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PubMed1993

Alopecia universalis as a single abnormality in an inbred Pakistani kindred.

A Pakistani kindred comprising 5 generations contained 9 males and 4 females with alopecia universalis as a single abnormality without any associated defects. The skin biopsy from the scalp showed hair follicles without hair. Analysis of the pedigree is strongly suggestive of autosomal recessive inheritance, and consanguineous loops could account for all affected persons being homozygous for the abnormal allele.

Alopecia↗
PubMed2003

Primary hypergonadotropic hypogonadism, partial alopecia, and Müllerian hypoplasia: report of a second family with additional findings.

Two sisters with primary hypergonadotropic hypogonadism associated with microcephaly, flat occiput, partial alopecia, absent or streak ovaries, and Müllerian hypoplasia are reported. Their parents are first cousins. Despite some clinical differences, their features were very close to a family described with such an association by Al-Awadi et al. [1985: Am J Med Genet 22:619-622] in Kuwait.

Adolescent↗
PubMedDate not supplied

Midline alopecia reduction combined with hair transplantation.

The advantages gained by incorporating alopecia reduction (AR) in patients undergoing hair transplantation, or with patients who have previously had hair transplantation, are delineated. The specific advantages of the midline elliptical pattern are discussed. Clinical considerations that determine whether ARs are necessary are the degree of baldness, laxity of the scalp, age of the patient, and ultimate goal of the individual. The advantages and disadvantages of performing ARs or hair transplantation first are discussed and the new concept of minireductions also outlined.

Adult↗
PubMed2007

5alpha-Reductase type 2 gene variant associations with prostate cancer risk, circulating hormone levels and androgenetic alopecia.

Controversy exists over the significance of associations between the SRD5A2 (5alpha-reductase type 2) polymorphisms, A49T and V89L, and risk of prostate cancer. These potentially functional polymorphisms may alter life-long exposure to androgens with subsequent effects on male health and aging. The aim of this study was to examine the association of these variants with prostate cancer risk, plasma hormone levels and androgenetic alopecia. Subjects include 827 cases and 736 controls from an Australian population-based case-control study of prostate cancer. Information on prostate cancer risk factors and patterns of balding were collected. Plasma levels of testosterone, 3alpha-diol glucuronide (3alpha-diolG), dehydroepiandrosterone sulfate, androstenedione, sex hormone-binding globulin and estradiol were measured for controls. No associations with the V89L polymorphism were found. Carriers of the rarer A49T A allele were at a 60% higher risk of prostate cancer (OR = 1.60; 95% CI 1.09-2.36; p = 0.02) and 50% lower risk of vertex and frontal balding (p = 0.03) compared with men homozygous for the more common G allele. Although we found little evidence of association between this variant and plasma levels of 5 measured androgens, circulating 3alpha-diolG levels were 34% lower in A49T A allele carriers (p < 0.0001). Our study provides evidence that the SRD5A2 A49T A variant is associated with an increased risk of prostate cancer, lower levels of circulating 3alpha-diolG and decreased risk of baldness. These findings raise important questions with respect to previous assumptions concerning hormonal influences on prostate cancer risk in ageing males.

3-Oxo-5-alpha-Steroid 4-Dehydrogenase↗
PubMed1987

Topical minoxidil in the treatment of male pattern alopecia.

Male pattern hair loss (androgenetic alopecia) is a common problem. In fact, it affects nearly all males to some degree. Expression of the disorder is variable, and while it is never life-threatening, it often becomes a major source of consternation. The biology of the process is poorly understood, and no current therapy can halt or reverse the process. Only cosmetic surgery, which is painful, time consuming, and expensive, has been effective. In the past 7 years, since it was noted that a patient taking minoxidil for hypertension had reversal of male pattern hair loss, awareness of a possible therapeutic role for topical minoxidil in the management of this disorder has grown among physicians, scientists, and the general public. It can be concluded from available data that topical application of minoxidil is effective in providing cosmetically satisfying thickening of hair in a select group of individuals with male pattern hair loss. The drug's mechanism of action remains obscure. No serious side effects have been demonstrated with its use, however, and it is therefore advised in selected patients.

Administration, Topical↗
PubMed2006

Development and progression of alopecia in the vitamin D receptor null mouse.

Humans with selected mutations in the vitamin D receptor (VDR) and mouse models lacking VDR develop alopecia. Mice null for the Vdr gene are born with a normal coat of hair, but fail to initiate normal hair follicle cycling. In this study, we examined the morphology of the hair follicle of the Vdr null mouse during days 13-22 when the hair follicle normally initiates and completes the first catagen. We then explored the possibility that the abnormality in hair follicle cycling was associated with abnormal expression of hairless (Hr), a putative transcriptional regulator known to regulate hair follicle cycling and recently shown to regulate VDR transcriptional activity. Our results demonstrate the progressive deterioration of the hair follicle through catagen. Comparable to VDR, Hr was found in the basal cells of the epidermis and ORS of the hair follicle. However, Hr was also found in the IRS and matrix of the follicle, regions with little or no VDR. Hr levels increased during catagen, reaching a peak by day 19. Levels of Hr were greater in the Vdr null mice compared to wildtype controls, results confirmed by quantitative RT-PCR. We conclude that lack of VDR causes disruption of hair follicle structure during the first catagen resulting in failure of subsequent hair follicle cycling. These changes are associated with increased expression of Hr, suggesting a role for VDR in regulating Hr expression. Both Hr and VDR are required for normal hair follicle cycling.

