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Ragaie MH, Mohammed SE, Shehata SS. Intralesional vitamin D3 versus intralesional triamcinolone acetonoid in patchy alopecia areata: a comparative clinical and dermoscopic study. J COSMET LASER THER 2024:1-5. [PMID: 39139085 DOI: 10.1080/14764172.2024.2389275] [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: 08/05/2023] [Revised: 03/29/2024] [Accepted: 08/02/2024] [Indexed: 08/15/2024]
Abstract
BACKGROUND Alopecia areata (AA) is a common autoimmune T-cell mediated non-scarring, form of hair loss. It affects people of all ages and sexes. AIM To compare the efficacy of intralesional vitamin D3 injection versus that of intralesional triamcinolone acetonide in the treatment of patchy alopecia areata. PATIENTS AND METHODS This clinical study was carried on 40 adult patients with patchy alopecia areata, the patients were categorized into two groups. Group I involved 20 patients who received 1 ml of intralesional injection of vitamin D3 (cholecalciferol aqueous preparation 200 000 IU/2 ml) every 4 weeks for a maximum of three sessions. Group II involved 20 patients who received 1 ml of intralesional injection of triamcinolone acetonide 40 mg/mL every 4 weeks for a maximum of three sessions. Clinical and trichoscopic evaluations were done at the baseline, each session and for 3 months after the last session. RESULTS There was no statistically significant difference between the two studied groups regarding the degree of clinical improvement (p = .8). A statistically significant reduction in AA specific trichoscopic signs was detected at the end of the sessions and after 3 months of follow-up in both groups, without any statistically significant difference between them. Also a statistically significant difference was found between both groups regarding the reported adverse effects with a significant better patient satisfaction encountered toward the intralesional vitamin D3 injection. CONCLUSION Intralesional vitamin D3 is a promising effective, simple, safe, and inexpensive, therapeutic modality for patchy AA.
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Affiliation(s)
- Maha H Ragaie
- Department of Dermatology, STD's and Andrology, Faculty of Medicine, Minia University, Minya, Al, Egypt
| | - Shimaa E Mohammed
- Department of Dermatology, STD's and Andrology, Faculty of Medicine, Minia University, Minya, Al, Egypt
| | - Shimaa S Shehata
- Department of Dermatology, STD's and Andrology, Faculty of Medicine, Minia University, Minya, Al, Egypt
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2
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Zong X, Yang S, Tang Z, Li X, Long D, Wang D. 1,25-(OH) 2D 3 promotes hair growth by inhibiting NLRP3/IL-1β and HIF-1α/IL-1β signaling pathways. J Nutr Biochem 2024; 132:109695. [PMID: 38936782 DOI: 10.1016/j.jnutbio.2024.109695] [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: 03/10/2024] [Revised: 05/16/2024] [Accepted: 06/20/2024] [Indexed: 06/29/2024]
Abstract
Vitamin D is a crucial vitamin that participates in various biological processes through the Vitamin D Receptor (VDR). While there are studies suggesting that VDR might regulate hair growth through ligand-independent mechanisms, the efficacy of Vitamin D in treating hair loss disorders has also been reported. Here, through in vivo experiments in mice, in vitro organ culture of hair follicles, and cellular-level investigations, we demonstrate that 1,25-(OH)2D3 promotes mouse hair regeneration, prolongs the hair follicle anagen, and enhances the proliferation and migration capabilities of dermal papilla cells and outer root sheath keratinocytes in a VDR-dependent manner. Transcriptome analysis of VDR-knockout mouse skin reveals the involvement of HIF-1α, NLRP3, and IL-1β in these processes. Finally, we confirm that 1,25-(OH)2D3 can counteract the inhibitory effects of DHT on hair growth. These findings suggest that 1,25-(OH)2D3 has a positive impact on hair growth and may serve as a potential therapeutic agent for androgenetic alopecia (AGA).
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Affiliation(s)
- Xiule Zong
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Shengbo Yang
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Ziting Tang
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Xuemei Li
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Daijing Long
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Dan Wang
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, China.
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3
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Ma YQ, Sun Z, Li YM, Xu H. Oxidative stress and alopecia areata. Front Med (Lausanne) 2023; 10:1181572. [PMID: 37396920 PMCID: PMC10311488 DOI: 10.3389/fmed.2023.1181572] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 05/31/2023] [Indexed: 07/04/2023] Open
Abstract
Alopecia areata (AA) is an inflammatory autoimmune disease characterized by non-scarring hair loss on the scalp or any other part of the hair-bearing skin. While the collapse of the immune privilege is considered as one of the most accepted theories accounting for AA, the exact pathogenesis of this disease remains unclear by now. Other factors, such as genetic predisposition, allergies, microbiota, and psychological stress, also play an important role in the occurrence and development of AA. Oxidative stress (OS), an unbalance between the oxidation and antioxidant defense systems, is believed to be associated with AA and may trigger the collapse of hair follicle-immune privilege. In this review, we examine the evidence of oxidative stress in AA patients, as well as the relationship between the pathogenesis of AA and OS. In the future, antioxidants may play a new role as a supplementary therapy for AA.
