251
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Lee S, Kim BJ, Lee CH, Lee WS. Increased prevalence of vitamin D deficiency in patients with alopecia areata: a systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2018; 32:1214-1221. [PMID: 29633370 DOI: 10.1111/jdv.14987] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 03/22/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Alopecia areata (AA) is a hair follicle-specific autoimmune disorder. Vitamin D deficiency has been associated with various autoimmune disorders for its immunomodulatory effects. However, in previous studies, there had been inconsistent association found between AA and vitamin D deficiency. OBJECTIVE To demonstrate the differences of the mean serum 25-hydroxyvitamin D level and prevalence of vitamin D deficiency between AA patients and non-AA population. METHODS A systematic review and meta-analysis of observational studies on AA and serum vitamin D levels and/or prevalence of vitamin D deficiency was performed searching MEDLINE, Cochrane, Web of Science and Google Scholar databases. RESULTS In all, 14 studies including a total of 1255 AA subjects and 784 non-AA control were analysed. The mean serum 25-hydroxyvitamin D level was significantly lower in AA subjects (-8.52 ng/dL; 95% confidential interval; -5.50 to -11.53). The AA subjects had higher odds of vitamin D deficiency (odds ratio of 3.89; 2.02 to 7.49, mean prevalence of 73.8%; 59.1 to 84.6%). However, it was difficult to find clear correlation between serum 25-hydroxyvitamin D level and extent of hair loss in AA subjects. CONCLUSION The AA subjects had lower serum 25-hydroxyvitamin D level, and vitamin D deficiency was highly prevalent compared to non-AA controls. Hence, vitamin D deficiency should be assessed in AA patients. Furthermore, nutritional supplementation of vitamin D or topical vitamin D analogues can be considered for AA patients with vitamin D deficiency. The limitation of this study is the highly heterogeneity of the included studies.
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Affiliation(s)
- S Lee
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - B J Kim
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - C H Lee
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - W S Lee
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
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252
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El Tahlawi SM, El Eishi NH, Kahhal RK, Hegazy RA, El Hanafy GM, Abdel Hay RM, Shaker OG. Do Prolactin and its Receptor Play a Role in Alopecia Areata? Indian J Dermatol 2018; 63:241-245. [PMID: 29937561 PMCID: PMC5996625 DOI: 10.4103/ijd.ijd_590_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Context: Studying the link between prolactin and autoimmunity has gained much ground over the past years. Its role played in alopecia areata (AA) is not clear yet, as previous reports yielded controversial results. Aims: This study aimed to measure the serum level of prolactin and to detect the expression of its receptor in AA, in an attempt to highlight its possible role in the pathogenesis of this disease. Subjects and Methods: A case-control study of 30 AA patients and 20 controls from outpatient clinic were undertaken. Every patient was subjected to history taking and clinical examination to determine the severity of alopecia tool (SALT) score. Blood samples were taken from patients and controls to determine the serum prolactin level. Scalp biopsies were obtained from the lesional skin of patients and normal skin of controls for assessment of the prolactin receptor. Statistical Analysis: Depending upon the type of data, t-test, analysis of variance test, Chi-square, receiver operator characteristic curve were undertaken. Results: On comparing the serum prolactin level between patients and controls, no significant difference was found, while the mean tissue level of prolactin receptor was significantly higher in patients than in controls. In patients, a significant positive correlation was found between the prolactin receptor and the SALT score. Conclusions: Prolactin plays a role in AA, and this role is probably through the prolactin receptors rather than the serum prolactin level.
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Affiliation(s)
- Samar M El Tahlawi
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nermeen H El Eishi
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rima K Kahhal
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rehab A Hegazy
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ghada M El Hanafy
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rania M Abdel Hay
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Olfat G Shaker
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University, Cairo, Egypt
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253
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Moravvej H, Tabatabaei-Panah PS, Ebrahimi E, Esmaeili N, Ghaderian SMH, Ludwig RJ, Akbarzadeh R. TNF-α -308G/A gene polymorphism in bullous pemphigoid and alopecia areata. Hum Antibodies 2018; 26:201-207. [PMID: 29843231 DOI: 10.3233/hab-180339] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND TNF-α -308G/A polymorphism has been investigated in few studies for an association with susceptibility to bullous pemphigoid (BP) and alopecia areata (AA). Yet, these findings had so far not been independently replicated, and no data on a possible association of TNFα -308G/A polymorphism with these diseases in Iranian population were available. OBJECTIVES In the present study, a possible effect of TNF-α -308G/A variation on susceptibility to BP or AA disease was evaluated. METHODS Genomic DNA was extracted from the blood of the patients with BP and AA as well as control subjects which genotyped for the TNF-α -308 G/A polymorphism. TNF-α gene expression levels were analyzed by real-time RT-PCR. RESULTS No association was observed between the TNF-α -308 G/A variation and susceptibility to BP or AA diseases in our Iranian cohort. In contrast to AA patients, expression of TNF-α gene was significantly higher in BP patients compared to control group. TNF-α gene was found to be similarly expressed in mutant and wild-type genotypes. CONCLUSIONS TNF-α -308G/A polymorphism is not associated with the risk to develop of BP and AA in our Iranian cohort. Furthermore, this polymorphism is contributed to altering the levels of gene expression in BP disease.
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Affiliation(s)
- Hamideh Moravvej
- Skin Research Centre, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Skin Research Centre, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pardis-Sadat Tabatabaei-Panah
- Biology Department, East Tehran Branch, Islamic Azad University, Tehran, Iran.,Skin Research Centre, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elaheh Ebrahimi
- Biology Department, East Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Nafiseh Esmaeili
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ralf J Ludwig
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - Reza Akbarzadeh
- Urogenital Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.,Institute of Anatomy, University of Lübeck, Lübeck, Germany
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254
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Lee JS, Huh CH, Kwon O, Yoon HS, Cho S, Park HS. Nail involvement in patients with moderate-to-severe alopecia areata treated with oral tofacitinib. J DERMATOL TREAT 2018; 29:819-822. [DOI: 10.1080/09546634.2018.1466024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Ji Su Lee
- Department of Dermatology, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Chang-Hun Huh
- Department of Dermatology, Seoul National University Bundang Hospital, Gyeonggi, Korea
| | - Ohsang Kwon
- Department of Dermatology, Seoul National University Hospital, Seoul, Korea
| | - Hyun-Sun Yoon
- Department of Dermatology, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Soyun Cho
- Department of Dermatology, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Hyun-sun Park
- Department of Dermatology, SMG-SNU Boramae Medical Center, Seoul, Korea
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255
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Evaluation of platelet-rich plasma in treatment of alopecia areata. JOURNAL OF THE EGYPTIAN WOMEN’S DERMATOLOGIC SOCIETY 2018. [DOI: 10.1097/01.ewx.0000540042.97989.cf] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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256
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Yun D, Silverberg NB, Stein SL. Alopecia areata treated with hydroxychloroquine: A retrospective study of nine pediatric cases. Pediatr Dermatol 2018; 35:361-365. [PMID: 29575039 DOI: 10.1111/pde.13451] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND/OBJECTIVES Alopecia areata is a common hair loss condition that is often emotionally devastating for patients. There is a paucity of effective treatments available. Hydroxychloroquine has been reported as variably effective in inducing significant hair regrowth in adults with alopecia areata. The objective of this retrospective study was to assess the benefit and tolerability of hydroxychloroquine in pediatric alopecia areata. METHODS We conducted a retrospective review of nine children with a history of alopecia areata treated with hydroxychloroquine. Clinical data were obtained from patients treated at two tertiary care centers in the United States between July 1, 2013, and July 1, 2015. RESULTS Alopecia scores of five patients improved by 6 months of treatment. Four patients experienced no improvement from baseline evaluation. The most common side effect associated with treatment was gastrointestinal intolerance and headache. CONCLUSION This retrospective series suggests that hydroxychloroquine can be considered as a treatment option for alopecia areata in children.
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Affiliation(s)
- Duri Yun
- Division of Dermatology, University of Chicago Medicine, Chicago, IL, USA
| | - Nanette B Silverberg
- Mt Sinai St. Luke's-Roosevelt Hospital Center, Mt Sinai Beth Israel Medical Center, New York, NY, USA
| | - Sarah L Stein
- Division of Dermatology, University of Chicago Medicine, Chicago, IL, USA
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257
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Morsy H, Maher R, Negm D. Correlation between serum IL-17A level and SALT score in patients with alopecia areata before and after NB-UVB therapy. J Cosmet Dermatol 2018; 17:533-537. [DOI: 10.1111/jocd.12664] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2018] [Indexed: 01/13/2023]
Affiliation(s)
- Hanan Morsy
- Department of Dermatology, Venereology and Andrology; Faculty of Medicine; Assiut University; Assiut Egypt
| | - Reham Maher
- Department of Dermatology, Venereology and Andrology; Faculty of Medicine; Assiut University; Assiut Egypt
| | - Dalia Negm
- Department of Clinical Pathology; Faculty of Medicine; Assiut University; Assiut Egypt
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258
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Waśkiel A, Rakowska A, Sikora M, Olszewska M, Rudnicka L. Trichoscopy of alopecia areata: An update. J Dermatol 2018; 45:692-700. [DOI: 10.1111/1346-8138.14283] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 03/01/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Anna Waśkiel
- Department of Dermatology; Medical University of Warsaw; Warsaw Poland
| | - Adriana Rakowska
- Department of Dermatology; Medical University of Warsaw; Warsaw Poland
| | - Mariusz Sikora
- Department of Dermatology; Medical University of Warsaw; Warsaw Poland
| | | | - Lidia Rudnicka
- Department of Dermatology; Medical University of Warsaw; Warsaw Poland
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259
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Choe SJ, Lee S, Pi LQ, Keum DI, Lee CH, Kim BJ, Lee WS. Subclinical sensitization with diphenylcyclopropenone is sufficient for the treatment of alopecia areata: Retrospective analysis of 159 cases. J Am Acad Dermatol 2018; 78:515-521.e4. [PMID: 29108907 DOI: 10.1016/j.jaad.2017.10.042] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 10/24/2017] [Accepted: 10/29/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Contact immunotherapy with diphenylcyclopropenone (DPCP) is presently considered the treatment of choice for extensive alopecia areata. However, a major concern with contact immunotherapy is that it causes various adverse effects (AEs) that contribute to discontinuation of treatment. OBJECTIVE We investigated whether a modified DPCP treatment protocol can promote hair regrowth with fewer AEs. METHODS All patients were sensitized with 0.1% DPCP and began treatment with 0.01% DPCP. Thereafter, the DPCP concentration was slowly increased according to the treatment response and AEs. This was a retrospective review of DPCP treatment with modified protocols in 159 patients with alopecia areata. RESULTS Of the 159 patients, 46 (28.9%) showed a complete response and 59 (37.1%) showed a partial response. No patients had AEs after sensitization. During the treatment, only 3 patients (1.9%) showed severe AEs, and 55 showed moderate AEs; however, all were well controlled with antihistamines alone or antihistamines and medium-potency topical steroids. There was no association between treatment response and AEs. LIMITATIONS Sample size, subject composition, and the retrospective study design represent potential limitations. CONCLUSION A modified DPCP treatment protocol with subclinical sensitization could induce a favorable therapeutic response and result in fewer AEs.
