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Barrera-Ochoa CA, Alonso-León MT, Arenas R, Vega-Memjie ME, Asz-Sigall D. Secondary alopecia induced by aesthetic procedures: An unrecognized potential complication. Australas J Dermatol 2023; 64:322-329. [PMID: 37265044 DOI: 10.1111/ajd.14090] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 05/02/2023] [Accepted: 05/15/2023] [Indexed: 06/03/2023]
Abstract
Surgical facelifts and noninvasive techniques such as mesotherapy, hyaluronic fillers and botulinum toxin, among other procedures are widely used nowadays to reverse skin ageing and achieve rejuvenation effects. Secondary alopecia due to cosmetic procedures is a rare side effect and is poorly described in the literature. The mechanisms in which hair loss develops after an aesthetical procedure or surgical technique are not well known. The development of secondary scarring alopecia or non-scarring alopecia depends upon the interaction between different external factors, the individual host response and the extent of damage to the hair follicle anatomy. Current knowledge hints at the type of substance used, pressure to hair structures and vasculature due to the materials used, previously unknown or unaware hair disorder, and poor surgical techniques to be the main factors contributing to the development of secondary alopecia. Physicians and patients must be aware of all the substances used for the procedures and be attentive to any change in hair density or hair loss. Clinicians must have a low threshold to take biopsies if the risk of scarring alopecia may occur. Herein, we review the clinical, trichoscopic, histopathological findings and potential pathophysiological mechanisms of hair loss due to different aesthetic procedures.
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Affiliation(s)
| | | | - Roberto Arenas
- Micology Section, Hospital General Dr. Manuel Gea González, Mexico City, Mexico
| | | | - Daniel Asz-Sigall
- Dermatology Department, Hospital General Dr. Manuel Gea González, Mexico City, Mexico
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Kaiser M, Abdin R, Yaghi M, Gaumond SI, Jimenez JJ, Issa NT. Beard Alopecia: An Updated and Comprehensive Review of Etiologies, Presentation and Treatment. J Clin Med 2023; 12:4793. [PMID: 37510908 PMCID: PMC10381635 DOI: 10.3390/jcm12144793] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/15/2023] [Accepted: 07/16/2023] [Indexed: 07/30/2023] Open
Abstract
Facial hair is an important social and psychologic aspect of clinical appearance for men. The purpose of this review is to provide a comprehensive overview of the causes of alopecia of the beard including the prevalence, pathophysiology, clinical presentation, and treatment. In this review, we highlight more common causes of beard alopecia including alopecia areata and pseudofolliculitis barbae, infectious causes such as tinea barbae and herpes simplex folliculitis, and rare causes including dermatopathia pigmentosa reticularis and frontal fibrosing alopecia. This review serves as an important resource for clinicians when faced with patients suffering from beard alopecia.
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Affiliation(s)
- Michael Kaiser
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Rama Abdin
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA
| | - Marita Yaghi
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Simonetta I Gaumond
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Joaquin J Jimenez
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Naiem T Issa
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Forefront Dermatology, Vienna, VA 22182, USA
- Issa Research and Consulting, LLC, Springfield, VA 22152, USA
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Kaiser M, Abdin R, Gaumond SI, Issa NT, Jimenez JJ. Treatment of Androgenetic Alopecia: Current Guidance and Unmet Needs. Clin Cosmet Investig Dermatol 2023; 16:1387-1406. [PMID: 37284568 PMCID: PMC10239632 DOI: 10.2147/ccid.s385861] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 05/23/2023] [Indexed: 06/08/2023]
Abstract
Androgenetic alopecia (AGA) is the most common cause of hair loss in men and women. Traditionally, topical minoxidil and oral finasteride have been the standard of care yielding mixed results. New treatments such as Low-Level Laser Therapy (LLLT), microneedling, platelet-rich plasma (PRP), and others have been extensively studied in the literature, and the purpose of this review is to provide a comprehensive discussion of the latest treatment methods and their efficacy in treating AGA. Novel therapies such as oral minoxidil, topical finasteride, topical spironolactone, botulinum toxin, and stem cell therapy offer interesting alternatives to standard of care therapies for patients. In this review, we present data from recent studies on the clinical efficacy of these treatments. Furthermore, as new treatments have emerged, clinicians have tested combination therapies to assess whether there may be a synergistic relationship between multiple modalities. While there has been a great increase in the treatments available for AGA, the quality of evidence varies greatly and there is still a great need for randomized double blinded clinical trials to adequately assess the clinical efficacy of some treatments. While PRP and LLLT have demonstrated encouraging results, standardized treatment protocols are needed to adequately inform clinicians on how to use such therapies. Given the abundance of new therapeutic options, clinicians and patients must weigh the benefits and risks of each treatment option for AGA.