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Affiliation(s)
| | | | | | - Hui Xu
- Department of Dermatology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
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Park H, Kim JE, Choi JW, Kim DY, Jang YH, Lee Y, Jeon J, Shin HT, Kim MS, Shin JW, Cho SB, Lew BL, Choi GS. Guidelines for the Management of Patients with Alopecia Areata in Korea: Part I Topical and Device-based Treatment. Ann Dermatol 2023; 35:190-204. [PMID: 37290953 DOI: 10.5021/ad.22.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 12/17/2022] [Accepted: 01/24/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND Alopecia areata (AA) is a chronic disease with an unpredictable disease course and severe psychological impact. OBJECTIVE To provide evidence- and consensus-based insights regarding the treatment of patients with AA in Korea. METHODS We searched for relevant studies on the topical and device-based treatment of AA in the literature from inception until May 2021. Evidence-based recommendations were also prepared. The evidence for each statement was graded and classified according to the strength of the recommendations. Hair experts from the Korean Hair Research Society (KHRS) voted on the statements, and an agreement of 75% or greater was considered as consensus. RESULTS Currently, there remains a scarcity of topical treatments, which is supported by robust evidence from a number of high-quality randomized controlled trials. Current evidence supports the efficacy of topical corticosteroids, corticosteroid intralesional injection, and contact immunotherapy in AA patients. Topical corticosteroids and contact immunotherapy are recommended for pediatric AA. A consensus was achieved in 6 out of 14 (42.8%), and 1 out of 5 (20.0%) statements pertaining to topical and device-based treatments in AA, respectively. The expert consensus was from a single country, and the study may not cover all the treatments used. CONCLUSION The present study provides up-to-date, evidence-based treatment guidelines for AA based on the consensus reached among experts after considering regional healthcare circumstances, adding diversity to the previous guidelines.
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Affiliation(s)
- Hyunsun Park
- Department of Dermatology, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Jung Eun Kim
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jee Woong Choi
- Department of Dermatology, Ajou University School of Medicine, Suwon, Korea
| | - Do Young Kim
- Department of Dermatology, Yonsei University College of Medicine, Seoul, Korea
| | - Yong Hyun Jang
- Department of Dermatology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Young Lee
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Jiehyun Jeon
- Department of Dermatology, Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Hyun-Tae Shin
- Department of Dermatology, Inha University School of Medicine, Incheon, Korea
| | - Min Sung Kim
- Department of Dermatology, School of Medicine, Chosun University, Gwangju, Korea
| | - Jung Won Shin
- Department of Dermatology, Seoul National University Bundang Hospital, Bundang, Korea
| | - Sung Bin Cho
- Yonsei Seran Dermatology and Laser Clinic, Seoul, Korea
| | - Bark-Lynn Lew
- Department of Dermatology, Kyung Hee University School of Medicine, Seoul, Korea.
| | - Gwang Seong Choi
- Department of Dermatology, Inha University School of Medicine, Incheon, Korea
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Touil H, Mounts K, De Jager PL. Differential impact of environmental factors on systemic and localized autoimmunity. Front Immunol 2023; 14:1147447. [PMID: 37283765 PMCID: PMC10239830 DOI: 10.3389/fimmu.2023.1147447] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/08/2023] [Indexed: 06/08/2023] Open
Abstract
The influence of environmental factors on the development of autoimmune disease is being broadly investigated to better understand the multifactorial nature of autoimmune pathogenesis and to identify potential areas of intervention. Areas of particular interest include the influence of lifestyle, nutrition, and vitamin deficiencies on autoimmunity and chronic inflammation. In this review, we discuss how particular lifestyles and dietary patterns may contribute to or modulate autoimmunity. We explored this concept through a spectrum of several autoimmune diseases including Multiple Sclerosis (MS), Systemic Lupus Erythematosus (SLE) and Alopecia Areata (AA) affecting the central nervous system, whole body, and the hair follicles, respectively. A clear commonality between the autoimmune conditions of interest here is low Vitamin D, a well-researched hormone in the context of autoimmunity with pleiotropic immunomodulatory and anti-inflammatory effects. While low levels are often correlated with disease activity and progression in MS and AA, the relationship is less clear in SLE. Despite strong associations with autoimmunity, we lack conclusive evidence which elucidates its role in contributing to pathogenesis or simply as a result of chronic inflammation. In a similar vein, other vitamins impacting the development and course of these diseases are explored in this review, and overall diet and lifestyle. Recent work exploring the effects of dietary interventions on MS showed that a balanced diet was linked to improvement in clinical parameters, comorbid conditions, and overall quality of life for patients. In patients with MS, SLE and AA, certain diets and supplements are linked to lower incidence and improved symptoms. Conversely, obesity during adolescence was linked with higher incidence of MS while in SLE it was associated with organ damage. Autoimmunity is thought to emerge from the complex interplay between environmental factors and genetic background. Although the scope of this review focuses on environmental factors, it is imperative to elaborate the interaction between genetic susceptibility and environment due to the multifactorial origin of these disease. Here, we offer a comprehensive review about the influence of recent environmental and lifestyle factors on these autoimmune diseases and potential translation into therapeutic interventions.
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Affiliation(s)
- Hanane Touil
- Center for Translational and Computational Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center, New York, NY, United States
| | - Kristin Mounts
- Center for Translational and Computational Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center, New York, NY, United States
| | - Philip Lawrence De Jager
- Center for Translational and Computational Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center, New York, NY, United States
- Columbia Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, United States
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Ali MS, Hafiz HSA, Ahmed NA, Galal SA. Combined microneedling with topical vitamin D3 or bimatoprost versus microneedling alone in the treatment of alopecia areata: A comparative randomized trial. J Cosmet Dermatol 2023; 22:1286-1296. [PMID: 36762396 DOI: 10.1111/jocd.15569] [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: 09/06/2022] [Revised: 11/15/2022] [Accepted: 12/05/2022] [Indexed: 02/11/2023]
Abstract
INTRODUCTION Alopecia areata (AA) is a challenging disease with variable treatment outcomes. Hair follicles express vitamin D receptors. Therefore, vitamin D3 may be promising for AA treatment through immunomodulatory mechanisms. The efficacy of bimatoprost in scalp AA treatment was reported by few studies. OBJECTIVE To evaluate the efficacy and safety of microneedling (MN) with topical vitamin D3 versus MN with bimatoprost in comparison with MN alone in the treatment of localized AA. PATIENTS AND METHODS Seventy-five patients with localized AA were divided into three groups. The first group: 25 patients were treated with MN alone. The second group: 25 patients treated with MN combined with topical vitamin D3. The third group: 25 patients treated with MN combined with bimatoprost solution. The response was evaluated clinically and dermoscopically. RESULTS At the end of the study, all groups showed a statistically significant decrease in the SALT score compared to the baseline. The clinical response (regrowth scale): vitamin D and bimatoprost groups showed a statistically significant higher regrowth scale compared to MN alone group (p-value = 0.000). After treatment, hair regrowth was significantly higher in MN combined with bimatoprost than in MN combined with topical vitamin D3. However, after 3 months of follow-up, there was no statistically significant difference between both groups. Side effects were mild and transient in all groups. CONCLUSION Topical vitamin D3 and bimatoprost combined with MN are safe and effective therapeutic options for localized AA.
