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PubMed1999

The psychosocial consequences of androgenetic alopecia: a review of the research literature.

Androgenetic alopecia is a common dermatological condition, with potentially adverse psychosocial sequelae. The present review critically examines scientific evidence concerning the effects of androgenetic hair loss on social processes and psychological functioning, as well as the psychosocial outcomes of medical treatments. Research confirms a negative but modest effect of visible hair loss on social perceptions. More importantly, androgenetic alopecia is typically experienced as a moderately stressful condition that diminishes body image satisfaction. Deleterious effects on self-esteem and certain facets of psychological adjustment are more apparent among women than men and among treatment-seeking patients. Various 'risk factors' vis-à-vis the psychological adversity of androgenetic alopecia are identified. Medical treatments, i.e. minoxidil and finasteride, appear to have some psychological efficacy. A conceptual model is delineated to explain the psychological effects of hair loss and its treatment. Directions for needed research are discussed. Strategies are presented for the clinical management of psychological issues among these patients.

Alopecia↗
PubMed2003

Postmenopausal frontal fibrosing alopecia.

Recently a new entity, postmenopausal frontal fibrosing alopecia, was added to the established subtypes of scarring alopecias affecting postmenopausal women. This condition is characterized by a progressive frontal hairline recession associated with scarring. We studied the clinical and histopathologic features in four women with this disorder. Of note, a history of bilateral oophorectomy in two of them appears to be a new association. All four cases had frontoparietal recession of the hairline and two of them also had loss of their eyebrows. None of our four patients had any mucous membrane or other skin lesions. Histological examination showed perifollicular fibrosis and lymphocytic inflammation around the isthmus and infundibular areas of the follicles. No effective treatments have emerged for this type of postmenopausal alopecia, but progression of the hair loss and scarring appears to be self-limiting. We believe that this condition is a distinct clinicopathological variant of lichen planopilaris.

Adult↗
PubMed2000

Celiac disease and alopecia areata in a child with Down's syndrome.

According to recent reports in the literature, there seems to be an association between alopecia areata and celiac disease. The present author describes a 9-year-old girl with Down's syndrome, and alopecia areata, and documented celiac disease, who displayed a normal growth of hair after a gluten-free diet. Given the high prevalence of these two diseases in patients with Down's syndrome, the present author recommends both serological screening for celiac disease in every individual with Down's syndrome, and in particular, the inclusion of such screening in any diagnostic work-up for alopecia areata.

Alopecia Areata↗
PubMed2003

Retrospective evaluation of sex hormones and steroid hormone intermediates in dogs with alopecia.

The purpose of this study was to determine if there are specific steroid hormone aberrations associated with suspect endocrine alopecias in dogs in whom hypothyroidism and hyperadrenocorticism have been excluded. Steroid hormone panels submitted to the UTCVM endocrinology laboratory over a 7.5-year period (783 samples) from dogs with alopecia were reviewed. During this period, 276 dogs met the criteria for inclusion and were comprised of 54 different breeds. Approximately 73% of dogs had at least one baseline or post-ACTH stimulation steroid hormone intermediate greater than the normal range. The most frequent hormone elevation noted was for progesterone (57.6% of samples). When compared with normal dogs, oestradiol was significantly greater in Keeshond dogs and progesterone was significantly greater in Pomeranian and Siberian Husky dogs. Not all individual dogs had hormone abnormalities. Chow Chow, Samoyed and Malamute dogs had the greatest percentage of normal steroid hormone intermediates of the dogs in this study. Baseline cortisol concentrations were significantly correlated with progesterone, 17-hydroxyprogesterone (17-OHP) and androstenedione. Results of this study suggest that the pathomechanism of the alopecia, at least for some breeds, may not relate to steroid hormone intermediates and emphasizes the need for breed specific normals.

17-alpha-Hydroxyprogesterone↗
PubMed2003

Linear polarized infrared irradiation using Super Lizer is an effective treatment for multiple-type alopecia areata.