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Affiliation(s)
- Sung Jay Choe
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Solam Lee
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Long Quan Pi
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Dong In Keum
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Chung Hyeok Lee
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Beom Jun Kim
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Won-Soo Lee
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
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260
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Czarnowicki T, He HY, Wen HC, Hashim PW, Nia JK, Malik K, Estrada Y, Kimmel GW, Taliercio M, Krueger JG, Guttman-Yassky E. Alopecia areata is characterized by expansion of circulating Th2/Tc2/Th22, within the skin-homing and systemic T-cell populations. Allergy 2018; 73:713-723. [PMID: 29083474 DOI: 10.1111/all.13346] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Characterizing blood profile of alopecia areata (AA) is important not only for treatment advancements, but also for possibly identifying peripheral biomarkers that will eliminate the need for scalp biopsies. We aimed to compare frequencies of skin homing (CLA+ ) vs systemic (CLA- ) "polar" CD4+ and CD8+ and activated T-cell subsets in AA vs atopic dermatitis (AD) and control blood. METHODS Flow cytometry was used to measure IFN-γ, IL-13, IL-9, IL-17, and IL-22 cytokines in CD4+ and CD8+ T cells. Inducible co-stimulator molecule (ICOS) and HLA-DR were used to define mid- and long-term T-cell activation. We compared peripheral blood from 32 moderate-to-severe AA adults with 43 moderate-to-severe AD patients and 30 age-matched controls. RESULTS AA patients had increased CLA+ /CLA- Th2 (P < .007), CLA+ Tc2 (P = .04), and CLA+ Th22 (P < .05) frequencies than controls. Except of CLA- Tc1 cells (P = .03), IFN-γ levels were mostly similar between AA, AD, and controls (P > .1). ICOS and HLA-DR activation were significantly higher in AA than controls (P < .05). T regulatory cells were significantly decreased in AA patients than controls (P < .01) and were correlated with activated CD8+ T cells and with multiple cytokine subsets (P < .05). While Th2 and Tc2 clustered with disease severity, IFN-γ producing cells were linked with AA duration. CONCLUSIONS Alopecia areata is accompanied by Th2/Tc2 activation in skin-homing and systemic subsets, correlating with disease severity, while IFN-γ is linked to disease chronicity. These data hint for a possible role of diverse T-cells subsets in disease pathogenesis and emphasize the systemic nature of AA supporting the need for systemic therapeutic strategies in severe patients.
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Affiliation(s)
- T. Czarnowicki
- Department of Dermatology and the Laboratory for Inflammatory Skin Diseases; Icahn School of Medicine at Mount Sinai; New York NY USA
- Laboratory for Investigative Dermatology; The Rockefeller University; New York NY USA
| | - H. Y. He
- Department of Dermatology and the Laboratory for Inflammatory Skin Diseases; Icahn School of Medicine at Mount Sinai; New York NY USA
| | - H.-C. Wen
- Department of Dermatology and the Laboratory for Inflammatory Skin Diseases; Icahn School of Medicine at Mount Sinai; New York NY USA
| | - P. W. Hashim
- Department of Dermatology and the Laboratory for Inflammatory Skin Diseases; Icahn School of Medicine at Mount Sinai; New York NY USA
| | - J. K. Nia
- Department of Dermatology and the Laboratory for Inflammatory Skin Diseases; Icahn School of Medicine at Mount Sinai; New York NY USA
| | - K. Malik
- Department of Dermatology and the Laboratory for Inflammatory Skin Diseases; Icahn School of Medicine at Mount Sinai; New York NY USA
- Laboratory for Investigative Dermatology; The Rockefeller University; New York NY USA
- SUNY Downstate College of Medicine; Brooklyn NY USA
| | - Y. Estrada
- Department of Dermatology and the Laboratory for Inflammatory Skin Diseases; Icahn School of Medicine at Mount Sinai; New York NY USA
| | - G. W. Kimmel
- Department of Dermatology and the Laboratory for Inflammatory Skin Diseases; Icahn School of Medicine at Mount Sinai; New York NY USA
| | - M. Taliercio
- Department of Dermatology and the Laboratory for Inflammatory Skin Diseases; Icahn School of Medicine at Mount Sinai; New York NY USA
| | - J. G. Krueger
- Laboratory for Investigative Dermatology; The Rockefeller University; New York NY USA
| | - E. Guttman-Yassky
- Department of Dermatology and the Laboratory for Inflammatory Skin Diseases; Icahn School of Medicine at Mount Sinai; New York NY USA
- Laboratory for Investigative Dermatology; The Rockefeller University; New York NY USA
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261
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Karamali M, Kashanian M, Alaeinasab S, Asemi Z. The effect of dietary soy intake on weight loss, glycaemic control, lipid profiles and biomarkers of inflammation and oxidative stress in women with polycystic ovary syndrome: a randomised clinical trial. J Hum Nutr Diet 2018; 31:533-543. [PMID: 29468748 DOI: 10.1111/jhn.12545] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND The present study aimed to evaluate the effects of dietary soy intake on weight loss and metabolic status of patients with polycystic ovary syndrome (PCOS). METHODS A randomised clinical trial was conducted among 60 women with PCOS. Participants were randomly assigned into two groups to receive either a test diet (n = 30) or a control diet (n = 30) for 8 weeks. Participants in the test group consumed a diet containing 0.8 g protein kg-1 body weight (35% animal proteins, 35% soy protein and 30% vegetable proteins) and participants in the control group consumed a similar diet containing 70% animal proteins and 30% vegetable proteins. RESULTS Adherence to the test diet, compared with the control diet, resulted in significant decreases [mean (SD)] in body mass index (BMI) [-0.3 (0.6) versus +0.1 (0.5) kg m-2 , P = 0.02], fasting plasma glucose [-0.2 (0.5) versus +0.1 (0.3) mmol L-1 , P = 0.01], total testosterone [-0.3 (0.7) versus +0.3 (0.3) mmol L-1 , P < 0.001], insulin [-15.0 (18.0) versus +4.8 (18.6) pmol L-1 , P < 0.001] and insulin resistance [-0.6 (0.6) versus +0.2 (0.7), P < 0.001], as well as a significant increase in quantitative insulin sensitivity check index [+0.01 (0.01) versus -0.002 (0.02), P = 0.01]. In addition, significant decreases in triglycerides [-0.1 (0.4) versus +0.2 (0.3) mmol L-1 , P = 0.01] and malondialdehyde (MDA) [-1.2 (1.0) versus +0.2 (1.2) μmol L-1 , P < 0.001] and significant increases in nitric oxide (NO) [+13.6 (14.1) versus +0.9 (24.3) μmol L-1 , P = 0.01] and glutathione (GSH) [+170.1 (175.5) versus +24.2 (168.7) μmol L-1 , P = 0.002] were seen in the test group compared to the control. CONCLUSIONS Adherence to test diet among subjects with PCOS significantly decreased BMI, glycaemic control, total testosterone, triglycerides and MDA, and significantly increased NO and GSH compared to the control diet.
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Affiliation(s)
- M Karamali
- Department of Gynecology and Obstetrics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - M Kashanian
- Department of Gynecology and Obstetrics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | - Z Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
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262
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Lee SH, Moon JH, Ban DH, Byun JW, Shin J, Choi GS. Can the Cytokine Analysis of the Scales on Alopecic Patch Predict the Response to Diphenylcyclopropenone Treatment in Alopecia Areata Patients? Ann Dermatol 2018; 30:150-157. [PMID: 29606811 PMCID: PMC5839885 DOI: 10.5021/ad.2018.30.2.150] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 08/28/2017] [Accepted: 09/05/2017] [Indexed: 11/27/2022] Open
Abstract
Background Contact immune modulating therapy with diphenylcyclopropenone (DPCP) is a topical treatment option for extensive alopecia areata (AA). Because the response to DPCP treatment varies according to the patient, and it takes several months to evaluate the clinical effectiveness of the treatment, it is necessary to identify the factors that can predict the prognosis of the disease while treating with topical DPCP. Objective In this study, cytokine levels in the scales of alopecic patches were investigated to identify whether they could predict response to DPCP during the early treatment period. Methods Scale samples were taken from the alopecic patches in eight AA patients at 1 week, 2 months, and 4 months after DPCP sensitization. The patients were divided into responders and non-responders according to the clinical responses of DPCP treatment. Interferon (IFN)-gamma, interleukin (IL)-2, IL-12 and IL-10 levels of the subjects were compared in several perspectives. Results Cytokine levels after 1 week of DPCP sensitization showed no statistically significant difference between two groups. After 4 months of treatment, IFN-gamma levels were significantly lower in responders than in non-responders. Conclusion The results of this study show IFN-gamma levels in the scales of alopecic patches might possibly reflect the clinical response in AA patients treated with DPCP. However, initial cytokine levels could not predict the treatment response.
