SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
The propensity of cytotoxic drugs to cause alopecia is well known, but nurses are perhaps less aware of the capacity of other drug groups to cause this unwanted side-effect. Increasing nurses' awareness of the actions of these drugs will enable the association between alopecia and toxicity to be recognised at an early stage, before the distressing effects of drug-induced alopecia develop.
The monoclonal antibody Ki-67 was used to determine the numbers of cycling cells in hair follicles both in alopecia areata and in normal scalp skin. Pronounced nuclear staining was limited to the area below the critical line of Auber and the exterior part of the outer root sheath. In alopecia areata there is reduced nuclear Ki-67 binding in the bulb of anagen hair follicles. These findings indicate that inhibition of keratinocyte proliferation might be a pathogenetic mechanism in alopecia areata.
One hundred and seventy-eight patients with severe alopecia areata were asked at interview whether they attributed their first attack of hair loss to an emotional trauma. Twelve patients (6.7%) reported a severely disturbing event during the 6 months preceding the first symptoms of their disease. No patient reported that episodes of hair loss coincided with stressful life events. Emotional triggers were not especially correlated with any particular type of alopecia areata. The present study does not therefore provide evidence of a significant role of emotional stress in the pathogenesis of alopecia areata.
Leukemic patients receiving marrow from HLA-identical sibling donors were randomized to treatment with either busulfan 16 mg/kg (n = 88) or total body irradiation ([TBI] n = 79) in addition to cyclophosphamide 120 mg/kg. The patients were observed for a period of 5 to 9 years. Busulfan-treated patients had an increased risk of veno-occlusive disease (VOD) of the liver (12% v 1%, P =.01) and hemorrhagic cystitis (32% v 10%, P =.003). Acute graft-versus-host disease (GVHD) was similar in the two groups, but the 7-year cumulative incidence of chronic GVHD was 59% in the busulfan-treated group versus 47% in the TBI group (P =.05). Death from GVHD was more common in the busulfan group (22% v 3%, P <.001). Obstructive bronchiolitis occurred in 26% of the busulfan patients but in only 5% of the TBI patients (P <.01). Complete alopecia developed in 8 busulfan patients and partial alopecia in 17, versus five with partial alopecia in the TBI group (P <.001). Cataracts occurred in 5 busulfan-treated patients and 16 TBI patients (P =.02). The incidence of relapse after 7 years was 29% in both groups. Seven-year transplant-related mortality (TRM) in patients with early disease was 21% in the busulfan group and 12% in the TBI group. In patients with more advanced disease, the corresponding figures were 64% and 22%, respectively (P =.004). Leukemia-free survival (LFS) in patients with early disease was 68% in busulfan-treated patients and 66% in TBI patients. However, 7-year LFS in patients with more advanced disease was 17% in the busulfan group versus 49% in the TBI group (P <.01). In patients with chronic myeloid leukemia (CML) in first chronic phase, 7-year LFS was 72% and 83% in the two groups, respectively.
BACKGROUND: Data suggest that androgenetic alopecia is a process dependent on dihydrotestosterone (DHT) and type 2 5alpha-reductase. Finasteride is a type 2 5alpha-reductase inhibitor that has been shown to slow further hair loss and improve hair growth in men with androgenetic alopecia. OBJECTIVE: We attempted to determine the effect of finasteride on scalp skin and serum androgens. METHODS: Men with androgenetic alopecia (N = 249) underwent scalp biopsies before and after receiving 0.01, 0.05, 0.2, 1, or 5 mg daily of finasteride or placebo for 42 days. RESULTS: Scalp skin DHT levels declined significantly by 13.0% with placebo and by 14.9%, 61.6%, 56. 5%, 64.1%, and 69.4% with 0.01, 0.05, 0.2, 1, and 5 mg doses of finasteride, respectively. Serum DHT levels declined significantly (P <.001) by 49.5%, 68.6%, 71.4%, and 72.2% in the 0.05, 0.2, 1, and 5 mg finasteride treatment groups, respectively. CONCLUSION: In this study, doses of finasteride as low as 0.2 mg per day maximally decreased both scalp skin and serum DHT levels. These data support the rationale used to conduct clinical trials in men with male pattern hair loss at doses of finasteride between 0.2 and 5 mg.
Contemporary views of feminine diffuse alopecia's etiopathogenesis have been presented on the grounds of literature data. In the considerable part of cases feminine diffuse alopecia is a symptom of many systemic diseases and hypovitaminosis. Sideropenia is often diagnosed. However it seems that neuroses and psychic traumas provoke alopecia in some cases.
