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At least 1,045 records · Page 58Linked to original sources
PubMed1991

Alopecia totalis: is treating nonresponder patients useful?

The purpose of this study was to assess the effectiveness of different treatments in patients with alopecia totalis or universalis who did not respond to sensitizing therapies. Twenty-six patients, who had been receiving sensitizing therapy for at least 1 year without any response, were randomly assigned to receive the following treatments: topical 10% cyclosporine in oily solution (eight patients), PUVA (eight patients), and intravenous thymopentin (ten patients). None of them had any acceptable regrowth after at least 6 months of treatment. Our results suggest that other treatments are not useful in patients with 100% hair loss who fail to respond to sensitizing therapies.

Administration, Topical↗
PubMed1992

The psychological effects of androgenetic alopecia in men.

BACKGROUND: Despite the prevalence of androgenetic alopecia among men, little is known about its psychological effects. OBJECTIVE: This investigation examined the psychosocial sequelae that balding men attribute to hair loss and compared balding and nonbalding men in personality functioning. METHODS: Subjects included 63 men with modest balding, 40 men with more extensive balding, and 42 nonbalding controls. All anonymously completed a battery of standardized psychological measures. RESULTS: Reported effects of balding reflected considerable preoccupation, moderate stress or distress, and copious coping efforts. These effects were especially salient among men with more extensive balding and among younger men, single men, and those with an earlier hair-loss onset. Relative to controls, balding men had less body-image satisfaction yet were comparable on other personality indexes. Personality correlates of the psychological responses to hair loss were identified. CONCLUSION: Although most men regard hair loss to be an unwanted, distressing experience that diminishes their body image, balding men actively cope and generally retain the integrity of their personality functioning.

Adaptation, Psychological↗
PubMed1993

Diagnostic and predictive value of horizontal sections of scalp biopsy specimens in male pattern androgenetic alopecia.

BACKGROUND: Vertical sections of small scalp biopsy specimens are often inadequate for the diagnosis of male pattern androgenetic alopecia (MPAA). Quantitative analysis of follicular structures in horizontal sections can provide more information. OBJECTIVES: Our purpose was to establish better diagnostic criteria by comparing horizontal and vertical sections of scalp biopsy specimens from MPAA and normal control subjects and to determine the predictive value of horizontal sections, by relating counts of follicular structures in MPAA to subsequent hair regrowth from topical minoxidil therapy. METHODS: Paired 4 mm punch biopsy specimens were taken from 22 normal control subjects and 106 patients with MPAA, for horizontal and vertical sectioning. In horizontal sections, hair bulbs, terminal anagen, catagen and telogen hairs, telogen germinal units, and vellus hairs were counted, as were follicular units and stelae. RESULTS: The diagnosis of MPAA was confirmed by finding decreased terminal hairs and increased stelae and vellus hairs. The average horizontal section contained 22 terminal and 13 vellus hairs, a 1.7:1 ratio. Changes compatible with MPAA were found in most vertical and horizontal sections, but horizontal sections were required for follicular counts and showed terminal:vellus hair ratios diagnostic of MPAA in 67% of cases. Of 44 patients treated with topical minoxidil, five with less than 2 follicular structures/mm2 showed no hair regrowth, 32 with 2 to 4 follicular structures/mm2 showed regrowth in 72%, and seven with more than 4 follicular structures/mm2 showed regrowth in 86% of cases. In MPAA with no significant inflammation, regrowth occurred in 77% of cases, versus 55% in cases with significant inflammation. CONCLUSION: Horizontal sections of scalp biopsy specimens in MPAA provide more diagnostic information than vertical sections and appear to have a predictive value for hair regrowth.

Administration, Cutaneous↗
PubMed1995

Vertical and transverse sections of alopecia biopsy specimens: combining the two to maximize diagnostic yield.

BACKGROUND: Traditional vertical sections of scalp biopsy specimens contain few hair follicles. For this reason transverse sections of scalp biopsy specimens have been advocated. Both methods have advantages and disadvantages. We have developed a simple method that we believe offers the best of both methods. OBJECTIVE: Our purpose was to assess the impact of combining vertical and transverse sections of scalp biopsy specimens. METHODS: Two 4 mm punch biopsies are performed. One specimen is bisected vertically: half for hematoxylin-eosin (H-E) staining, half for direct immunofluorescence. The second specimen is bisected transversely and submitted for H-E. The three pieces of tissue for H-E staining are embedded in a single cassette. RESULTS: Because a biopsy specimen for direct immunofluorescence is commonly obtained in cases of alopecia, our method does not add a surgical procedure. All three pieces of tissue for H-E staining are embedded in a single paraffin block. Therefore the cost of histologic interpretation is not increased. Our diagnostic yield improved. Transverse sections were superior in cases of lupus erythematosus and lichen planopilaris with focal follicular involvement. Features of the follicular degeneration syndrome were also best demonstrated in transverse sections. Interface changes, lupus panniculitis, miniaturized hairs, and trichomalacia were better demonstrated in vertical sections. CONCLUSION: Our method exploits the advantages of both vertical and transverse sections and improves diagnostic yield without increasing cost.