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Affiliation(s)
- Mona S Ali
- Faculty of Medicine (Girls), Al- Azhar University, Cairo, Egypt
| | - Hala S A Hafiz
- Faculty of Medicine (Girls), Al- Azhar University, Cairo, Egypt
| | - Naglaa A Ahmed
- Faculty of Medicine (Girls), Al- Azhar University, Cairo, Egypt
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Malhotra K, Madke B. An Updated Review on Current Treatment of Alopecia Areata and Newer Therapeutic Options. Int J Trichology 2023; 15:3-12. [PMID: 37305188 PMCID: PMC10251289 DOI: 10.4103/ijt.ijt_28_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 03/14/2022] [Accepted: 06/14/2022] [Indexed: 06/13/2023] Open
Abstract
Alopecia areata (AA) is a dermatological disease that causes nonscarring hair loss. It can occur at any age and has an unpredictable and variable evolution in individuals. The aim of this review is to provide an update on the novel therapies currently being used, as well as upcoming therapeutic options in the treatment of AA.
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Affiliation(s)
- Karan Malhotra
- Department of Dermatology, Venereology and Leprosy, Desun Hospital, Kolkata, West Bengal, India
| | - Bhushan Madke
- Department of Dermatology, Venereology and Leprosy, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research (DMIHER) (Deemed to be University), Wardha, Maharashtra, India
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8
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Clinical Translation of Microbiome Research in Alopecia Areata: A New Perspective? COSMETICS 2022. [DOI: 10.3390/cosmetics9030055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The continuous research advances in the microbiome field is changing clinicians’ points of view about the involvement of the microbiome in human health and disease, including autoimmune diseases such as alopecia areata (AA). Both gut and cutaneous dysbiosis have been considered to play roles in alopecia areata. A new approach is currently possible owing also to the use of omic techniques for studying the role of the microbiome in the disease by the deep understanding of microorganisms involved in the dysbiosis as well as of the pathways involved. These findings suggest the possibility to adopt a topical approach using either cosmetics or medical devices, to modulate or control, for example, the growth of overexpressed species using specific bacteriocins or postbiotics or with pH control. This will favour at the same time the growth of beneficial bacteria which, in turn, can impact positively both the structure of the scalp ecosystem on the host’s response to internal and external offenders. This approach, together with a “systemic” one, via oral supplementation, diet, or faecal transplantation, makes a reliable translation of microbiome research in clinical practice and should be taken into consideration every time alopecia areata is considered by a clinician.
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Rashad AF, El Gamal EED, Fouda I. Intralesional Vitamin D3 in Treatment of Alopecia Areata: A randomized‐controlled clinical trial. J Cosmet Dermatol 2022; 21:4617-4622. [DOI: 10.1111/jocd.14844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 01/31/2022] [Accepted: 02/08/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Amira Fathy Rashad
- Kafr El‐Sheikh Dermatology and Leprosy Hospital Ministry of Health and Population Kafr El‐Sheikh Egypt
| | - Emad El Din El Gamal
- Dermatology, Venereology and Andrology Department Damietta Faculty of Medicine Al‐Azhar University Damietta Egypt
| | - Ibrahim Fouda
- Dermatology, Venereology and Andrology Department Damietta Faculty of Medicine Al‐Azhar University Damietta Egypt
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10
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The Role of Nutrition in Immune-Mediated, Inflammatory Skin Disease: A Narrative Review. Nutrients 2022; 14:nu14030591. [PMID: 35276950 PMCID: PMC8840467 DOI: 10.3390/nu14030591] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/23/2022] [Accepted: 01/27/2022] [Indexed: 11/16/2022] Open
Abstract
Immune-mediated inflammatory skin diseases are characterized by a complex multifactorial etiology, in which genetic and environmental factors interact both in genesis and development of the disease. Nutrition is a complex and fascinating scenario, whose pivotal role in induction, exacerbation, or amelioration of several human diseases has already been well documented. However, owing to the complexity of immune-mediated skin disease clinical course and breadth and variability of human nutrition, their correlation still remains an open debate in literature. It is therefore important for dermatologists to be aware about the scientific basis linking nutrition to inflammatory skin diseases such as psoriasis, atopic dermatitis, hidradenitis suppurativa, bullous diseases, vitiligo, and alopecia areata, and whether changes in diet can influence the clinical course of these diseases. The purpose of this narrative review is to address the role of nutrition in immune-mediated inflammatory skin diseases, in light of the most recent and validate knowledge on this topic. Moreover, whether specific dietary modifications could provide meaningful implementation in planning a therapeutic strategy for patients is evaluated, in accordance with regenerative medicine precepts, a healing-oriented medicine that considers the whole person, including all aspects of the lifestyle.
