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PubMed1993

Quantitative study of the human hair follicle in normal scalp and androgenetic alopecia.

We carried out a quantitative study of the matrix and dermal papilla of the human hair follicle of the scalp, both normal and in various degrees of androgenetic alopecia. A stereological study showed the measured parameters to decrease with increase in the degree of alopecia, particularly as regards the total volume of the matrix and its papilla. The ratio of the two volumes increased by 30%, indicating a much more marked decrease in size of the papilla than in the matrix size. The number of cell nuclei in the matrix and the papilla of alopecic scalp was found to be 30% and 50% smaller, respectively, than those of normal scalp. Finally, a morphometric study revealed enlarged nuclei in the matrix and papilla, as shown by their increased areas, perimeters, and maximal diameters.

Adult↗
PubMed2006

Female-patterned alopecia in teenage brothers with unusual histologic features.

BACKGROUND: Patterned hair loss, follicular miniaturization, and increased telogen hair counts characterize androgenic alopecia (AGA). Follicular inflammation in AGA has been associated with treatment resistance and progressive hair loss. CASE REPORT: Brothers, 15 and 18 years old, presented with frontal and mid-scalp hair loss with an intact frontal hairline noted over a 1-year period. The elder reported past use of androgenic steroids. Laboratory assessment for metabolic and hormonal abnormalities was unrevealing, and hair pull test was negative. Scalp biopsies revealed decreased terminal hairs, marked diameter variation of anagen hairs, decreased terminal to vellus hair ratios (3.7:1/3.4:1, older/younger), and increased telogen counts (23%/21%). Infrabulbar and peri-isthmic (follicular bulge region) lymphocytic infiltrates were present. Hair loss has progressed, unabated by daily topical 0.5% clobetasol (for 6 months), daily 5% minoxidil (1 year), and latter, daily oral finasteride (2 years - older brother only). DISCUSSION: Based on patterned hair loss and miniaturized hairs, these brothers have AGA. The female pattern of hair loss (diffuse hair loss affecting the central scalp with preservation of frontal hair line) coupled with follicular isthmic lymphocytic inflammation represents an unusual presentation, possibly a treatment resistant, inflammatory variant of AGA. The differential diagnosis includes exogenous androgen-mediated hair loss, cicatricial pattern hair loss, or the superimposition of alopecia areata.

Adolescent↗
PubMed2005

[Alopecia areata universalis and disseminated mollusca contagiosa in atopic dermatitis. Hair re-growth during treatment with interferon gamma--therapeutic effect or coincidence?].

A 35-year-old woman presented with severe recalcitrant atopic dermatitis, in association with disseminated mollusca contagiosa and alopecia areata universalis. After several weeks of systemic interferon gamma, which was administered subcutaneously,the viral infection cleared and, surprisingly, four weeks after starting treatment hair re-growth was observed. Complete remission of alopecia areata was documented few weeks later and persists. After four cycles of high-dose intravenous immunoglobulin, a sustained remission of the atopic dermatitis was achieved.

Adult↗
PubMed2005

[Excimer laser therapy of alopecia areata--side-by-side evaluation of a representative area].

We report for the first time on hair regrowth in alopecia areata of the scalp achieved with the 308-nm xenon-chloride excimer laser in a prospective side-by-side trial. The alopecia areata had shown progression over a period of three years, and various treatments had not been effective. Out of a number of affected areas, one representative lesion was chosen; one half of it was treated, the other half remained untreated. After 27 sessions (200 - 4000 mJ/cm2, cumulative dose 52.6 J/cm2) over 3 months, only the treated area showed hair growth; which suggests that this was most probably not a spontaneous remission.

Adult↗
PubMed1996

Investigation of the reproductive and growth hormone status of dogs affected by idiopathic recurrent flank alopecia.