Alopecia↗
PubMed1994

Quality of life and maladjustment associated with hair loss in women with alopecia androgenetica.

Quality of life and maladjustment related to hair loss were studied by means of a standardized interview in a group of 58 women with alopecia androgenetica who applied for treatment at the Department of Dermatology. The hair loss was found to have a negative influence on the quality of life on the majority of them. In 88%, hair loss had negative effects on their daily life; in about 75%, the hair problems were manifested in negative self-esteem and about 50% experienced social problems. General psychosocial maladjustment in relation to hair loss was indicated in almost one-third of the women.

Adaptation, Psychological↗
PubMed1994

Capillary electrophoretic profiling of rat hair: a tool for alopecia areata diagnosis.

Capillary electrophoretic profiling of hair fractions obtained by 0.25 M HCl treatment of the tissue with subsequent extraction of the solubilized fraction with chloroform-isopropanol (9:1, v/v) revealed clear differences between hair obtained from alopecia areata affected laboratory rats (both in hair obtained from non-affected areas and hair growing on once hairless patches) and controls. Differences were observed both in the organic-phase extractable material as well as in the aqueous phase after extraction. The separations were carried out in 25 mM borate buffer pH 9.2 for the chloroform-isopropanol extractable fraction while profiling of the aqueous phase was done in the same buffer at pH 10. Untreated fused-silica capillaries, 40-45 cm to the detector of I.D. 50 and 75 microns were used at a running voltage of 20 kV. Detection was done either by UV absorbance at a fixed wavelength of 200 nm or by using a diode array detector.

Alopecia Areata↗
PubMed1991

The effectiveness of the hair-restorer "Dabao" in males with alopecia androgenetica. A clinical experiment.

In a randomized, double-blind trial the effectiveness of 6 months' use of a Chinese herb extract (Dabao) as a hair-restorer was studied on 396 males with alopecia androgenetica. The effect was evaluated by nonvellus hair counts, participants' opinions and a panel's judgement of a photo-report. Twenty-three participants withdrew prematurely from the study. In both the Dabao and placebo groups an increase in the amount of hair was observed; 133 and 109 hairs on a 5 cm2 marked area, a difference of 24 hairs (p = 0.03, one-sided). Participants as well as the panel reached a similar conclusion. Regarding cosmetic effect, 42% of the participants in the Dabao group and 37% in the placebo group reported positive results. The average panel score for the cosmetic result on a scale of -10 to +10 was 0.46 in the Dabao and 0.21 in the placebo group, a difference of 0.24 (p = 0.04, one-sided). It appears from our study that, although the cosmetic effect over 6 months is modest, Dabao does have a certain effect on the growth of nonvellus hair.

Administration, Topical↗
PubMed1994

Genetic disorders of keratin: are scarring alopecias a sub-set?

Recent advances have challenged the prevailing view that keratins are merely passive bystanders of keratinocyte biology. With the exciting discovery that three autosomal dominant genetic skin disorders, epidermolysis bullosa simplex (EBS), epidermolytic hyperkeratosis (EHK) and palmoplantar keratoderma (PPK), are in fact disorders of keratins comes the realization that the integrity of the keratin filament network is crucial to the structural integrity of the skin. Since it has been recently established that mutations in keratins K5/K14, K1/K10 and K9 are causative for these keratinocyte disorders, it is very likely that mutations in K6 or in its obligate partner, K16 will result in disease. In order to test this we have produced transgenic mice that express a mutant K6 gene. These mice develop a progressive scarring alopecia at about 6 months of age. Later, the denuded areas developed a keratosis which was prone to infection. Ultrastructural analysis suggests that hair loss is due to the destruction of the outer root sheath. We believe that these mice are models of another keratin disorder.

Alopecia↗
PubMed1994

RU 58841, a new specific topical antiandrogen: a candidate of choice for the treatment of acne, androgenetic alopecia and hirsutism.

A new topically active non-steroidal antiandrogen, RU 58841 has been synthesized. It displays high affinity for the hamster prostate and flank organ (F.O.) androgen receptors. In vivo, when topically applied, it exerts a potent dose-dependent regression of F.O. area at a dose as low as 1 microgram/animal while being devoid of antiandrogenic activity on deep accessory sex organs and of any effect on testosterone level up to 100 micrograms/animal. In the same species, after subcutaneous administration, it induces at the dose of 300 micrograms/animal, a small decrease in F.O. area equivalent to that of 1 microgram applied topically and a weak systemic activity. In intact rats, no effects were observed up to 1 microgram/animal whatever the route of administration. These results suggest that RU 58841 might useful for the topical treatment of androgen-dependent skin disorders such as acne, androgenetic alopecia and hirsutism.

Acne Vulgaris↗
PubMed2006

A unique insertion/duplication in the VDR gene that truncates the VDR causing hereditary 1,25-dihydroxyvitamin D-resistant rickets without alopecia.