Topical immunotherapy with diphencyprone (DPCP) for the treatment of severe alopecia areata has been used since 1983 and is felt to be the treatment of choice by many dermatologists. Although there have been no major side effects reported since its initial use, there remain some unknowns regarding its safety. Because DPCP has at least a 40% success rate for cosmetically acceptable regrowth in extensive alopecia areata, its availability is an important matter for patients with alopecia areata.
There are 2 stages of alopecia, anagen and telogen effluvium, both of which may be associated with medication-related alopecia. We describe massive hair loss in a 51-year-old woman during treatment with Seroxat (paroxetine), which remitted after it was discontinued. Pathological mechanisms of drug-associated alopecia are complex and have yet to be fully elucidated.
The aim of the study was the clinical and trichological examination (trichogram and hair loss evaluation) conducted comparatively before and after the treatment in 46 women between pubescence and 30 years of age who had symptoms of diffuse alopecia. Calcium pantothenate was administered twice a day orally in doses 100 mg for 4-5 months. Vitamin B6 was injected every day (i ampoule intramusculary) for the period of 20 to 30 days and repeated again after 6 month. On the basis of clinical and trichological studies it was revealed that vitamin B6 administered parenterally for a period of several weeks induces improvement in the hair condition in a number of women and it reduces the hair loss especially in alopecia of telogenic patomechanism. Whereas calcium pantothenate in feminine diffuse alopecia did not show clearly the positive effect.
Growing evidence shows alopecia areata (AA) to be a T cell-mediated organ-specific autoimmune disease. This study aimed to evaluate the efficacy of high-dose steroid pulse therapy in Taiwanese patients with severe widespread AA exceeding 40% of the scalp. A total of 17 Taiwanese patients with severe AA lasting less than 2 years were treated once monthly at the outpatient clinic for six sessions. Children younger than 12 years of age received oral prednisolone (5 mg/kg) in three divided doses, while for adults, 500 mg methylprednisolone was infused intravenously over 2 hours. Patients with multifocal AA exhibited the most favorable response, with more than 75% hair regrowth (9/11). Relapse occurred in two patients at 4 and 8 months after the last treatment, respectively. One patient with ophiatic AA showed a transient response, but subsequently lost hair even upon continuation of therapy. Two patients of four with alopecia totalis had full hair regrowth but one lost hair again 6 months later. In the only patient with alopecia universalis, less than 10% hair regrowth occurred. No major side effects were observed. In summary, 11 of 17 patients (64.7%) had more than 75% hair regrowth after steroid pulse therapy. Our results indicated that steroid pulse therapy, given at 5-10 mg/kg once monthly for an average of 6 months, is effective and well tolerated in Taiwanese patients with severe multifocal AA lasting less than 2 years.
Congenital triangular alopecia is a nonscarring loss of hair mass on the scalp's temporal regions. The area of hair diminution commonly is described as triangular or lancet shaped. Although previously considered congenital, this condition usually is noticed after 2 years of age and, more recently, is thought to be acquired. We propose that this entity be renamed triangular alopecia. Because this condition involves normal rather than inflamed skin, it does not respond to topical or intralesional steroids. It is important to make the correct diagnosis to avoid unnecessary and potentially harmful interventions. We present the case of a 10-year-old boy with triangular alopecia.
Topic immunotherapy in alopecia areata consist in a mild contact dermatitis with help of a chemical substances, with a high potency of sensitization, such as dinytroclorbenzenul (DNCB), squaric acid dibutylester (SADBE) and diphencypronil (DPCP). Eight patients with alopecia areata, 3 with mild form and 5 with severe form was treated with DPCP in acetone solution. We have obtained a positive result in 3 cases (37.5%), one with total regrows and 2 with partial regrows and a negative result in 5 cases, 3 with partial regrows and loss of the hair in other areas and 2 cases with no response after 24 weeks. We consider this method like an alternative therapy in severe alopecia areata resistant at other treatments.
One of the genetic factors associated with the development of alopecia areata (AA) is the HLA locus. The study comprised 52 patients with AA aged 10 to 64 years. The frequences of HLA-DRB alleles in the patients and controls were compared. The control group comprised 152 healthy persons. Familial occurrence of AA was seen in 7 (13.5%) cases. A significantly lower frequency of HLA-DRB1*03 was observed in patients with AA comparison with the control group. In all patients with AA, alleles HLA-DRB1*15/*16 occurred more frequently than in the control group, but this was not significant after correction. In the group of patients with more severe forms of alopecia areata (alopecia areata totalis/alopecia areata universalis) there was no significant difference in HLA-DR allele distribution.
