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Liu L, Xue Y, Wang J, Shen C, Li Y, Huang Y. Transcriptome analysis of frontal fibrosis alopecia revealed involvement of immune cells and ferroptosis. Skin Res Technol 2024; 30:e13608. [PMID: 38314944 PMCID: PMC10840369 DOI: 10.1111/srt.13608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 01/26/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND Frontal fibrosis alopecia (FFA) is a primary cicatricial alopecia and has received increasing attention in recent years. However, the pathogenesis of FFA has not been fully elucidated. METHODS AND RESULTS Herein, we collected the transcriptome data of scalp lesions of seven patients with FFA and seven healthy controls. The differential expression analysis and weighted gene co-expression network analysis were conducted and we identified 458 differentially expressed genes (DEGs) in two key modules. Later, we performed functional enrichment analysis and functional modules identification, revealing the participation of immune response and fatty acid metabolism. Based on the results, we processed further studies. On the one hand, we analyzed the infiltrating immune cells of FFA through CIBERSORT algorithm, indicating the activation of M1 macrophage and CD8+ T cell. On the other hand, considering lipid metabolism of FFA and oxidative stress of hair follicle cells in alopecia, we explored the potential ferroptosis of FFA. By intersection of DEGs and ferroptosis-related genes from FerrDb database, 19 genes were identified and their expression was validated in an external dataset containing 36 FFA cases and 12 controls. Then, we used LASSO algorithms to construct a four-gene diagnostic model, which achieved an AUC of 0.924 in validation dataset. Additionally, the immune cells were found to be related to ferroptosis in FFA. CONCLUSION Taken together, this study contributed to reveal the molecular mechanisms of FFA and is expected to inspire future research on treatment.
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Affiliation(s)
- Lin Liu
- Department of Dermatologythe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Yuzhou Xue
- Department of Cardiology and Institute of Vascular MedicinePeking University Third HospitalBeijingChina
| | - Jingyu Wang
- Renal DivisionPeking University First HospitalBeijingChina
| | - Chengcheng Shen
- Department of Dermatologythe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Yuhao Li
- Department of Dermatologythe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Yujing Huang
- Department of Dermatologythe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
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Khutsishvili N, Rudnicka L, Ovcharenko Y, Starace M, Buchukuri I, Pataraia S, Lortkipanidze N. Trichoscopy - a valuable tool for identifying conditions mimicking androgenetic alopecia. Int J Dermatol 2024; 63:23-31. [PMID: 37950461 DOI: 10.1111/ijd.16895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 10/20/2023] [Accepted: 10/22/2023] [Indexed: 11/12/2023]
Abstract
Androgenetic alopecia (AGA) is the most prevalent type of hair loss in women and men. Recently, a European consensus group published guidelines for the diagnostic evaluation of AGA in men, women, and adolescents. This S1 guideline presents expert opinion-based recommendations for gender-dependent steps in the diagnostic procedure, which can easily be implemented in the daily clinical routine. For diagnosing AGA, detailed anamnesis and objective learning are not enough because there are several conditions mimicking this disease. Trichoscopy can be considered an important, non-invasive tool for diagnosing hair and scalp disorders that may have similar clinical signs to AGA.
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Affiliation(s)
| | | | | | | | - Irma Buchukuri
- Petre Shotadze Tbilisi Medical Academy, Tbilisi, Georgia
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Lyakhovitsky A, Segal O, Galili E, Thompson CT, Tzanani I, Scope A, Baum S, Barzilai A. Diagnoseverzögerung, komorbide Hidradenitis suppurativa und die prognostische Bedeutung bakterieller Kulturen bei Folliculitis decalvans: eine Kohortenstudie. J Dtsch Dermatol Ges 2023; 21:1469-1478. [PMID: 38082530 DOI: 10.1111/ddg.15202_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 07/09/2023] [Indexed: 12/18/2023]
Abstract
ZusammenfassungHintergrundFolliculitis decalvans (FD) ist eine primäre neutrophile vernarbende Alopezie, die häufig zu irreversiblem Haarverlust führt. Daten zu Epidemiologie, klinischen Merkmalen, Folgen und prognostischen Faktoren sind nur eingeschränkt verfügbar.ZielDie Beurteilung einer Patientenkohorte mit FD sowie die Charakterisierung schwerer Krankheitsverläufe und prognostischer Faktoren, die eine Remission verhindern.Patienten und MethodenDiese retrospektive Kohortenstudie umfasste 192 Patienten, bei denen zwischen 2010 und 2020 an einem tertiären Zentrum eine FD diagnostiziert und die mindestens sechs Monate nachverfolgt wurden.ErgebnisseDie Diagnose wurde im Mittel um 22,2 (± 29,7) Monate verzögert gestellt. Komorbide Erkrankungen mit Okklusion der Haarfollikel waren häufig. In 45,6% der Fälle waren Bakterienkulturen positiv, am häufigsten mit Staphylococcus (S.) aureus. Schwere Krankheitsverläufe waren mit komorbider Hidradenitis suppurativa und positiver Bakterienkultur, insbesondere S. aureus, assoziiert. Bei 50,7% der Patienten kam es zu vollständiger Remission: Bei 32% innerhalb der ersten sechs Monate der Behandlung und bei 18,7% während der Nachkontrolle. Rezidive waren häufig. Negative Prognosefaktoren bezüglich der Remission waren jüngeres Alter und positive Bakterienkultur.SchlussfolgerungenEs besteht Bedarf hinsichtlich der Ausbildung von Dermatologen, um die Diagnoseverzögerung zu reduzieren. Das Screening von FD‐Patienten auf komorbide Hidradenitis suppurativa und Bakterienkulturen sind wichtig für die Behandlungsplanung.