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Affiliation(s)
- Si Hyub Lee
- Department of Dermatology, Inha University School of Medicine, Incheon, Korea
| | - Jong Hyuk Moon
- Department of Dermatology, Naval Pohang Hospital, Pohang, Korea
| | | | - Ji Won Byun
- Department of Dermatology, Inha University School of Medicine, Incheon, Korea
| | - Jeonghyun Shin
- Department of Dermatology, Inha University School of Medicine, Incheon, Korea
| | - Gwang Seong Choi
- Department of Dermatology, Inha University School of Medicine, Incheon, Korea
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263
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Jabbari A, Sansaricq F, Cerise J, Chen JC, Bitterman A, Ulerio G, Borbon J, Clynes R, Christiano AM, Mackay-Wiggan J. An Open-Label Pilot Study to Evaluate the Efficacy of Tofacitinib in Moderate to Severe Patch-Type Alopecia Areata, Totalis, and Universalis. J Invest Dermatol 2018; 138:1539-1545. [PMID: 29452121 DOI: 10.1016/j.jid.2018.01.032] [Citation(s) in RCA: 117] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 01/09/2018] [Accepted: 01/26/2018] [Indexed: 01/14/2023]
Abstract
Alopecia areata (AA) is a common autoimmune disease with a lifetime risk of ∼2%. In AA, the immune system targets the hair follicle, resulting in clinical hair loss. The prognosis of AA is unpredictable, and currently there is no definitive treatment. Our previous whole genome expression studies identified active immune circuits in AA lesions, including common γ-chain cytokine and IFN pathways. Because these pathways are mediated through JAK kinases, we prioritized clinical exploration of small molecule JAK inhibitors. In preclinical trials in mice, tofacitinib successfully prevented AA development and reversed established disease. In our tofacitinib trial in 12 patients with moderate to severe AA, 11 patients completed a full course of treatment with minimal adverse events. Following limited response to the initial dose (5 mg b.i.d.), the dose was escalated (10 mg b.i.d.) for nonresponding subjects. Eight of 12 patients demonstrated ≥50% hair regrowth, while three patients demonstrated <50% hair regrowth, as measured by Severity in Alopecia Tool scoring. One patient demonstrated no regrowth. Gene expression profiles and Alopecia Areata Disease Activity Index scores correlated with clinical response. Our open-label studies of ruxolitinib and tofacitinib have shown dramatic clinical responses in moderate to severe AA, providing strong rationale for larger clinical trials using JAK inhibitors in AA. ClinicalTrials.gov ID NCT02299297.
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Affiliation(s)
- A Jabbari
- Department of Dermatology, Columbia University, New York, New York, USA; Department of Dermatology and Interdisciplinary Program in Immunology, University of Iowa, Iowa City, Iowa, USA
| | - F Sansaricq
- Department of Dermatology, Columbia University, New York, New York, USA
| | - J Cerise
- Department of Dermatology, Columbia University, New York, New York, USA
| | - J C Chen
- Department of Dermatology, Columbia University, New York, New York, USA
| | - A Bitterman
- Department of Dermatology, Columbia University, New York, New York, USA
| | - G Ulerio
- Department of Dermatology, Columbia University, New York, New York, USA
| | - J Borbon
- Department of Dermatology, Columbia University, New York, New York, USA
| | - R Clynes
- Department of Dermatology, Columbia University, New York, New York, USA; Department of Genetics, Columbia University, New York, New York, USA; Department of Pathology, Columbia University, New York, New York, USA; Department of Medicine, Columbia University, New York, New York, USA
| | - A M Christiano
- Department of Dermatology, Columbia University, New York, New York, USA
| | - J Mackay-Wiggan
- Department of Dermatology, Columbia University, New York, New York, USA.
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264
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Nasri K, Akrami S, Rahimi M, Taghizadeh M, Behfar M, Mazandaranian MR, Kheiry A, Memarzadeh MR, Asemi Z. The effects of vitamin D and evening primrose oil co-supplementation on lipid profiles and biomarkers of oxidative stress in vitamin D-deficient women with polycystic ovary syndrome: A randomized, double-blind, placebo-controlled trial. Endocr Res 2018; 43:1-10. [PMID: 28742409 DOI: 10.1080/07435800.2017.1346661] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 06/20/2017] [Indexed: 12/30/2022]
Abstract
PURPOSE OF THE STUDY There was inconsistent evidence about the benefit of vitamin D plus evening primrose oil (EPO) supplement intake on lipid profiles and reduced oxidative stress among women with polycystic ovary syndrome (PCOS). The current study was performed to evaluate the effects of vitamin D plus EPO supplementation on lipid profiles and biomarkers of oxidative stress in vitamin D-deficient women with PCOS. MATERIALS AND METHODS This randomized, double-blind, placebo-controlled trial was performed among 60 vitamin D-deficient women with PCOS. Participants were randomly assigned into two groups to receive either 1000 IU vitamin D3 plus 1000 mg EPO (n = 30) or placebo (n = 30) for 12 weeks. Metabolic profiles were quantified at baseline and after the 12-week intervention. RESULTS Compared with the placebo group, women in vitamin D and EPO co-supplementation group had significant increases in serum 25-hydroxyvitamin D (25(OH)D) (+10.7 ± 8.4 vs. -0.5 ± 1.6 ng/mL, p < 0.001) and plasma total glutathione (GSH) (+62.7 ± 58.0 vs. -0.7 ± 122.7 µmol/L, p = 0.01), while there were significant decreases in triglycerides (-7.3 ± 23.8 vs. +6.9 ± 26.3 mg/dL, p = 0.03), very low-density lipoprotein (VLDL) cholesterol levels (-1.5 ± 4.7 vs. +1.4 ± 5.3 mg/dL, p = 0.03), total/high-density lipoprotein cholesterol ratio (-0.3 ± 0.4 vs. -0.02 ± 0.4, p = 0.02), and malondialdehyde (MDA) concentration (-0.4 ± 0.4 vs. +0.5 ± 1.8 µmol/L, p = 0.008). CONCLUSION Overall, vitamin D and EPO co-supplementation for 12 weeks among vitamin D-deficient women with PCOS significantly improved triglycerides, VLDL cholesterol, GSH, and MDA levels.
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Affiliation(s)
- Khadijeh Nasri
- a Endocrinology and Metabolism Research Center, Department of Gynecology and Obstetrics , School of Medicine, Arak University of Medical Sciences , Arak , Iran
| | - Sedighe Akrami
- a Endocrinology and Metabolism Research Center, Department of Gynecology and Obstetrics , School of Medicine, Arak University of Medical Sciences , Arak , Iran
| | - Maryam Rahimi
- b Department of Gynecology and Obstetrics, School of Medicine , Iran University of Medical Sciences , Tehran , Iran
| | - Mohsen Taghizadeh
- c Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences , Kashan , I.R . Iran
| | - Masoud Behfar
- c Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences , Kashan , I.R . Iran
| | - Mohammad Reza Mazandaranian
- c Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences , Kashan , I.R . Iran
| | - Abbas Kheiry
- c Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences , Kashan , I.R . Iran
| | | | - Zatollah Asemi
- c Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences , Kashan , I.R . Iran
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265
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Celik SD, Ates O. Genetic analysis of interleukin 18 gene polymorphisms in alopecia areata. J Clin Lab Anal 2018; 32:e22386. [PMID: 29349811 DOI: 10.1002/jcla.22386] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 12/22/2017] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Alopecia areata (AA), which appears as nonscarring hair shedding on any hair-bearing area, is a common organ-specific autoimmune condition. Cytokines have important roles in the development of AA. Interleukin (IL) 18 is a significant proinflammatory cytokine that was found higher in the patients with AA. We aimed to investigate whether the IL-18 (rs187238 and rs1946518) single nucleotide polymorphisms (SNPs) may be associated with AA and/or clinical outcome of patients with AA in Turkish population. METHODS Genotyping of rs187238 and rs1946518 SNPs were detected using sequence-specific primer-polymerase chain reaction (SSP-PCR) method in 200 patients with AA and 200 control subjects. RESULTS The genotype distribution of rs1946518 (-607C>A) SNP was found to be statistically significantly different among patients with AA and controls (P = .0008). Distribution of CC+CA genotypes and frequency of -607/allele C of rs1946518 SNP were higher in patients with AA (P = .001, P = .001, respectively). The genotype distribution of rs187238 (-137G>C) SNP was found to be statistically significantly different among patients with AA and control subjects (P = .0014). Distribution of GG genotype and frequency of -137/allele G of rs187238 SNP were higher in patients with AA (P = .0003, P = .001, respectively). CONCLUSION The rs1946518 (-607C>A) and rs187238 (-137G>C) polymorphisms were found associated with alopecia areata disease. The study suggests that IL-18 rs187238 and rs1946518 SNPs may be the cause of the AA susceptibility.
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Affiliation(s)
- Sumeyya Deniz Celik
- Department of Medical Biology, Medical Faculty, Gaziosmanpasa University, Tokat, Turkey
| | - Omer Ates
- Department of Medical Biology, Medical Faculty, Gaziosmanpasa University, Tokat, Turkey
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266
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Bernardis E, Nukpezah J, Li P, Christensen T, Castelo-Soccio L. Pediatric severity of alopecia tool. Pediatr Dermatol 2018; 35:e68-e69. [PMID: 29105836 DOI: 10.1111/pde.13327] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The Severity of Alopecia Tool serves as a tool for alopecia research and a clinical guideline for following progression of disease. The original Severity of Alopecia Tool score does not take into account pediatric age groups. As new clinical trials for alopecia areata include more children, a more accurate tool should be available for this population. By collecting images from patients 2-21 years of age and aligning the hair-bearing regions of the scalp, we created an adaptation of the Severity of Alopecia Tool for scoring hair loss percentage of the top, parietal, and occipital scalp in individuals 2-5, 6-11, and 12-21 years of age.
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Affiliation(s)
- Elena Bernardis
- Division of Pediatrics, Section of Dermatology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | - Ping Li
- Shenzhen Children's Hospital, Shenzhen, China
| | | | - Leslie Castelo-Soccio
- Division of Pediatrics, Section of Dermatology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
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267
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Bernardis E, Castelo-Soccio L. Quantifying Alopecia Areata via Texture Analysis to Automate the SALT Score Computation. J Investig Dermatol Symp Proc 2018; 19:S34-S40. [PMID: 29273104 DOI: 10.1016/j.jisp.2017.10.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Quantifying alopecia areata in real time has been a challenge for clinicians and investigators. Although several scoring systems exist, they can be cumbersome. Because there are more clinical trials in alopecia areata, there is an urgent need for a quantitative system that is reproducible, standardized, and simple. In this article, a computer imaging algorithm to recreate the Severity of Alopecia Tool scoring system in an automated way is presented. A pediatric alopecia areata image set of four view-standardized photographs was created, and texture analysis was used to distinguish between normal hair and bald scalp. By exploiting local image statistics and the similarity of hair appearance variations across the pediatric alopecia examples, we then used a reference set of hair textures, derived from intensity distributions over very small image patches, to provide global context and improve partitioning of each individual image into areas of different hair densities. This algorithm can mimic a Severity of Alopecia Tool (score) and may also provide more information about the continuum of changes in density of hair seen in alopecia areata.
