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Nutz M, Deußing M, Hartmann D, Daxenberger F, Eijkenboom QL, Gust C, French LE, Schuh S, Welzel J, Sattler EC. Line-field confocal optical coherence tomography: Characteristic hints for the diagnosis of scarring alopecia due to lupus erythematodes: A preliminary study. Skin Res Technol 2024; 30:e13859. [PMID: 39096179 PMCID: PMC11297418 DOI: 10.1111/srt.13859] [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: 07/02/2024] [Accepted: 07/05/2024] [Indexed: 08/05/2024]
Abstract
INTRODUCTION Lupus erythematosus (LE) is an inflammatory autoimmune disease, that can affect the skin to varying degree. In particular, discoid LE (DLE) and the rare form of lupus panniculitis/profundus are associated with scarring alopecia. The heterogeneity of the clinical, dermatoscopic, and histologic presentation poses a major challenge to the clinician in the diagnosis and differential diagnosis of other forms of scarring alopecia. OBJECTIVE While noninvasive imaging techniques using optical coherence tomography (OCT) and reflectance confocal microscopy (RCM) have proven to be helpful in the diagnosis of scarring alopecia in the context of LE, this study aimed to investigate line-field confocal OCT (LC-OCT) to identify characteristic features of cicatricial alopecia in LE. METHODS Fifteen patients with cicatricial alopecia in LE were included and the most affected/inflamed areas of the scalp were prospectively examined. In analogy to histopathology and previously reported criteria in RCM, all images were evaluated according to seven established criteria and underwent descriptive analyses. RESULTS LC-OCT revealed characteristic features of cicatricial alopecia, such as lymphocytic interface dermatitis (14/15; 93.3%) and basal cell vacuolization (13/15; 86.7%). The most impressive feature was the occurrence of prominent hyperreflective fibers in 14/15 patients (93.3%). CONCLUSION LC-OCT imaging can noninvasively detect morphologic criteria such as lymphocytic and vacuolar interface dermatitis of cicatricial alopecia due to LE. In particular, the presence of hyperreflective collagen fibers appears to be a characteristic easily recognizable feature that may facilitate differential diagnosis with other forms of cicatricial alopecia. Further studies are mandatory to differentiate other forms of scarring alopecia.
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Affiliation(s)
- Marie‐Christine Nutz
- Department of Dermatology and AllergyLMU University HospitalLMU MunichMunichGermany
| | - Maximilian Deußing
- Department of Dermatology and AllergyLMU University HospitalLMU MunichMunichGermany
| | - Daniela Hartmann
- Department of Dermatology and AllergyLMU University HospitalLMU MunichMunichGermany
| | - Fabia Daxenberger
- Department of Dermatology and AllergyLMU University HospitalLMU MunichMunichGermany
| | | | - Charlotte Gust
- Department of Dermatology and AllergyLMU University HospitalLMU MunichMunichGermany
| | - Lars E. French
- Department of Dermatology and AllergyLMU University HospitalLMU MunichMunichGermany
- Department of Dermatology and Cutaneous SurgeryMiller School of MedicineUniversity of MiamiMiamiFloridaUSA
| | - Sandra Schuh
- Department of Dermatology and AllergologyUniversity HospitalUniversity of AugsburgAugsburgGermany
| | - Julia Welzel
- Department of Dermatology and AllergologyUniversity HospitalUniversity of AugsburgAugsburgGermany
| | - Elke C. Sattler
- Department of Dermatology and AllergyLMU University HospitalLMU MunichMunichGermany
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Du W, He K, Liu X, Yin T, Xiao S, Zheng Y. Genetic association between asthma and alopecia areata: A two-sample Mendelian randomization study. Skin Res Technol 2024; 30:e13844. [PMID: 38965800 PMCID: PMC11224124 DOI: 10.1111/srt.13844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 06/17/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Many patients with asthma experience alopecia areata (AA) in their lives. However, it is unclear whether asthma causes or results from AA. Our objective was to investigate the genetic causal relationship between asthma and AA. METHODS Two-sample Mendelian randomization (MR) was used to assess the causal relationship between asthma and AA based on the largest publicly available genome-wide association study summary statistics. Androgenetic alopecia (AGA) and cicatricial alopecia (CA) were chosen as the control groups for AA. The main estimates were obtained using inverse variance weighting meta-analysis (IVW), Mendelian randomization-Egger (MR-Egger), maximum likelihood estimation, and the weighted median. Sensitivity analyses were conducted using Cochran's Q test, MR-Egger, and leave-one-out methods. Lastly, we conducted a reverse MR analysis to evaluate the possibility of reverse causation. RESULTS Genetically, asthma is associated with an increased risk of AA, while the association between genetically predicted AGA or CA and asthma was negative. The risk of AA increased by 1.86 times in patients with asthma under the IVW method (OR = 1.86, 95% CI = 1.31-2.629, p < 0.001). The reverse MR analysis did not find evidence supporting reverse causality from three phenotypes of alopecia to asthma. Sensitivity analyses yielded consistent causal estimates. CONCLUSION This study suggests that asthma is causally associated with AA. The findings deepen our understanding of the role of asthma in the pathology of AA, which emphasizes the potential for opening a new vista for the prevention and diagnosis of AA.
