proposed as a possible treatment for alopecia areata involving the eyelashes. We report a case of hypertrichosis of the eyelashes caused by the prostamide bimatoprost (Lumigan; Allergan, Inc, Irvine, Calif), a new IOP-lowering drug.

Aged↗

A gene locus responsible for the familial hair shaft abnormality pili annulati maps to chromosome 12q24.32-24.33.

Pili annulati, a rare hair shaft abnormality with a characteristic shiny appearance due to alternating light and dark bands of the hair, is assumed to be inherited in an autosomal dominant mode with high penetrance. A locus for pili annulati has not been found yet. We identified one large and four small European kindreds with pili annulati and conducted a genomewide linkage analysis using 382 microsatellite markers. A multipoint logarithm of the odds (LOD) score of 3.19 was demonstrated between D12S1659 and D12S1723 on the telomeric part of the long arm of chromosome 12. Subsequent finemapping in a region of 20 cM gave a maximum multipoint LOD score of 3.24 at D12S1723 under the assumption of homogeneity and a LOD score of 3.57 around D12S343 under the assumption of heterogeneity, both exceed the statistical thresholds necessary to conclude linkage. Most of this LOD score came from the largest family, which reached a maximum LOD score of 3.81. The maximum two-point LOD score for all families was 3.97 at D12S1609. Definite recombination events narrowed the region of shared haplotype in the affected individuals to an 8 Mb region between the marker D12S324 and the telomeric end of the long arm of chromosome 12.

Chromosome Mapping↗

Drug-induced nail abnormalities.

A large number of drugs may be responsible for the development of nail changes, including cancer chemotherapeutic agents and retinoids, however, only a few classes of drugs are consistently associated with nail symptoms. Drug-induced nail abnormalities result from toxicity to the matrix, the nail bed, the periungual tissues or the digit blood vessels. The most common symptoms include Beau's lines, onychomadesis, melanonychia, onycholysis and periungual pyogenic granulomas. Drug-induced nail changes usually involve several or all of the nails. In most cases, nail abnormalities are asymptomatic, but can sometimes cause pain and impair manual activities.

Drug-Related Side Effects and Adverse Reactions↗

Management of onychomycosis in children.

Terbinafine, itraconazole, and fluconazole are effective and well tolerated for treating onychomycosis in children. Dosage depends on body weight. Duration of treatment is the same for adults.

Antifungal Agents↗

Treatment of nondermatophyte mold and Candida onychomycosis.

Mold onychomycosis often can be clinically suspected because of the presence of periungual inflammation. Treatment with systemic antifungals is very effective in onychomycosis caused by Aspergillus sp. Scopulariopsis brevicaulis and Fusarium sp. infection are difficult to eradicate and treatment with systemic antifungals should always be associated with topical treatment with nail lacquers. Candida onychomycosis is always a sign of immunodepression. Systemic treatment with itraconazole or fluconazole is usually effective, but relapses are very common.

Administration, Cutaneous↗