Alkaline Phosphatase↗
PubMed1993

Response of grafts from patients with alopecia areata transplanted onto nude mice, to administration of interferon-gamma.

A variety of evidence has pointed to immunological involvement in the pathogenesis of alopecia areata (AA). The aim of the present study was to determine whether differential expression of HLA-DR and intracellular adhesion molecules-1 (ICAM-1) occurs in hair structures of patients with longstanding AA, following stimulation with interferon-gamma (IFN-gamma). IFN-gamma was injected i.v. to nude mice grafted with transplants obtained from affected areas of seven patients and of normal individuals. All mice were injected with IFN-gamma or phosphate-buffered saline (PBS) alone for 3 consecutive days. Immunohistochemical studies were performed in specimens of grafts in order to detect the change in adhesion molecules, HLA-DR antigen, and Langerhans cells. ICAM-1 and HLA-DR induction was found to be similar in grafts from AA patients and normal skin grafts in the IFN-gamma injected mice. However, more intraepithelial Langerhans cells were observed in the AA patients' grafts treated with IFN-gamma than in those treated with PBS and in normal grafts treated with IFN-gamma. This study suggests an important role of Langerhans cells in this issue.

Adult↗
PubMed1991

Expression of tenascin in perifollicular connective tissue: comparison of normal scalp and alopecia areata.

Tenascin, a recently discovered extracellular matrix protein, was demonstrated in perifollicular connective tissue of normal human scalp using immunohistochemistry. Its localization was different from other well-known extracellular matrix components, like fibronectin, laminin and heparan sulphate proteoglycan. A comparison between alopecia areata and normal scalps did not reveal major qualitative differences, except for an increased expression near heavily infiltrated follicles.

Alopecia Areata↗
PubMed1981

Cell-mediated immunity in alopecia areata.

A study of cell-mediated immunity was carried out in total of 69 subjects with alopecia areata (AA) of the scalp in various phases of its evolution. The blastic responses to mitogens PHA, Con A, and PWM proved significantly reduced, quite independently of the phase of the disease. The total E-rosettes test demonstrated a significant reduction in T-lymphocytes in patients with active AA. On the other hand, no significant differences could be demonstrated between the patients and the controls by means of active E rosette test. The mean values for Tgamma and for theophylline-sensitive T-lymphocytes were reduced in patients with active AA. The significance of the results is discussed.

Adolescent↗
PubMed1986

Topical immunotherapy changes the composition of the peribulbar infiltrate in alopecia areata.

It has previously been shown that, in patients with untreated progressive alopecia areata (AA), the peribulbar T4/T8 ratio is about 4:1. In the present study, the immunohistochemical findings obtained in untreated AA patients were compared to those obtained in patients who had received topical immunotherapy with diphencyprone. The untreated group consisted of 5 patients with progressive AA and 5 patients with inactive AA. The treated group consisted of 5 patients with a good response to diphencyprone and 5 patients with little or no hair regrowth after treatment. In untreated patients with progressive AA, the mean peribulbar T4/T8 ratio was 4:1, whereas in untreated patients with stable AA, the ratio was 2:1. In the treated patients with a good response to diphencyprone, the mean T4/T8 ratio was 1:1, while in the patients with poor or no response to treatment, the ratio was 0.7. In conclusion, topical immunotherapy considerably alters the peribulbar T4/T8 ratio in AA. The results are consistent with, but do not prove, the concept of topical immunomodulation.

Administration, Topical↗
PubMed1976

EEG findings, rapid ACTH test and autonomic nervous symptoms in patients with alopecia areata.

Patients of multiple alopecia areata were examined in their EEG findings and rapid ACTH test and described the symptoms concerning the neuroautonomic system. Some abnormal EEG findings were seen in 75 cases out of the examined 105 patients. As to the rapid ACTH test, 10 cases out of 45 subjects were abnormal. A positive correlation was considered between abnormal EEG findings and abnormal value in the rapid ACTH test. It is speculated that the regulation centers in the brainstem and hypothalamus play a great role in pathophysiology of multiple areata.

Adrenocorticotropic Hormone↗
PubMed1997

Scalp cooling in the prevention of alopecia in patients receiving depilating chemotherapy.