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Affiliation(s)
- Elena Bernardis
- Division of Pediatrics, Section of Dermatology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Leslie Castelo-Soccio
- Division of Pediatrics, Section of Dermatology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Departments of Pediatrics and Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
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268
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Alopecia areata. J Am Acad Dermatol 2018; 78:1-12. [DOI: 10.1016/j.jaad.2017.04.1141] [Citation(s) in RCA: 181] [Impact Index Per Article: 30.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Revised: 04/04/2017] [Accepted: 04/10/2017] [Indexed: 01/01/2023]
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269
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Mahmoudi H, Salehi M, Moghadas S, Ghandi N, Teimourpour A, Daneshpazhooh M. Dermoscopic Findings in 126 Patients with Alopecia Areata: A Cross-Sectional Study. Int J Trichology 2018; 10:118-123. [PMID: 30034191 PMCID: PMC6028992 DOI: 10.4103/ijt.ijt_102_17] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Dermoscopy is used increasingly in dermatological practice. Although dermoscopic findings of alopecia areata (AA) are described in the literature, studies are limited. Aim: Our aim was to evaluate dermoscopic findings of Iranian patients with AA and correlate them with disease activity and severity. Subjects and Methods: Totally 126 patients were examined using a Dermlite II multispectral dermoscope. Severity, activity, pull test, nail changes, treatments, and dermoscopic findings were recorded. Statistical Analysis Used: Statistical analysis was done by SPSS version 22, using appropriate statistical tools. Results: The most common dermoscopic findings were yellow dots (84.1%), vellus hairs (62.6%), black dots (48.4%), exclamation mark (30.9%), and broken hair (9.5%), in decreasing order. Furthermore, the most common dermoscopic findings in patients on diphencyprone were vellus hairs and yellow dots. Yellow dots and vellus hairs were most common in patients with alopecia universalis. However, broken hairs and exclamation mark hairs were mostly observed in patchy multiple AA patients. Yellow dots and exclamation mark hairs were also significantly more common in patients with positive pull test. Furthermore, vellus hairs were more common in patients with remitting disease pattern. With regard to scalp severity, yellow dots related positively, while vellus hairs, broken hairs, and exclamation mark hairs related negatively with severity of disease. Conclusions: Dermoscopic findings differ in various stages of activity and severity of AA. Dermoscopy is a valuable tool for the dermatologist for the diagnosis, follow-up, and evaluation of response to treatment.
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Affiliation(s)
- Hamidreza Mahmoudi
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdieh Salehi
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Saba Moghadas
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Narges Ghandi
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Teimourpour
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Daneshpazhooh
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
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270
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Darwin E, Hirt PA, Fertig R, Doliner B, Delcanto G, Jimenez JJ. Alopecia Areata: Review of Epidemiology, Clinical Features, Pathogenesis, and New Treatment Options. Int J Trichology 2018; 10:51-60. [PMID: 29769777 PMCID: PMC5939003 DOI: 10.4103/ijt.ijt_99_17] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Alopecia areata (AA) is a complex autoimmune condition that causes nonscarring hair loss. It typically presents with sharply demarcated round patches of hair loss and may present at any age. In this article, we review the epidemiology, clinical features, pathogenesis, and new treatment options of AA, with a focus on the immunologic mechanism underlying the treatment. While traditional treatment options such as corticosteroids are moderately effective, a better understanding of the disease pathogenesis may lead to the development of new treatments that are more directed and effective against AA. Sources were gathered from PubMed, Embase, and the Cochrane database using the keywords: alopecia, alopecia areata, hair loss, trichoscopy, treatments, pathogenesis, and epidemiology.
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Affiliation(s)
- Evan Darwin
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Fl 33136, USA
| | - Penelope A Hirt
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Fl 33136, USA
| | - Raymond Fertig
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Fl 33136, USA
| | - Brett Doliner
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Fl 33136, USA
| | - Gina Delcanto
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, Fl 33136, USA
| | - Joaquin J Jimenez
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Fl 33136, USA
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271
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Okhovat JP, Grogan T, Duan L, Goh C. Willingness to pay and quality of life in alopecia areata. J Am Acad Dermatol 2017; 77:1183-1184. [PMID: 29132855 DOI: 10.1016/j.jaad.2017.07.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 07/12/2017] [Accepted: 07/23/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Jean-Phillip Okhovat
- Stanford University Medical Center, Palo Alto, CA; Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; Department of Biostatistics and Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts.
| | - Tristan Grogan
- Department of Medicine Statistics Core, University of California, Los Angeles, Los Angeles, California
| | - Lewei Duan
- Department of Medicine Statistics Core, University of California, Los Angeles, Los Angeles, California
| | - Carolyn Goh
- Division of Dermatology, University of California, Los Angeles, Los Angeles, California
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272
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Sriphojanart T, Khunkhet S, Suchonwanit P. A retrospective comparative study of the efficacy and safety of two regimens of diphenylcyclopropenone in the treatment of recalcitrant alopecia areata. Dermatol Reports 2017; 9:7399. [PMID: 29299216 PMCID: PMC5745358 DOI: 10.4081/dr.2017.7399] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 11/06/2017] [Indexed: 12/12/2022] Open
Abstract
Diphenylcyclopropenone (DPCP) is an effective topical immunotherapy for recalcitrant alopecia areata (AA), which sometimes requires prolonged treatment. We developed a new treatment protocol to shorten the duration of therapy. This study aimed to compare the efficacy and safety of the new treatment protocol with the standard treatment protocol in the treatment of recalcitrant AA. We conducted a 6-year retrospective comparative study of patients with AA who received one of the DPCP treatment protocols at our institute. Patients’ information was collected and subsequent statistically analyzed. Thirtynine patients (16 in the new treatment group and 23 in the standard treatment group) were included. There were no statistically significant differences in area of hair regrowth. Mean duration to initial hair regrowth and mean duration to significant hair regrowth in the new treatment group were significantly shorter than in the standard treatment group (P=0.002 and 0.01, respectively). Adverse effects were slightly higher in the new treatment group. The present study reveals the effectiveness and safety of the new treatment protocol, which shortens the duration of DPCP treatment and could represent an alternative regimen.
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Affiliation(s)
- Tueboon Sriphojanart
- Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Saranya Khunkhet
- Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Poonkiat Suchonwanit
- Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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273
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Unal M. Use of adapalene in alopecia areata: Efficacy and safety of mometasone furoate 0.1% cream versus combination of mometasone furoate 0.1% cream and adapalene 0.1% gel in alopecia areata. Dermatol Ther 2017; 31. [PMID: 29193637 DOI: 10.1111/dth.12574] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 10/03/2017] [Accepted: 10/24/2017] [Indexed: 12/01/2022]
Abstract
Alopecia areata (AA) is an autoimmune disease characterized by non-cicatricial hair loss. No definitive therapy currently exists for AA. To compared the efficacy and safety of the mometasone furoate 0.1% cream alone with the mometasone furoate 0.1% cream plus adapalene 0.1% gel in treatment of AA. Twenty patients with AA and with mean age of 27.4 ± 9.2 years were enrolled. Patches with a diameter of < 5 cm were treated with mometasone furate 0.1% cream (M), and patches with a diameter of ≥5 cm were treated with mometasone furate 0.1% cream plus adapalene 0.1% gel (M + D) for a period of 12 weeks. Hair regrowth was evaluated using a Re-growth score (RGS). Mean RGSs of M + D group were higher than M group for 4th week (2.60 vs. 1.45); 8th week (3.85 vs. 2.40) and 12th week (4.40 vs. 3.30). Mean percentages of hair re-growth in M + D group were statistically higher than M group for 4th (50.2% vs. 23.5%), 8th (78.5% vs. 50.7%), and 12th week (90.5% vs. 71%). Study revealed the efficacy and safety of adapalene and mometasone furoate combination in AA. Adapalene can be used as a new therapeutic modality in AA.
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Affiliation(s)
- Mehmet Unal
- Faculty of Medicine, Department of Dermatology, Selcuk University, Konya, Turkey
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274
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Choi JW, Suh DW, Lew BL, Sim WY. Simvastatin/Ezetimibe Therapy for Recalcitrant Alopecia Areata: An Open Prospective Study of 14 Patients. Ann Dermatol 2017; 29:755-760. [PMID: 29200765 PMCID: PMC5705358 DOI: 10.5021/ad.2017.29.6.755] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 03/30/2017] [Accepted: 04/18/2017] [Indexed: 11/29/2022] Open
Abstract
Background Simvastatin belongs to the statin family, whose members have immunomodulatory activities. Ezetimibe have synergetic effects when co-administered with simvastatin. In several case reports, alopecia totalis and alopecia universalis were successfully treated with simvastatin/ezetimibe, suggesting that this combination could be a new efficient therapy for recalcitrant alopecia areata (AA). Objective To verify the efficacy of the simvastatin/ezetimibe combination therapy for recalcitrant AA and investigate the relationship between various treatment responses and prognostic factors. Methods This prospective open study was performed in patients with recalcitrant AA with the bald surface exceeding 75%. All patients took simvastatin (40 mg) and ezetimibe (10 mg) daily. The extent of hair regrowth expressed as percentage of the bald area was used to evaluate the effectiveness of the therapy. Results Of 14 enrolled patients, 4 patients (28.6%) were judged as responders showing regrowth of 30% to 80% after 3 months of treatment. The mean age of onset in non-responders was significantly lower than in responders. The total score of prognostic factors, calculated as a sum of factors related to poor prognosis, was much lower in responders than in non-responders. Conclusion The remission rate in this study was unsatisfactory. However, since the recruited patients had not responded to any other treatments for AA, simvastatin/ezetimibe can still be considered as an alternative treatment for recalcitrant AA. The total scores of the prognostic factors were statistically different between responders and non-responders. These results can be used to predict the outcome of treatment with simvastatin/ezetimibe and anticipate prognosis.
