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PubMedDate not supplied

Early diffuse alopecia in a neonate with congenital syphilis.

Neonatal alopecia has been described in many circumstances but never as a part of the constellation of signs in congenital syphilis. Common clinical features of early congenital syphilis include hepatosplenomegaly, skeletal deformities, hematologic disturbances, and mucocutaneous features such as rhinitis and maculopapular rash. Syphilitic alopecia has previously been described only in conjunction with secondary syphilis. In this article, we describe the first occurrence of alopecia in a neonate with congenital syphilis.

Adult↗
PubMed1977

Traumatic alopecia in trichotillomania: a pathogenic interpretation of histologic lesions in the pilosebaceous unit.

Ten patients with traumatic alopecia (trichotillomania) were being investigated histologically and, in five of them, hairs from the affected scalp area were plucked out for direct microscopic examination. Some histologic features appear to be specific markers for traumatic alopecia: empty hair ducts, plucked out hair bulbs, clefts in hair matrix, catagen involution of empty outer root sheaths, Miescher's trichomalacia in the deep dermis and torn-off sebaceous glands. Other signs are unspecific, such as presence of catagen and anagen VI hairs, infundibular plugging, melanin in keratin plugs and in the dermal papilla. The relative frequency of the different histopathologic features was evaluated. When little clinical information is available, a diagnosis of traumatic alopecia can be supported by skin biopsy. The histologic picture of trichotillomania is always incomplete, depending upon factors such as intensity of pulling or/and time of biopsy after plucking.

Alopecia↗
PubMed1979

Giant cells in male pattern alopecia: a histologic marker and pathogenetic clue.

Twenty-one of 65 (31%) biopsy specimens from patients with male pattern alopecia demonstrated the presence of individually displaced multinucleate giant cells without a significant concomitant cellular infiltrate. This finding was absent in a diverse group of other forms of alopecia. Whether individually displaced multinucleate cells are a useful histologic marker for diagnosing early stages of androgenetic alopecia remains to be determined.

Alopecia↗
PubMed1990

Syringoma-like sweat duct proliferation in scalp alopecias.

We have reviewed a series of 585 scalp biopsies taken for histologic evaluation of hair loss and have looked for syringoma-like eccrine sweat duct proliferation. This feature was found in 6 specimens with scarring alopecia and one each with alopecia areata and female-pattern alopecia. Syringoma-like sweat duct proliferation appears to play no role in the etiology of hair loss.

Adenoma↗
PubMed2006

Stem cell apoptosis in HIV-1 alopecia.

BACKGROUND: Diffuse alopecia occurs in almost 7% of HIV-1-infected patients. Telogen effluvium is the main pathogenic mechanism involved. Apoptotic keratinocytes in the outer root sheath at bulge level was described as the most characteristic histopathologic finding of this kind of hair loss. METHODS: A case-control study was conducted to investigate the occurrence of apoptosis of follicular stem cells at the bulge in diffuse alopecia of HIV-1 infection. We applied a double-staining procedure to transverse scalp sections from 15 HIV-1-infected patients and 12 controls, with the monoclonal antibody anticytokeratin 19 as stem cell marker and TUNEL technique to identify apoptosis. RESULTS: Eighty percent of cases and 25% of controls presented at least one double-stained follicle. The proportion of positive follicles per section was 48% (+/-7%) for cases and 26% (+/-13%) for controls. CONCLUSION: Our study demonstrated that diffuse alopecia related to HIV-1 infection represents a hair cycle disturbance and that part of the follicular stem cell population become apoptotic in a higher proportion than normal subjects. We found no cytotoxic folliculitis. Owing to its cell-cycle interaction and caspase-induction capacities, we propose HIV-1 viral protein R as a possible follicular stem cell apoptosis inductor.

Adult↗
PubMed1998

A case of feline paraneoplastic alopecia with secondary Malassezia-associated dermatitis.