The reproductive and growth hormone status of a group of 12 neutered dogs affected by idiopathic recurrent flank alopecia was investigated at both maximum and minimum photoperiod using the adrenocorticotrophic hormone (ACTH) stimulation test, the xylazine stimulation test and the insulin-like growth factor I (IGF-I) assay. When compared with a group of nine neutered control dogs, the plasma reproductive hormone concentrations were not significantly different with one exception; a significantly greater post-ACTH plasma progesterone concentration was detected in the affected group at minimum photoperiod (P < 0.05). The significance of this finding in isolation is unclear. Growth hormone response to intravenous xylazine was assessed in the affected group at maximum photoperiod only and was found to be within normal limits in eight of the dogs. Serum IGF-I concentrations were significantly greater in the affected group at maximum photoperiod but the groups were not significantly different at minimum photoperiod. These results suggest that dogs with idiopathic recurrent flank alopecia are of normal reproductive and growth hormone status.

17-alpha-Hydroxyprogesterone↗
PubMed1998

Alopecia universalis associated with a mutation in the human hairless gene.

There are several forms of hereditary human hair loss, known collectively as alopecias, the molecular bases of which are entirely unknown. A kindred with a rare, recessively inherited type of alopecia universalis was used to search for a locus by homozygosity mapping, and linkage was established in a 6-centimorgan interval on chromosome 8p12 (the logarithm of the odds favoring linkage score was 6.19). The human homolog of a murine gene, hairless, was localized in this interval by radiation hybrid mapping, and a missense mutation was found in affected individuals. Human hairless encodes a putative single zinc finger transcription factor protein with restricted expression in the brain and skin.

Alopecia↗
PubMed2001

Prevention of chemotherapy-induced alopecia in rats by CDK inhibitors.

Most traditional cytotoxic anticancer agents ablate the rapidly dividing epithelium of the hair follicle and induce alopecia (hair loss). Inhibition of cyclin-dependent kinase 2 (CDK2), a positive regulator of eukaryotic cell cycle progression, may represent a therapeutic strategy for prevention of chemotherapy-induced alopecia (CIA) by arresting the cell cycle and reducing the sensitivity of the epithelium to many cell cycle-active antitumor agents. Potent small-molecule inhibitors of CDK2 were developed using structure-based methods. Topical application of these compounds in a neonatal rat model of CIA reduced hair loss at the site of application in 33 to 50% of the animals. Thus, inhibition of CDK2 represents a potentially useful approach for the prevention of CIA in cancer patients.

Alopecia↗
PubMed2000

Alopecia areata and coeliac disease: no effect of a gluten-free diet on hair growth.

BACKGROUND: An association between alopecia areata (AA) and coeliac disease has recently been reported. AIM: The aim of this paper was to evaluate the possible effect of a gluten-free diet (GFD) on the new growth of hair in 5 alopecic patients with CD. METHODS: CD was diagnosed in 5 patients with AA (universalis in 3 cases and patchy in 2 cases). The diagnosis of CD was based on serological and histological standard criteria. RESULTS: In all patients the GFD resolved CD clinically, serologically and histologically but had no effect on the course of alopecia. CONCLUSION: AA and CD, when associated, present different responses to a GFD and have an independent course.

Adult↗
PubMed2000

An X-linked gene involved in androgenetic alopecia: a lesson to be learned from adrenoleukodystrophy.

BACKGROUND: Adrenoleukodystrophy (ALD), including its adult variant adrenomyeloneuropathy (AMN), is an X-linked recessive trait characterized by progressive demyelinization of the nervous system. The gene defect involves a peroxisomal transporter protein, resulting in accumulation of very-long-chain fatty acids in the brain and other organs such as the adrenal glands. Affected men show various endocrine disorders. Moreover, disturbances of hair growth are frequently mentioned in reports on ALD/AMN. OBJECTIVE: This study was performed to delineate further the hair status and type of hair loss in men with AMN. METHODS: We examined and documented the status of hair growth in 16 men suffering from AMN. A meticulous history with particular regard to hair changes was taken from all patients and their family members. RESULTS: The age of the patients varied between 27 and 62 years, their mean age was 39.8 years. Twelve men showed male-pattern androgenetic alopecia (AGA), Hamilton grades IV-VIII, 3 men had a female-pattern AGA (Ludwig grade I or II). Ten of the patients with male-pattern AGA had reached Hamilton stage VII or VIII. The remaining scalp hair was unusually scarce and thin in 11 cases, regardless of the grade of AGA. Moreover, in 10 of 16 patients the eyelids showed pronounced madarosis. The remaining body hair was found to be normal. If present, endocrine manifestations had started prior to the onset of alopecia, and in 11 of 12 patients hair loss was apparent before neurological symptoms were noted. CONCLUSION: ALD/AMN gives rise to two different types of hair loss. Firstly, affected men show diffuse hair loss involving the entire scalp and the eyelashes. Secondly, they tend to develop AGA more frequently and earlier and in a severer form. Paradoxically, pronounced AGA is present although the patients may simultaneously show some degree of hypogonadism. Hence, the X-linked ALD mutation can be taken as a well-defined gene within the polygenic spectrum of genes responsible for AGA. This may be of theoretical importance for the elucidation of the pathogenetic pathways of AGA.