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Affiliation(s)
- Joong-Woon Choi
- Department of Dermatology, Kyung Hee University College of Medicine, Seoul, Korea
| | - Dong-Woo Suh
- Department of Dermatology, Kyung Hee University College of Medicine, Seoul, Korea
| | - Bark-Lynn Lew
- Department of Dermatology, Kyung Hee University College of Medicine, Seoul, Korea
| | - Woo-Young Sim
- Department of Dermatology, Kyung Hee University College of Medicine, Seoul, Korea
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275
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Jun M, Lee WS. Therapeutic Effect of Superficial Cryotherapy on Alopecia Areata: A Prospective, Split-scalp Study in Patients with Multiple Alopecia Patches. Ann Dermatol 2017; 29:722-727. [PMID: 29200760 PMCID: PMC5705353 DOI: 10.5021/ad.2017.29.6.722] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 02/27/2017] [Accepted: 03/20/2017] [Indexed: 11/18/2022] Open
Abstract
Background Alopecia areata (AA) affects anagen hair follicles resulting in non-scarring hair loss. Since its introduction, superficial cryotherapy has been used as one of the meaningful treatment modalities for AA. Objective The purpose of this study is to clarify the therapeutic efficacy and safety of superficial cryotherapy for treatment of AA. Methods In 19 patients with multiple bilateral AA patches on their scalp, superficial cryotherapy was performed on the right side, every 2 weeks. Prednicarbate 0.25% solution was applied twice a day to both the treated and the control sides. Clinical improvement was estimated using the Severity of Alopecia Tool (SALT) score by 3 different dermatologists, along with the changes in terminal and vellus hair count and hair thickness analyzed by phototrichogram. Results After 4 months of treatment, mean terminal hair count on the right scalp was 1.6-fold increased (p=0.005), while mean terminal hair count on the left scalp showed no significant change (110.1% increase, p=0.285). Mean SALT score decrease on the right was 4-fold greater than that on the left (40.7% and 9.6%), without statistical significance (p=0.282). Mean vellus hair count and mean hair thickness did not show significant changes after superficial cryotherapy. No remarkable adverse event was observed. Conclusion Superficial cryotherapy is an efficacious treatment modality with advantages of simplicity and noninvasiveness. It can be considered as a meaningful therapeutic modality for AA, especially when the disease status is limited to minimal to mild, or the conventional AA treatment is not applicable.
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Affiliation(s)
- Myungsoo Jun
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Won-Soo Lee
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
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276
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Scarampella F, Roccabianca P. Alopecia Areata in a Dog: Clinical, Dermoscopic and Histological Features. Skin Appendage Disord 2017; 4:112-117. [PMID: 29765971 DOI: 10.1159/000479781] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 07/26/2017] [Indexed: 11/19/2022] Open
Abstract
Alopecia areata (AA)-like disease is characterized by multifocal patchy hair loss in humans, rodents, dogs, and horses. Remarkable similarities between human and nonhuman AA cases have been reported in terms of clinical presentation, histology, and immune mechanisms of the disease. Canine AA-like lesions most often consist of well-demarcated alopecic patches, frequently but not only involving the face and the head, which extend to the ear pinnae and legs. In some cases, hair loss can have a more generalized distribution. As in humans, hair regrowth is most commonly spontaneous in canine AA-like disease and the resistant cases usually respond to glucocorticoids or cyclosporine treatment. Diagnosis of AA in veterinary medicine relies on presentation, histopathology, and immunohistochemistry and on regrowth following therapy. This case report describes the first dermoscopic evaluation of AA-like disease in a dog with a clinical presentation of symmetrical hair loss.
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Affiliation(s)
- Fabia Scarampella
- Studio Dermatologico Veterinario, Faculty of Veterinary Medicine, Milan, Italy
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277
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Maktabi M, Chamani M, Asemi Z. The Effects of Vitamin D Supplementation on Metabolic Status of Patients with Polycystic Ovary Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial. Horm Metab Res 2017; 49:493-498. [PMID: 28679140 DOI: 10.1055/s-0043-107242] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Data on the effects of vitamin D supplementation on metabolic status of patients with polycystic ovary syndrome (PCOS) are scarce. The current study was conducted to evaluate the effects of vitamin D supplementation on metabolic status of patients with PCOS. This randomized double-blind, placebo-controlled trial was performed on 70 vitamin D-deficient (serum concentrations<20 ng/ml) women with phenotype B-PCOS according to the Rotterdam criteria aged 18-40 years old. Participants were randomly allocated into 2 groups to take either 50 000 IU vitamin D (n=35) or placebo (n=35) every 2 weeks for 12 weeks. Metabolic, endocrine, inflammation, and oxidative stress biomarkers were quantified at the beginning of the study and after 12-week intervention. After the 12-week intervention, compared to the placebo, vitamin D supplementation significantly decreased fasting plasma glucose (FPG) (-3.1±7.3 vs. +0.5±6.3 mg/dl, p=0.02), insulin (-1.4±3.6 vs. +2.6±7.0 μIU/ml, p=0.004), homeostasis model of assessment-estimated insulin resistance (-0.3±0.8 vs. +0.6±1.6, p=0.003), homeostasis model of assessment-estimated B cell function (-4.9±13.4 vs. +9.9±26.9, p=0.005), and increased quantitative insulin sensitivity check index (+0.01±0.01 vs. -0.02±0.05, p=0.007). Supplementation with vitamin D also led to significant reductions in serum high-sensitivity C-reactive protein (hs-CRP) (-0.7±1.4 vs. +0.5±2.1 μg/mL, p=0.009) and plasma malondialdehyde (MDA) levels (-0.1±0.5 vs. +0.9±2.1 μmol/l, p=0.01) compared to the placebo. Overall, vitamin D supplementation for 12 weeks in vitamin D-deficient women with phenotype B-PCOS had beneficial effects on glucose homeostasis parameters, hs-CRP, and MDA.
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Affiliation(s)
- Maryam Maktabi
- Department of Gynecology and Obstetrics, Endocrinology and Metabolism Research Center, School of Medicine, Arak University of Medical Sciences, Arak, I. R. Iran
| | - Maryam Chamani
- Department of Gynecology and Obstetrics, School of Medicine, Iran University of Medical Sciences, Tehran, I. R. Iran
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I. R. Iran
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278
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Abstract
Alopecia areata (AA), a prevalent inflammatory cause of hair loss, lacks FDA-approved therapeutics for extensive cases, which are associated with very poor rates of spontaneous hair regrowth and major psychological distress. Current treatments for severe cases include broad immune-suppressants, which are associated with significant adverse effects, precluding long-term use, with rapid hair loss following treatment termination. As a result of the extent of the disease in severe cases, topical contact sensitizers and intralesional treatments are of limited use. The pathogenesis of AA is not yet fully understood, but recent investigations of the immune activation in AA skin reveal Th1/IFN-γ, as well as Th2, PDE4, IL-23, and IL-9 upregulations. Tissue analyses of both animal models and human lesions following broad-acting and cytokine-specific therapeutics (such as JAK inhibitors and ustekinumab, respectively) provide another opportunity for important insights into the pathogenesis of AA. As reviewed in this paper, numerous novel therapeutics are undergoing clinical trials for AA, emphasizing the potential transformation of the clinical practice of AA, which is currently lacking. Dermatologists are already familiar with the revolution in disease management of psoriasis, stemming from better understanding of immune dysregulations, and atopic dermatitis will soon follow a similar path. In light of these recent developments, the therapeutic arena of AA treatments is finally getting more exciting. AA will join the lengthening list of dermatologic diseases with mechanism-targeted drugs, thus changing the face of AA.
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Affiliation(s)
- Yael Renert-Yuval
- Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Emma Guttman-Yassky
- Department of Dermatology and the Laboratory for Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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279
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Abstract
Alopecia areata (AA) is an autoimmune-mediated, nonscarring form of hair loss. Despite its prevalence, current management options are limited, especially when the disease has progressed to alopecia totalis (AT) or alopecia universalis (AU). Recent evidence that janus kinase (JAK) signaling contributes to AA pathogenesis prompted the investigation of JAK inhibitors such as tofacitinib and ruxolitinib as possible oral treatments. However, the potential for significant adverse effects with systemic JAK inhibition makes local administration a more attractive option. Yet, a paucity of data exists on topical JAK inhibition in AA. A success of topical ruxolitinib (0.6% cream) use in a young patient with AU has been reported to date. Here we report the treatment of a 66-year-old with AA with the same formulation of topical ruxolitinib, where it failed to induce hair growth. Our report demonstrates the importance of examining the factors contributing to variation in treatment response in a clinical trial of topical JAK inhibitors in AA. It is likely that both intrinsic factors specific to individual patients and extrinsic factors relating to treatment regimen are involved. Furthermore, characterisation of the specific JAKs overexpressed in AA may better target medication. Finally, this report highlights the need to compare the outcomes of topical vs oral ruxolitinib administration in patients with severe AA, AT, and AU and may support the possibility that extensive disease is more adequately treated with oral administration of ruxolitinib.
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280
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Affiliation(s)
- Solam Lee
- Department of Dermatology; Institute of Hair and Cosmetic Medicine; Yonsei University Wonju College of Medicine; Wonju Korea
| | - Won-Soo Lee
- Department of Dermatology; Institute of Hair and Cosmetic Medicine; Yonsei University Wonju College of Medicine; Wonju Korea
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281
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El-Ashmawy AA, El-Maadawy IH, El-Maghraby GM. Efficacy of topical latanoprost versus minoxidil and betamethasone valerate on the treatment of alopecia areata. J DERMATOL TREAT 2017; 29:55-64. [PMID: 28521549 DOI: 10.1080/09546634.2017.1330527] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Alopecia areata (AA) is one of the most common causes of localized hair loss. There is no universally proven therapy that induces and sustains remission of hair growth in AA. OBJECTIVE To compare the efficacy and safety of topical latanoprost, minoxidil and betamethasone valerate on hair growth in patients with AA. PATIENTS AND METHODS Hundred patients with AA classified into five groups of 20 treated with: Group I, latanoprost 0.1% lotion; Group II, minoxidil 5% lotion; Group III, betamethasone valerate 0.1% solution; Group IV, combination of latanoprost lotion and betamethasone valerate solution and Group V, a vehicle lotion control group. RESULTS There was a statistically significant improvement in all therapeutic groups when compared with control group and reduction of severity of alopecia tool score of scalp and beard before and after treatment for all therapeutic groups. CONCLUSION Latanoprost, minoxidil and betamethasone valerate are effective and safe in the treatment of patchy AA. The use of latanoprost added to the therapeutic efficacy of topical betamethasone valerate in the treatment of AA and could be an effective adjunctive topical therapy for AA.
