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PubMed2006

The use of methotrexate alone or in combination with low doses of oral corticosteroids in the treatment of alopecia totalis or universalis.

Treatment of severe alopecia areata (AA) remains difficult. To assess the tolerance and efficacy of methotrexate (MTX) in the treatment of severe long-term AA, we retrospectively evaluated 22 patients with AA totalis or universalis with a mean duration of 11.0 +/- 8.8 years who were treated with MTX either alone (n = 6) or associated with low doses of oral prednisone (n = 16). MTX was given at an initial weekly dosage of 15 mg (n = 3), 20 mg (n = 9), or 25 mg (n = 10). Oral prednisone was given at an initial dosage of 10 mg/d in one patient and 20 mg/d in 15 patients. In all, 14 patients (64%) achieved a total recovery including 3 of 6 patients treated by MTX alone and 11 of 16 who had received the combined treatment. Of the 14 patients who had total hair regrowth, 6 stopped MTX. In all, 3 patients maintained hair regrowth and 3 relapsed. Retreatment of these 3 patients by MTX resulted again in hair regrowth. No severe side effect was observed. Although limited by its uncontrolled character, this study shows that MTX and low doses of oral corticosteroids may be an effective and well-tolerated treatment for severe types of AA.

Administration, Oral↗
PubMed2006

Familial aggregation of alopecia areata.

BACKGROUND: Familial aggregation of alopecia areata (AA) has been previously described, but systematic studies with information obtained directly from family members have yet to be undertaken. OBJECTIVE: We sought to study the pattern of familial aggregation of AA by assessing the affection status of patients' relatives. The study included 206 index patients with a total of 1029 first-degree and 2625 second-degree relatives. METHODS: First-degree relatives were directly interviewed, whereas information on second-degree relatives was obtained by interviewing the index patients and their first-degree relatives. RESULTS: Estimated lifetime risks were 7.1% in siblings, 7.8% in parents, and 5.7% in offspring. The risk in second-degree relatives was slightly higher than the reported population risk. Age at onset in index patients and first-degree relatives was significantly correlated. LIMITATIONS: Using patients drawn from specialized hair clinics may have produced results showing a higher proportion of early onset and severe cases. CONCLUSION: The familial aggregation of AA supports the role of genetic factors in the development of the disease. In addition, our data indicate genetic factors might contribute to the age at onset of AA.

Adolescent↗
PubMed2006

Nonscarring inflammatory alopecia associated with the epidermal growth factor receptor inhibitor gefitinib.

Gefitinib (ZD1839, Iressa, AstraZeneca, Wilmington, Del) is a novel oral anticancer agent that acts by blocking the function of the epidermal growth factor receptor. Gefitinib and other drugs that block epidermal growth factor receptor function have been associated with a similar and interesting pattern of cutaneous adverse effects, including follicular acneiform eruptions, xerosis, desquamation, seborrheic dermatitis, chronic paronychia, and hair texture changes. These effects appear to reflect the significance of epidermal growth factor receptor signaling in the skin. Here we present a case of a woman who developed an extensive nonscarring inflammatory alopecia after 2 years of gefitinib therapy.

Aged↗
PubMed2006

Treatment of alopecia areata partim universalis with efalizumab.

Alopecia areata (AA) is considered an autoimmune disease targeted at hair follicles with T-lymphocytes playing an important role in the pathogenesis. Treatment of AA, particularly the totalis and universalis subtypes, is often difficult and remains a therapeutic challenge. Novel biologic therapies that have been developed for the treatment of other immune-mediated inflammatory skin diseases may represent a new therapeutic modality for this disease. Efalizumab is a humanized monoclonal anti-CD11a antibody that inhibits T-cell activation and migration. We report a case of a 19-year-old man suffering from AA partim universalis, treated with efalizumab monotherapy. The treatment was well tolerated with no reported side effects. The striking improvement warrants further studies with this biologic therapy in AA.

Adult↗
PubMed2004

Different gene expression profile observed in dermal papilla cells related to androgenic alopecia by DNA macroarray analysis.

BACKGROUND: Androgenic alopecia (AGA) is the most common type of baldness in men. Although etiological studies have proved that androgen is one of the causes of this symptom, the defined molecular mechanism underlying androgen-related actions remains largely unknown. OBJECTIVES: To clarify the difference in the gene expression profile of dermal papilla cells (DPCs) in skin affected by baldness. METHODS: DNA macroarray study was carried out on cultured DPCs from AGA skin comparing with DPCs from skin that is not affected by baldness. RESULTS: From DNA macroarray analysis, we observed that 107 of the 1185 analyzed genes had differing expression levels. A marked difference was observed in the decreased gene expression of BMP2 and ephrin A3 and up-regulated in NT-4 gene. In order to clarify the roles of BMP2 and ephrin A3 in the hair follicles, we examined the proliferation of hair follicle keratinocyte and expression of a hair acidic keratin gene. Both BMP2 and ephrin A3 raised the proliferation rate of the outer root sheath cells (ORSCs) and induced gene expression in acidic hair keratin 3-II. CONCLUSION: These results lead us to the hypothesis that both BMP2 and ephrin A3 function as hair growth promoting factors in the hair cycle.