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Lintzeri DA, Constantinou A, Hillmann K, Ghoreschi K, Vogt A, Blume-Peytavi U. Alopecia areata – Aktuelles Verständnis und Management. J Dtsch Dermatol Ges 2022; 20:59-93. [PMID: 35040563 DOI: 10.1111/ddg.14689_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 11/11/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Dimitra Aikaterini Lintzeri
- Klinik für Dermatologie, Venerologie und Allergologie, Clinical Research Center for Hair and Skin Science, Charité - Universitätsmedizin Berlin
| | - Andria Constantinou
- Klinik für Dermatologie, Venerologie und Allergologie, Clinical Research Center for Hair and Skin Science, Charité - Universitätsmedizin Berlin
| | - Kathrin Hillmann
- Klinik für Dermatologie, Venerologie und Allergologie, Clinical Research Center for Hair and Skin Science, Charité - Universitätsmedizin Berlin
| | - Kamran Ghoreschi
- Klinik für Dermatologie, Venerologie und Allergologie, Clinical Research Center for Hair and Skin Science, Charité - Universitätsmedizin Berlin
| | - Annika Vogt
- Klinik für Dermatologie, Venerologie und Allergologie, Clinical Research Center for Hair and Skin Science, Charité - Universitätsmedizin Berlin
| | - Ulrike Blume-Peytavi
- Klinik für Dermatologie, Venerologie und Allergologie, Clinical Research Center for Hair and Skin Science, Charité - Universitätsmedizin Berlin
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12
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Lintzeri DA, Constantinou A, Hillmann K, Ghoreschi K, Vogt A, Blume-Peytavi U. Alopecia areata - Current understanding and management. J Dtsch Dermatol Ges 2022; 20:59-90. [PMID: 35040577 DOI: 10.1111/ddg.14689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 11/11/2021] [Indexed: 02/06/2023]
Abstract
Alopecia areata (AA) is a chronic, immune-mediated disease characterized by acute or chronic non-scarring hair loss, with a heterogeneity in clinical manifestations ranging from patchy hair loss to complete scalp and body hair loss. An overview of the up-to-date pathophysiology and the underlying signaling pathways involved in AA together with diagnostic and therapeutic recommendations will be provided. Current treatments, including topical, systemic and injectable interventions show varying response and frequent relapses reflecting the unmet clinical need. Thus, the new emerging concepts and therapeutic approaches, including Janus kinase inhibitors are eagerly awaited. Traditional and emerging therapies of AA will be discussed, in order to provide physicians with guidance for AA management. Since the latter is so challenging and often tends to take a chronic course, it can have an enormous psychosocial burden on patients, compromising their quality of life and often causing depression and anxiety. Therefore, the psychosocial aspects of the disease need to be evaluated and addressed, in order to implement appropriate psychological support when needed.
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Affiliation(s)
- Dimitra Aikaterini Lintzeri
- Department of Dermatology, Venereology and Allergology, Clinical Research Center for Hair and Skin Science, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany
| | - Andria Constantinou
- Department of Dermatology, Venereology and Allergology, Clinical Research Center for Hair and Skin Science, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany
| | - Kathrin Hillmann
- Department of Dermatology, Venereology and Allergology, Clinical Research Center for Hair and Skin Science, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany
| | - Kamran Ghoreschi
- Department of Dermatology, Venereology and Allergology, Clinical Research Center for Hair and Skin Science, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany
| | - Annika Vogt
- Department of Dermatology, Venereology and Allergology, Clinical Research Center for Hair and Skin Science, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany
| | - Ulrike Blume-Peytavi
- Department of Dermatology, Venereology and Allergology, Clinical Research Center for Hair and Skin Science, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany
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Zubair Z, Kantamaneni K, Jalla K, Renzu M, Jena R, Jain R, Muralidharan S, Yanamala VL, Alfonso M. Prevalence of Low Serum Vitamin D Levels in Patients Presenting With Androgenetic Alopecia: A Review. Cureus 2021; 13:e20431. [PMID: 35047268 PMCID: PMC8759975 DOI: 10.7759/cureus.20431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 12/15/2021] [Indexed: 11/18/2022] Open
Abstract
The role of vitamin D receptor (VDR) has been well established and extensively studied in the hair cycle. Its deficiency is also closely linked to several types of alopecia, including alopecia areata, telogen effluvium, and androgenetic alopecia (AGA). Since there is limited research on the correlation between androgenetic alopecia and low serum vitamin D levels, our review aims to find relevant articles and comprehensively present them. A review of the literature was performed to gain insight into AGA. Specifically, PubMed and Google Scholar databases were searched to identify any relevant articles with a focus on androgenetic alopecia, male pattern baldness, and serum vitamin D levels. References within the included articles were also reviewed and taken into the study if found appropriate. All articles that met the inclusion criteria were analyzed for demographics, clinical, laboratory, radiographic, treatment, and outcomes data. We found 13 relevant studies that elucidated the relationship between low serum vitamin D levels and androgenetic alopecia and included them in the review. We concluded that serum vitamin D might be a possible parameter for diagnosing the onset and severity of AGA. Vitamin D supplementation has proven to be useful in the regrowth of hair in non-human subjects. Vitamin D could be a valid therapeutic approach, such as topical vitamin D (calcipotriol) seems to be a good treatment option to regrow hair follicles and prevent miniaturization of follicles due to androgenetic alopecia.