A 13-year-old neutered female domestic shorthaired cat had progressive ventral abdominal alopecia attributed initially to hyperthyroidism. Corrective treatment by unilateral thyroidectomy did not, however, resolve the dermatosis and the alopecia progressed to involve the whole ventral trunk, the lower limbs and the head. Pruritus of the lower limbs was a prominent feature and was associated with the finding of Malassezia on cytology; Malassezia-associated dermatitis was diagnosed. Resolution of pruritus was seen after treatment with oral ketoconazole and a cleansing shampoo to eliminate the yeast, but severe polyphagia, small intestinal diarrhoea and polydipsia developed subsequently and the cat was euthanased. Necropsy revealed an exocrine pancreatic adenocarcinoma with hepatic metastases. The pancreatic, hepatic and dermatological lesions were found to be typical of feline paraneoplastic alopecia (FPA). Malassezia-associated dermatitis can be associated with pruritus in cats with FPA.

Adenocarcinoma↗
PubMed1999

Resolution of paraneoplastic alopecia following surgical removal of a pancreatic carcinoma in a cat.

A 13-year-old female neutered domestic longhaired cat was presented with a five-month history of progressive weight loss and bilaterally symmetrical alopecia of the ventrum, limbs and perineum. The alopecic skin had a shiny appearance and hair in the non-alopecic areas was easily epilated. Fine needle aspirate cytology of a palpable cranial abdominal mass revealed it to be of epithelial or glandular origin. A pancreatic mass was excised by left pancreatectomy during exploratory laparotomy, and histopathology and skin biopsies confirmed a diagnosis of pancreatic carcinoma with concurrent paraneoplastic alopecia. No evidence of metastases was found on liver and lymph node biopsies. At re-examination 10 weeks after surgery, the hair had fully regrown. Skin signs recurred after 18 weeks and metastatic spread of the tumour was confirmed on postmortem examination. This case confirms that paraneoplastic alopecia associated with internal malignancies is a potentially reversible process if the internal neoplasm is excised.

Alopecia↗
PubMed2001

Traction alopecia with vasculitis in an Old English sheepdog.

A seven-year-old entire male Old English sheepdog was presented with a well circumscribed, completely alopecic area on the top of its head, located where a rubber band had been used for several years. A punch biopsy was taken from the centre of the lesion and histological examination revealed cell-poor, interface mural folliculitis with follicular atrophy and vasculitis. A diagnosis of traction alopecia was made. Oral pentoxyfilline, at 400 mg twice daily, was prescribed for two months, with a slight improvement. To the authors' knowledge, this is the first report of canine traction alopecia accompanied by vascular damage. This vascular damage may represent the pathomechanism of this type of alopecia in the dog.

Alopecia↗
PubMed1981

Prevention of doxorubicin-induced alopecia by scalp cooling in patients with advanced breast cancer.

Scalp cooling with gel packs was used to try to prevent alopecia in 31 patients being treated with doxorubicin (Adriamycin), 29 for advanced breast carcinoma and two for carcinoid tumour. Twenty-eight of the 31 patients tolerated the procedure well, and 22 of these had either no hair loss or only slight loss which remained acceptable and did not require a wig. The main factor limiting success was biochemical impairment of liver function, which occurred in nine patients; of these, six had severe or total alopecia despite scalp cooling. Conversely, the technique was successful in all 19 patients with normal liver function. Carried out properly, this simple and effective technique greatly diminishes socially unacceptable alopecia associated with doxorubicin, and merits wider use.

Adult↗
PubMed1991

Alopecia totalis and vitiligo in common variable immunodeficiency.

Three cases of severe and irreversible alopecia occurring in patients with common variable immunodeficiency are described. In all three cases, hair loss developed after the diagnosis of immune deficiency; one of the patients also had extensive vitiligo. A fourth patient had vitiligo in the absence of alopecia. No change in the alopecia or vitiligo was noted in any patient as a result of immunoglobulin replacement therapy.

Adult↗
PubMed2004

A phase I study of topical Tempol for the prevention of alopecia induced by whole brain radiotherapy.