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Affiliation(s)
- Anna Lyakhovitsky
- Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Oz Segal
- Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Eran Galili
- Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Curtis T Thompson
- CTA Pathology, Portland, USA
- Departments of Dermatology and Pathology, Oregon Health Sciences University, Portland, USA
| | - Ido Tzanani
- Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Alon Scope
- Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
- Kittner Skin Cancer Screening and Research Institute, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Sharon Baum
- Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Aviv Barzilai
- Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
- Institute of Pathology, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
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Lyakhovitsky A, Segal O, Galili E, Thompson CT, Tzanani I, Scope A, Baum S, Barzilai A. Diagnostic delay, comorbid hidradenitis suppurativa and the prognostic value of bacterial culture in folliculitis decalvans: A cohort study. J Dtsch Dermatol Ges 2023; 21:1469-1477. [PMID: 37875786 DOI: 10.1111/ddg.15202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 07/09/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND Folliculitis decalvans (FD) is a type of primary neutrophilic cicatricial alopecia often leading to irreversible hair loss. Data on its epidemiology, clinical features, outcomes, and prognostic factors are limited. OBJECTIVE To evaluate a cohort of patients with FD and identify characteristics of severe disease and prognostic factors which impede remission. PATIENTS AND METHODS This retrospective cohort study included 192 patients diagnosed with FD and followed for at least six months at a tertiary center between 2010 and 2020. RESULTS There was a diagnostic delay averaging 22.2 (± 29.7) months. Comorbid follicular occlusion disorders were common. Bacterial cultures were positive in 45.6% of the cases, with Staphylococcus (S.) aureus being the most common pathogen. Severe disease was associated with comorbid hidradenitis suppurativa and a positive bacterial culture, particularly S. aureus. 50.7% of patients experienced complete remission: 32% within the first six months of treatment and 18.7% later during follow-up. Relapses were frequent. Negative prognostic factors for achieving remission included younger age and a positive bacterial culture. CONCLUSIONS There is a need for the education of dermatologists to reduce the diagnostic delay. Screening FD patients for comorbid hidradenitis suppurativa and obtaining bacterial cultures is important for treatment planning.
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Affiliation(s)
- Anna Lyakhovitsky
- Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Oz Segal
- Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Eran Galili
- Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Curtis T Thompson
- CTA Pathology, Portland, USA
- Departments of Dermatology and Pathology, Oregon Health Sciences University, Portland, USA
| | - Ido Tzanani
- Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Alon Scope
- Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
- Kittner Skin Cancer Screening and Research Institute, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Sharon Baum
- Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Aviv Barzilai
- Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
- Institute of Pathology, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
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Pinedo-Moraleda F, Tristán-Martín B, Dradi GG. Alopecias: Practical Tips for the Management of Biopsies and Main Diagnostic Clues for General Pathologists and Dermatopathologists. J Clin Med 2023; 12:5004. [PMID: 37568407 PMCID: PMC10419566 DOI: 10.3390/jcm12155004] [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: 07/06/2023] [Revised: 07/21/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
Accurately diagnosing specific variants of alopecia remains challenging for pathologists, potentially delaying appropriate therapeutic decisions by dermatologists. Issues such as limited knowledge on optimal biopsy types and processing methods add complexity. Understanding the normal histology of hair follicles and their changes throughout the follicular cycle further complicates microscopic evaluation. This paper aims to summarize these characteristics and highlight essential diagnostic clues for pathologists to confidently suggest a diagnosis, therefore playing a key role in alopecia diagnosis. Ongoing education, collaboration with dermatologists, and staying up to date on advancements is crucial for the accurate diagnosis and effective management of different types of alopecia.