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Affiliation(s)
- Amal Ahmad El-Ashmawy
- a Department of Dermatology and Venereology, Faculty of Medicine , Tanta University , Tanta , Egypt
| | - Iman Hamed El-Maadawy
- a Department of Dermatology and Venereology, Faculty of Medicine , Tanta University , Tanta , Egypt
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282
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Ngwanya MR, Gray NA, Gumedze F, Ndyenga A, Khumalo NP. Higher concentrations of dithranol appear to induce hair growth even in severe alopecia areata. Dermatol Ther 2017; 30. [PMID: 28598005 DOI: 10.1111/dth.12500] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 04/17/2017] [Indexed: 11/26/2022]
Abstract
Alopecia areata (AA) is the commonest autoimmune cause of non-scarring alopecia. Topical treatments including corticosteroids and irritants maybe beneficial. Studies report variable hair regrowth with dithranol (anthralin) but all used low concentrations (0.1-1.25%) and inconsistent measurements of AA severity. We report retrospective data (2005-2014) of 102 patients who had failed ultra-potent topical steroids and were referred to a specialist hair clinic for treatment with dithranol up to 3%. The severity of alopecia areata tool was used and participants graded as mild (<25%), moderate (>25 to 75%), and severe (>75%) hair loss. Compared with baseline any and at-least 50% hair regrowth [72%, 68%, 50% and 61.5%, 48.4%, 37.5%, in mild, moderate and severe AA respectively] occurred in all groups (median treatment duration 12 months). Twenty-nine patients (28.4%) were discharged with complete regrowth; with no difference in proportions in severity groups (33.3%, 29%, and 21.9%) but in the period to discharge [7.9, 6.3, and 29.4 months (p-values <.05)] for mild, moderate, and severe AA. Treatment trials of 12 months with dithranol at higher concentrations may be an option in patients who failed potent topical or intra-lesional steroids) regardless of AA severity. Randomized trials (of less staining formulations) of dithranol are warranted.
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Affiliation(s)
- M R Ngwanya
- Division of Dermatology, Groote Schuur Hospital, University of Cape Town, South Africa
| | - N A Gray
- Division of Dermatology, Groote Schuur Hospital, University of Cape Town, South Africa
| | - F Gumedze
- Department of Statistical Sciences, University of Cape Town, South Africa
| | - A Ndyenga
- Division of Dermatology, Groote Schuur Hospital, University of Cape Town, South Africa
| | - N P Khumalo
- Division of Dermatology, Groote Schuur Hospital, University of Cape Town, South Africa
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283
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Nasri K, Hantoushzadeh S, Aghadavod E, Taghizadeh M, Asemi Z. The Effects of Omega-3 Fatty Acids Supplementation on Gene Expression Involved in the Insulin and Lipid Signaling Pathway in Patients with Polycystic Ovary Syndrome. Horm Metab Res 2017; 49:446-451. [PMID: 28235206 DOI: 10.1055/s-0042-122782] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Limited data are available evaluating the effects of omega-3 fatty acids supplementation on gene expression involved in the insulin and lipid-signaling pathway in women with polycystic ovary syndrome (PCOS). This study was conducted to evaluate the effects of omega-3 fatty acids supplementation on gene expression involved in the insulin and lipid signaling pathway in women with PCOS. This randomized double blind, placebo-controlled trial was done among 60 women aged 18-40 years old and diagnosed with PCOS according to the Rotterdam criteria. Participants were randomly assigned into 2 groups to receive either 1 000 mg omega-3 fatty acids from flaxseed oil containing 400 mg α-linolenic acid (n=30) or placebo (n=30) twice a day for 12 weeks. Gene expressions involved in the insulin and lipid-signaling pathway were quantified in blood samples of PCOS women with RT-PCR method. Quantitative results of RT-PCR demonstrated that compared with the placebo, omega-3 fatty acids supplementation upregulated peroxisome proliferator-activated receptor gamma (PPAR-γ) mRNA (p=0.005) in peripheral blood mononuclear cells of women with PCOS. In addition, compared to the placebo, omega-3 fatty acids supplementation downregulated expressed levels of oxidized low-density lipoprotein receptor (LDLR) mRNA (p=0.002) in peripheral blood mononuclear cells of women with PCOS. We did not observe any significant effect of omega-3 fatty acids supplementation on expressed levels of glucose transporter 1 (GLUT-1) and lipoprotein(a) [Lp(a)] genes in peripheral blood mononuclear cells. Overall, omega-3 fatty acids supplementation for 12 weeks in PCOS women significantly improved gene expression of PPAR-γ and LDLR.
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Affiliation(s)
- Khadijeh Nasri
- Maternal-Fetal & Neonatal Research Center and Breast Feeding Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Gynecology and Obstetrics, Endocrinology and Metabolism Research Center, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Sedigheh Hantoushzadeh
- Maternal-Fetal & Neonatal Research Center and Breast Feeding Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Esmat Aghadavod
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohsen Taghizadeh
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
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284
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Chong J, Taïeb A, Morice-Picard F, Dutkiewicz A, Léauté-Labrèze C, Boralevi F. High-dose pulsed corticosteroid therapy combined with methotrexate for severe alopecia areata of childhood. J Eur Acad Dermatol Venereol 2017; 31:e476-e477. [DOI: 10.1111/jdv.14291] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- J.H. Chong
- Department of Pediatric Dermatology; National Centre for Rare Skin Disorders; Hôpital Pellegrin-Enfants; CHU de Bordeaux; Bordeaux France
- Pediatric Dermatology Service; KK Women's and Children's Hospital; Singapore Singapore
| | - A. Taïeb
- Department of Pediatric Dermatology; National Centre for Rare Skin Disorders; Hôpital Pellegrin-Enfants; CHU de Bordeaux; Bordeaux France
| | - F. Morice-Picard
- Department of Pediatric Dermatology; National Centre for Rare Skin Disorders; Hôpital Pellegrin-Enfants; CHU de Bordeaux; Bordeaux France
| | - A.S. Dutkiewicz
- Department of Pediatric Dermatology; National Centre for Rare Skin Disorders; Hôpital Pellegrin-Enfants; CHU de Bordeaux; Bordeaux France
| | - C. Léauté-Labrèze
- Department of Pediatric Dermatology; National Centre for Rare Skin Disorders; Hôpital Pellegrin-Enfants; CHU de Bordeaux; Bordeaux France
| | - F. Boralevi
- Department of Pediatric Dermatology; National Centre for Rare Skin Disorders; Hôpital Pellegrin-Enfants; CHU de Bordeaux; Bordeaux France
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285
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Lim SK, Lim CA, Kwon IS, Im M, Seo YJ, Kim CD, Lee JH, Lee Y. Low-Dose Systemic Methotrexate Therapy for Recalcitrant Alopecia Areata. Ann Dermatol 2017; 29:263-267. [PMID: 28566900 PMCID: PMC5438930 DOI: 10.5021/ad.2017.29.3.263] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 07/07/2016] [Accepted: 08/08/2016] [Indexed: 12/03/2022] Open
Abstract
Background Alopecia areata (AA) is an autoimmune skin disease difficult to manage and treat. The pathogenesis of AA features a T-cell-associated autoimmune process, and systemic immunosuppressive therapy is prescribed widely for AA. Objective To evaluate the efficacy and tolerance of systemic low-dose methotrexate (LD-MTX) therapy in treatment of recalcitrant AA multiplex. Methods In a retrospective, non-controlled study, we evaluated 29 patients with recalcitrant AA treated with LD-MTX and assessed the therapeutic response according to severity of disease, disease duration, cumulative dose of MTX, and drug safety. Results MTX was administered twice weekly, and the mean maximum weekly dose was 14.48 mg. The response was A5 (regrowth=100.0%) in 14 (48.3%) patients and A4 (regrowth of 75%~90%) in 12 (41.4%) patients. Three patients had poor response to LD-MTX treatment (A2: n=2 [6.9%], A1: n=1 [3.4%]). All three of the patients showing a poor response had disease durations exceeding 24 months. Relapse was observed in 31% of patients with more than 75% regrowth. Common side-effects were elevated liver enzyme levels and gastrointestinal discomfort. Conclusion LD-MTX appears to be an effective and well-tolerated treatment for recalcitrant AA multiplex.
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Affiliation(s)
- Seul-Ki Lim
- Department of Dermatology, Chungnam National University School of Medicine, Daejeon, Korea
| | - Cho-Ah Lim
- Department of Dermatology, Chungnam National University School of Medicine, Daejeon, Korea
| | - In Sun Kwon
- Clinical Trials Center, Chungnam National University Hospital, Daejeon, Korea
| | - Myung Im
- Department of Dermatology, Chungnam National University School of Medicine, Daejeon, Korea
| | - Young-Joon Seo
- Department of Dermatology, Chungnam National University School of Medicine, Daejeon, Korea
| | - Chang-Deok Kim
- Department of Dermatology, Chungnam National University School of Medicine, Daejeon, Korea
| | - Jeung-Hoon Lee
- Department of Dermatology, Chungnam National University School of Medicine, Daejeon, Korea
| | - Young Lee
- Department of Dermatology, Chungnam National University School of Medicine, Daejeon, Korea
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286
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Bolduc C, Sperling LC, Shapiro J. Primary cicatricial alopecia: Lymphocytic primary cicatricial alopecias, including chronic cutaneous lupus erythematosus, lichen planopilaris, frontal fibrosing alopecia, and Graham-Little syndrome. J Am Acad Dermatol 2017; 75:1081-1099. [PMID: 27846944 DOI: 10.1016/j.jaad.2014.09.058] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 09/14/2014] [Accepted: 09/15/2014] [Indexed: 12/19/2022]
Abstract
Both primary and secondary forms of cicatricial alopecia have been described. The hair follicles are the specific target of inflammation in primary cicatricial alopecias. Hair follicles are destroyed randomly with surrounding structures in secondary cicatricial alopecia. This 2-part continuing medical education article will review primary cicatricial alopecias according to the working classification suggested by the North American Hair Research Society. In this classification, the different entities are classified into 3 different groups according to their prominent inflammatory infiltrate (ie, lymphocytic, neutrophilic, and mixed). Part I discusses the following lymphocytic primary cicatricial alopecias: chronic cutaneous lupus erythematosus, lichen planopilaris, frontal fibrosing alopecia, and Graham-Little syndrome.