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Aşkın Ö, Uzunçakmak TKÜ, Altunkalem N, Tüzün Y. Vitamin deficiencies/hypervitaminosis and the skin. Clin Dermatol 2021; 39:847-857. [PMID: 34785012 DOI: 10.1016/j.clindermatol.2021.05.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Vitamins are an indispensable food source and important owing to the enzyme cofactor and catalytic roles they play in the body. Fat-soluble vitamins A, D, E, K, and B12, are stored in the body and can cause problems with their excessive accumulation. Other vitamins rarely accumulate in the body because they dissolve in water and are excreted through the kidneys. Alcoholism, strict diets, insufficient parental nutrition, and gastrointestinal absorption problems may be included in the causes of vitamin deficiencies. Although clinical findings of vitamin deficiencies display different characteristics depending on the vitamins, the signs that generally occur are cutaneous pigmentation, pigmentation on mucous membranes, palmoplantar keratoderma characterized by fissures, palmar streaking, yellow streaking on the nails, nail layering, and intranail hemorrhage.
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Affiliation(s)
- Özge Aşkın
- Dermatology Department, İstanbul University Cerrahpaşa, Cerrahpaşa, İstanbul, Turkey.
| | | | - Neval Altunkalem
- Dermatology Department, İstanbul University Cerrahpaşa, Cerrahpaşa, İstanbul, Turkey
| | - Yalçın Tüzün
- Altınbaş University, Medical Park Bahçelievler Hospital, İstanbul, Turkey
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15
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Papadimitriou DT, Bothou C, Dermitzaki E, Alexopoulos A, Mastorakos G. Treatment of alopecia totalis/universalis/focalis with vitamin D and analogs: Three case reports and a literature review. World J Clin Pediatr 2021; 10:192-199. [PMID: 34868895 PMCID: PMC8603638 DOI: 10.5409/wjcp.v10.i6.192] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 04/18/2021] [Accepted: 07/06/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Alopecia areata (AA) is an inflammatory disease with autoimmune, environmental, and inherited components directed at the hair follicle, either limited to patchy hair loss over the scalp (Focalis, AF), total loss of scalp hair (Totalis, AT), or total loss of both scalp and body hair (Universalis, AU). Despite multiple treatment modalities, no therapy exists. Vitamin D deficiency in patients with AA/AT/AF influences disease severity and duration, inversely correlating with inflammation histologically.
CASE SUMMARY Three girls presented with AT (P1), AU (P2), and AF (P3) at the ages of 1, 5, and 5 years, respectively. For P1-P2, all available treatments implemented for 2 years had failed. We started an initial 6-mo repletion with oral cholecalciferol 2000/4000 IU/d, with no apparent effect. Then we attempted immunomodulation using oral calcitriol and its analog paricalcitol. On calcitriol, 0.5 mcg/d P1 regrew hair within 6 mo. After 4 years, a relapse with loss of eyebrow hair was resolved after doubling the calcitriol dose to 0.5 mcg × 2/d; the results have been maintained for 6 years to date. On calcitriol, 0.25 mcg × 3/d P2 led to the development of asymptomatic hypercalcemia-hypercalciuria, which was immediately resolved by switching to paricalcitol 2 mcg × 3/d; mild tolerable hypercalciuria was maintained. Hair regrowth was observed at 6 mo, stabilizing only as fur at 12 mo. AF in P3 was resolved completely within 3 mo on a daily high dose (8000 IU) of cholecalciferol.
CONCLUSION Vitamin D may have immunomodulating therapeutic impact on AT/AU/AF, which needs to be explored with further pilot clinical trials.
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Affiliation(s)
- Dimitrios T Papadimitriou
- Department of Pediatric-Adolescent Endocrinology and Diabetes, Athens Medical Center, Athens 15125, Greece
- Endocrine Unit, Aretaieion University Hospital, Athens 11528, Greece
| | - Christina Bothou
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich (USZ), University of Zurich (UZH), CH-8091 Zurich, Switzerland
| | - Eleni Dermitzaki
- Department of Pediatric-Adolescent Endocrinology and Diabetes, Athens Medical Center, Athens 15125, Greece
| | - Alexios Alexopoulos
- Special Unit of Dermatology, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Agia Sofia Children's Hospital, Athens 11527, Greece
| | - George Mastorakos
- Endocrine Unit, Aretaieion University Hospital, Athens 11528, Greece
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Saini K, Mysore V. Role of vitamin D in hair loss: A short review. J Cosmet Dermatol 2021; 20:3407-3414. [PMID: 34553483 DOI: 10.1111/jocd.14421] [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: 05/08/2021] [Revised: 07/31/2021] [Accepted: 08/20/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Vitamin D, a vitamin and hormone, plays an important role in dermatology and dermatotherapeutics, due to its anti-inflammatory and immunomodulatory properties, and regulation of keratinocyte differentiation and proliferation. It also affects the hair cycle, and its role in hair loss is under constant research. OBJECTIVES This review aims to give a brief overview of vitamin D biology within the hair follicle, role in the etiopathogenesis, and rationale for supplementation in various alopecias. METHODS A PubMed literature search was performed to review relevant current literature and studies investigating the role of vitamin D in the etiopathogenesis, as a supplement and a potential therapeutic modality in hair loss. RESULTS AND CONCLUSION Vitamin D is intricately involved in various signaling pathways of growth and differentiation of hair follicles. Most studies show an inverse relationship between serum vitamin D levels and non-scarring alopecias such as telogen effluvium, androgenetic alopecia, alopecia areata, and trichotillomania. Vitamin D deficiency is also associated with scarring alopecia. However, conclusive studies to demonstrate the benefit of vitamin D administration in correcting hair loss and managing these conditions are lacking. Hence, further studies are needed before vitamin D can be routinely recommended as a treatment modality in these conditions.
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Affiliation(s)
- Kriteeka Saini
- Venkat Center for Skin and Plastic Surgery, Bengaluru, India
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17
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Abstract
Alopecia areata (AA) is an autoimmune condition that affects up to 2% of the general population. Currently available treatment options for AA are of limited efficacy and can be associated with adverse effects. The advancement in understanding of the genetic and molecular mechanisms of AA has led to the development of novel treatment options, with the Janus kinase (JAK) inhibitor class of drugs at the forefront of ongoing clinical trials. Platelet-rich plasma, fecal transplants, and cytokine-targeted therapy with ustekinumab and dupilumab have also been shown to regrow hair in patients with AA in individual case reports or small studies. Several other novel therapies have preliminary data or are being tested in clinical trials.