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Affiliation(s)
- Wenqian Du
- Department of DermatologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Ke He
- Department of DermatologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Xinyi Liu
- Department of DermatologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Tingyi Yin
- Department of DermatologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Shengxiang Xiao
- Department of DermatologyThe Second Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Yan Zheng
- Department of DermatologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
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Sadeghi S, Ghane Y, Hajizadeh N, Goodarzi A. Autologous adipose tissue injection in the treatment of alopecia: A mini-review. J Cosmet Dermatol 2024; 23:758-765. [PMID: 37955172 DOI: 10.1111/jocd.16081] [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: 09/06/2023] [Revised: 10/07/2023] [Accepted: 10/29/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Alopecia may decrease patients' quality of life and self-confidence by limiting their social life. Therefore, the main goal of the treatment is to limit or halt the progression of inflammation, scarring, and hair loss. The promising effect of fat injection on hair regrowth, limited adverse effects, and subsiding inflammation can be proof of its efficacy and safety in treating alopecia. AIMS This review sought to assess the role of autologous fat tissue injection in scarring and non-scarring alopecia. METHODS Accordingly, a thorough search was performed on the Web of Science, Scopus, and PubMed/Medline databases, as well as the Google Scholar search engine, for studies published from inception until September 1st, 2023, using the related keywords. RESULTS Autologous fat grafting (AFG) is a novel and potentially effective modality for treating alopecia, particularly primary and secondary cicatricial alopecia. AFG can be an effective semi-invasive option for treating refractory lichen planopilaris because it induces angiogenesis, which supports hair regrowth. In addition to cicatricial alopecia, AFG held promise for treating non-scarring alopecia, including androgenic alopecia and alopecia areata. The adipose-derived regenerative cells (ADRCs) in adipose tissue (AT) secrete different growth factors, further supporting hair regeneration. Moreover, different anti-inflammatory and anti-oxidative agents are known in AT, preventing further damage to hair follicles. CONCLUSIONS AFG can significantly control inflammatory processes, improve signs and symptoms, and increase hair density and diameter.
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Affiliation(s)
- Sara Sadeghi
- Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), Iran University of Medical Sciences, Tehran, Iran
- Department of Medicine, New York Health System, South Brooklyn Hospital, New York, New York, USA
| | - Yekta Ghane
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Nima Hajizadeh
- Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), Iran University of Medical Sciences, Tehran, Iran
- School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Azadeh Goodarzi
- Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), Iran University of Medical Sciences, Tehran, Iran
- Department of Dermatology, Faculty of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Hajizadeh N, Heidari A, Sadeghi S, Goodarzi A. Tumor necrosis factor inhibitors and janus kinase inhibitors in the treatment of cicatricial alopecia: A systematic review. PLoS One 2024; 19:e0293433. [PMID: 38335182 PMCID: PMC10857607 DOI: 10.1371/journal.pone.0293433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/12/2023] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Cicatricial alopecia (CA) refers to various conditions that result in permanent hair loss. Treatment of CA has always been challenging. Regarding immune-mediated pathophysiology for many CA subtypes, the administration of Janus kinase (JAK) and tumor necrosis factor (TNF) inhibitors have potentiated the treatments of CA. METHODS After a thorough systematic search in PubMed/Medline, Embase, Web of Science, Scopus, Google Scholar, ClinicalTrials.gov, and WHO ICTRP, a total of 3,532 relevant records were retrieved and screened. Accordingly, 56 studies met the eligibility criteria and entered the review. RESULTS Among JAK inhibitors, oral tofacitinib was the most frequently reported and the most effective treatment in improving signs and symptoms of CA with minimal adverse effects (AEs). Baricitinib was another JAK inhibitor with sustained improvement while causing mild AEs. As a TNF inhibitor, adalimumab induced a rapid and stable improvement in signs and symptoms in most patients with rare, tolerable AEs. Thalidomide was the other frequently reported yet controversial TNF inhibitor, which caused a rapid and significant improvement in the condition. However, it may result in mild to severe AEs, particularly neuropathies. Infliximab is a TNF inhibitor with mostly favorable results, albeit in a few patients caused treatable dermatological AEs. Apremilast and certolizumab pegol caused an incomplete amelioration of signs and symptoms with no AEs. Lenalidomide is another TNF inhibitor that can induce temporary improvement in CA with probable AEs. It is noteworthy that utilizing adalimumab, infliximab, etanercept, golimumab, and an anonymous TNF inhibitor has induced paradoxical CA and other A.E.s in some patients. CONCLUSION Recent studies have recommended JAK and TNF inhibitors, especially oral tofacitinib and adalimumab, as a new modality or adjuvant therapy to previous medications for primary CA. Nonetheless, monitoring AEs on a regular basis is suggested, and further extensive studies are required before definitive recommendations.
