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PubMed1992

[Narcolepsy and alopecia areata: a new association?].

We here present three cases with Alopecia Areata and Narcolepsy, an association we believe to be hitherto undescribed. Narcolepsy is a low-frequency (0.5%) disorder. It is now accepted that the majority of patients with narcolepsy are DR2 positive. Alopecia Areata is a disease whose incidence in Caucasian population is between 0.05% and 1%. In both diseases there is a set of common data and the origins of the two diseases have been related to an autoimmunity mechanism. In both, a higher than normal incidence of diabetes has been recorded, together with a predominant HLA type pattern. We believe that this association is not casual although epidemiological studies are needed to test our working hypothesis.

Adolescent↗
PubMed1978

Dinitrochlorobenzene therapy for alopecia areata.

Ninety patients with alopecia areata were treated with weekly applications to one side of the head of dinitrochlorobenzene (DNCB) dissolved in acetone, the other side of the head serving as control region. In 80 patients (89%) hair regrew either exclusively on the treated side, or considerably faster and denser on this side. The difference was noted, in the majority of cases, within eight weeks. The initial response, however, could not be maintained in all of these patients. Persistent response was observed in 72 patients (80%). Peribulbar round cell infiltrates were found to be more constant and denser on the treated side, suggesting that topically applied DNCB affects the peribulbar infiltrate present in alopecia areata. Possibly, the therapeutic result is due to altered local immunoregulation.

Adolescent↗
PubMed2004

Topical sensitizers in alopecia areata.

Though many therapies exist for alopecia areata, one of the most unique is topical sensitization. By altering the pathogenic inflammatory response with few side effects, sensitizers offer an attractive treatment option for many patients with alopecia areata, including those who have previously failed more traditional treatments and those who have extensive disease.

Adjuvants, Immunologic↗
PubMed2004

[Alopecia areata and treatment].

Alopecia areata is a non scarring inflammatory hair disease, frequently recurrent. It commonly presents as round patches of hair loss which can be the first manifestation of a more severe alopecia: totalis or universalis. A CD4 lymphocytic infiltrate surrounds the hair follicle and is presumed to play a role in the hair fall. There are many treatments available which may help stimulate regrowth. The efficacy, risks, and benefits of each treatment have to be considered when choosing a treatment plan.

Alopecia Areata↗
PubMed1979

Hypopigmentation in alopecia mucinosa.

Alopecia mucinosa was found in the hypopigmented skin of two black patients. Alopecia mucinosa should be included in the differential diagnosis of hypopigmented papular skin lesions.

Alopecia↗
PubMed2005

RU 58841-myristate--prodrug development for topical treatment of acne and androgenetic alopecia.

Acne and androgenetic alopecia are linked to androgen effects and therefore should improve following topical application of antiandrogens. We present a new antiandrogen prodrug, RU 58841-myristate (RUM) for topical therapy. Almost devoid of affinity to the androgen receptor, as derived from investigations in the mouse fibroblast cell line 29 +/GR +, RUM is rapidly metabolised to the potent antiandrogen RU 58841 by cultured human foreskin fibroblasts and keratinocytes, male occipital scalp skin dermal papilla cells, and by cells of the sebaceous gland cell line SZ95. In order to improve a specific targeting of the hair follicle, RUM was loaded on solid lipid nanoparticles (SLN), which are already known to support dermal targeting effects. Physically stable RUM loaded SLN were produced by hot homogenization. Penetration/permeation studies carried out using the Franz diffusion cell proved only negligible permeation of reconstructed epidermis and excised porcine skin within 6 h, implying a more topical action of the drug. Targeting to the hair follicle using SLN was visualised by fluorescence microscopy, following the application of Nile Red labelled SLN to human scalp skin. Transmission electron microscopy (TEM) allowed to detect intact silver labelled SLN in porcine hair follicles of preparations applied to the skin for 24 h. RUM loaded SLN should be considered for topical antiandrogen therapy of acne and androgenetic alopecia.

Acne Vulgaris↗
PubMed2005

[Mechanism of alopecia in patients with paraneoplastic pemphigus].