To assess any difference in the incidence of alopecia during treatment and of skull metastases during follow-up among breast cancer patients undergoing scalp cooling during chemotherapy and those treated at ambient temperatures. A series of 35 breast cancer patients receiving adjuvant chemotherapy were consecutively assigned either to a scalp cooling regimen (19 patients) or to an ambient temperature regimen (16 patients). Hypothermia was administered with electrically cooled caps (SCS II: Amit Technology, Jerusalem) for 1 h after treatment. A significant difference (P = 0.014) was detected in the incidence of alopoecia: 48% (9 patients) of those who had undergone cooling suffered alopoecia, while 81% (13 patients) of the group who had not undergone cooling lost scalp hair. Patient comfort levels were high. Follow-up (median time 14 months) has disclosed no scalp metastases. The implementation of routine scalp hypothermia as part of adjuvant chemotherapy treatment, especially in cancers without tendencies to bone metastases, should be seriously considered.

Alopecia↗
PubMed1990

Simultaneous primary infection with HIV and CMV leading to severe pancytopenia, hepatitis, nephritis, perimyocarditis, myositis, and alopecia totalis.

Simultaneous primary infection with HIV and CMV in an 18-year-old woman led to an acute cytotoxic reaction, manifesting as pancytopenia, hepatitis, nephritis, perimyocarditis, and myositis. Within 14 days parameters indicating acute cell damage reverted to normal. Two weeks later transient alopecia totalis developed. Initially, HIV-antigen but no HIV antibodies were present. Within 3 weeks HIV-IgG antibodies appeared while HIV antigen disappeared. Anti-CMV-IgM was clearly and anti-CMV-IgG questionably positive; IgM persisted further, while IgG remained definitely undetectable. We speculate that a particular HIV-induced imbalance of the immune system led to a generalized severe cytotoxic reaction to a simultaneous infection with CMV.

Adolescent↗
PubMed1996

Cytokines and growth factors influence hair growth in vitro. Possible implications for the pathogenesis and treatment of alopecia areata.

Factors that influence the growth of the anagen hair follicle or initiate the switch to a catagen growth pattern have so far not been definitely determined, but there is increasing evidence that cytokines and growth factors play an important role during these processes. Recently we detected an aberrant in situ expression pattern of cytokines of the Th1 type (IFN gamma, IL-2) plus IL-1 beta expression in untreated alopecia areata (AA), and a switch to high levels of IL-10 TGF-beta 1 expression after successful treatment with the contact allergen diphenylcyclopropenone (DCP). Hence the question arose as to whether cytokines are able to arrest hair growth and whether IL-10 or TGF beta 1 have the capacity to antagonize this process. Using whole-organ cultures of microdissected human hair follicles we studied the effect of a panel of cytokines and growth factors on hair growth and on the gross morphology of the hair follicles in vitro. IL-2, IL-10 and IFN-gamma had no effect in this regard, whereas TGF beta 1 partially inhibited hair growth and EGF, TNF alpha and IL-1 beta completely abrogated it. EGF and TNF alpha induced the formation of a club-like hair follicle, similar to catagen morphology of the hair bulb, whereas hair follicles grown in the presence of IL-1 beta or TGF beta 1 showed no particular morphological changes. We conclude that cytokines and growth factors are pivotal regulators of hair growth at least in vitro. IL-1 is suggested as playing an important role during the pathogenesis of AA. Possible mediators of therapeutic contact dermatitis (IL-10, TGF beta 1, TNF alpha, PGE2) are, at least in vitro, not able to antagonize the IL-1 beta-triggered hair growth inhibition. Therefore, we infer that these mediators rather "modulate' the immune response in AA.

Alopecia↗
PubMed2006

Association of pelvic endometriosis with alopecia universalis, autoimmune thyroiditis and multiple sclerosis.

An adult Caucasian female developed a previously unreported association of pelvic endometriosis (PE) with the triad of alopecia universalis (AU), autoimmune thyroiditis (AT) and multiple sclerosis (MS). Molecular human leukocyte antigen (HLA)-tissue typing of this subject showed the presence of the DR(2) 15 and DR(3) 17 alleles, which are associated to an increased risk of MS and AT, respectively. Clinical onset of AT followed withdrawal of corticosteroid treatment for AU, whereas MS become clinically evident after withdrawal from long-term estroprogestin therapy for PE. This clinical case is presented to discuss the autoimmune origin of PE, its possible association with multiple autoimmune disorders as well as the effect of other factors, such as administration and/ or discontinuation of specific hormonal regimens, on genetic autoimmunity-prone background.

Adolescent↗
PubMed2003

Nitric oxide donors as potential additions to anti-alopecia areata armamentarium.

Th1-type cytokines play a critical role in the pathogenesis of alopecia areata (AA) and a Th2 lymphocyte-like response may inhibit the tissue-damaging effects of Th1 lymphocytes. It is suggested that nitric oxide (NO) could induce a switch from Th1 to Th2 lymphocytes in the immune response. Additionally, decreased levels of calcitonin gene-related peptide (CGRP) in lesions have been proposed to play an important role in the pathomechanism of AA and NO augments both the release of CGRP and the vasorelaxation induced by it. Taken together, these data suggest that 1) NO donors could be useful in the treatment of AA through the induction of T cell switching towards Th2 cells and 2) induction of inducible nitric oxide synthase (iNOS) by both allergic and irritant contact dermatitis could provide a mechanism for the efficacy of contact dermatitis in the treatment of AA.

Alopecia Areata↗