Alopecia↗
PubMed2004

Bilateral subthalamic nucleus stimulation results in reversal of alopecia in Parkinson's disease.

Alopecia is a rare but important side effect of anti-parkinsonian medications. Our patient was a 72-year-old man with advanced Parkinson's disease (PD) who received levodopa and anti-cholinergic drugs and whose head had become almost completely bald. As bilateral subthalamic nucleus (STN) stimulation produced improvement in his motor symptoms, his drug dosages were reduced postoperatively. At 8 months after surgery, hair again covered his entire head. Our study presents a new aspect of the benefit of STN stimulation with regard to drug-induced non-motor symptoms in patient with PD.

Aged↗
PubMed2004

Postoperative alopecia areata: is pressure-induced ischemia the only cause to blame?

INTRODUCTION: Postoperative alopecia areata (PAA) following surgery has been reported, especially after certain gynecologic and cardiac procedures; however, no cases have been reported after liver transplant (LT). Localized pressure associated with prolonged anesthesia is usually blamed. Herein we report a few cases of PAA encountered especially in relation to LT procedures. OBJECTIVE: To report our PAA cases, identifying possible contributing risk factors. METHODS: Between April 2001 and May 2003 the data on eight PAA cases were analyzed for age, sex, type of surgery, duration of anesthesia, type of head support, periods of hypotension, and psychiatric comorbidity. RESULTS: Median age of affected patients was 27 years (10 to 44) and the male/female ratio 3/5. The type of surgery included: two LT recipients, two LT donors, three cardiac valve replacements, and one coronary bypass surgery. Median anesthesia time was 6 hours (3 to 12). Sponge or jelly donut was used for head support with frequent change of its position as per protocol. There were no significant periods of hypotension. Surprisingly, almost all patients had a documented psychiatric comorbidity, mainly anxiety, adjustment/adaptation, or mood disorders. CONCLUSIONS: PAA is a rare complication following certain surgeries including both donor and recipient LT procedures. Although pressure-induced ischemia is the most likely etiological factor, we believe that psychiatric comorbidity plays a major role in its development. Therefore, preoperative thorough psychiatric counseling in addition to frequent intraoperative head repositioning will help to avoid this minor but distressing postoperative complication.

Adolescent↗
PubMed2006

Severe alopecia due to demodicosis in roe deer (Capreolus capreolus) in Belgium.

Demodex mites are part of the normal fauna of hair follicles of many, if not all, healthy mammal species. Normally these parasites live in harmony with their host, however in states of putative immunosuppression the acarids undergo excessive proliferation and cause clinical disease, which may be localised or generalised. This paper describes four cases of demodicosis in roe deer (Capreolus capreolus) with localised to generalised alopecia.

Alopecia↗
PubMed2000

Overexpression of Bcl-2 protects from ultraviolet B-induced apoptosis but promotes hair follicle regression and chemotherapy-induced alopecia.

Hair follicle (HF) growth and regression is an exquisitely regulated process of cell proliferation followed by massive cell death and is accompanied by cyclical expression of the apoptosis regulatory gene pair, Bcl-2 and Bax. To further investigate the role of Bcl-2 expression in the control of hair growth and keratinocyte apoptosis, we have used transgenic mice that overexpress human Bcl-2 in basal epidermis and in the outer root sheath under the control of the human keratin-14 promoter (K14/Bcl-2). When irradiated with ultraviolet B (UVB) light, K14/Bcl-2 mice developed about 5-10-fold fewer sunburn cells (ie, apoptotic keratinocytes) in the basal layer of the epidermis, compared to wild-type mice, whereas cultures of primary keratinocytes from transgenic mice were completely resistant to UVB-induced histone formation, at doses that readily induced histone release from wild-type cells. K14/Bcl-2 mice show no alteration of neonatal hair follicle morphogenesis or of the onset of the first wave of HF regression (catagen). However, compared to wild-type controls, K14/Bcl-2 mice subsequently displayed a significant acceleration of spontaneous catagen progression. During chemotherapy-induced alopecia, follicular dystrophy was promoted in K14/Bcl-2 mice. Thus, although K14-driven overexpression of Bcl-2 protected murine epidermal keratinocytes from UVB-induced apoptosis, it surprisingly promoted catagen- and chemotherapy-associated keratinocyte apoptosis.

Alopecia↗
PubMed1992

Clinical response of alopecia, trichorrhexis nodosa, and dry, scaly skin to zinc supplementation.