Adrenoleukodystrophy↗
PubMed1998

Comparison of alopecia areata in human and nonhuman mammalian species.

Alopecia areata (AA) is a nonscarring form of inflammatory hair loss in humans. AA-like hair loss has also been observed in other species. In recent years the Dundee experimental bald rat and the C3H/HeJ mouse have been put forward as models for human AA. AA in all species presents with a wide range of clinical features from focal, locally extensive, diffuse hair loss, to near universal alopecia. Histologically, all species have dystrophic anagen stage hair follicles associated with a peri- and intrafollicular inflammatory cell infiltrate. Autoantibodies directed against anagen stage hair follicle structures are a consistent finding. Observations on AA pathogenesis suggest nonhuman species can provide excellent models for the human disease. Ultimately, animal models will be used to determine the genetic basis of AA, potential endogenous and/or environmental trigger(s), mechanism(s) of disease initiation and progression, and allow rapid evaluation of new and improved disease treatments.

Alopecia Areata↗
PubMed2001

Alopecia syphilitica: report of two cases in Geneva.

Two patients with alopecia syphilitica are presented. Moth-eaten alopecia is the most typical look of secondary syphilis on the scalp. With the decrease in syphilis cases in western countries, this rarer clinical manifestation tends to be misdiagnosed.

Adult↗
PubMedDate not supplied

EEMCO guidance for the assessment of hair shedding and alopecia.

Knowledge of the hair follicle anatomy and the dynamics of hair cycling is substantial. Recognizing the anagen, catagen and telogen phases as well as teloptosis and the hair eclipse phenomenon clearly characterizes the typical hair chronobiology. Physiological modulators include hormones, neuromediators, miscellaneous biomolecules, seasons, micro-inflammation and ageing. For individuals who present with the complaint of increased hair shedding or alopecia, a host of evaluation techniques are available in addition to history, physical examination and laboratory assessment. Various clinical hair techniques can help in assessing the efficacy of drugs and cosmetics on hair growth. The methods are quite similar to those used to establish a definite diagnosis in dermatological practice. Great strides have been made during the recent decades in the methodology of hair growth trials in dermatology and cosmetology. Clinical evaluations benefit from a few additional specific techniques that enhance the perception of hair (re-) growth, shedding and alopecia. These assessments include the determination of hair patterning and density that may be helped by the 'black-and-white felt' examination. Daily hair counts, the 'hair pull test' and the 'hair feathering test' are also available. Instrumental methods provide reliable quantitative information that is useful if there are adequate controls. Some photographic methods, the trichogram, hair weighing and variants of the hair growth window technique including the phototrichogram, videotrichogram and tractio-phototrichogram provide insight into the complexities of hair cycling and shedding. Skin biopsy is indicated for diagnostic purposes, especially when the hair loss is accompanied by scarring.

Alopecia↗
PubMed2006

A comparison of the efficacy, relapse rate and side effects among three modalities of systemic corticosteroid therapy for alopecia areata.

