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The emotional disturbance underlying alopecia areata, alopecia totalis and trichotillomania.

A psychological study on fifteen children with diverse etiologies of hair loss, viz., alopecia areata, alopecia totalis and trichotillomania was conducted in order to assess the degree of underlying psychodynamics in children with hair loss. The results confirm the relationship of the underlying emotional disturbance to the hair loss. Further, it appears that the more severe the psychopathology of the individual, the greater is the hair loss and/or the clinical manifestation of trichotillomania.

Affective Symptoms

Direct immunofluorescence studies in alopecia areata and male pattern alopecia.

Direct immunofluroescence studies were performed on hairy and alopecic areas of scalp in patients with alopecia areata, alopecia totalis and male pattern alopecia. Abnormal deposits of C3 and occasionally of IgG and IgM were found in 92% of 12 patients with alopecia areata and in 21% of patients with male pattern alopecia. No abnormalities were seen in 4 patients with alopecia totalis. In both alopecia areata and male pattern alopecia, the deposits were most common along the basement zone of the inferior segment of hair follicles and occurred with equal frequency in alopecic and normal scalp. These observations suggest that immune factors may play a role in the pathogenesis of alopecia areata.

Alopecia

Alopecia areata.

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Alopecia Areata

Alopecia areata.

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Alopecia Areata

Large doses of glucocorticoid in the treatment of alopecia areata.

Severe extensive alopecia areata (totalis) was treated with prednisolone as a single 2 g dose i.v. (22 patients) or 0.5 g daily for 5 days orally (13 patients). Four of the patients responded well, 12 had a poor response and 19 had no response. There was a relapse in some at about 6 months, which could be arrested by a further single i.v. dose, but the risks of this form of therapy are unclear and it cannot be recommended for general use. The clinical response to a single dose of corticosteroid implies, however, that there may be a 'switch' mechanism in certain auto-immune diseases, with an all-or-none response.

Administration, Oral

Alopecia areata, autoimmunity, and Down's syndrome.

Alopecia areata occurs more often in Down's syndrome than would be expected by chance, sixty cases being found among 1000 patients with this syndrome compared with one case among 1000 subnormal controls. Because alopecia areata is associated with some organ-specific autoimmune disease and thyroid antibodies are often found in Down's syndrome sera from affected patients were examined for the presence of fluorescent autoantibodies. Antibodies against thyroid components tended to be present in female mongols with alopecia areata in comparison with females in a normal population but not in male mongols. Futhermore, eight out of 23 female mongols (35%) with alopecia areata had antibodies against thyroid components compared with two out of 23 female mongols (9%) without alopecia areata.

Adolescent

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

Treatment of alopecia areata with dinitrochlorobenzene.

Persistent refractory alopecia areata in 26 patients was treated topically with dinitrochlorobenzene (DNCB). Sixteen patients have had excellent regrowth of hair; three patients could either not be initially sensitized or an adequate allergic contact dermatitis on the scalp did not develop. Two patients discontinued therapy within two months; hair growth did not develop in five patients despite an adequate trial. Augmentation of the T-lymphocyte pool via DNCB sensitization and challenge may become effective therapy for some patients with severe alopecia areata.

Administration, Topical

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

Investigation of ACE gene polymorphism and serum ACE activity in relation to alopecia areata among Iraqi patients.

BACKGROUND: Alopecia areata (AA) is a multifactorial disorder with immune dysregulation and genetic susceptibility, affecting 0.5-2% globally. OBJECTIVE: This study investigated angiotensin converting enzyme (ACE) gene insertion /deletion (I/D) polymorphism and serum ACE activity in Iraqi AA patients and their association with inflammatory cytokines (interleukin [IL]-17) and nutritional markers to understand disease progression. METHODS: This case-control study included 50 AA patients (Male and Female) and 35 healthy controls. ACE gene polymorphism (rs1799752) was analyzed using real-time polymerase chain reaction (qPCR) with high-resolution melting (HRM) analysis. Serum IL-17 levels were determined by enzyme-linked immunosorbent assay (ELISA), and biochemical markers were measured using an automated analyzer. RESULTS: ACE gene polymorphism (rs1799752) showed non-significant genotype distribution between patient and control groups (p&#xa0;>&#xa0;0.05), though a trend toward DD genotype enrichment was observed in patients. Serum ACE levels were significantly higher in patients versus controls (p&#xa0;<&#xa0;0.0001) with high diagnostic performance. ACE correlated positively with IL-17 (P&#xa0;<&#xa0;0.0001) and negatively with vitamin D3 and zinc (P&#xa0;<&#xa0;0.0001). Female patients had significantly higher ACE levels than males (P&#xa0;<&#xa0;0.01). CONCLUSIONS: ACE emerges as an immunometabolic hub in AA pathogenesis, integrating inflammation with nutritional deficits, suggesting its potential as a biomarker and therapeutic target.