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Affiliation(s)
- Nima Hajizadeh
- School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), Iran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Heidari
- Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Sara Sadeghi
- Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), Iran University of Medical Sciences, Tehran, Iran
- Department of Medicine, New York Health System, South Brooklyn Hospital, New York, NY, United States of America
| | - Azadeh Goodarzi
- Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), Iran University of Medical Sciences, Tehran, Iran
- Department of Dermatology, Faculty of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Melgosa Ramos FJ, Berna-Rico E, Suarez-Valle A, Mateu Puchades A, Vañó-Galván S, García-Ruiz R, Saceda Corralo D. Bestimmende Faktoren für die Therapie der dissezierenden Zellulitis der Kopfhaut mit Biologika: Determinant factors of biological therapy for dissecting cellulitis of the scalp. J Dtsch Dermatol Ges 2024; 22:115-117. [PMID: 38212915 DOI: 10.1111/ddg.15271_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 09/08/2023] [Indexed: 01/13/2024]
Affiliation(s)
| | - Emilio Berna-Rico
- Abteilung für Dermatologie, Universitätsklinikum Ramón y Cajal, IRICYS, Madrid, Spanien
| | - Ana Suarez-Valle
- Abteilung für Dermatologie, Universitätsklinikum Ramón y Cajal, IRICYS, Madrid, Spanien
| | | | - Sergio Vañó-Galván
- Abteilung für Dermatologie, Universitätsklinikum Ramón y Cajal, IRICYS, Madrid, Spanien
- Universität von Alcalá, Alcalá de Henares, Madrid, Spanien
| | - Ramón García-Ruiz
- Abteilung für Dermatologie, Universitätsklinikum Doctor Peset, Valencia, Spanien
| | - David Saceda Corralo
- Abteilung für Dermatologie, Universitätsklinikum Ramón y Cajal, IRICYS, Madrid, Spanien
- Universität von Alcalá, Alcalá de Henares, Madrid, Spanien
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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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7
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Melgosa Ramos FJ, Berna-Rico E, Suarez-Valle A, Mateu Puchades A, Vañó-Galván S, García-Ruiz R, Saceda Corralo D. Determinant factors of biological therapy for dissecting cellulitis of the scalp. J Dtsch Dermatol Ges 2024; 22:115-117. [PMID: 38110849 DOI: 10.1111/ddg.15271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 09/08/2023] [Indexed: 12/20/2023]
Affiliation(s)
| | - Emilio Berna-Rico
- Department of dermatology, university hospital Ramón y Cajal, IRICYS, Madrid, Spain
| | - Ana Suarez-Valle
- Department of dermatology, university hospital Ramón y Cajal, IRICYS, Madrid, Spain
| | | | - Sergio Vañó-Galván
- Department of dermatology, university hospital Ramón y Cajal, IRICYS, Madrid, Spain
- University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Ramón García-Ruiz
- Department of Dermatology, University Hospital Doctor Peset, Valencia, Spain
| | - David Saceda Corralo
- Department of dermatology, university hospital Ramón y Cajal, IRICYS, Madrid, Spain
- University of Alcalá, Alcalá de Henares, Madrid, Spain
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8
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Ji ZH, Ren WZ, He S, Wu HY, Yuan B, Chen J, Jin HJ. A missense mutation in Lama3 causes androgen alopecia. Sci Rep 2023; 13:20818. [PMID: 38012251 PMCID: PMC10682005 DOI: 10.1038/s41598-023-48337-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 11/25/2023] [Indexed: 11/29/2023] Open
Abstract
Hair loss disorders such as androgenetic alopecia have caused serious disturbances to normal human life. Animal models play an important role in exploring pathogenesis of disease and evaluating new therapies. NIH hairless mice are a spontaneous hairless mouse discovered and bred in our laboratory. In this study, we resequenced the genomes of NIH normal mice and NIH hairless mice and obtained 3,575,560 high-quality, plausible SNP loci and 995,475 InDels. The Euclidean distance algorithm was used to assess the association of SNP loci with the hairless phenotype, at a threshold of 0.62. Two regions of chromosome 18 having the highest association with the phenotype contained 345 genes with a total length of 13.98 Mb. The same algorithm was used to assess the association of InDels with the hairless phenotype at a threshold of 0.54 and revealed a region of 25.45 Mb in length, containing 518 genes. The mutation candidate gene Lama3 (NM_010680.2: c.652C>T; NP_034810.1: p. Arg217Cys) was selected based on the results of functional gene analysis and mutation prediction screening. Lama3 (R217C) mutant mice were further constructed using CRISPR/Cas9 technology, and the relationship between Lama3 point mutations and the hairless phenotype were clarified by phenotypic observation. The results showed that male Lama3 point mutation mice started to lose hair on the 80th day after birth, and the hair loss area gradually expanded over time. H&E staining of skin sections showed that the point mutation mice had increased sebaceous glands in the dermis and missing hair follicle structure (i.e., typical symptoms of androgenetic alopecia). This study is a good extension of the current body of knowledge about the function of Lama3, and the constructed Lama3 (R217C) mutant mice may be a good animal model for studying androgenetic alopecia.