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Affiliation(s)
- Michael Kaiser
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Rama Abdin
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Simonetta I Gaumond
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Naiem T Issa
- Forefront Dermatology, Vienna, VA, USA
- Issa Research and Consulting, LLC, Springfield, VA, USA
| | - Joaquin J Jimenez
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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Kim JH. A narrative review on subcutaneous injection components used for alopecia. J Cosmet Dermatol 2023; 22:776-783. [PMID: 36437700 DOI: 10.1111/jocd.15522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 11/04/2022] [Accepted: 11/08/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Studies reporting the development and effectiveness of topical agents for alopecia are available. However, it was difficult to demonstrate a direct advantage of subcutaneous injection rather than topical application. Since existing articles lack information, future studies are needed to solve these problems and to narrow the knowledge gap. AIMS Present article is aimed to review of the possible materials used in subcutaneous injection for alopecia with a hope for better guiding the analytic application and further evaluating the effective component for alopecia management. METHODS A wide range of clinical articles was retrieved using electronic databases to determine the possible components used in subcutaneous injection and their potential mechanism of action. RESULTS Eight components from 19 articles were found to be used for alopecia via subcutaneous administration. CONCLUSIONS The current study illuminated the curative effects of possible substances and discussed the efficacy of subcutaneous injections.
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Affiliation(s)
- Jung Hyun Kim
- Department of Acupucture and Moxibustion, College of Korean Medicine Kyung Hee University, Kyung Hee University Hospital at Gangdong, Seoul, South Korea
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5
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Alopecia After Cosmetic Injection Procedures: A Review. Dermatol Surg 2022; 48:855-861. [PMID: 35642921 DOI: 10.1097/dss.0000000000003498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cosmetic procedures for antiaging carry inherent risks of adverse events. One that has not yet been well characterized is transitory or permanent alopecia. This is attributable to numerous mechanisms including pressure, ischemia, inflammation, and necrosis. Cases of postcosmetic procedure alopecia have been reported after mesotherapy as well as hyaluronic acid filler, deoxycholic acid, and botulinum toxin injections. OBJECTIVE This review serves to describe the currently known causes of postcosmetic procedure alopecia and the mechanisms by which alopecia is attained. Furthermore, this review highlights the risk of unregulated mesotherapy injections for cosmetic enhancement and to bring attention to the increasing number reports of alopecia after these procedures. METHODS A systematic review of the literature from 2000 to 2022 was conducted looking for keywords such as "alopecia," "cosmetic procedures," "mesotherapy," and "hyaluronic acid" in Google Scholar and PubMed. RESULTS Ten articles met the criteria set forth in the authors' literature review. Many of the procedures resulted in partial or complete resolution of alopecia. CONCLUSION Alopecia after cosmetic injection procedures is an underreported adverse effect. More research is needed to further characterize the risk of alopecia after mesotherapy and other injection procedures.