Humans

[Alopecia areata: successful half-side treatment with DNCB].

In 46 patients with alopecia areata, one side of the head was treated with weekly applications of DNCB, dissolved in acetone. The therapeutic aim was mild contact dermatitis. The other side of the head served as control region. A therapeutic effect was noted in 36 patients: 22 patients showed regrowth of hair exclusively on the treated side, and in 14 patients regrowth of hair was considerably faster and more dense on the treated side. In 8 patients no regrowth was observed, and in 2 patients regrowth occurred on both sides without any difference of intensity. The difference between both sides with regard to hair growth was seen in all of the 7 patients with moderate involvement and in 12 out of 13 patients with extensive involvement; but also in 17 out of 26 patients with alopecia areata totalis or fere totalis. The difference was noted, in the majority of cases, within 3 months. These results prove the efficacy of DNCB treatment of alopecia areata.

Adolescent

[Contribution to the DNCB therapy of alopecia areata].

14 patients suffering from longstanding alopecia areata totalis or fere totalis were treated with dinitrochlorobenzene (DNCB) over a period of 2 to 11 months. Hair growth was induced in 9 patients. Side effects were not observed so far.

Adolescent

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

[DNCB therapy of alopecia areata].

Long-term treatment of alopecia areata with dinitrochlorobenzene is effective. During the last two and a half years, 227 patients who suffered, in the majority of cases, from total or subtotal hair loss, were treated by this method. Unilateral application of DNCB induced unilateral regrowth of hair in 88% of these patients. Under continuous treatment of both sides of the head, this initial response was followed by complete regrowth of hair in 78%. The same result could be obtained by application of squaric acid dibutylester, another potent contact allergen. This indicates that the essential mechanism is contact allergy. Possibly, the regrowth of hair is due to the induction of local nonspecific immunosuppression.

Alopecia Areata

Alopecia areata: immunofluorescence and other studies.

In a study of 24 patients with alopecia areata, scalp biopsies were examined for immunofluorescence; all were negative. A number of other tests also failed to confirm an auto-immune aetiology for this disease. A possible explanation lies in the heterogeneity of alopecia areata, only a small proportion of cases being of the auto-immune type.

Adolescent

Magnesium content of the hair in alopecia areata atopica.

The magnesium content of hair from alopecia areata atopica patients, from nonatopic dermatological patients and from normal controls has been studied using atomic absorption spectroscopy. The two groups of patients had lower means and ranges than did the normal subjects, but the overlap was considerable. It is suggested that the lower levels found in the patients may be due to the nonspecific 'metabolic cost' of the skin diseases.

Alopecia Areata

[The histodynamic of alopecia areata in the dependence on the griseofulvin-induced epithelial proliferation (author's transl)].

The histodynamic of the alopecia areata--without or with the medicamentous induction of the hair growth respectively--was investigated comparatively. 1. Griseofulvin induced an epithelial proliferation in alopecia areata, which is noticeable in the surface epithelium as well as in the follicular epithelium. 2. Under the influence of griseofulvin a deeper penetration of the follicles into the fatty tissue--in connexion with a cutan-subcutaneous volume increase--results; at the same time the supra- and infraseboglandular follicular areas are lengthened. 3. The matter for discussion is that these epithelial changes originate from an increase of metabolic activity or blood supply respectively in the adjacent cutan- and subcutaneous tissue.

Alopecia Areata