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Affiliation(s)
- Zhong-Hao Ji
- Department of Plastic Surgery, The First Hospital of Jilin University, Changchun, 130062, Jilin, China
- Department of Basic Medicine, Changzhi Medical College, Changzhi, 046000, Shanxi, China
- Department of Laboratory Animals, College of Animal Sciences, Jilin University, Changchun, 130062, Jilin, China
| | - Wen-Zhi Ren
- Department of Laboratory Animals, College of Animal Sciences, Jilin University, Changchun, 130062, Jilin, China
| | - Song He
- Department of Laboratory Animals, College of Animal Sciences, Jilin University, Changchun, 130062, Jilin, China
| | - Hong-Yu Wu
- Department of Laboratory Animals, College of Animal Sciences, Jilin University, Changchun, 130062, Jilin, China
- Jilin Academy of Agricultural Sciences, Jilin City, 132101, Jilin, China
| | - Bao Yuan
- Department of Laboratory Animals, College of Animal Sciences, Jilin University, Changchun, 130062, Jilin, China
| | - Jian Chen
- Department of Laboratory Animals, College of Animal Sciences, Jilin University, Changchun, 130062, Jilin, China.
| | - Hong-Juan Jin
- Department of Plastic Surgery, The First Hospital of Jilin University, Changchun, 130062, Jilin, China.
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GOKCE NURIYE, BASGOZ NESLIHAN, KENANOGLU SERCAN, AKALIN HILAL, OZKUL YUSUF, ERGOREN MAHMUTCERKEZ, BECCARI TOMMASO, BERTELLI MATTEO, DUNDAR MUNIS. An overview of the genetic aspects of hair loss and its connection with nutrition. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2022; 63:E228-E238. [PMID: 36479473 PMCID: PMC9710406 DOI: 10.15167/2421-4248/jpmh2022.63.2s3.2765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Hair loss is a widespread concern in dermatology clinics, affecting both men's and women's quality of life. Hair loss can have many different causes, which are critical to identify in order to provide appropriate treatment. Hair loss can happen due to many variables, such as genetic factors or predisposition, vitamin and mineral deficiencies, skin problems, hair growth disorders, poor diet, hormonal problems, certain internal diseases, drug use, stress and depression, cosmetic factors, childbirth, and the chemotherapy process. Treatment for hair loss varies depending on the type of alopecia, deficiency, or excess of structures such as vitamins and minerals, and also on hair and skin structure. The Mediterranean diet is characterized by low amounts of saturated fat, animal protein, and high amounts of unsaturated fat, fiber, polyphenols, and antioxidants. The main nutrients found in the Mediterranean Diet are rich in antioxidant, anti-inflammatory components. It also has an important place in hair loss treatment, since recently treatment strategies have included polyphenols and unsaturated oils more and more frequently. The goal of this work was to review published articles examining alopecia and its types, the many micronutrients that affect alopecia, and the role of the Mediterranean diet in alopecia. The literature shows that little is known about hair loss, nutritional factors, and diet, and that the data collected are conflicting. Given these differences, research into the function of diet and nutrition in the treatment of baldness is a dynamic and growing topic.