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Carloni R, Pechevy L, Postel F, Zielinski M, Gandolfi S. Is there a therapeutic effect of botulinum toxin on scalp alopecia? Physiopathology and reported cases: A systematic review of the literature. J Plast Reconstr Aesthet Surg 2020; 73:2210-2216. [DOI: 10.1016/j.bjps.2020.05.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 05/09/2020] [Indexed: 01/04/2023]
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7
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Wang Y, Zhang H, Zheng Q, Tang K, Fang R, Sun Q. Botulinum toxin as a double‐edged sword in alopecia: A systematic review. J Cosmet Dermatol 2020; 19:2560-2565. [PMID: 32745302 DOI: 10.1111/jocd.13647] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/25/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Yuanzhuo Wang
- Department of Dermatology Peking Union Medical College Hospital Beijing China
- Eight‐Year MD Program Peking Union Medical College Beijing China
| | - Hanlin Zhang
- Department of Dermatology Peking Union Medical College Hospital Beijing China
- Eight‐Year MD Program Peking Union Medical College Beijing China
| | - Qingyue Zheng
- Department of Dermatology Peking Union Medical College Hospital Beijing China
- Eight‐Year MD Program Peking Union Medical College Beijing China
| | - Keyun Tang
- Department of Dermatology Peking Union Medical College Hospital Beijing China
- Eight‐Year MD Program Peking Union Medical College Beijing China
| | - Rouyu Fang
- Department of Dermatology Peking Union Medical College Hospital Beijing China
| | - Qiuning Sun
- Department of Dermatology Peking Union Medical College Hospital Beijing China
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Yeh YT, Peng JH, Peng HLP. Literature review of the adverse events associated with botulinum toxin injection for the masseter muscle hypertrophy. J Cosmet Dermatol 2018; 17:675-687. [DOI: 10.1111/jocd.12721] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 07/18/2018] [Accepted: 06/28/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Yu-Ting Yeh
- P-Skin Professional Clinic; Kaohsiung Taiwan
| | - Jui-Hui Peng
- National Yang-Ming University School of Medicine; Taipei Taiwan
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Yu V, Juhász M, Chiang A, Atanaskova Mesinkovska N. Alopecia and Associated Toxic Agents: A Systematic Review. Skin Appendage Disord 2018; 4:245-260. [PMID: 30410891 DOI: 10.1159/000485749] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 11/24/2017] [Indexed: 11/19/2022] Open
Abstract
Importance/Objective There are a number of toxic agents that can cause alopecia. In this review we summarize the known substances that cause alopecia as one of the clinical signs of overdose or toxicity. Evidence Review A search was conducted using PubMed, EMBASE, and Cochrane for studies describing hair loss of any type as a result of exposure to or ingestion of a toxic agent. The search yielded 856 articles, with 47 studies included in this review. Findings Agents with the strongest evidence of association to alopecia include thallium, mercury, selenium, and colchicine. Agents with described incidents include boric acid, arsenic, vitamin A, botulinum toxin, Podostroma cornu-damae, and the synthetic opioid MT-45. Conclusions and Relevance Numerous toxic agents have been implicated in alopecia, and the strength of evidence behind each agent varies. Toxic levels of thallium and colchicine have long been established to cause alopecia, as compared to agents such as botulinum toxin A and synthetic recreational drugs which have less literature describing their links to alopecia and will need further investigation to characterize their relationships to hair loss. Knowledge of typical presentations of hair loss will aid in the development of a differential diagnosis for patients presenting with alopecia.