OBJECTIVE: To investigate the relationship between the levels of antidesmoglein (DSG) 1, 3 antibodies in the sera of patients with paraneoplastic pemphigus (PNP) and alopecia. METHODS: Sera from PNP patients, bullous pemphigoid patients, and normal healthy subjects were collected and 2 tissue samples from 2 healthy scalps were resected. Anti-DSG 1, 3 antibodies in the sera of PNP patients were detected by enzyme-linked immunosorbent assay (ELISA). Indirect immunofluorescent assay was used to detect whether the antibodies in the sera of PNP patients binds with the follicular epithelium of normal healthy scalp. RESULTS: Anti-DSG3 autoantibody was strongly positive and anti-DSG1 weakly positive in one patient, while both two antibodies were negative in the other patient. Their sera could bind to keratinocytes and follicular epithelium in human scalp. Immunofluorescent signals were found on the intercellular epidermal cell surface and outer root sheath of the follicular epithelium. However, the immunofluorescent signals in the section incubating with serum of bullous pemphigoid were only found on basal membrane zone. No signals were found in the section incubating with normal healthy serum. CONCLUSION: Alopecia in PNP patients are correlated with the anti-DSG3.

Adult↗
PubMed2005

Color-dilution alopecia in dogs.

Color-dilution alopecia is a relatively uncommon hereditary skin disease seen in "Blue" and other color-diluted dogs. This syndrome is associated with a color-dilution gene. The initial clinical signs are the gradual onset of a dry, dull and poor hair coat quality. Hair shafts and hair regrowth are poor, and follicular papules may develop and progress to frank comedones. Hair loss and comedo formation are usually most severe on the trunk, especially color-diluted area on the skin. Six cases of color-dilution alopecia are reported in 3 months to 10 years old dogs. The breeds of dogs are blue Doberman Pinscher, Miniature Pinscher, Dachshund, and Schnauzer. Grossly, extensive partial hair loss was seen on the skin. Histopathologically, the epidermis is relatively normal but may be hyperplastic. Hair follicles are characterized by atrophy and distortion. Heavily clumped melanin is present in the epidermis, dermis and hair follicles.

Alopecia↗
PubMed2005

Large, nonhealing scalp ulcer associated with scarring alopecia and sclerodermatous change in a patient with porphyria cutanea tarda.

Porphyria cutanea tarda (PCT) is a disorder caused by deficient activity of a liver enzyme that leads to the accumulation of photoactive metabolites in the skin. The initial clinical presentation commonly includes mechanical fragility of the skin and blisters in sun-exposed areas. Sclerodermatous skin changes and scarring alopecia are described in up to 20% of patients. Although these unique skin changes have been reported in the literature, information regarding nonhealing ulcers of extraordinary size is lacking. We report a unique cutaneous manifestation of PCT that is not well documented: unusually large, nonhealing ulcers in the setting of sclerodermatous skin changes and scarring alopecia.

Alanine Transaminase↗
PubMed2005

Premature androgenic alopecia and insulin resistance. Male equivalent of polycystic ovary syndrome?

BACKGROUND: Polycystic ovary syndrome (PCOS), the most frequent endocrinopathy in women with estimated prevalence of 5-10 %, is characterised by a hormonal and metabolic imbalance of polygene autosomal trait. The complexity of symptoms and genetic base started up the hypothesis on the existence of male equivalent of PCOS. Precocious loss of hair before 30 years of age was suggested as one of the male symptoms of this syndrome. OBJECTIVES: The aim was to confirm the association of lower levels of follicle stimulating hormone (FSH) and sexual hormone binding globulin (SHBG) or higher free androgen index (FAI) in premature balding men with a reduced insulin sensitivity. PATIENTS/METHODS: The study included 30 men with premature hair loss (defined as grade 3 vertex or more on the alopecia classification scale by Hamilton with Norwood modification) starting before 30 years of age. The hormonal values of the investigated group were compared with those regarded as normal reference values obtained in a group of 256 males in the age of 20-40 years during the Czech population study of iodine deficiency. In all men with premature baldness besides hormonal level determinations insulin tolerance test was carried out. RESULTS: The observed group was divided into two subgroups. The first one showed similar hormonal changes as women with PCOS, namely subnormal SHBG, FSH or increased FAI. The other had either no anomalies in steroid spectrum or only lower SHBG. The groups did not differ either in BMI or in age. The group with hormonal profile resembling that of women with PCOS, showed significantly higher insulin resistance than the group without these changes. CONCLUSIONS: The findings are consistent with the hypothesis that at least a part of the men with premature androgenic alopecia could be considered as a male equivalent of the polycystic ovary syndrome of the women. These premature balding men represent a risk group for the development of impaired glucose tolerance or diabetes mellitus type 2.

Adult↗
PubMed2006

Oral mega pulse methylprednisolone in alopecia universalis.

Intravenous pulse corticosteroids is an alternative method of corticosteroids delivery, which proved to be safe with rapid and potent efficacy. It is an effective treatment of alopecia areata, but not for the totalis, universalis or ophiasis types, for which no effective therapy is available yet. Recently, it has been confirmed that oral and intravenous pulse methylprednisolone MP have comparable efficacy. Here, we report a 9-year-old Saudi boy with alopecia universalis who was treated with MP sodium succinate 15 mg/kg ideal body weight orally for 3 consecutive days bimonthly for 12 sessions. Complete hair regrowth was obtained without toxic effects. When the interval was increased to 4 weeks, he showed partial relapse. So, 2 more pulses were given with an interval of 3 weeks in between. This maintained his regrown hair for a year without treatment.