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Molinelli E, Campanati A, Brisigotti V, Sapigni C, Paolinelli M, Offidani A. Efficacy and Safety of Topical Calcipotriol 0.005% Versus Topical Clobetasol 0.05% in the Management of Alopecia Areata: An Intrasubject Pilot Study. Dermatol Ther (Heidelb) 2020; 10:515-521. [PMID: 32342443 PMCID: PMC7211771 DOI: 10.1007/s13555-020-00379-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Indexed: 12/31/2022] Open
Abstract
Introduction Alopecia areata (AA) is a chronic inflammatory non-scarring type of hair loss. Current therapies for alopecia areata are rather limited and mainly involve the use of topical, intra-lesional or systemic steroids and topical immunotherapy, with variable benefit. Recent studies have demonstrated that vitamin D analogues could potentially promote hair growth in patients with patchy AA. Methods We investigated the efficacy and safety of treatment with calcipotriol, a synthetic derivative of vitamin D (calcipotriol 0.005% ointment), versus treatment with the corticosteroid clobetasol (topical clobetasol 0.05% formulation), in a series of 35 patients with scalp AA, using an intrasubject design. Results Patches treated with calcipotriol ointment showed greater and faster response rates than did those treated with topical clobetasol, although the differences were not statistically significant. The main strength of the study is its prospective design; the main limitation is the small number of participants. Conclusions Treatment with the calcipotriol would appear to be reasonably effective in patients with mild to moderate patchy AA and was associated with only limited and reversible side effects.
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Affiliation(s)
- Elisa Molinelli
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Conca 71 Street, Ancona, Italy.
| | - Anna Campanati
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Conca 71 Street, Ancona, Italy
| | - Valerio Brisigotti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Conca 71 Street, Ancona, Italy
| | - Claudia Sapigni
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Conca 71 Street, Ancona, Italy
| | - Matteo Paolinelli
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Conca 71 Street, Ancona, Italy
| | - Annamaria Offidani
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Conca 71 Street, Ancona, Italy
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Alam M, Amin SS, Adil M, Arif T, Zahra FT, Varshney I. Comparative Study of Efficacy of Topical Mometasone with Calcipotriol versus Mometasone Alone in the Treatment of Alopecia Areata. Int J Trichology 2019; 11:123-127. [PMID: 31360041 PMCID: PMC6580810 DOI: 10.4103/ijt.ijt_18_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Alopecia areata is one of the common causes of nonscarring hair loss with autoimmune etiology. This study was designed to evaluate any added benefit of topical calcipotriol when combined with topical mometasone in the treatment of alopecia areata. To the best of our knowledge, no such study has been conducted in the past. Materials and Methods It was a comparative analytical study done over 100 patients of clinically diagnosed alopecia areata. Group A patients (n = 50) were advised to apply topical mometasone 0.1% cream along with topical calcipotriol 0.005% ointment each once daily, whereas patients of Group B (n = 50) were advised to apply only topical mometasone 0.1% cream in the same amount, once a day. Follow-up of all patients was done at 6, 12, and 24 weeks, and the outcome was assessed according to the Severity of Alopecia Tool (SALT) score at every visit. Results Both the groups were statistically comparable in terms of age (P = 0.694) and sex (P = 0.683) distribution. Baseline mean SALT score of Group A and Group B patients was 7.22 and 6.05, respectively (P = 0.145). At the end of 24 weeks, mean SALT score of Group A and Group B patients decreased by 4.24 and 3.39, respectively (P < 0.001). We also found that there was a significant decrease (P < 0.001) in mean SALT score at 24 weeks in patients of both groups when compared with baseline values. Conclusion We found that adding topical calcipotriol 0.005% ointment with topical mometasone 0.1% cream has higher efficacy than topical mometasone alone, in the treatment of alopecia areata.
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Affiliation(s)
- Mahtab Alam
- Department of Dermatology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Syed Suhail Amin
- Department of Dermatology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Mohammad Adil
- Department of Dermatology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Tasleem Arif
- Ellahi Medicare Clinic, Srinagar, Jammu and Kashmir, India
| | - Fatima Tuz Zahra
- Department of Dermatology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Iti Varshney
- Department of Dermatology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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20
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Topical calcipotriol vs narrowband ultraviolet B in treatment of alopecia areata: a randomized-controlled trial. Arch Dermatol Res 2019; 311:629-636. [DOI: 10.1007/s00403-019-01943-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/14/2019] [Accepted: 06/18/2019] [Indexed: 02/03/2023]
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21
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Damiani G, Conic R, Orlando G, Zampetti A, Marinello E, Piai M, Linder MD. Vitamin D in trichology: a comprehensive review of the role of vitamin D and its receptor in hair and scalp disorders. GIORN ITAL DERMAT V 2019; 155:190-197. [PMID: 31210464 DOI: 10.23736/s0392-0488.19.06305-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Vitamin D plays an important role in maintaining the homeostasis of various biological systems. Beside its well-known function in calcium and phosphate metabolism, it plays a major role in pathophysiology of skin and adnexa. Indeed, vitamin D, through its receptor (VDR), decreases keratinocyte proliferation, improves their differentiation and modulates both cutaneous innate (antimicrobial activity and antigen presentation) and adaptative immunity (T and B lymphocyte function). The maintenance of normal hair is dependant on the integrity of the dermis, epidermis and hair cycles. Beside its effect on epidermal differentiation, VDR plays a vital role in preserving the hair follicle integrity. While the relevance of VDR has been fully elucidated, the real value of vitamin D in the hair follicle cycle still remains uncertain. To date, results in literature remain contradicting and far from definitive; still, the role of vitamin D in the various forms of human alopecia is likely to be significant. The aim of this article is to review evidence about the role of vitamin D and its receptor in trichology, with a focus on scarring and non-scarring alopecia and in particular on the potential therapeutic use of Vitamin D for hair and scalp disorders.