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Affiliation(s)
- NURIYE GOKCE
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - NESLIHAN BASGOZ
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - SERCAN KENANOGLU
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - HILAL AKALIN
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - YUSUF OZKUL
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - MAHMUT CERKEZ ERGOREN
- Department of Medical Genetics, Faculty of Medicine, Near East University, Nicosia, Cyprus
- DESAM Institute, Near East University, Nicosia, Cyprus
| | - TOMMASO BECCARI
- Department of Pharmaceutical Science, University of Perugia, Perugia, Italy
| | - MATTEO BERTELLI
- MAGISNAT, Peachtree Corners (GA), USA
- MAGI Euregio, Bolzano, Italy
- MAGI’S LAB, Rovereto (TN), Italy
| | - MUNIS DUNDAR
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
- Correspondence: Munis Dundar, Department of Medical Genetics, Faculty of Medicine, Erciyes University, 38039, Kayseri, Turkey. E-mail:
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[Frontal fibrosing alopecia-update]. Hautarzt 2022; 73:344-352. [PMID: 35394176 DOI: 10.1007/s00105-022-04983-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2022] [Indexed: 10/18/2022]
Abstract
The number of patients presenting with frontal fibrosing alopecia (FAA) is increasing not only in hair clinics. The recognition of the peculiar clinical pattern and associated symptoms is an important prerequisite to ensure adequate counseling and therapeutic management of the patients. Experimental studies and a range of case series give first insights into the pathogenesis, possible trigger factors, clinical course of disease and treatment options. The clinical spectrum of FFA extends beyond the typical recession of the frontal hair line initially observed in postmenopausal women. Younger women, men and rarely adolescents may also be affected. Band-like extension to the occiput, diffuse bitemporal hair thinning, eyebrow and body hair involvement as well as facial papules are part of the clinical spectrum. Similar to lichen planopilaris, inflammation and fibrosis with involvement of the stem cell region result in permanent loss of hair follicles. Which additional factors contribute to the characteristic pattern remains to be elucidated. Currently, therapeutic management largely relies on anti-inflammatory treatment with combined topical, intralesional and systemic administration depending on disease activity. The chronic progressive course, sometimes even in the absence of pronounced inflammation remains a challenge for both the affected individuals and the treating physicians. Controlled studies are required to develop evidence-based recommendations and to explore novel treatment strategies.
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Paichitrojjana A, Paichitrojjana A. Platelet Rich Plasma and Its Use in Hair Regrowth: A Review. Drug Des Devel Ther 2022; 16:635-645. [PMID: 35300222 PMCID: PMC8922312 DOI: 10.2147/dddt.s356858] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 03/04/2022] [Indexed: 11/23/2022] Open
Abstract
Platelet rich plasma (PRP) was described as a small volume of plasma containing higher concentrations of platelets than those found in peripheral blood and initially used as a transfusion product for treatment of thrombocytopenia. To date, it was discovered that there are several growth factors and cytokines that can accelerate wound healing and tissue regeneration, leading to a wider range of applications in the medical field, such as in sport medicine, regenerative medicine, and aesthetic medicine. Several studies have shown that PRP can be used effectively for treatment of hair loss. Although it has been widely used, the exact mechanism of action of PRP is still not fully elucidated. In this article, we aim to review and update current information on the definition, classification, mechanism of action, clinical efficacy in hair regrowth, and adverse events of PRP.
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Affiliation(s)
- Anon Paichitrojjana
- School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University, Bangkok, Thailand
- Correspondence: Anon Paichitrojjana, School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University, 36/87-88 PS Tower 25Fl, Asoke Road, Sukhumvit 21, Klong Toey Nua, Wattana, Bangkok, 10110, Thailand, Tel +66 81-9343050, Email
| | - Anand Paichitrojjana
- Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Pili Torti: A Feature of Numerous Congenital and Acquired Conditions. J Clin Med 2021; 10:jcm10173901. [PMID: 34501349 PMCID: PMC8432236 DOI: 10.3390/jcm10173901] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/20/2021] [Accepted: 08/25/2021] [Indexed: 02/06/2023] Open
Abstract
Pili torti is a rare condition characterized by the presence of the hair shaft, which is flattened at irregular intervals and twisted 180° along its long axis. It is a form of hair shaft disorder with increased fragility. The condition is classified into inherited and acquired. Inherited forms may be either isolated or associated with numerous genetic diseases or syndromes (e.g., Menkes disease, Björnstad syndrome, Netherton syndrome, and Bazex-Dupré-Christol syndrome). Moreover, pili torti may be a feature of various ectodermal dysplasias (such as Rapp-Hodgkin syndrome and Ankyloblepharon-ectodermal defects-cleft lip/palate syndrome). Acquired pili torti was described in numerous forms of alopecia (e.g., lichen planopilaris, discoid lupus erythematosus, dissecting cellulitis, folliculitis decalvans, alopecia areata) as well as neoplastic and systemic diseases (such as cutaneous T-cell lymphoma, scalp metastasis of breast cancer, anorexia nervosa, malnutrition, cataracts, and chronic graft-vs.-host disease). The condition may also be induced by several drugs (epidermal growth factor receptor inhibitors, oral retinoids, sodium valproate, and carbamide perhydrate). The diagnosis of pili torti is based on trichoscopic or microscopic examination. As pili torti is a marker of numerous congenital and acquired disorders, in every case, the search for the signs of underlying conditions is recommended.