Alopecia↗
PubMed2006

Acute alopecia totalis.

From a group of 1,189 AA patients seen in our dermatology unit, thirteen (3 males, 10 females) experienced hair shedding that started profusely and diffusely over the entire scalp. They were under observation for about 5 years, histopathology and trichograms being performed in all instances. The mean age of the patients was 26.7 years. It took only 2.3 months on average from the onset of hair shedding to total denudation of the scalp. The trichogram at the time of diffuse shedding showed that about 80% had dystrophic roots and the remaining 20% had telogen roots. Histopathological findings and exclamation mark hairs were compatible with alopecia areata. Regrowth of hair was noted 3.2 month after the onset of hair shedding and recovery observed in 4.8 months. All patients were treated by methylprednisolone pulse therapy. During the follow-up period, 53 months on average after recovery, 8 of the 13 patients (61.5%) showed normal scalp hair without recurrence, in 4 patients the recovery was cosmetically acceptable in spite of focal recurrences and only 1 patient showed a severe relapse after recovery. Considering all of the above findings, this group of the patients should be delineated by the term acute alopecia totalis.

Adult↗
PubMed2006

[Alopecia areata caused by extreme solar abuse].

The Authors present a female patient who suffered from alopecia areata caused by extreme solar abuse. Biological effects of ionizing radiation, the damages by free radicals and protection against oxidative damage are summarized. The main forms and risk factors of UV-radiation, skin damages by UV-light as well as the pathogenesis of the alopecia areata are reviewed.

Adult↗
PubMed1991

Cutaneous immunopathology of androgenetic alopecia.

Male pattern baldness is assumed to result from a combination of normal serum concentrations of androgen and an appropriate genetic background. To study whether inflammation contributes to the development of androgenetic alopecia, direct immunofluorescence and dermatopathologic studies were performed on biopsy specimens from bald scalp of patients, with specimens from uninvolved scalp of these patients or from scalp of volunteers who were not bald serving as controls. Granular deposits of Immunoglobulin M or C3 (or both) were found at the basement membrane in 25 (96%) of 26 study patients and 1 (12%) of 8 control subjects. Granular C3 was also deposited on eccrine myoepithelial cells in 8 (31%) of 26 study patients, but no control subjects. Porphyrins were found in the pilosebaceous canal in 15 (58%) of 26 study subjects and in 1 (12%) of 8 control subjects. These results support an inflammatory pathogenesis of androgenetic alopecia. Propionibacterium acnes is known to produce porphyrins. Ultraviolet radiation may excite microbiologic porphyrins that could activate C3 and, subsequently, the complement cascade producing inflammatory mediators.

Adult↗
PubMed1991

Thyroid antibodies in alopecia totalis.

Auto-antibodies to different thyroid cell components in serum of patients with thyroid disease have been estimated. Some types of antibodies were detected only in sporadic cases of nonthyroid auto-immune diseases. This study was performed on 24 patients who had alopecia totalis. Although they had normal serum free T3, T4 and TSH levels, five patients had significantly increased anti-microsomal antibody and one patient had both increased antithyroglobulin and antimicrosomal antibody levels. These results suggested that in alopecia totalis cases, it is reasonable to analyse thyroid antibodies because they can be taken as one part of the abnormal immune reactivity.

Adolescent↗
PubMed1991

Topical minoxidil in the treatment of androgenetic alopecia in women.

Twenty-eight women with mild to moderate androgenetic alopecia were randomly assigned to apply either 2 percent topical minoxidil or placebo (vehicle) to their involved scalp areas twice daily. At the end of thirty-two weeks, there was a statistically significant increase of nonvellus target area hairs in the minoxidil-treated versus the vehicle-treated group (p = 0.006). Investigator assessment of moderate regrowth showed better results in subjects who used 2 percent topical minoxidil solution than those who used vehicle (p = 0.007), although subjects discerned no difference between treatment groups. Two percent topical minoxidil appears to be effective in the treatment of female androgenetic alopecia.

Administration, Topical↗
PubMed1991

Androgenetic alopecia (common baldness).

Alopecia is a common problem affecting the scalp in both men and women. The vast majority of all cases of alopecia are of the androgenetic variety. The clinical and endocrinologic features of this disorder are reviewed. Potential therapies, including surgical and medical modalities, are mentioned.

Aging↗