BACKGROUND: Super Lizer trade mark is a linear polarized light instrument, which has been used with good effect in orthopedics and anesthesiology to treat arthralgia and neuralgia with a high output of infrared radiation. AIM: To test Super Lizer trade mark 's efficacy for the treatment of alopecia areata. METHODS: Fifteen patients over 18 years of age, diagnosed with alopecia areata and displaying symptoms of patchy hair loss, were topically irradiated with infrared radiation using the Super Lizer trade mark. The patients were irradiated intermittently for an interval of 3 min once every week or every 2 weeks. RESULTS: Seven of 15 (46.7%) of the irradiated areas showed hair regrowth 1.6 months earlier than the nonirradiated areas (chi2 official approval, P = 0.003). With regard to adverse effects caused by Super Lizer trade mark treatment, only one patient complained of a sensation of heat in the irradiated area. CONCLUSIONS: These findings suggest that Super Lizer trade mark, with its noninvasive properties, is a useful apparatus for the treatment of mild forms of alopecia areata.

Adult↗
PubMed2004

[Two cases of frontal fibrosing alopecia in postmenopausal women].

Frontal fibrosing alopecia (FFA) is an uncommon, slowly progressive, cicatricial alopecia which mainly affects postmenopausal women. It is considered to be a variant of lichen planopilaris. We describe two postmenopausal women who developed over 11 and 24 months an asymptomatic atrophic alopecia, restricted to the frontal hairline. The diagnosis of FFA was confirmed by biopsy showing a perifollicular lymphocytic infiltrate with fibrosis. Topical corticosteroids, in one case combined with minoxidil, administered for 3 months arrested the hair loss. The treatment of FFA is often difficult. In most cases, the disease resolves spontaneously after several years. Immunomodulators such as corticosteroids and calcineurin antagonists should be tried in the early stage of FFA (frontal effluvium with perifollicular erythema) in order to arrest the disease in its inflammatory phase.

Administration, Topical↗
PubMed2003

Cutaneous angiosarcoma of the face and scalp presenting as alopecia.

An 83-year-old woman presented with a 6-month history of hair loss and painless bruising involving her forehead and scalp. She was otherwise well. Skin biopsy of her scalp confirmed angiosarcoma with a significant increase in miniaturized and telogen hair follicles and some tumour-associated scarring hair loss. She was commenced on the chemotherapeutic agent paclitaxel and then subsequently the semi-synthetic taxane docetaxol. Treatment was terminated because of lack of response and adverse effects. Alopecia is an uncommon presentation in angiosarcoma and in this case there was a mixed pattern of focal scarring and follicular miniaturization. The latter was present only in areas of tumour involvement and not in a typical pattern distribution for androgenetic alopecia. The direct role of tumour in follicular miniaturization and alopecia is speculated and the implications of this for novel future treatment strategies is discussed.

Aged↗
PubMed2001

Lupus erythematosus/lichen planus overlap syndrome with scarring alopecia.

Lupus erythematosus (LE) and lichen planus (LP) may occur as an overlap syndrome (LE/LP). The term comprises a heterogeneous group of patients who have clinical, histological and/or immunopathological characteristics of both diseases at the same time. The disease occurs so infrequently as to limit clinical cases for study. We present a case of scarring alopecia due to LE/LP overlap syndrome. Initial biopsy of the scalp showed scarring alopecia only, with subsequent biopsies showing histological features of LE. Direct immunofluorescence was negative for the LE band, but showed features consistent with LP. We report this case as an uncommon cause of scarring alopecia illustrating the importance of multiple biopsies in the diagnosis of LE/LP overlap syndrome.

Alopecia↗
PubMed2003

Androgenetic alopecia: combining medical and surgical treatments.

BACKGROUND: Medical treatment or surgical reconstruction is used separately to treat androgenetic alopecia. Two drug molecules (5% minoxidil solution and oral finasteride 1 mg) have proven efficacy to stabilize hair loss and promote hair regrowth. Microtransplant of one to three hair follicular unit grafts can provide a definitive hair restoration with a natural appearance. OBJECTIVES: Aesthetic results can be optimized with a combination of drugs and transplantation of follicular unit grafts. The Dynamic Multifactorial Classification is used to select suitable candidates for this combined approach and also to assess follow-up results. RESULTS: Dynamic Multifactorial Classification assists the evaluation of the natural history of androgenetic alopecia evolution and also the effects of treatment. Regression of male androgenetic alopecia from Hamilton type V to type III can be achieved by combining drugs with hair grafts. CONCLUSION: Improvement of investigative methods and especially the Dynamic Multifactorial Classification makes it easier for a patient to follow the results of treatment adapted to their case.