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Affiliation(s)
- Giovanni Damiani
- Research Center of the Italian Group for Epidemiologic Studies in Dermatology (GISED), Bergamo, Italy.,Department of Clinical Dermatology, Galeazzi Orthopedic Institute IRCCS, Milan, Italy.,Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Rosalynn Conic
- Department of Dermatology, Cleveland Clinic, Cleveland, OH, USA
| | - Gloria Orlando
- Department of Dermatology, University of Padua, Padua, Italy -
| | - Anna Zampetti
- Rare Diseases and Fevers Research Center, A. Gemelli University Polyclinic, IRCCS and Foundation, Rome, Italy
| | - Elena Marinello
- Department of Dermatology, University of Padua, Padua, Italy
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22
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Navarro-Triviño F, Arias-Santiago S, Gilaberte-Calzada Y. Vitamin D and the Skin: A Review for Dermatologists. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2019.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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23
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Navarro-Triviño FJ, Arias-Santiago S, Gilaberte-Calzada Y. Vitamin D and the Skin: A Review for Dermatologists. ACTAS DERMO-SIFILIOGRAFICAS 2019; 110:262-272. [PMID: 30857638 DOI: 10.1016/j.ad.2018.08.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 07/28/2018] [Accepted: 08/02/2018] [Indexed: 02/07/2023] Open
Abstract
In recent years, the growing interest in the role played by vitamin D in skin disease has given rise to the publication of many studies of the relationship between this vitamin and certain skin conditions. As dermatologists, we need to understand, among other aspects, how vitamin D is synthesized and the main sources in humans, as well as plasma levels and the factors that can modify them. Of particular interest are the latest discoveries about the role of vitamin D in skin diseases such as lupus erythematosus, ichthyosis, atopic dermatitis, hidradenitis suppurativa, acne, alopecia areata, androgenetic alopecia, melanoma, and nonmelanoma skin cancer. Also of interest is the importance of vitamin D as adjuvant therapy in patients on long-term treatment with corticosteroids. In this review, we provide an overview of the most important and most recent information regarding the relationship between vitamin D and skin disease and discuss the importance of assessing individual vitamin D status and correcting deficiencies.
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Affiliation(s)
- F J Navarro-Triviño
- Unidad de Dermatología Médico-Quirúrgica y Venereología, Hospital Comarcal Alcalá la Real, Jaén, España.
| | - S Arias-Santiago
- Unidad de Gestión Clínica de Dermatología y Venereología, Hospital Universitario Virgen de las Nieves, Granada, España
| | - Y Gilaberte-Calzada
- Servicio de Dermatología, Hospital Universitario Miguel Servet, IIS Aragón, Zaragoza, España
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24
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Hosking AM, Juhasz M, Atanaskova Mesinkovska N. Complementary and Alternative Treatments for Alopecia: A Comprehensive Review. Skin Appendage Disord 2019; 5:72-89. [PMID: 30815439 PMCID: PMC6388561 DOI: 10.1159/000492035] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Accepted: 07/10/2018] [Indexed: 12/29/2022] Open
Abstract
The treatment of alopecia is limited by a lack of therapies that induce and sustain disease remission. Given the negative psychosocial impact of hair loss, patients that do not see significant hair restoration with conventional therapies often turn to complementary and alternative medicine (CAM). Although there are a variety of CAM treatment options on the market for alopecia, only a few are backed by multiple randomized controlled trials. Further, these modalities are not regulated by the Food and Drug Administration and there is a lack of standardization of bioactive in gredients in over-the-counter vitamins, herbs, and supplements. In this article, we provide a comprehensive review of the efficacy, safety, and tolerability of CAM, including natural products and mind and body practices, in the treatment of hair loss. Overall, there is a need for additional studies investigating CAM for alopecia with more robust clinical design and standardized, quantitative outcomes.
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Affiliation(s)
- Anna-Marie Hosking
- Department of Dermatology, University of California, Irvine, Irvine, California, USA
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25
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Lee S, Kim BJ, Lee CH, Lee WS. Increased prevalence of vitamin D deficiency in patients with alopecia areata: a systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2018; 32:1214-1221. [PMID: 29633370 DOI: 10.1111/jdv.14987] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 03/22/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Alopecia areata (AA) is a hair follicle-specific autoimmune disorder. Vitamin D deficiency has been associated with various autoimmune disorders for its immunomodulatory effects. However, in previous studies, there had been inconsistent association found between AA and vitamin D deficiency. OBJECTIVE To demonstrate the differences of the mean serum 25-hydroxyvitamin D level and prevalence of vitamin D deficiency between AA patients and non-AA population. METHODS A systematic review and meta-analysis of observational studies on AA and serum vitamin D levels and/or prevalence of vitamin D deficiency was performed searching MEDLINE, Cochrane, Web of Science and Google Scholar databases. RESULTS In all, 14 studies including a total of 1255 AA subjects and 784 non-AA control were analysed. The mean serum 25-hydroxyvitamin D level was significantly lower in AA subjects (-8.52 ng/dL; 95% confidential interval; -5.50 to -11.53). The AA subjects had higher odds of vitamin D deficiency (odds ratio of 3.89; 2.02 to 7.49, mean prevalence of 73.8%; 59.1 to 84.6%). However, it was difficult to find clear correlation between serum 25-hydroxyvitamin D level and extent of hair loss in AA subjects. CONCLUSION The AA subjects had lower serum 25-hydroxyvitamin D level, and vitamin D deficiency was highly prevalent compared to non-AA controls. Hence, vitamin D deficiency should be assessed in AA patients. Furthermore, nutritional supplementation of vitamin D or topical vitamin D analogues can be considered for AA patients with vitamin D deficiency. The limitation of this study is the highly heterogeneity of the included studies.