BACKGROUND: Systemic corticosteroids are one of the most commonly used therapeutic modalities for patients with extensive alopecia areata (AA), although they entail several drawbacks. OBJECTIVE: To determine the best modality for systemic corticosteroid use in terms of their efficacy, relapse rate, and side effects. METHODS: Fifty-one patients with single or multiple AA (AA/multiplex) and 38 patients with alopecia totalis or AA universalis (AA totalis/universalis) were enrolled in this open study. They were randomly divided into three groups depending on the time of their initial visit. They were administered (1) oral dexamethasone (Dex) 0.5 mg/day for 6 months (Dex group), (2) intramuscular triamcinolone acetonide (imTA) 40 mg once a month for 6 months followed by 40 mg once every 1.5 months for 1 year (imTA group), and (3) pulse therapy (PT) using oral predonine 80 mg for 3 consecutive days once every 3 months (PT group). After the treatment, each treatment modality was evaluated by the response rate, relapse rate, and side effect profile. RESULTS: The response rate of AA/multiplex was significantly better in the imTA group than in the Dex group. The overall relapse rate and that of AA totalis/universalis were significantly better in the PT group than in the Dex group. Dysmenorrhea was the most common and problematic side effect. Impairment of the adrenocortical reserve was seen in 7% of the PT group and 23% of the imTA group, which was recovered without any further medical treatment. CONCLUSION: imTA or pulse therapy is effective for AA and has an acceptable level of side effects. The development of a new strategy to reduce the relapse rate is needed.

Administration, Oral↗
PubMed1979

Immunological studies in patients with alopecia areata.

Cellular and humoral immune parameters were studied in 10 patients with alopecia areata totalis and universalis. Trends to low normal immunoglobulins levels and in vitro lymphocyte transformation to concanavalin A were observed. Serum CH-50 levels and skin test responses to mumps, candida, trichophytin and dinitrochlorobenzene (DNCB) not found in vitro. 1 patient with alopecia universalis of 33 years duration developed hair at the site of DNCB skin testing. The findings point to rather subtle immune defects in patients with this disease.

Adolescent↗
PubMed1996

Acquired eyelash trichomegaly and alopecia areata in a human immunodeficiency virus-infected patient.

We describe a human immunodeficiency virus (HIV) seropositive man with acquired eyelash trichomegaly and alopecia areata. This combination of clinical manifestations is intriguing since the new onset of elongated eyelashes in patients with acquired immunodeficiency syndrome has usually been associated with severe immunosuppression and alopecia areata has a presumed autoimmune etiology that requires T cell activation. The occurrence of these dichotomous conditions illustrates the potential selective pathogenesis of progressive HIV infection.

Adult↗
PubMed1995

Alopecia areata in a patient with candidiasis-endocrinopathy syndrome: unsuccessful treatment trial with diphenylcyclopropenone.

The association of chronic mucocutaneous candidiasis with endocrine dysfunction (candidiasis-endocrinopathy syndrome, CES) is a complex immune disorder, in which autoimmunity is found besides selective impairment of cellular immunity. We report a case of CES associated with alopecia areata. The histology of a scalp biopsy demonstrated minor inflammation with profound atrophy of the hair follicles and sclerotic whorls in the region of the hair papillae. A treatment trial with topical immunotherapy using diphenylcyclopropenone was unsuccessful, which might be explained by both long-standing alopecia areata and the underlying immune deficiency with an impaired delayed hypersensitivity reaction. Furthermore, the patient presented with agenesis of the spleen. Atrophy of the spleen in patients suffering from CES has formerly been described in the literature, but not asplenia. Its significance in the setting of the syndrome is discussed.

Adolescent↗
PubMed1992

Topical immunotherapy for alopecia areata: re-evaluation of 139 cases after an additional follow-up period of 19 months.

Within a group of 139 patients previously studied during treatment for alopecia areata with diphenylcyclopropenone (DCP), hair growth was re-evaluated after a period of 19 months following completion of our previous study. Fifty-four patients treated with DCP had total and 6 had partial but cosmetically acceptable regrowth. Twenty-five patients with total regrowth had stopped DCP treatment for a mean period of 15 months and had not relapsed. Nineteen of 28 patients who still applied DCP were in the process of stepwise discontinuation of treatment. Fifteen patients had subsequently been treated with squaric acid dibutylester (SADBE) after having acquired 'tolerance' to DCP; at the time of re-evaluation 3 of these patients had complete regrowth, and 4 patients had partial but cosmetically acceptable regrowth. Topical immunotherapy with DCP and SADBE had resulted in total regrowth in 57/139 patients (41.0%) and in partial but cosmetically satisfactory regrowth in 10/139 patients (7.2%). The type of involvement and duration of alopecia areata were factors of prognostic significance.

Administration, Topical↗