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PubMed1995

A scalp garment for prestretching prior to alopecia-reducing procedures.

BACKGROUND: This article demonstrates a scalp stretching device that improves scalp laxity prior to alopecia reducing procedures. This device replaces the former use of vigorous, preoperative scalp stretching exercises. OBJECTIVE: To improve scalp laxity prior to alopecia-reducing procedures by using a device rather than vigorous prestretching exercises, which are physically fatiguing. METHOD: A scalp stretching device was developed that uses the principle of cyclic loading in the immediate preoperative period and the principle of biologic creep during the month prior to the procedure. This device is simply applied by patients at home for 30 minutes per day starting 30 days before an alopecia-reducing procedure. RESULTS: The device demonstrates ease of use for the patients and does not require any physical activity on their part. It accomplishes the same improvement in laxity that prestretching exercises formerly achieved. CONCLUSION: The scalp stretching garment introduced improves the laxity of the scalp prior to alopecia-reducing procedures with no physical exertion being required by the patient.

Alopecia↗
PubMedDate not supplied

The epidemiology of childhood alopecia areata in China: a study of 226 patients.

To study the clinical and epidemiologic profile of childhood alopecia areata, we performed a survey in which a total of 226 childhood patients less than 16 years old were enrolled. Statistical analysis and heritability were performed using EPI INFO 6.0, SPSS10.0, and the Falconer method. The median age of onset was 10 years. The majority of patients (84.96%) presented with limited alopecia. The male : female ratio was 1.4:1. Boys appeared to have more severe involvement. The earlier the age of onset, the greater the severity of the disease. Sixty-seven patients (29.65%) had previous episodes of alopecia areata. Greater severity and longer duration were seen in the relapsing patients than in the primary patients. Six patients (2.65%) had an associated disease. A positive family history was reported in 25 patients (11.06%). The prevalence figures for alopecia areata in first-, second-, and third-degree relatives of the probands were 2.87%, 0.40%, and 0.13%, respectively. The heritabilities of AA in first-, second-, and third-degree relatives were 51.20%, 46.25%, and 25.65%, respectively. It can be speculated that the effect of genetic factors is important in the occurrence of this disease.

Adolescent↗
PubMedDate not supplied

Diseases on hair follicles leading to hair loss part I: nonscarring alopecias.

Hair follicles are unique structures with exceptional regenerative potential. They are believed to be crucial for epidermal homeostasis and reepithelialization after damage to human skin. Like other, more active and quickly proliferating organ systems, hair follicles may be easily disturbed in their normal growth cycle by systemic and local influences, including specific skin diseases. This may lead to hair loss, a very common complaint in men and women. The difficulties in reviewing the diseases of hair follicles lay in the long list of different etiologic factors (infectious, autoimmune, inflammatory, neoplastic, physical, chemical, congenital) and a still missing classification system according to etiopathogenetic principles. In this article (Part I of II), the structure and function of hair follicles, the diagnostic approach to diseases causing hair loss, and the most common nonscarring alopecias (telogen effluvium, anagen effluvium, androgenetic alopecia, and alopecia areata) are reviewed in regard to pathogenesis, clinical findings, and current options of treatment. Part II will focus on scarring alopecias.

Alopecia↗
PubMed1975

Cellular activity in the dermis surrounding the hair bulb in alopecia areata.

The metabolic activity of the cells in the connective tissue surrounding the hair bulb has been studied by radioautography in alopecia areata and in normal scalp, using in vitro incorporation of tritiated thymidine, uridine, histidine, leucine and proline. In alopecia areata, the hair bulbs are blocked in the anagen IV stage and DNA, RNA and protein synthesis are restrained. Cells in the papilla, as well as the cellular infiltrate, display a very low rate of metabolic activity. During regrowth in alopecia areata, the activity of endothelial cells is increased in the papillary and peribulbar layers before DNA, RNA and protein synthesis are restored in the epithelial cells of the hair bulb. The dermal and epithelial labelling patterns eventually reach levels comparable to those observed in an induced anagen IV state of a normal scalp. It is concluded that the progression from anagen IV to a further stage represents a critical period in the growth of hair that would closely depend upon an adequate metabolic function of the connective tissue. It is impaired in alopecia areata.

Alopecia Areata↗
PubMed2005

Recurrent flank alopecia in a Tibetan Terrier.