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Torales J, Castaldelli-Maia JM, Ventriglio A, Almirón-Santacruz J, Barrios I, O'Higgins M, García O, Navarro R, Melgarejo O, Jafferany M. Alopecia areata: A psychodermatological perspective. J Cosmet Dermatol 2021; 21:2318-2323. [PMID: 34449973 DOI: 10.1111/jocd.14416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 08/16/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Alopecia Areata (AA) is an autoimmune dermatological disease that could be influenced by psychological factors as part of the pathophysiology of the illness. AIMS This review article aims to report on psychodermatological and psychopathological aspects involved in the etiopathogenesis and comorbidities of AA, as well as on the psychiatric and psychological management of affected patients. METHODS We conducted a literature search on PubMed and Google Scholar from January 1980 to May 2021 employing the search terms of alopecia areata, psychological factors, psychological impact, psychodermatology, and psychopathology. All lists of references from the identified articles were screened for further relevant studies. The search was limited to English and Spanish language articles and was supplemented with themed books and book chapters. No specific quality criteria were used for the studies selection. RESULTS Several authors have found a high comorbidity rate between AA and mental disorders, concluding that stress and psychological factors are involved in both the development and exacerbation of the illness. More evidences are needed in order to describe the associations between the immune response, stress, and the physiological factors observed in AA patients. CONCLUSION AA is a complex illness characterized by multifactorial etiology. An interaction between genetic, autoimmune, hormonal, neural, and psychological factors is supposed. Psychopathological aspects of illness need to be better described and considered in the clinical setting.
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Affiliation(s)
- Julio Torales
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - João Mauricio Castaldelli-Maia
- Department of Neuroscience, Medical School, Fundação do ABC, Santo André, SP, Brazil.,Department of Psychiatry, Medical School, University of São Paulo, São Paulo, SP, Brazil
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - José Almirón-Santacruz
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Iván Barrios
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Marcelo O'Higgins
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Oscar García
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Rodrigo Navarro
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Osvaldo Melgarejo
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Mohammad Jafferany
- Department of Psychiatry, Central Michigan University, Mount Pleasant, MI, USA
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14
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Cardoso CO, Tolentino S, Gratieri T, Cunha-Filho M, Lopez RFV, Gelfuso GM. Topical Treatment for Scarring and Non-Scarring Alopecia: An Overview of the Current Evidence. Clin Cosmet Investig Dermatol 2021; 14:485-499. [PMID: 34012282 PMCID: PMC8126704 DOI: 10.2147/ccid.s284435] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 04/25/2021] [Indexed: 12/22/2022]
Abstract
Alopecia is a clinical condition related to hair loss that can significantly affect both male and female adults' quality of life. Despite the high market demand, only few drugs are currently approved for alopecia treatment. Topical formulations still bring drawbacks, such as scalp irritation with frequent use, and low drug absorption to the site of action, which limits the efficacy. The most recent research points out that different formulation technology could circumvent the aforementioned flaws. Such technology includes incorporation of drugs in rigid or deformable nanoparticles, strategies involving physical, energetical and mechanical techniques, such as iontophoresis, sonophoresis, microneedling, and the use of solid effervescent granules to be hydrated at the moment of application in the scalp. In this paper, the progress of current research on topical formulations dedicated to the treatment of alopecia is reviewed and discussed.
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Affiliation(s)
- Camila O Cardoso
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia, Brasília, 70910-900, DF, Brazil
| | - Seila Tolentino
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia, Brasília, 70910-900, DF, Brazil
| | - Tais Gratieri
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia, Brasília, 70910-900, DF, Brazil
| | - Marcilio Cunha-Filho
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia, Brasília, 70910-900, DF, Brazil
| | - Renata F V Lopez
- School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, 14040-903, SP, Brazil
| | - Guilherme M Gelfuso
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia, Brasília, 70910-900, DF, Brazil
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15
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Senatore S, Maglie R, Maio V, Montefusco F, Antiga E. Folliculitis decalvans with exclusive beard involvement. Indian J Dermatol Venereol Leprol 2021; 87:569-571. [PMID: 33969666 DOI: 10.25259/ijdvl_694_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 01/01/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Stefano Senatore
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - Roberto Maglie
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - Vincenza Maio
- Department of Health Sciences, Section of Pathological Anatomy, University of Florence, Florence, Italy
| | - Francesca Montefusco
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - Emiliano Antiga
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
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16