Two unrelated patients had dry brittle hair, alopecia, trichorrhexis nodosa, dry scaly skin, pigment dyschromia, short stature, and neurosecretory growth hormone deficiency. By means of the zinc tolerance test, patient 1 was shown to have zinc deficiency, whereas no clear zinc deficiency could be demonstrated in patient 2. In both patients, hair and the skin abnormalities responded to oral zinc therapy.

Alopecia↗
PubMed1979

Rickets with alopecia: an inborn error of vitamin D metabolism.

Rickets with alopecia, an inborn error of vitamin D metabolism, is described in two sisters. The rachitic disorder began during the first year of life and was refractory to 50,000 IU of vitamin D2/day. Surprisingly, both children had marked elevations in serum concentrations of 1,25-(OH)2D. Although the molecular basis for this disorder is not evident to date, intestinal end-organ unresponsiveness to exceedingly high levels of 1,25-(OH)2D was present, in addition to hyporesponsiveness of bone to these high levels of the hormone, since normocalcemia was maintained despite elevated serum levels of PTH. Therapy with oral 1,25-(OH)2D3 failed to reverse the disorder, but oral phosphorus supplements resulted in significant radiographic and clinical improvement.

Alopecia↗
PubMed1993

Hair replacement surgery for male pattern alopecia.

Male pattern alopecia is the most common type of hair loss encountered. Although this malady has no direct adverse consequences on physical health, physicians should be aware of the impact hair loss may have on a man's self-esteem. This type of hair loss and current hair replacement surgical techniques are discussed.

Alopecia↗
PubMed1977

Induction of hair growth in alopecia areata with D.N.C.B.

43 patients with alopecia areata were treated with weekly applications of dinitrochlorobenzene (D.N.C.B.), dissolved in acetone, on one side of the head, with the other side serving as control region. The therapeutic aim was a mild contact dermatitis. A significant difference of hair growth between the treated and untreated sides was observed in 33 patients. 21 patients showed regrowth of hair exclusively on the treated side, and in 12 patients regrowth was considerably faster and more dense on the treated side. In the majority of patients the difference was noted within 3 months.

Administration, Topical↗
PubMed1979

Biotin-responsive alopecia and developmental regression.

A 10-month-old boy presented with dermatitis and alopecia and became severely hypotonic. Screening for urinary organic acids revealed a large quantity of 3-hydroxyisovaleric acid and raised levels of beta-methylcrotonylglycine and 3-hydroxypropionate. Activities of propionyl CoA carboxylase, beta-methylcrotonyl CoA carboxylase, and pyruvate carboxylase in cultured fibroblasts were normal. Treatment with oral biotin resulted in a dramatic clinical improvement, which might therefore suggest a defect in biotin absorption or transport.

Alopecia↗
PubMed1999

Total hypotrichosis: genetic form of alopecia not linked to hairless gene.

We describe a hereditary form of alopecia in an aboriginal Finno-Ugric population. Linkage and mutation analyses of 21 families showed that the disorder was not linked to the hairless gene on chromosome 8. This implies that an isolated hairless defect caused by a single gene is a genetically heterogeneous disorder in human populations.

Adolescent↗
PubMed2003

Restoration of hair growth with topical diphencyprone in mouse and rat models of alopecia areata.

BACKGROUND: The contact sensitizer, diphencyprone (DPCP), is one of the most effective therapies for the more severe forms of alopecia areata (AA). OBJECTIVE: The purpose of this study was to determine the efficacy of topical DPCP on the 2 available rodent models for AA, and to determine the underlying therapeutic mechanisms. METHODS: AA-affected mice and rats were treated unilaterally with topical DPCP on the ventral and dorsal surface, respectively. The opposite sides were treated with vehicle alone. Skin biopsy specimens were collected from both sides for histologic analysis. RESULTS: Hair regrowth was observed on the treated sides in the majority of the animals of both species. Immunohistochemical analyses revealed reduction of intrafollicular CD8(+) lymphocyte infiltrates after successful treatment in mice. CONCLUSION: The AA-like hair disorder of these 2 rodent models can be used as a tool for furthering our understanding of human AA and the therapeutic actions of DPCP.

Administration, Topical↗
PubMed1980

Analysis of hair from alopecia congenita.

Two patients with alopecia congenita had short vellus hairs of the scalp but some apparently normal-sized hairs in other areas. Both fibrous and matrix proteins were detected in the scalp hairs by polyacrylamide gel electrophoresis (PAGE), and x-ray diffraction analysis revealed a normal alpha pattern. Amino acid analysis showed a decreased cystine content suggesting a quantitative or qualitative change in the matrix component. Scanning electron microscopic examination revealed pits and bulges in the cuticle cells which may be related to wearing a wig. The data suggest a defect in the development of the follicle rather than an abnormality in a component of the hair.

Adult↗