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Affiliation(s)
- Vicky Yu
- University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA
| | - Margit Juhász
- University of California, Irvine, Department of Dermatology, Irvine, California, USA
| | - Audris Chiang
- University of California, Irvine, Department of Dermatology, Irvine, California, USA
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Soyer E, Orenay OM, Aksakal AB. An exceptional case with unilateral eyelash loss due to intracranial lesion. J Eur Acad Dermatol Venereol 2016; 31:e174-e175. [PMID: 27726199 DOI: 10.1111/jdv.13893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- E Soyer
- Faculty of Medicine, Department of Dermatology, Gazi University, Ankara, Turkey
| | - O M Orenay
- Faculty of Medicine, Department of Dermatology, Turgut Ozal University, Ankara, Turkey
| | - A B Aksakal
- Faculty of Medicine, Department of Dermatology, Gazi University, Ankara, Turkey
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11
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[Unilateral loss of eyebrows and repeated botulinum toxin injections: questionable correlation in essential blepharospasm]. Ophthalmologe 2015; 112:174-6. [PMID: 25566735 DOI: 10.1007/s00347-014-3166-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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12
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Yiannakopoulou E. Serious and long-term adverse events associated with the therapeutic and cosmetic use of botulinum toxin. Pharmacology 2015; 95:65-9. [PMID: 25613637 DOI: 10.1159/000370245] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 12/01/2014] [Indexed: 11/19/2022]
Abstract
Although botulinum toxin is generally considered safe, its widespread use and the constantly expanded indications raise safety issues. This study aimed to review the serious and long-term adverse events associated with the therapeutic and cosmetic use of botulinum toxin. Serious adverse events included dysphagia, respiratory compromise, generalized muscle weakness, marked bilateral ptosis, pseudoaneurysm of the frontal branch of the temporal artery, necrotizing fasciitis, sarcoidal granuloma, Fournier gangrene, and cervical kyphosis. Death was attributed to botulism or anaphylactic shock. In conclusion, botulinum toxin may cause serious adverse events, which are more common after its therapeutic use, but can also be noticed after its cosmetic use. Thorough knowledge of the anatomy of the treated muscles and of the pharmacology of the drug is imperative to avoid serious adverse events.
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Affiliation(s)
- Eugenia Yiannakopoulou
- Faculty of Health and Caring Professions, Technological Educational Institute of Athens, Athens, Greece
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Pedemonte C, Pérez Gutiérrez H, González E, Vargas I, Lazo D. Use of onabotulinumtoxinA in post-traumatic oromandibular dystonia. J Oral Maxillofac Surg 2014; 73:152-7. [PMID: 25315313 DOI: 10.1016/j.joms.2014.07.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Revised: 07/16/2014] [Accepted: 07/21/2014] [Indexed: 11/28/2022]
Abstract
PURPOSE Post-traumatic oromandibular dystonia (PTOD) is a disorder whose symptoms can include bruxism, muscle pain, and involuntary muscle contraction, among others. The use of onabotulinumtoxinA (ObT-A) is helpful in controlling the symptoms of patients with PTOD. The aim of this study was to evaluate the use of ObT-A in the treatment of PTOD. MATERIALS AND METHODS In this prospective case-series study, the population consisted exclusively of patients diagnosed with PTOD, without distinction by age or gender, from January 2007 to December 2010. The patients were diagnosed with PTOD and treated with ObT-A infiltration (primary predictor) at the Department of Maxillofacial Surgery at the Hospital Clínico Mutual de Seguridad (Santiago, Chile). The primary outcome variables were bruxism, muscle pain, and involuntary muscle contraction. The data were obtained through questionnaires registered in tables at each control. Systat 13.1 was used for statistical analysis. The statistical test used to compare patients' evolution over time was the test of signs. RESULTS Thirty male patients 18 to 65 years old diagnosed with PTOD were treated with ObT-A infiltrations. The signs and symptoms associated with oromandibular dystonia (bruxism, muscle pain, and involuntary muscle contraction) were decreased in all patients after ObT-A infiltrations. CONCLUSIONS The positive results and the absence of complications recommend the use of the infiltration protocol presented in this study for the treatment of PTOD.
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Affiliation(s)
- Christian Pedemonte
- Maxillofacial Surgeon, Department of Maxillofacial Surgery, Hospital Clínico Mutual de Seguridad, Santiago, Chile
| | - Hernán Pérez Gutiérrez
- Dental Surgeon, Department of Maxillofacial Surgery, Hospital Clínico Mutual de Seguridad, Santiago, Chile.