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Mikiel D, Polańska A, Żaba R, Adamski Z, Dańczak-Pazdrowska A. Suitability of high-frequency ultrasonography (20 MHz) in evaluation of various forms of primary cicatricial alopecia in relation to trichoscopy - pilot study. Skin Res Technol 2021; 27:774-784. [PMID: 33751668 DOI: 10.1111/srt.13018] [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: 10/14/2020] [Revised: 12/14/2020] [Accepted: 01/25/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Primary cicatricial alopecia is a potentially irreversible process of hair loss, in which for proper diagnosis a skin biopsy is necessary. Searching for new, non-invasive diagnostic methods may shorten the time for final diagnosis, initiating appropriate treatment and reduce the need for biopsy. The aim of this study was to evaluate the usefulness of high-frequency ultrasonography (HF-USG) as a diagnostic method in patients with primary scarring alopecia and to compare it with trichoscopy. MATERIALS AND METHODS The study covered a total of 44 adults: 8 with classic lichen planopilaris (LPP), 11 with discoid lupus erythematosus (DLE), 14 with frontal fibrosing alopecia (FFA), and 11 healthy volunteers. Each patient underwent physical and trichoscopic examination which was the base for qualification for active/inactive stage of the disease. Then, HF-USG was performed using a probe with a frequency of 20 MHz. In HF-USG images, the following elements were evaluated and measured: entrance echo (EE), follicular structures (FS), dermal background (DB), and dermal/subdermal border (D/SB). RESULTS Inactive phase was characterized by significantly lower number/lack of FS compared to the active phase of scarring alopecia. HF-USG of active LPP/FFA presented cigar-like shaped FS, while inactive stage pronounced D/SB forming saw-like pattern. Active DLE in HF-USG were associated with focal, doubled EE and widened FS with a tendency to create hypoechogenic wide, structureless bands within the skin. In inactive DLE, there was no specific pattern of D/SB or rarely puzzle-like pattern. CONCLUSION HF-USG images differ depending on the phase of the disease and the type of scarring alopecia, similarly to trichoscopic examination.
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Affiliation(s)
- Dominik Mikiel
- Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland.,Department of Skin Diseases, Provincial Hospital in Poznan, Poznan, Poland
| | - Adriana Polańska
- Department of Dermatology and Venereology, Poznan University of Medical Sciences, Poznan, Poland
| | - Ryszard Żaba
- Department of Dermatology and Venereology, Poznan University of Medical Sciences, Poznan, Poland
| | - Zygmunt Adamski
- Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
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17
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Fang H, Liu Q, Cheng T, Yang C, Wu R, Yang Z, Yang D. Innovative use of concentrated growth factors combined with corticosteroids to treat discoid lupus erythematosus alopecia: A case report. J Cosmet Dermatol 2021; 20:2538-2541. [PMID: 33356005 DOI: 10.1111/jocd.13904] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 11/21/2020] [Accepted: 12/09/2020] [Indexed: 11/27/2022]
Abstract
Alopecia for patients with discoid lupus erythematosus can sometimes be a refractory condition, where mixed infiltrates of T lymphocytes and histiocytes leads to destruction of hair follicles, which might cause permanent scarring. Early diagnosis and timely treatment can achieve hair regeneration and prevent further disease progression. Concentrated growth factor, a novel autologous plasma extract, contains various growth factors that could promote tissue regeneration. In this article, we report a case of cell growth factor combined with corticosteroids for the treatment of discoid lupus erythematosus alopecia. This case study concludes with satisfactory clinical effect.
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Affiliation(s)
- Huijuan Fang
- School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, China.,Department of Dermatology, China-Japan Friendship Hospital, Beijing, China
| | - Qingwu Liu
- School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Tiantian Cheng
- School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, China.,Department of Dermatology, China-Japan Friendship Hospital, Beijing, China
| | - Chaowei Yang
- School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Ruiying Wu
- School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, China.,Department of Dermatology, China-Japan Friendship Hospital, Beijing, China
| | - Zhishan Yang
- School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, China.,Department of Dermatology, China-Japan Friendship Hospital, Beijing, China
| | - Dingquan Yang
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, China
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18
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Kurzeja M, Czuwara J, Walecka I, Olszewska M, Rudnicka L. Features of classic lichen planopilaris and frontal fibrosing alopecia in reflectance confocal microscopy: A preliminary study. Skin Res Technol 2020; 27:266-271. [PMID: 32743819 DOI: 10.1111/srt.12940] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 06/12/2020] [Accepted: 06/25/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Classic lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA) are primary lymphocytic cicatricial alopecia. In patients with ambiguous clinical presentation, reflectance confocal microscopy (RCM) a new noninvasive skin imaging technique, could be a helpful diagnostic tool. The aim of our study was to describe the characteristic features of classic LPP and FFA using RCM. MATERIALS AND METHODS Ten patients with classic lichen planopilaris and two with frontal fibrosing alopecia were examined with RCM. RESULTS Lichenoid inflammatory infiltrate around the hair follicle was observed in three cases of classic LPP and FFA (3/12; 25.0%). Extensive perifollicular fibrosis was seen in nine patients (9/12; 75.0%) with classic LPP and FFA. An increased number of white, ill-defined, coarse dermal fibers at the level of the superficial dermis were visible in seven cases (7/12; 58.3%). Moreover, dilated blood vessels were present in seven patients with classic LPP and FFA (7/12; 58.3%). CONCLUSION Summing up, reflectance confocal microscopy allows to visualize major key diagnostic features of classic lichen planopilaris and frontal fibrosing alopecia in the real time. The value of RCM examination in scarring alopecia needs to be further evaluated, but it appears to be a useful adjuvant tool for the initial diagnosis of classic LPP and FFA.