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Affiliation(s)
- Chantal Bolduc
- Department of Dermatology, University of Montreal, Montreal, Quebec, Canada.
| | - Leonard C Sperling
- Department of Dermatology, Uniformed Services University of the Health Sciences, Bethesda, Maryland; Department of Pathology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Jerry Shapiro
- Department of Dermatology, University of British Columbia, Vancouver, British Columbia, Canada; Department of Dermatology, New York University, New York, New York
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287
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Th1/Th2 PB balance and CD200 expression of patients with active severe alopecia areata. Exp Ther Med 2017; 13:2883-2887. [PMID: 28587354 PMCID: PMC5450686 DOI: 10.3892/etm.2017.4312] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 01/25/2017] [Indexed: 11/16/2022] Open
Abstract
Th1/Th2 peripheral blood balance and CD200 expression in patients with severe alopecia areata (SAA) in the active stage were investigated. Fifty patients with active SAA, 50 patients with stable SAA and 50 healthy controls were continuously selected and expression of Th1/Th2 of peripheral T lymphocytes, and peripheral B lymphocytes was detected by flow cytometry; RT-PCR was used to detect the expression of the PBMC CD200 mRNA and the expression of CD200 in hair follicles of alopecia area was detected by immunohistochemically staining; ELISA was used to detect expression levels of serum LFN-γ and serum interleukin (IL)-10. The expression of CD200 in patients with alopecia areata in active phase on CD3+ T lymphocytes and CD19+ B lymphocytes was significantly lower (P<0.05) than those in stable phase and of the control group. CD200 expression in patients with alopecia areata in stable phase on T lymphocytes was greatly lower than that of the control group (P<0.05). However, the comparison of expression of CD200 in patients with alopecia areata in stable phase on B lymphocytes with the control group were statistically non-significant. The level of the expression of CD200 mRNA in active phase was obviously lower than those of the other two groups and the difference was statistically significant (P<0.05); the moderate positive and strong positive percentage of CD200 in the active phase was significantly lower than those of the other two groups. Positive expression rate of CK15 among the three groups were compared with each other; the differences had no statistical significance. The level of LFN-γ in the active phase had obviously increased while the IL-10 level decreased significantly (P<0.05). In conclusion, the level of expression of CD200 on peripheral blood and hair follicle outer root sheath of patients with SAA was decreased. This may be associated with the imbalance of the Th1/Th2 equilibrium.
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288
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Samimi M, Zarezade Mehrizi M, Foroozanfard F, Akbari H, Jamilian M, Ahmadi S, Asemi Z. The effects of coenzyme Q10 supplementation on glucose metabolism and lipid profiles in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. Clin Endocrinol (Oxf) 2017; 86:560-566. [PMID: 27911471 DOI: 10.1111/cen.13288] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 11/21/2016] [Accepted: 11/27/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND Data on the effects of coenzyme Q10 (CoQ10) supplementation on metabolic profiles among subjects with polycystic ovary syndrome (PCOS) are scarce. OBJECTIVE This study was carried out to evaluate the effects of CoQ10 supplementation on glucose metabolism and lipid profiles in subjects with PCOS. DESIGN, PATIENTS AND MEASUREMENTS This randomized, double-blind, placebo-controlled trial was conducted on 60 women diagnosed with PCOS. Subjects were randomly assigned into two groups to intake either 100 mg CoQ10 supplements (N = 30) or placebo (N = 30) per day for 12 weeks. Markers of insulin metabolism and lipid profiles were assessed at first and 12 weeks after the intervention. RESULTS After 12 weeks of intervention, compared to the placebo, subjects who received CoQ10 supplements had significantly decreased fasting plasma glucose (-0·24 ± 0·51 vs +0·01 ± 0·44 mmol/l, P = 0·04), serum insulin concentrations (-7·8 ± 14·4 vs +6·0 ± 15·0 pmol/l, P < 0·001), the homeostasis model of assessment-estimated insulin resistance (-0·3 ± 0·6 vs +0·2 ± 0·6, P = 0·001), the homeostasis model of assessment-estimated B-cell function (-5·4 ± 9·5 vs +4·5 ± 9·9, P < 0·001) and increased the quantitative insulin sensitivity check index (+0·006 ± 0·009 vs -0·006 ± 0·01, P < 0·001). In addition, changes in serum total- (-0·10 ± 0·48 vs +0·19 ± 0·50 mmol/l, P = 0·02) and LDL-cholesterol concentrations (-0·15 ± 0·40 vs +0·14 ± 0·49 mmol/l, P = 0·01) in supplemented women were significantly different from those of women in the placebo group. When we adjusted the analysis for baseline values of biochemical parameters, age and baseline BMI, serum LDL-cholesterol (P = 0·05) became nonsignificant, and other findings did not alter. CONCLUSIONS Overall, CoQ10 supplementation for 12 weeks among subjects with PCOS had beneficial effects on glucose metabolism, serum total- and LDL-cholesterol levels.
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Affiliation(s)
- Mansooreh Samimi
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Maryam Zarezade Mehrizi
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Fatemeh Foroozanfard
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Hossein Akbari
- Department of Biostatistics and Epidemiology, Kashan University of Medical Sciences, Kashan, Iran
| | - Mehri Jamilian
- Endocrinology and Metabolism Research Center, Department of Gynecology and Obstetrics, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Shahnaz Ahmadi
- Department of Gynecology and Obstetrics, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
- Department of Gynecology and Obstetrics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
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289
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Abstract
Alopecia areata is an autoimmune disorder characterized by transient, non-scarring hair loss and preservation of the hair follicle. Hair loss can take many forms ranging from loss in well-defined patches to diffuse or total hair loss, which can affect all hair-bearing sites. Patchy alopecia areata affecting the scalp is the most common type. Alopecia areata affects nearly 2% of the general population at some point during their lifetime. Skin biopsies of affected skin show a lymphocytic infiltrate in and around the bulb or the lower part of the hair follicle in the anagen (hair growth) phase. A breakdown of immune privilege of the hair follicle is thought to be an important driver of alopecia areata. Genetic studies in patients and mouse models have shown that alopecia areata is a complex, polygenic disease. Several genetic susceptibility loci were identified to be associated with signalling pathways that are important to hair follicle cycling and development. Alopecia areata is usually diagnosed based on clinical manifestations, but dermoscopy and histopathology can be helpful. Alopecia areata is difficult to manage medically, but recent advances in understanding the molecular mechanisms have revealed new treatments and the possibility of remission in the near future.
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Affiliation(s)
- C Herbert Pratt
- Department of Genetic Resource Sciences, The Jackson Laboratory, Bar Harbor, Maine, USA
| | - Lloyd E King
- Department of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | - Angela M Christiano
- Departments of Dermatology and Genetics &Development, Columbia University, New York, New York, USA
| | - John P Sundberg
- Department of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Research and Development, The Jackson Laboratory, 600 Main Street, Bar Harbor, Maine 04609-1500, USA
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290
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Maouia A, Sormani L, Youssef M, Helal AN, Kassab A, Passeron T. Differential expression of CXCL9, CXCL10, and IFN-γ in vitiligo and alopecia areata patients. Pigment Cell Melanoma Res 2017; 30:259-261. [PMID: 27863059 DOI: 10.1111/pcmr.12559] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Amal Maouia
- Laboratory of Bioresources, Integrative Biology and Valorization, Higher Institute of Biotechnology of Monastir, Monastir, Tunisia
| | | | - Monia Youssef
- Department of Dermatology, CHU Fattouma Bourguiba, Monastir, Tunisia
| | - Ahmed N Helal
- Laboratory of Bioresources, Integrative Biology and Valorization, Higher Institute of Biotechnology of Monastir, Monastir, Tunisia
| | - Asma Kassab
- Biochemistry and Molecular Biology Laboratory, Faculty of Pharmacy, Monastir, Tunisia
| | - Thierry Passeron
- C3M, INSERM U1065, Team 12, Nice, France.,Department of Dermatology, University Hospital Center of Nice, Nice, France
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291
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Grenier PO, Veillette H. Treatment of alopecia universalis with oral alitretinoin: A case report. JAAD Case Rep 2017; 3:140-142. [PMID: 28349112 PMCID: PMC5358928 DOI: 10.1016/j.jdcr.2017.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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292
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Herz-Ruelas ME, Gomez-Flores M, Miranda-Maldonado I, Welsh E, Ocampo-Candiani J, Welsh O. Escalating dosimetry of UVA-1 in the treatment of alopecia areata. Int J Dermatol 2017; 56:653-659. [DOI: 10.1111/ijd.13572] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 11/30/2016] [Accepted: 01/09/2017] [Indexed: 01/01/2023]
Affiliation(s)
- Maira E. Herz-Ruelas
- Dermatology Department; Universidad Autonoma de Nuevo Leon; Facultad de Medicina; University Hospital; Monterrey Mexico
| | - Minerva Gomez-Flores
- Dermatology Department; Universidad Autonoma de Nuevo Leon; Facultad de Medicina; University Hospital; Monterrey Mexico
| | - Ivett Miranda-Maldonado
- Pathology Department; Universidad Autonoma de Nuevo Leon; Facultad de Medicina; University Hospital; Monterrey Mexico
| | - Esperanza Welsh
- Dermatology Department; Universidad Autonoma de Nuevo Leon; Facultad de Medicina; University Hospital; Monterrey Mexico
| | - Jorge Ocampo-Candiani
- Dermatology Department; Universidad Autonoma de Nuevo Leon; Facultad de Medicina; University Hospital; Monterrey Mexico
| | - Oliverio Welsh
- Dermatology Department; Universidad Autonoma de Nuevo Leon; Facultad de Medicina; University Hospital; Monterrey Mexico
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293
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Rahmani E, Samimi M, Ebrahimi FA, Foroozanfard F, Ahmadi S, Rahimi M, Jamilian M, Aghadavod E, Bahmani F, Taghizadeh M, Memarzadeh MR, Asemi Z. The effects of omega-3 fatty acids and vitamin E co-supplementation on gene expression of lipoprotein(a) and oxidized low-density lipoprotein, lipid profiles and biomarkers of oxidative stress in patients with polycystic ovary syndrome. Mol Cell Endocrinol 2017; 439:247-255. [PMID: 27619403 DOI: 10.1016/j.mce.2016.09.008] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 08/15/2016] [Accepted: 09/08/2016] [Indexed: 01/07/2023]
Abstract
This study was conducted to determine the effects of omega-3 fatty acids and vitamin E co-supplementation on gene expression of lipoprotein(a) (Lp[a]) and oxidized low-density lipoprotein (Ox-LDL), lipid profiles and biomarkers of oxidative stress in women with polycystic ovary syndrome (PCOS). This randomized double-blind, placebo-controlled trial was done on 68 women diagnosed with PCOS according to the Rotterdam criteria aged 18-40 years old. Participants were randomly assigned into two groups to receive either 1000 mg omega-3 fatty acids from flaxseed oil containing 400 mg α-Linolenic acid plus 400 IU vitamin E supplements (n = 34) or placebo (n = 34) for 12 weeks. Lp(a) and Ox-LDL mRNA levels were quantified in peripheral blood mononuclear cells of PCOS women with RT-PCR method. Lipid profiles and biomarkers of oxidative stress were quantified at the beginning of the study and after 12-week intervention. Quantitative results of RT-PCR demonstrated that compared with the placebo, omega-3 fatty acids and vitamin E co-supplementation downregulated expressed levels of Lp(a) mRNA (P < 0.001) and Ox-LDL mRNA (P < 0.001) in peripheral blood mononuclear cells of women with PCOS. In addition, compared to the placebo group, omega-3 fatty acids and vitamin E co-supplementation resulted in a significant decrease in serum triglycerides (-22.1 ± 22.3 vs. +7.7 ± 23.6 mg/dL, P < 0.001), VLDL- (-4.4 ± 4.5 vs. +1.5 ± 4.7 mg/dL, P < 0.001), total- (-20.3 ± 16.6 vs. +12.2 ± 26.1 mg/dL, P < 0.001), LDL- (-16.7 ± 15.3 vs. +11.9 ± 26.1 mg/dL, P < 0.001) and total-/HDL-cholesterol (-0.5 ± 0.6 vs. +0.4 ± 0.8, P < 0.001). There were a significant increase in plasma total antioxidant capacity (+89.4 ± 108.9 vs. +5.9 ± 116.2 mmol/L, P = 0.003) and a significant decrease in malondialdehyde levels (-0.3 ± 0.4 vs. -0.008 ± 0.6 μmol/L, P = 0.01) by combined omega-3 fatty acids and vitamin E intake compared with the placebo group. Overall, omega-3 fatty acids and vitamin E co-supplementation for 12 weeks in PCOS women significantly improved gene expression of Lp(a) and Ox-LDL, lipid profiles and biomarkers of oxidative stress.