| | - Edgardo González
- Maxillofacial Surgeon, Department of Maxillofacial Surgery, Hospital Clínico Mutual de Seguridad, Santiago, Chile
| | - Ilich Vargas
- Maxillofacial Surgeon, Department of Maxillofacial Surgery, Hospital Clínico Mutual de Seguridad, Santiago, Chile
| | - Diego Lazo
- Dental Surgeon, Department of Maxillofacial Surgery, Hospital Clínico Mutual de Seguridad, Santiago, Chile
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Abstract
Madarosis is a terminology that refers to loss of eyebrows or eyelashes. This clinical sign occurs in various diseases ranging from local dermatological disorders to complex systemic diseases. Madarosis can be scarring or non-scarring depending upon the etiology. Appropriate diagnosis is essential for management. Follicular unit transplantation has been found to be a useful method of treating scarring madarosis and the procedure relevant to eyebrow and eyelash reconstruction has been discussed. A useful clinical approach to madarosis has also been included for bedside diagnosis. The literature search was conducted with Pubmed, Medline, and Google scholar using the keywords madarosis, eyebrow loss, and eyelash loss for articles from 1960 to September 2011. Relevant material was also searched in textbooks and used wherever appropriate.
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Affiliation(s)
- Annapurna Kumar
- Department of Ophthalmology, Sri Manakula Vinayagar Medical College, Pondicherry, India
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Nezafati S, Rahimi S, Mohseni H. Temporary eyelash loss following dental treatment. Int J Oral Maxillofac Surg 2010; 39:1142-4. [PMID: 20598856 DOI: 10.1016/j.ijom.2010.04.052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2009] [Revised: 02/17/2010] [Accepted: 04/27/2010] [Indexed: 11/27/2022]
Abstract
The isolated absence or loss of eyelashes (madarosis) is associated with many processes including systemic and local diseases. Madarosis of dental origin has not been reported. This paper is a report of the successful treatment of unilateral eyelash loss following root canal therapy of an upper posterior tooth.
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Affiliation(s)
- S Nezafati
- Oral and Maxillofacial Surgery, Emam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
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Hornik A, Gruener G, Jay WM. Adverse Reactions from Botulinum Toxin Administration. Neuroophthalmology 2010. [DOI: 10.3109/01658100903576334] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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17
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Lim ECH, Seet RCS. Botulinum toxin, Quo Vadis? Med Hypotheses 2007; 69:718-23. [PMID: 17499937 DOI: 10.1016/j.mehy.2007.03.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2007] [Accepted: 03/27/2007] [Indexed: 11/21/2022]
Abstract
Botulinum toxin (BTX), derived from the exotoxin of Clostridium botulinum, cleaves Soluble N-ethylmaleimide-sensitive factor-Attachment protein REceptor (SNARE) proteins, causing chemodenervation of cholinergic neurons. BTX also inhibits exocytosis of vesicles containing norepinephrine, glutamate, substance P and calcitonin gene-related peptide (CGRP) and inhibits expression of the vanilloid receptor. Clinical applications of BTX, which include the treatment of overactive skeletal and smooth muscles, hypersecretory and painful disorders, have increased exponentially since it was first used clinically to treat strabismus more than two decades ago. In this editorial, we discuss reports of new therapeutic indications of BTX, and propose new areas for research.
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Abstract
Madarosis may be a presenting feature of a number of vision and life-threatening conditions, including herpes zoster, leprosy, HIV/AIDS, trachoma, malignant eyelid tumors, discoid lupus, scleroderma, and hypothyroidism. It may occur via two broad pathogenic pathways: scarring and non-scarring, which indicates the potential for lash re-growth. Madarosis may occur as an isolated finding or together with loss of other body and scalp hair. The etiology of madarosis can be further divided into dermatological, infection, endocrine, neoplastic, drug-related, congenital, and trauma. This report includes salient points in the clinical history and examination of patients with madarosis, with an emphasis on excluding or diagnosing visual or life threatening disorders associated with madarosis.
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Affiliation(s)
- J J Khong
- Oculoplastic and Orbital Unit, Department of Ophthalmology and Visual Science, Royal Adelaide Hospital, University of Adelaide, North Terrace, Adelaide, SA 5000, Australia
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