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Affiliation(s)
- Marta Kurzeja
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - Joanna Czuwara
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - Irena Walecka
- Department of Dermatology Centre of Postgraduate Medical Education/CSK MSWIA, Warsaw, Poland
| | | | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
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19
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Bertoli MJ, Sadoughifar R, Schwartz RA, Lotti TM, Janniger CK. Female pattern hair loss: A comprehensive review. Dermatol Ther 2020; 33:e14055. [PMID: 32700775 DOI: 10.1111/dth.14055] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 07/18/2020] [Indexed: 12/28/2022]
Abstract
Female pattern hair loss is a common form of hair loss in women that increases in incidence with age. The etiology is unknown with numerous factors identified that influence its onset. Female pattern hair loss may be viewed as a marker for an increased risk of cardiovascular and metabolic disease. New treatments include microneedling, low-level laser therapy, and autologous fat transfer. This article focuses on the pathophysiology, diagnosis, systemic associations, and current treatments for female pattern hair loss, which is the most common cause of alopecia in women.
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Affiliation(s)
- Mia J Bertoli
- Rutgers New Jersey Medical School, Newark, New Jersey, USA
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20
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Kanti V, Constantinou A, Reygagne P, Vogt A, Kottner J, Blume‐Peytavi U. Frontal fibrosing alopecia: demographic and clinical characteristics of 490 cases. J Eur Acad Dermatol Venereol 2019; 33:1976-1983. [DOI: 10.1111/jdv.15735] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 05/28/2019] [Indexed: 12/15/2022]
Affiliation(s)
- V. Kanti
- Department of Dermatology and Allergy Clinical Research Center for Hair and Skin Science Charité – Universitätsmedizin Berlin Berlin Germany
| | - A. Constantinou
- Department of Dermatology and Allergy Clinical Research Center for Hair and Skin Science Charité – Universitätsmedizin Berlin Berlin Germany
| | | | - A. Vogt
- Department of Dermatology and Allergy Clinical Research Center for Hair and Skin Science Charité – Universitätsmedizin Berlin Berlin Germany
| | - J. Kottner
- Department of Dermatology and Allergy Clinical Research Center for Hair and Skin Science Charité – Universitätsmedizin Berlin Berlin Germany
| | - U. Blume‐Peytavi
- Department of Dermatology and Allergy Clinical Research Center for Hair and Skin Science Charité – Universitätsmedizin Berlin Berlin Germany
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21
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Kaya İslamoğlu ZG, Uysal E. A preliminary study on ultrasound techniques applied to cicatricial alopecia. Skin Res Technol 2019; 25:810-814. [PMID: 31140656 DOI: 10.1111/srt.12725] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 04/15/2019] [Accepted: 04/28/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND Cicatricial alopecia (CA) is a group of disorder characterized by permanent destruction of the hair follicle. Shear wave elastography (SWE) and superb microvascular imaging (SMI) are noninvasive ultrasonic techniques which evaluate thickness, stiffness, and vascular index of tissues. OBJECTIVES This study explored the ranges of cicatricial alopecia area and normal scalp with a combined modality of SMI and SWE and investigated the feasibility of their use in assessing these diseases. METHODS Seventeen patients diagnosed with CA and twenty healthy controls were included in the study. SWE and SMI were performed with an Aplio 500 ultrasound system. RESULTS The mean age of patient group was 37.00 ± 13.16, and the mean age of the healthy controls were 36.00 ± 11.79. SWE results as m/s in cicatricial plaques ( x ¯ = 5191) were higher than non-alopecic scalp areas ( x ¯ = 4460) in patient group (t (16) = 2260; P = 0.038 < 0.05). SMI values in patient group (cicatricial plaques) ( x ¯ = 1200) were significantly higher than control group SMI values ( x ¯ = 0.005) (t (35) = 3.075; P = 0.012 < 0.05). CONCLUSIONS To the best of our knowledge, this is the first study to evaluate SWE and SMI scores in cicatricial alopecia. We found higher stiffness and vascularity in patient group. We conclude that SWE and SMI can show fibrosis and inflammation like previous studies. Especially, SWE as m/s is more sensitive than as kPa for cicatricial alopecia.
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Affiliation(s)
| | - Emine Uysal
- Faculty of Medicine, Department of Radiology, Selcuk University, Selçuklu, Turkey
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