Alopecia↗
PubMedDate not supplied

Pili annulati coincident with alopecia areata.

Pili annulati is a rare hair shaft abnormality of unknown pathogenesis which gives a gross beading effect. An association with alopecia areata has been reported. We present a 13-year-old girl who had alopecia areata and coincidentally was found to have pili annulati. Her mother also had pili annulati which had become more noticeable as her hair had become paler with age. We discuss the possible pathogenesis of pili annulati and relate that to the microscopic banding appearance of the hair shaft. We note the relevance of the condition becoming more apparent with age. We also discuss the probable coincidental association with alopecia areata.

Adolescent↗
PubMedDate not supplied

Treatment of widespread alopecia areata in young patients with monthly oral corticosteroid pulse.

Sixteen patients up to 18 years of age with widespread alopecia areata (AA) were recruited for the study. They included 10 patients with extensive AA (> or = 40% loss of scalp hair and or more than 10 patches scattered over the scalp and body) and 3 each with alopecia totalis and circumscribed alopecia areata. Patients were divided into two groups. In group A, aged 12 to 18 years, patients received 300 mg of prednisolone in a monthly oral pulse; in group B, aged 3 to 11 years, patients received betamethasone sodium phosphate as soluble tablets or syrup equivalent to prednisolone 5 mg/kg body weight every month. The pulsed doses of corticosteroid were continued for a minimum of three doses or until cosmetically acceptable hair growth was obtained. All patients but one 5-year-old girl received a minimum of three doses. Excellent hair growth was obtained in 9 (60%) of 15 patients evaluated at 6 months. Four patients out of 13 (>12 month follow-up), including two each in group A and B, developed a localized relapse during mean follow-up of 16.4 and 33.7 months in group A and B, respectively. Side effects of pulsed corticosteroid were minimal and were recorded in two patients (transient giddiness and headache, epigastric burning in one each). We recommend pulsed doses of prednisolone as one of the modalities in the treatment of widespread AA in young patients, including children.

Administration, Oral↗
PubMedDate not supplied

Alopecia universalis in a patient with common variable immunodeficiency.

A 12-year-old boy with common variable immunodeficiency (CVI) who developed severe alopecia is presented. His sister also had alopecia and recurrent infections and died of lung infection at the age of 7 years. The loss of hair in both children was total; the pathology of a scalp skin biopsy specimen was typical for alopecia areata. The boy was subjected to clinical and immunologic evaluation and the results were compatible with common variable immunodeficiency.

Alopecia Areata↗
PubMedDate not supplied

Alopecia areata in infants and newborns.

Alopecia areata is a common cause of nonscarring hair loss in children and adults. In newborns and very young infants, however, it is thought to be extremely rare. In this article we describe five cases of alopecia areata in patients less than 6 months of age and briefly discuss the pertinent differential diagnosis of infants and newborns with both patchy and complete hair loss. We propose that alopecia areata may be more common in this age group than the literature suggests.

Alopecia Areata↗
PubMed1999

Temporal triangular alopecia acquired in adulthood.

Temporal triangular alopecia is a relatively common, nonscarring form of alopecia. Sometimes congenital, the vast majority of lesions appear during the first 6 years of life and remain stable thereafter. We report a case of temporal triangular alopecia arising during adulthood.

Adult↗
PubMed2002

Approach to the adult female patient with diffuse nonscarring alopecia.

Alopecias are traditionally categorized by the presence or absence of scarring and by a diffuse or localized pattern. A common clinical conundrum is that of a woman presenting with the chief complaint of diffuse, nonscarring hair loss. We review the 4 main diagnostic possibilities for this clinical scenario: (1) female pattern hair loss (androgenetic alopecia), (2) acute and chronic telogen effluvium, (3) diffuse alopecia areata, and (4) loose anagen syndrome. We also outline our approach to the individual patient, emphasizing the pertinent history, physical examination, and appropriate diagnostic testing. This approach usually allows the clinician to make a definitive diagnosis or limited differential diagnosis and to offer the patient therapeutic options.