Hereditary vitamin D resistant rickets (HVDRR) is caused by mutations in the vitamin D receptor (VDR). Here we describe a patient with HVDRR who also exhibited some hypotrichosis of the scalp but otherwise had normal hair and skin. A 102 bp insertion/duplication was found in the VDR gene that introduced a premature stop (Y401X). The patient's fibroblasts expressed the truncated VDR, but were resistant to 1,25(OH)2D3. The truncated VDR weakly bound [3H]-1,25(OH)2D3 but was able to heterodimerize with RXR, bind to DNA and interact with the corepressor hairless (HR). However, the truncated VDR failed to bind coactivators and was transactivation defective. Since the patient did not have alopecia or papular lesions of the skin generally found in patients with premature stop mutations this suggests that this distally truncated VDR can still regulate the hair cycle and epidermal differentiation possibly through its interactions with RXR and HR to suppress gene transactivation.

Alopecia↗
PubMed2006

The triple rotation scalp flap revisited: a case of reconstruction of cicatricial pressure alopecia.

Rotation flaps constitute a time-honoured method for repair of small-to-moderate scalp defects, in effect even in the era of microsurgical reconstruction. A case of cicatricial pressure alopecia that was successfully repaired using the Bardach modification of the curved tripod flap confirms the value of this flap in scalp reconstruction. The main advantages of this method are the natural appearance of the final result due to preservation of hair orientation, and the uniform distribution of the wound-closure tension over a wide peripheral area of the scalp, although extensive undermining is generally required.

Adult↗
PubMed2005

Topical tacrolimus in alopecia areata.

Eleven patients with alopecia areata affecting 10% to 75% of the scalp, average duration 6 years, had no terminal hair growth in response to tacrolimus ointment 0.1% applied twice daily for 24 weeks. Treatment failure may reflect insufficient depth of penetration of the ointment formulation and less than optimal patient selection.

Administration, Topical↗
PubMed2005

Placebo-controlled oral pulse prednisolone therapy in alopecia areata.

BACKGROUND: Systemic corticosteroids administered as pulse therapy have been found helpful in a wide array of diseases including alopecia areata (AA). None of the studies published so far regarding their use in AA have been randomized or placebo-controlled. OBJECTIVE: We sought to compare the efficacy of weekly oral prednisolone pulse therapy in a placebo-controlled trial for patients with extensive AA. METHODS: A total of 43 patients were randomly divided into two groups. Patients in group A (23 patients) were treated with oral prednisolone (200 mg once weekly, 5 40-mg tablets) and patients in group B (20 patients) were given placebo tablets on an identical schedule. The total study period was 6 months, consisting of 3 months of active therapy followed by another 3 months of observation. RESULTS: Significant hair regrowth was obtained in 8 patients in the prednisolone-treated group. Two of the responders experienced a relapse during the observation period of 3 months. In the placebo group, none of the patients had significant hair regrowth at the end of the study. CONCLUSION: Oral prednisolone pulse therapy is useful in AA. Placebo-controlled studies with varying dosage schedules are required to standardize the dose of prednisolone used in pulse therapy, optimize the therapeutic efficacy, and minimize side effects.

Administration, Oral↗
PubMed2005

Alopecia areata presenting in 2 kidney-pancreas transplant recipients taking cyclosporine.

Alopecia areata (AA) is an autoimmune disease of uncertain pathogenesis, typically treated with immunomodulators. We report the paradoxical development of AA in two kidney-pancreas transplant recipients receiving immunosuppressive therapy, which included cyclosporine. Review of the literature revealed only 7 other cases of AA occurring in solid organ transplant recipients; all occurred during long-term cyclosporine therapy. The development of AA in this population highlights the complexity of this immunologic disease.

Adult↗
PubMed2006

Changes in hair weight in men with androgenetic alopecia after treatment with finasteride (1 mg daily): three- and 4-year results.

BACKGROUND: We previously reported the effects of finasteride on scalp hair weight and count over a 2-year period in men with androgenetic alopecia (AGA). OBJECTIVE: Our purpose was to evaluate the effects of finasteride on hair weight and count over 4 years in men with AGA. METHODS: Men with AGA were randomized to receive finasteride (1 mg/d) or placebo for 192 weeks. Results of the second (weeks 96-144) and third (weeks 144-192) extension periods are reported. RESULTS: Finasteride increased hair weight at 144 and 192 weeks (week 192: finasteride, 21.6% increase from baseline; placebo, 24.5% decrease from baseline; net increase in hair weight for finasteride vs placebo = 46.0%, P < .001). Hair count also increased with finasteride at 144 and 192 weeks (week 192: finasteride, 7.2% increase from baseline; placebo, 13.0% decrease from baseline; net increase in hair count for finasteride vs placebo = 20.3%, P < .05). Finasteride was generally well tolerated. LIMITATIONS: Because this study was extended from its original 48-week duration to nearly 4 years, the sample size available for analysis decreased with time. CONCLUSION: Long-term finasteride treatment led to sustained improvement in hair weight compared with placebo. Hair weight increased to a larger extent than hair count, implying that factors other than the number of hairs, such as increased growth rate (length) and thickness of hairs, contribute to the beneficial effects of finasteride in treated men.

Adult↗