Recurrent flank alopecia is described in a 2-year-old, male, neutered Tibetan Terrier with concurrent atopic dermatitis. The diagnosis of recurrent flank alopecia was made after 3 consecutive years of localised, winter-onset alopecia. The diagnosis was based on history, compatible clinical signs and supportive histopathology. The diagnosis was complicated by the presence of concurrent pruritic dermatitis. To our knowledge this is the first report of recurrent flank alopecia in this breed.

Alopecia↗
PubMed1983

Topical minoxidil in the treatment of alopecia areata.

A modified double blind crossover study was performed to assess the effect of 1% topical minoxidil as compared with placebo in 30 patients with alopecia areata and alopecia totalis. The active preparation produced a highly significant incidence of hair regrowth. A cosmetically acceptable response was noted in 16 patients. No side effects were seen. The study confirmed that topical minoxidil will induce new hair growth in alopecia areata but that it is less likely to do so in more severe and extensive disease. Furthermore, patients with alopecia universalis and totalis may not respond at all. Nevertheless, as compared with other drugs minoxidil applied topically is relatively non-toxic, is easy to use, and has no systemic or local side effects.

Administration, Topical↗
PubMed1983

Alopecia in calves associated with milk substitute feeding.

Outbreaks of alopecia with unusually high morbidity occurred among calves reared on milk substitutes on two unrelated farms in Suffolk. On one farm alopecia occurred for three consecutive years; during the winter of 1981-82 there were also clinical signs of muscular dystrophy among the same calves. On the second farm calves with alopecia also showed signs of muscular dystrophy. The apparent relationship between alopecia and milk substitute feeding is discussed together with the possible involvement of vitamin E.

Alopecia↗
PubMed1997

Congenital alopecia areata.

Alopecia areata has never been documented in a newborn. Thus, it is generally assumed that alopecia areata is acquired only postnatally, and it is believed that the presence of an alopecia at birth virtually excludes its diagnosis. In this report we document a case of alopecia areata in a premature newborn.

Alopecia Areata↗
PubMed1997

Pulse steroid therapy for children's severe alopecia areata?

Seven children with severe, rapidly evolving alopecia areata (AA) were treated with pulse steroid therapy (PST). AA had been present for 3-44 weeks and involved more than 30% of the scalp. One patient had alopecia totalis. Intravenous methylprednisolone (5 mg/kg twice a day) was administered for 3 days. No serious side effects were noted. At the 12-month follow-up, complete regrowth had occurred in 5 patients (71%). The patient with alopecia totalis had no regrowth. PST appears to be a promising and safe treatment for extensive, recent-onset AA in children. No response is to be expected in alopecia totalis or long-standing AA.

Adolescent↗
PubMed1987

Alopecia areata incognita: a hypothesis.

To explain why in alopecia areata the hair falls out in a particular area the hypothesis is proposed that the area occurs as a stochastic event only in those subjects who, in a restricted zone of their scalp, happen to have a group of hairs that are simultaneously in the early anagen VI subphase of the hair cycle. Once this point has been accepted, a number of conclusions may be drawn. Especially important is the inference that only people with low percentages of telogen hairs are likely to exhibit areas, whereas those with androgenetic alopecia, when affected by alopecia areata, preferentially show a diffuse and delayed hair loss that has the features of Kligman's telogen effluvium (alopecia areata incognita). Epidemiological evidence is provided.

Alopecia Areata↗
PubMed1985

Treatment of alopecia areata with diphencyprone.

26 patients with alopecia areata were treated topically with diphencyprone. 10 had alopecia universalis, 7 alopecia totalis and 9 had alopecia areata. The treatment lasted from 4 to 14 months. In 13 patients a little response was obtained; only in 1 case it was satisfactory. Factors that appear to influence these results are discussed.

Adolescent↗
PubMed1991

Application of psychoimmunotherapy in patients with alopecia universalis.

Mental stress and immunological abnormality have recently been listed as causes of alopecia universalis. This disease is difficult to treat with only ordinary pharmacotherapy. Thus, from the standpoint of psychoneuroimmunology, stress was relieved by relaxation and image therapy, and administration of small doses of a strong immunosuppressant was effective, leading to clinically favorable results. In addition, changes were recognized in the subpopulation of peripheral lymphocytes and in beta-endorphin before and after relaxation and image therapy. The treatment of alopecia universalis favorably changed the subpopulations of T cells. A patient suffering from alopecia is always under stress. Alleviating this stress facilitates recovery of immunological competence. Our method was effective in 5 of 6 cases with refractory alopecia universalis.