PURPOSE: Complete alopecia is a universal complication of whole brain radiation therapy which contributes to patient anxiety over treatment. Tempol, a nitroxide radioprotector, has been shown to protect against radiation-induced alopecia in an animal model. This phase Ib study was designed to evaluate the safety and side effect profile of topical Tempol in patients with brain metastases being treated with whole brain radiotherapy. EXPERIMENTAL DESIGN: Twelve patients with metastatic cancer to the brain were enrolled in the study between October 2000 and February 2003. Tempol (70 mg/ml concentration solution) was applied topically to the scalp 15 minutes before and washed off immediately after the completion of each of 10 fractions of whole brain radiation. Pharmacokinetic studies to evaluate the systemic absorption of Tempol were performed. Patients were assessed for toxicity before, during, and after Tempol administration. A secondary end point of the study, hair retention, was also scored. RESULTS: Eleven patients were treated with topical Tempol. Adverse events that were considered possibly, probably, or definitely related to Tempol, included asymptomatic grade 2 (two patients) and grade 1 (one patient) hypoglycemia, grade 1 forehead skin redness (one patient), grade 1 dry scalp (one patient), and grade 1 tingling sensation on the scalp (one patient). Tempol was not detected in blood samples from more than 50% of the patients. Mean maximum Tempol levels for individual patients at any time point varied from 0.4 to 3.1 micromol/L. Hair retention was localized to the base of the scalp where the Tempol solution pooled after application in the first four patients on the study. Subsequently, full scalp hair retention was seen in three of final five evaluable patients after gauze had been wrapped around the head to hold the solution against the scalp. CONCLUSIONS: This study demonstrates that topical application of Tempol to the scalp before whole brain radiation is safe and well tolerated. Evidence of protection against radiation-induced alopecia was observed. A phase II study that uses a gel formulation to increase the exposure of scalp to Tempol has been initiated.

Administration, Topical↗
PubMed1998

Ketoconazole shampoo: effect of long-term use in androgenic alopecia.

BACKGROUND: The pathogenesis of androgenic alopecia is not fully understood. A microbial-driven inflammatory reaction abutting on the hair follicles might participate in the hair status anomaly. OBJECTIVE: The aim of our study was to determine if ketoconazole (KCZ) which is active against the scalp microflora and shows some intrinsic anti-inflammatory activity might improve alopecia. METHOD: The effect of 2% KCZ shampoo was compared to that of an unmedicated shampoo used in combination with or without 2% minoxidil therapy. RESULTS: Hair density and size and proportion of anagen follicles were improved almost similarly by both KCZ and minoxidil regimens. The sebum casual level appeared to be decreased by KCZ. CONCLUSION: Comparative data suggest that there may be a significant action of KCZ upon the course of androgenic alopecia and that Malassezia spp. may play a role in the inflammatory reaction. The clinical significance of the results awaits further controlled study in a larger group of subjects.

Adult↗
PubMed2000

Renbök phenomenon in alopecia areata.

We present a second case of alopecia areata sparing a congenital nevus of the eyebrow. This inverse counterpart of perinevoid alopecia is discussed and placed in context to the recently described Renbök phenomenon. According to the present definition of a nevus as a genetic mosaic, a genetically determined resistance to alopecia areata is suggested in our case.

Adolescent↗
PubMed1999

Contribution of interleukin 1beta and KM loci to alopecia areata.

Alopecia areata is a common skin disease in which proinflammatory cytokines such as IL-1beta may play a pathogenic role. In this study, we examined the distribution of genotypes of an IL-1beta single base change polymorphism at position +3953 in patients with alopecia areata. The distribution of immunoglobulin kappa light chain (KM) genotypes was similarly examined. The data obtained showed that the IL-1beta and KM loci act cooperatively to significantly increase susceptibility to alopecia areata.

Adolescent↗
PubMed2001

Acquired hair fragility in pili anulati: causal relationship with androgenetic alopecia.