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Affiliation(s)
| | - Belén Tristán-Martín
- Department of Pathology, Hospital Nuestra Señora de Sonsoles, 05004 Avila, Spain;
| | - Giulia Greta Dradi
- Department of Dermatology, Hospital Universitario Fundacion Alcorcon, 28922 Alcorcon, Spain;
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Kinoshita-Ise M, Fukuyama M, Ohyama M. Recent Advances in Understanding of the Etiopathogenesis, Diagnosis, and Management of Hair Loss Diseases. J Clin Med 2023; 12:jcm12093259. [PMID: 37176700 PMCID: PMC10179687 DOI: 10.3390/jcm12093259] [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: 03/26/2023] [Revised: 04/26/2023] [Accepted: 04/29/2023] [Indexed: 05/15/2023] Open
Abstract
Hair-loss diseases comprise heterogenous conditions with respective pathophysiology and clinicopathological characteristics. Major breakthroughs in hair follicle biology and immunology have led to the elucidation of etiopathogenesis of non-scarring alopecia (e.g., alopecia areata, AA) and cicatricial alopecia (e.g., lichen planopilaris, LPP). High-throughput genetic analyses revealed molecular mechanism underlying the disease susceptibility of hair loss conditions, such as androgenetic alopecia (AGA) and female pattern hair loss (FPHL). Hair loss attracted public interest during the COVID-19 pandemic. The knowledge of hair loss diseases is robustly expanding and thus requires timely updates. In this review, the diagnostic and measurement methodologies applied to hair loss diseases are updated. Of note, novel criteria and classification/scoring systems published in the last decade are reviewed, highlighting their advantages over conventional ones. Emerging diagnostic techniques are itemized with clinical pearls enabling efficient utilization. Recent advances in understanding the etiopathogenesis and management for representative hair diseases, namely AGA, FPHL, AA, and major primary cicatricial alopecia, including LPP, are comprehensively summarized, focusing on causative factors, genetic predisposition, new disease entity, and novel therapeutic options. Lastly, the association between COVID-19 and hair loss is discussed to delineate telogen effluvium as the predominating pathomechanism accounting for this sequela.
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Affiliation(s)
- Misaki Kinoshita-Ise
- Department of Dermatology, Kyorin University Faculty of Medicine, Tokyo 181-8611, Japan
| | - Masahiro Fukuyama
- Department of Dermatology, Kyorin University Faculty of Medicine, Tokyo 181-8611, Japan
| | - Manabu Ohyama
- Department of Dermatology, Kyorin University Faculty of Medicine, Tokyo 181-8611, Japan
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Ankad BS, Anusha HL, Nikam BP. Trichoscopic assessment of treatment response in dissecting cellulitis of scalp treated with combination therapy: A case report. Dermatol Ther 2022; 35:e15718. [PMID: 35837743 DOI: 10.1111/dth.15718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/30/2022] [Accepted: 07/13/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Balachandra S Ankad
- Department of Dermatology, S. Nijalingappa Medical College, Bagalkot, Karnataka, India
| | - Halehalli L Anusha
- Department of Dermatology, S. Nijalingappa Medical College, Bagalkot, Karnataka, India
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Zhang X, Zhu M, Zhou J, Wu S, Liu J, Qin Q. Folliculitis Decalvans and Lichen Planopilaris Phenotypic Spectrum: A Case Report. Clin Cosmet Investig Dermatol 2022; 15:993-996. [PMID: 35677221 PMCID: PMC9167836 DOI: 10.2147/ccid.s365566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/26/2022] [Indexed: 11/23/2022]
Abstract
The folliculitis decalvans (FD) and lichen planopilaris (LPP) phenotypic spectrum combines biphasic features of FD and LPP. It is characterized by successive or concomitant occurrence of pustules, crusts, follicular tufts, perifollicular erythema, perifollicular scales, and cicatricial alopecia and includes mixed histologic features of both FD and LPP. Here, we report the case of a 33-year-old female patient with a 30-year history of FD-LPP phenotypic spectrum lesions.
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Affiliation(s)
- Xi Zhang
- Department of Dermatology, The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, People's Republic of China
| | - Mingfang Zhu
- Department of Dermatology, The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, People's Republic of China
| | - Jia Zhou
- Department of Dermatology, The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, People's Republic of China
| | - Shuhui Wu
- Department of Dermatology, The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, People's Republic of China
| | - Juan Liu
- Department of Dermatology, The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, People's Republic of China
| | - Qiuyan Qin
- Department of Dermatology, The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, People's Republic of China
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