Adolescent↗
PubMed1999

Of hairless mice and men: the genetic basis of congenital alopecia universalis/congenital atrichia.

BACKGROUND: Mouse models of human diseases help identify gene defects. OBJECTIVE: The methods of homozygosity mapping and mouse/human homology to identify genes are reviewed. The genotype/phenotype correlation in two clinical entities with mutations in the human hairless gene are discussed. METHODS: The example of the hairless mouse's contribution to our knowledge of hereditary alopecia is used, and the utility of consanguineous families for genetic studies is highlighted. RESULTS: Mutations in the human homolog of the mouse hairless gene lead to congenital alopecia universalis and atrichia with papules. CONCLUSION: A mouse model of congenital alopecia has led to understanding the molecular basis of at least one type of severe human alopecia.

Alopecia↗
PubMed2005

Reversible alopecia universalis during treatment with PEG-interferon and ribavirin for chronic hepatitis C.

The combination of PEG-interferon and ribavirin is currently recommended for the treatment of chronic hepatitis C, which is a common cause of morbidity and mortality worldwide. Hair disorders have often been described during interferon therapy, which include reversible hair discoloration, hypertricosis and alopecia. Ribavirin is reported to cause photoallergic reactions. We report two cases of alopecia universalis, with complete hair loss extended to the whole body, secondary to PEG-interferon and ribavirin combination therapy for chronic hepatitis C virus infection. Both female patients were infected by genotype 1 and presented alopecia during the second half of a 48-week therapy, concurrently with low levels of ferritin and thyroid dysfunction (patient 1) or depression (patient 2). Patient 1 withdrew from the therapy on week 26 and, due to the occurrence of maculo-erythematous cutaneous eczema, underwent corticosteroid therapy with complete hair regrowth. Patient 2 completed the scheduled therapy and showed a spontaneous complete hair regrowth. It should be noted that in spite of an early (within 4 weeks of therapy) virological response, patient 1 had a disease relapse after therapy withdrawal and corticosteroid therapy, while patient 2 maintained a sustained virological response. In conclusion, interferon therapy may trigger reversible alopecia universalis in susceptible patients. However, given the benign and reversible nature of this side effect, patients who achieve a virological response should be strongly advised to complete the treatment in order to prevent disease relapse.

Adult↗
PubMed2005

Evaluation of the profile of alopecia areata and the prevalence of thyroid function test abnormalities and serum autoantibodies in Iranian patients.

BACKGROUND: The study aimed at evaluating the prevalence of thyroid function abnormalities in patients with alopecia areata (AA) and its association with other autoimmune diseases and various autoimmune antibodies. METHOD: We retrospectively analyzed medical records of 123 patients with AA. The main site of involvement, pattern, and extent of alopecia as well as presence of the similar disease in first-degree family members and serologic status of patients were recorded. RESULTS: Participating in the study were 57 males and 66 females (6 to 59 years old). In the majority of patients (69.9%) the disease was manifested in the first two decades of life. Patients with family members having alopecia were recorded in 24.4%. Thyroid function abnormalities were found in 8.9% of patients. Positive autoimmune antibodies were associated with AA in 51.4% of patients with no significant association between the severity and duration of disease and presence of these antibodies. CONCLUSION: The incidence of positive auto-immune antibodies in Iranian patients is higher than previous reports. Concerning the female:male ratio, thyroid function tests and the prevalence of alopecia in first-degree relatives, our results are compatible with previous data obtained from different ethnic populations. Previous reports documented that a greater severity and longer duration of AA were seen in the early onset forms; however our result are relatively different which could be explained by differences in genetic factors.

Adolescent↗
PubMed2005

Topical immunotherapy of severe alopecia areata with diphenylcyclopropenone (DPCP): experience in an Iranian population.