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Affiliation(s)
- S Lee
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - B J Kim
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - C H Lee
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - W S Lee
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
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26
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Yao CA. Serum vitamin D level and disease severity of alopecia areata: A meta-regression analysis. J Am Acad Dermatol 2018; 79:e49-e50. [PMID: 29753061 DOI: 10.1016/j.jaad.2018.05.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 03/06/2018] [Accepted: 05/01/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Chun-An Yao
- Department of Dermatology, Cathay General Hospital, Taipei, Taiwan.
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27
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Gerkowicz A, Chyl-Surdacka K, Krasowska D, Chodorowska G. The Role of Vitamin D in Non-Scarring Alopecia. Int J Mol Sci 2017; 18:E2653. [PMID: 29215595 PMCID: PMC5751255 DOI: 10.3390/ijms18122653] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 12/02/2017] [Accepted: 12/03/2017] [Indexed: 12/26/2022] Open
Abstract
Non-scarring hair loss is a common problem that affects both male and female patients. Since any disturbances in the hair follicle cycle may lead to hair shedding, or alopecia, it is not surprising that the possible role of vitamin D in alopecia was investigated in many studies. Vitamin D has been shown to have many important functions. A growing body of evidence shows that vitamin D and its receptor are responsible for maintaining not only calcium homeostasis but also skin homeostasis. Moreover, vitamin D could also regulate cutaneous innate and adaptive immunity. This paper presents a review of current literature considering the role of vitamin D in alopecia areata, telogen effluvium, and female pattern hair loss. The majority of studies revealed decreased serum 25-hydroxyvitamin D levels in patients with different types of non-scarring alopecia, which could suggest its potential role in the pathogenesis of hair loss. According to the authors, vitamin D supplementation could be a therapeutic option for patients with alopecia areata, female pattern hair loss, or telogen effluvium. However, further studies on a larger group of patients are required.
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Affiliation(s)
- Agnieszka Gerkowicz
- Chair and Department of Dermatology, Venereology and Paediatric Dermatology, Medical University of Lublin, Radziwiłłowska 13, 20-080 Lublin, Poland.
| | - Katarzyna Chyl-Surdacka
- Chair and Department of Dermatology, Venereology and Paediatric Dermatology, Medical University of Lublin, Radziwiłłowska 13, 20-080 Lublin, Poland.
| | - Dorota Krasowska
- Chair and Department of Dermatology, Venereology and Paediatric Dermatology, Medical University of Lublin, Radziwiłłowska 13, 20-080 Lublin, Poland.
| | - Grażyna Chodorowska
- Chair and Department of Dermatology, Venereology and Paediatric Dermatology, Medical University of Lublin, Radziwiłłowska 13, 20-080 Lublin, Poland.
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Thompson JM, Mirza MA, Park MK, Qureshi AA, Cho E. The Role of Micronutrients in Alopecia Areata: A Review. Am J Clin Dermatol 2017; 18:663-679. [PMID: 28508256 PMCID: PMC5685931 DOI: 10.1007/s40257-017-0285-x] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Alopecia areata (AA) is a common, non-scarring form of hair loss caused by immune-mediated attack of the hair follicle. As with other immune-mediated diseases, a complex interplay between environment and genetics is thought to lead to the development of AA. Deficiency of micronutrients such as vitamins and minerals may represent a modifiable risk factor associated with development of AA. Given the role of these micronutrients in normal hair follicle development and in immune cell function, a growing number of investigations have sought to determine whether serum levels of these nutrients might differ in AA patients, and whether supplementation of these nutrients might represent a therapeutic option for AA. While current treatment often relies on invasive steroid injections or immunomodulating agents with potentially harmful side effects, therapy by micronutrient supplementation, whether as a primary modality or as adjunctive treatment, could offer a promising low-risk alternative. However, our review highlights a need for further research in this area, given that the current body of literature largely consists of small case-control studies and case reports, which preclude any definite conclusions for a role of micronutrients in AA. In this comprehensive review of the current literature, we found that serum vitamin D, zinc, and folate levels tend to be lower in patients with AA as compared to controls. Evidence is conflicting or insufficient to suggest differences in levels of iron, vitamin B12, copper, magnesium, or selenium. A small number of studies suggest that vitamin A levels may modify the disease. Though understanding of the role for micronutrients in AA is growing, definitive clinical recommendations such as routine serum level testing or therapeutic supplementation call for additional studies in larger populations and with a prospective design.
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Affiliation(s)
- Jordan M Thompson
- Warren Alpert Medical School, Brown University, Providence, RI, 02903, USA
| | - Mehwish A Mirza
- Frank H. Netter MD School of Medicine, Quinnipiac University, North Haven, CT, 06473, USA
| | - Min Kyung Park
- Department of Dermatology, Warren Alpert Medical School, Brown University, 339 Eddy Street, Providence, RI, 02903, USA
| | - Abrar A Qureshi
- Department of Dermatology, Warren Alpert Medical School, Brown University, 339 Eddy Street, Providence, RI, 02903, USA
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, 02903, USA
| | - Eunyoung Cho
- Department of Dermatology, Warren Alpert Medical School, Brown University, 339 Eddy Street, Providence, RI, 02903, USA.
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, 02903, USA.
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