Adult↗
PubMed2006

Influence of FHIT on benzo[a]pyrene-induced tumors and alopecia in mice: chemoprevention by budesonide and N-acetylcysteine.

The FHIT gene has many hallmarks of a tumor-suppressor gene and is involved in a large variety of cancers. We treated A/J mice and (C57BL/6J x 129/SvJ)F1 (B6/129 F1) mice, either wild-type or FHIT+/-, with multiple doses of benzo[a]pyrene (B[a]P) by gavage. B[a]P caused a time-related increase of micronuclei in peripheral blood erythrocytes. Both A/J and B6/129 F1 mice, irrespective of their FHIT status, were sensitive to induction of forestomach tumors, whereas B[a]P induced glandular stomach hyperplasia and a high multiplicity of lung tumors in A/J mice only. Preneoplastic lesions of the uterus were more frequent in FHIT+/- mice. B6/129 F1 mice underwent spontaneous alopecia areata and hair bulb cell apoptosis, which were greatly accelerated either by FHIT heterozygosity or by B[a]P treatment, thus suggesting that FHIT plays a role in the pathogenesis of alopecia areata. The oral administration of either budesonide or N-acetyl-L-cysteine (NAC) inhibited the occurrence of this inflammatory skin disease. In addition, these agents prevented B[a]P-induced glandular stomach hyperplasia and decreased the size of both forestomach tumors and lung tumors in A/J mice. Budesonide also attenuated lung tumor multiplicity. In B6/129 F1 mice, NAC significantly decreased the proliferating cell nuclear antigen in lung tumors. Both budesonide and NAC inhibited B[a]P-induced forestomach tumors and preneoplastic lesions of the respiratory tract in B6/129 F1 mice. In conclusion, heterozygosity for FHIT affects susceptibility of mice to spontaneous alopecia areata and B[a]P-induced preneoplastic lesions of the uterus and does not alter responsiveness to budesonide and NAC.

Acetylcysteine↗
PubMed1981

Effects of heavy ions on rabbit tissues: alopecia.

During extended investigations of the radiation responses of optic and proximate tissues of New Zealand white rabbits (Oryctolagus cuniculus), the skin surrounding the eyes was exposed to the Bragg plateau regions of 530 MeV/amu Ar ions and 365 MeV/amu Ne ions, and also to 60Co gamma rays. The linear energy transfers (LET infinity s) for the radiations were 90 +/- 5, 35 +/- 3, and 0.3 keV/micron, respectively. Alopecia was measured after irradiation with subjective indices of baldness (0-5) that were calibrated against hair loss in other rabbits irradiated with Ne and Ar ions at the central region of the ear. The patterns of post-irradiation alopecia, which conformed to the model proposed by Casarett (1963) for the long-term expression of radiation damage in proliferating animal tissues, were modified by radiation quality in the following ways: (1) For acute (early) losses, the magnitude of the recovery phase decreased as the LET infinity of the incident radiation increased; (2) In the intermediate or plateau phase of radiation response, the values of relative biological effectiveness (r.b.e) approached those reported for proliferating cells in culture, but differences were found that may be related to the changes in the magnitude of the recovery phase; (3) For a given level of intermediate damage, the onset of the late degenerative phase of radiation response, which was expressed years after irradiation, occurred earlier the higher the LET infinity of the incident radiation. Taken overall, the most important finding of these experiments was that the r.b.e.s for alopecia varied with post-irradiation time.

Alopecia↗
PubMed1994

Minoxidil (Mx) as a prophylaxis of doxorubicin--induced alopecia.

BACKGROUND: Minoxidil (Mx) is known to induce hair growth in men with male-pattern baldness. Based on this potential, the effectiveness of Mx 2% topical solution was evaluated in cancer patients (pts) to prevent doxorubicin-induced alopecia. PATIENTS AND METHODS: 48 female pts with different types of solid tumors treated with doxorubicin-based chemotherapy in a dose range of 50-60 mg/m2/cycle were randomly assigned to receive Mx 2% topical solution or placebo. RESULTS: 88% and 92% of pts in both arms showed severe alopecia (p = ns). No adverse effects were observed. CONCLUSION: In this study Mx 2% topical solution was non-toxic but was not effective in the prevention of chemotherapy-induced alopecia.

Adult↗