BACKGROUND: Highly variable results of topical diphenylcyclopropenone (DPCP) in the treatment of alopecia areata have been reported so far. The purposes of the present study were to evaluate the efficacy and tolerability of DPCP treatment in severe alopecia areata. METHODS: Twenty-eight patients (16 female and 12 male, 10-35 years old, mean age 25 years) with extensive alopecia areata were enrolled in an open-label clinical trial. After sensitization with 2% DPCP, progressively higher concentrations beginning at 0.001% were applied weekly for 6 months to one side of the scalp, after which, if terminal hair growth was noted, the entire scalp was then treated under the same weekly protocol. The maximum concentration of DPCP in acetone was 2%. RESULTS: Twenty-seven of 28 patients completed therapy. The overall response rate was 81.5% (22/27), complete remission (90%-100% terminal hair re-growth) was obtained 22.2% (6/27) and partial remission (10%-90% terminal hair re-growth) in 59.3% (16/27). In all patients an eczematous reaction consisting of erythema, itching, and scaling at the site of application were observed. During therapy, other side effects including, occipital lymphadenopathy 40.7% (11/27), severe eczema/blister formation 40.7% (11/27), hyperpigmentation 18.5% (5/27) were observed, but no hypopigmentation, vitiligo, contact urticaria, and erythema multiforme-like reaction were seen in the patients. Nineteen of 27 (70.4%) patients had at least one side effect, other than eczematous reaction. Notably, partial recurrence was observed in 50.9% (13/22) of these patients after 6 to 12 months of follow-up. During the follow-up time the maintenance DPCP immunotherapy was continued. CONCLUSION: Topical DPCP treatment for alopecia areata is an effective therapy with a slightly high relapse rate during bilateral maintenance treatment. According to the author's knowledge this is the first experience with DPCP in Iran.

Administration, Topical↗
PubMed2004

Scarring alopecia in discoid lupus erythematosus: a clinical, histopathologic and immunopathologic study.

Scarring alopecia is a very frequent feature of chronic discoid lupus erythematosus (DLE). So far in the literature, only clinic-pathologic features or histopathologic-immunopathologic traits of DLE scarring alopecia (DLESA) have been reported. We describe the most significant features of clinical morphology, histopathology, serum and tissue immunopathology of 36 DLESA patients (41.9% of all our scarring alopecia patients). Clinically, 33.3% presented a single lesion and 52.7% presented multiple lesions of scarring alopecia, while 13.8% exhibited a picture resembling Pseudopelade of Brocq, with the classic 'footprints in the snow' appearance. The most frequent morphologic features were sclero-atrophy (80.5%) and erythema (63.8%). The main histopathologic aspects appeared to be fibrosis (100%), follicular hyperkeratosis (91.4%), epidermal atrophy (88.5%), lymphocytic infiltrate (88.5%), thickened basement membrane (77.1%) and basal vacuolar degeneration (74.2%). Antinuclear antibodies were present in 42.8% of patients and antigastric mucosa, antithyroid and anticardiolipin antibodies in 17-21% of patients. A positive lupus band test was demonstrated in 81.8% of cases and perivascular deposit in 30.3% of patients. Histopathology alone allowed a correct diagnosis only in 68.5% of cases; in the other cases, the diagnosis was assessed also taking into account immunopathologic findings. Our study defines the clinic, histopathologic and immunopathologic features of DLESA patients and points out that a multiparametric approach is mandatory to assess the diagnosis of DLESA.

Adolescent↗
PubMed2001

Targeting expression of the human vitamin D receptor to the keratinocytes of vitamin D receptor null mice prevents alopecia.

Vitamin D receptor (VDR) null mice develop hypocalcemia, hyperparathyroidism, rickets, osteomalacia and alopecia. Normalization of mineral ion homeostasis prevents all of these abnormalities except alopecia. Hair reconstitution assays, performed in athymic nude mice, demonstrate that the lack of VDR in keratinocytes leads to a defect in anagen initiation, similar to that observed in VDR null mice. Although these studies demonstrate that expression of the VDR in keratinocytes is necessary, they do not prove that it is sufficient for maintenance of the normal hair cycle. To address this hypothesis, we generated transgenic mice expressing the human VDR under the control of the keratin 14 (K14) promoter. Two highly expressing transgenic lines were mated with VDR null mice to obtain VDR null mice expressing the human VDR transgene (hVDR+/mVDR-). Expression of the transgene in the VDR null mice prevented alopecia. Furthermore, when subjected to anagen initiation, the hair follicle keratinocytes of the hVDR+/mVDR- mice demonstrated an enhanced proliferative response compared to those of control littermates. Restoration of VDR expression in the keratinocytes of VDR null mice, prevents the hair cycle defect that leads to the development of alopecia.

Alopecia↗