The aim of the study was to carry out clinical and trichological examination (trichogram and assessment of hair loss) before and after treatment in 17 women aged 41-50 years with androgenic alopecia. Minoxidil (Loxon) was topically applied twice a day massaging the solution into the scalp over 6-12 months. It was revealed on the ground of clinical and trichological examination that the medication containing 2% solution of minoxidil externally applied on the scalp with androgenic alopecia over a few months caused normalization of hair root condition and decrease of hair loss in some patients of the observed group. The drug has a stimulating influence on hair growth and should be administered as an adjuvant therapy in androgenic alopecia in women.
Androgenetic Alopecia (AA) afflicts a large part of the population and of the many treatments available today none is completely satisfactory. Testing the efficacy and safety of a novel topical treatment for AA which is based on cell culture medium supplemented with insulin, thyroxin and growth hormone (CCM). The 48 participants classified as androgenetic alopecia Type II, III or IV on the Hamilton scale, concluded a randomized, vehicle-controlled, double-blind trial of 6 months duration. Under occlusive cover the gel was self applied for at least 3 hours daily. Evaluation was based on hair counts, investigator global assessment and participants self-administered questionnaire. Cessation of hair loss was reported by most participants within 28 weeks, and further confirmed by the hair count (HC) in ~80% of participants. Moreover, as early as 4 months after the start of the treatment, a time dependent increase of up to 50% in HC was observed. The average change in HC between the two groups differed significantly (p=0.007), with values of 4.1% for control and 13.8% for CCM. Following 4 months of treatment, a time dependent increase in HC (>10%) above minimal was observed in 55% of the CCM and 25% of the control and this trend continued. At 6 months 63% of the CCM and 33% of the control group exhibited increase of HC higher than 10%. The average increase in HC in the CCM and the control groups was 17.1% and 8.9% respectively (p=0.035). Self evaluation questionnaires revealed a time dependent increase in satisfaction in the CCMusers compared to the control. While the average score at T2 was similar in CCM and control (2.7 and 2.6 respectively), the score at T6 in the CCM increased to 5.9 and decreased to -0.4 in the control (p=0.007). Global-clinical evaluation following six months treatment revealed significantly (p=0.02) more hair loss in the control group (40%) compared to the CCM (7%) treated group. CCM was found effective in treating androgenetic alopecia in men. It induced cessation of hair loss, increased rate of hair growth and appearance of new hair. No side effects were reported or observed.
Two cases of frontal fibrosing alopecia in post menopausal women, one of them biopsy-proven, are reported. Both women showed a progressive marginal alopecia and none had multifocal areas of involvement typical of lichen planopilaris nor the mucosal or cutaneous lesions of lichen planus. However, scalp biopsy specimens from the frontal hair margin showed perifollicular fibrosis and lymphocytic inflammation. Because the histologic findings are indistinguishable from those seen in lichen planopilaris, frontal fibrosing alopecia is considered a variant of lichen planus pilaris with a particular specific localization and usually onset in the postmenopausal age.
Helping a patient cope with a frustrating and unpredictable disease like alopecia areata can be a difficult task for many dermatology nurses. Five dermatology nurses who practice in the United States and Canada say that one important resource that should not be overlooked during the course of treatment of alopecia areata is the patient support group. Another major resource is the referral of patients to the National Alopecia Areata Foundation, which coordinates the patient support groups.
Alopecia areata (AA) is a heterogeneous disease characterized by nonscarring hair loss on the scalp or any hair-bearing surface. A wide range of clinical presentations can occur -- from a single patch of hair loss to complete loss of hair on the scalp (alopecia totalis) or the entire body (alopecia universalis). Particularly in severe or chronic cases, AA may cause considerable psychological and emotional distress for affected individuals. The estimated lifetime risk of developing AA is 1.7%. While the precise etiology of this common disorder has not been elucidated, a substantial body of evidence suggests that AA is an organ-specific, autoimmune disease, targeted to hair follicles. However, the antigenic target(s), mechanisms, and consequences of autoimmune attack in AA have yet to be determined. Here, we critically explore the evidence supporting the hypothesis that AA is an autoimmune disease and propose specific pathways by which self-directed immune responses are generated.