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Affiliation(s)
- Elham Rahmani
- Department of Gynecology and Obstetrics, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Mansooreh Samimi
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Faraneh Afshar Ebrahimi
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Fatemeh Foroozanfard
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Shahnaz Ahmadi
- Department of Gynecology and Obstetrics, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran; Department of Gynecology and Obstetrics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Rahimi
- Department of Gynecology and Obstetrics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mehri Jamilian
- Endocrinology and Metabolism Research Center, Department of Gynecology and Obstetrics, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Esmat Aghadavod
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Fereshteh Bahmani
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohsen Taghizadeh
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | | | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran.
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294
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Olsen EA, Canfield D. SALT II: A new take on the Severity of Alopecia Tool (SALT) for determining percentage scalp hair loss. J Am Acad Dermatol 2016; 75:1268-1270. [DOI: 10.1016/j.jaad.2016.08.042] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 08/15/2016] [Accepted: 08/18/2016] [Indexed: 10/20/2022]
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295
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Capo A, Amerio P. Polyglandular autoimmune syndrome type III with a prevalence of cutaneous features. Clin Exp Dermatol 2016; 42:61-63. [DOI: 10.1111/ced.12984] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2016] [Indexed: 11/29/2022]
Affiliation(s)
- A. Capo
- Department of Medicine and Aging Science; Dermatologic Clinic; University G. d'Annunzio; Chieti Italy
| | - P. Amerio
- Department of Medicine and Aging Science; Dermatologic Clinic; University G. d'Annunzio; Chieti Italy
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296
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El Taieb MA, Ibrahim H, Nada EA, Seif Al-Din M. Platelets rich plasma versus minoxidil 5% in treatment of alopecia areata: A trichoscopic evaluation. Dermatol Ther 2016; 30. [DOI: 10.1111/dth.12437] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 09/13/2016] [Accepted: 09/30/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Moustafa A. El Taieb
- Department of Dermatology, Venereology and Andrology; Aswan University; Aswan Egypt
| | - Hassan Ibrahim
- Department of Dermatology, Venereology and Andrology; South Valley University; Qena Egypt
| | - Essam A. Nada
- Department of Dermatology, Venereology and Andrology; Sohag University; Sohag Egypt
| | - Mai Seif Al-Din
- Department of Dermatology; Qina General Hospital; Qena Egypt
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297
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Kacar SD, Soyucok E, Bagcioglu E, Ozuguz P, Coskun KS, Asık AH, Mayda H. The Perceived Stigma in Patients with Alopecia and Mental Disorder: A Comparative Study. Int J Trichology 2016; 8:135-40. [PMID: 27625566 PMCID: PMC5007920 DOI: 10.4103/0974-7753.189005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Aim: We aimed to measure the perceived stigma, especially in patients with alopecia areata (AA) and to compare the results with patients with mental disorder (MD). Materials and Methods: This study included forty patients with AA who were consecutively recruited from dermatology outpatient clinic and 42 patients with MD who were consecutively recruited from psychiatric outpatient clinic. The presence of a MD was assessed by the Diagnostic and Statistical Manual of Mental Disorder Fourth Edition. All participants were asked to complete the 28 items modified stigmatization questionnaire. Results: Total and all subscale scores of stigmatization questionnaire scale were higher in the group of patients with AA than in the patients with MD. Conclusion: AA is a condition that leads to more self-stigmatization than MD.
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Affiliation(s)
- Seval Dogruk Kacar
- Department of Dermatology, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Ethem Soyucok
- Department of Psychiatry, Faculty of Medicine, Dumlupinar University, Kutahya, Turkey
| | - Erman Bagcioglu
- Department of Psychiatry, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Pınar Ozuguz
- Department of Dermatology, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Kerem Senol Coskun
- Department of Psychiatry, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Ahmet Hakki Asık
- Department of Psychiatry, Afyon State Hospital, Afyonkarahisar, Turkey
| | - Hasan Mayda
- Department of Psychiatry, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
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298
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Tiwary AK, Mishra DK, Chaudhary SS. Comparative Study of Efficacy and Safety of Topical Squaric Acid Dibutylester and Diphenylcyclopropenone for the Treatment of Alopecia Areata. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2016; 8:237-42. [PMID: 27500127 PMCID: PMC4960932 DOI: 10.4103/1947-2714.185029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Topical squaric acid dibutylester and diphenylcyclopropenone are still the most effective therapy for alopecia areata among widely available treatment options. Hence, it is important to know which one is more effective and safer between the two. AIMS The aim of this study was to compare topical squaric acid dibutylester and diphenylcyclopropenone for the treatment of alopecia areata in terms of their efficacy and side effects. SUBJECTS AND METHODS In the time period of January-March 2015, a total of 40 patients were selected for this study from the outpatient department of Rajendra Institute of Medical Sciences, Ranchi. After dropout of 16 patients, the remaining 24 patients were randomly divided into two groups; that is, group A for squaric acid dibutylester and group B for diphenylcyclopropenone. Each group received treatment for 6 months between March-November 2015. Their efficacy and side effects were compared. STATISTICAL TEST Unpaired student t-test was performed. P < 0.05 was considered to be significant and 95% confidence interval was also used to evaluate the efficacy. RESULTS The mean values of percentage change in baseline severity of alopecia tool score for squaric acid dibutylester and diphenylcyclopropenone were 52.25 and 34.45, respectively. At 6 months, 95% confidence interval was 43.5-61% for group A and 25-44% for group B. In 58.33% of group A patients, A3 (50-74%) grade of improvement was observed, whereas in group B patients, it was 33.33%. A4 grade of improvement (75-99%) was also seen in 1 patient of group A. Minor side effects were seen in 2 patients of group A and 10 patients of group B. None of the group A patients showed major side effects, however, 2 patients suffered major side effects in group B. CONCLUSIONS Between squaric acid dibutylester and diphenylcyclopropenone, squaric acid dibutylester is more efficacious. Further, frequencies of major and minor side effects are also lower than diphenylcyclopropenone.
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Affiliation(s)
- Anup K Tiwary
- Department of Dermatology, Venereology and Leprosy, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Dharmendra K Mishra
- Department of Dermatology, Venereology and Leprosy, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - S S Chaudhary
- Department of Dermatology, Venereology and Leprosy, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
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299
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Salem SA, Asaad MK, Elsayed SB, Sehsah HM. Evaluation of macrophage migration inhibitory factor (MIF) levels in serum and lesional skin of patients with alopecia areata. Int J Dermatol 2016; 55:1357-1361. [DOI: 10.1111/ijd.13344] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 02/06/2016] [Accepted: 03/01/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Samar A. Salem
- Department of Dermatology, Venereology and Andrology; Faculty of Medicine; Ain Shams University; Cairo Egypt
| | - Marwa K. Asaad
- Department of Dermatology, Venereology and Andrology; Faculty of Medicine; Ain Shams University; Cairo Egypt
| | - Sherin B. Elsayed
- Department of Medical Microbiology and Immunology; Faculty of Medicine; Ain Shams University; Cairo Egypt
| | - Hend M. Sehsah
- Department of Dermatology, Venereology and Andrology; Faculty of Medicine; Ain Shams University; Cairo Egypt
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300
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Rencz F, Gulácsi L, Péntek M, Wikonkál N, Baji P, Brodszky V. Alopecia areata and health-related quality of life: a systematic review and meta-analysis. Br J Dermatol 2016; 175:561-71. [PMID: 26914830 DOI: 10.1111/bjd.14497] [Citation(s) in RCA: 118] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND No systematic review has yet evaluated the available evidence on health-related quality of life (HRQOL) in alopecia areata (AA). OBJECTIVES To conduct a systematic review and meta-analysis of HRQOL studies among patients diagnosed with AA. METHODS A systematic search was performed for papers published between 1946 and 15 December 2014 in Medline, Embase, Web of Science, CINAHL, PsycINFO and the Cochrane Library. Random-effects meta-analyses were conducted to pool data. RESULTS Twenty-one studies were included, representing a total of 2530 adult patients with AA. Of the 14 different HRQOL measures used in the studies, Dermatology Life Quality Index (DLQI; n = 8) and SF-36 (n = 7) were the most common. Three AA-specific HRQOL instruments were identified: Alopecia Areata Quality of Life Index, Alopecia Areata Quality of Life and Alopecia Areata Symptom Impact Scale. The mean pooled DLQI score of patients with AA was 6·3 (95% confidence interval 5·6-7·1). Comparing age- and sex-matched controls, the meta-analysis of SF-36 studies revealed significantly reduced HRQOL across the role-emotional, mental health and vitality domains (P < 0·001). Wearing a wig had a positive impact, while scalp involvement, anxiety and depression had a negative impact on HRQOL. Conflicting results were found regarding the association between HRQOL and age, sex, marital status and disease duration. CONCLUSIONS Patients with AA experience significant impairment in HRQOL, especially in the area of mental health. Several generic and dermatology-specific HRQOL instruments have been used, but no validation studies have confirmed their applicability in AA. The newly developed AA-specific measures seem very promising; however, a more extensive assessment of validity and reliability is needed.
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Affiliation(s)
- F Rencz
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary.,Doctoral School of Clinical Medicine, Semmelweis University, Pf. 2, H-1428, Budapest, Hungary
| | - L Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - M Péntek
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - N Wikonkál
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Mária u. 41, H-1085, Budapest, Hungary
| | - P Baji
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - V Brodszky
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary.
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