Pili anulati are defined by characteristic alternating light and dark banding in the hair shaft, due to air-filled spaces between the macrofibrillar units of the hair cortex, and are regarded as a congenital hair shaft disorder without increased hair fragility. Two cases of pili anulati are presented, in which fragility of hair developed in a causal relationship with the onset of androgenetic alopecia. Accordingly, trichorrhexis-nodosa-like hair fracturing was exclusively limited to the androgenetic region. In general, secondary trichorrhexis nodosa is an unspecific finding related to excess stress of hair in relation to its fragility. With onset of hair thinning due to androgenetic alopecia, progressive reduction of hair shaft diameter may cause increased fragility in pili anulati. In this case, hair shaft fracturing occurs within the area of androgenetic alopecia and colocalizes with the air-filled cavities of pili anulati.

Adult↗
PubMed2001

Alopecia areata and affected skin CRH receptor upregulation induced by acute emotional stress.

BACKGROUND: Recent evidence indicates that acute stress can precipitate a number of dermatological conditions, including alopecia areata. This effect may be mediated by corticotropin-releasing hormone (CRH) released locally in the skin from dorsal root ganglia or immune cells. CRH typically acts through activation of specific receptors that are either type 1 or types 2 alpha and 2 beta. CRH, or related peptides such as urocortin, could have proinflammatory effects directly or through activation of mast cells leading to destruction of the hair root. OBJECTIVES: To investigate the expression of CRH receptors on the affected skin of patients who developed alopecia areata following acute emotional stress. METHODS: Scalp skin biopsies were obtained from 1 normal volunteer and 3 patients after ring infiltration of the relevant site with lidocaine. The biopsies were frozen and were later processed for in situ hybridization for CRH receptors type 1 or types 2 alpha and 2 beta. Sections showing positive results were photographed. RESULTS: The skin from the normal volunteer showed weak background expression of all three receptor types. However, skin from the affected sites of all 3 patients studied showed intense expression only on the type 2 beta receptor around the hair follicles. CONCLUSION: Acute emotional stress may precipitate alopecia areata by activation of overexpressed type 2 beta CRH receptors around the hair follicles leading to intense local inflammation.

Adult↗
PubMed2005

Value of direct immunofluorescence for differential diagnosis of cicatricial alopecia.

BACKGROUND: There are diverse causes of cicatricial alopecia characterized by lack of follicular ostia and irreversible loss of hair. While clinical differentiation between the causes may be difficult, particularly with regard to lichen planus (LP), lupus erythematosus (LE) and pseudopelade of Brocq (PB), it has been suggested that both histopathologic examination and direct immunofluorescence studies (DIF) are necessary for an accurate diagnosis. OBJECTIVE: The aim of this study was to evaluate the diagnostic value of DIF studies in addition to histopathology in patients with cicatricial alopecia as a clinical feature. METHODS: 136 scalp biopsy specimens received for histopathology and DIF during a 5-year period were reviewed. RESULTS: Definitive diagnosis was achieved by careful evaluation of scalp biopsies. The most prevalent diagnoses in order of frequency were LP (26%), LE (21%) and folliculitis decalvans (20%). PB was diagnosed in 10%. In most cases, the diagnosis could be made on the basis of histopathology and independently of DIF. Characteristic DIF patterns showed high specificity, but low sensitivity for LP, and high specificity and sensitivity for LE. The DIF pattern in PB showed no difference to LP. CONCLUSIONS: Histopathology permits diagnosis in the majority of cicatricial alopecias. DIF is of value in histopathologically inconclusive cases, particularly when LE is in question.

Adult↗
PubMed1997

Nonscarring alopecia associated with solitary circumscribed neuroma.

We report an unusual case of nonscarring alopecia clinically resembling patchy alopecia areata around central solitary circumscribed neuroma. Prompt and spontaneous complete hair regrowth was observed after removal of the tumor. Further knowledge of growth factor and receptor interaction in regulating the hair follicle cycle, as well as on the production of growth factors and cytokines by tumor cells and/or cells within the tumor microenvironment may contribute to better understand the pathologic mechanisms underlying certain curious phenomena such as peritumoral nonscarring alopecia.

Aged↗