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Aboalola D, Aouabdi S, Ramadan M, Alghamdi T, Alsolami M, Malibari D, Alsiary R. An Update on Alopecia and its Association With Thyroid Autoimmune Diseases. TOUCHREVIEWS IN ENDOCRINOLOGY 2023; 19:54-59. [PMID: 38187080 PMCID: PMC10769472 DOI: 10.17925/ee.2023.19.2.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 05/30/2023] [Indexed: 01/09/2024]
Abstract
Alopecia is comorbid with several illnesses, including various autoimmune conditions such as thyroid disease. Leukocyte-mediated inflammation of hair follicles in alopecia was first described over a century ago. However, the high prevalence of the role of thyroid autoimmune disease in the pathogenesis of alopecia has only recently come to light, together with a strong association between the two. Therefore, this review focuses on articles published between 2011 and 2022 on alopecia's association with thyroid autoimmune disease, and the mechanism behind it. In addition, it highlights the link between alopecia and thyroid cancer, as patients with alopecia have increased risk of thyroid cancer. In conclusion, this comprehensive, focused, scoping review will serve as a reference highlighting recent information on alopecia, exploring its association with thyroid autoimmune diseases.
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Affiliation(s)
- Doaa Aboalola
- King Abdullah International Medical Research Center, Jeddah, Western Region, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Jeddah, Western Region, Saudi Arabia
- Ministry of National Guard Health Affairs, Jeddah, Western Region, Saudi Arabia
| | - Sihem Aouabdi
- King Abdullah International Medical Research Center, Jeddah, Western Region, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Jeddah, Western Region, Saudi Arabia
- Ministry of National Guard Health Affairs, Jeddah, Western Region, Saudi Arabia
| | - Majed Ramadan
- King Abdullah International Medical Research Center, Jeddah, Western Region, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Jeddah, Western Region, Saudi Arabia
- Ministry of National Guard Health Affairs, Jeddah, Western Region, Saudi Arabia
| | - Tariq Alghamdi
- King Abdullah International Medical Research Center, Jeddah, Western Region, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Jeddah, Western Region, Saudi Arabia
- Ministry of National Guard Health Affairs, Jeddah, Western Region, Saudi Arabia
| | - Mona Alsolami
- King Abdullah International Medical Research Center, Jeddah, Western Region, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Jeddah, Western Region, Saudi Arabia
- Ministry of National Guard Health Affairs, Jeddah, Western Region, Saudi Arabia
| | - Dalal Malibari
- King Abdullah International Medical Research Center, Jeddah, Western Region, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Jeddah, Western Region, Saudi Arabia
- Ministry of National Guard Health Affairs, Jeddah, Western Region, Saudi Arabia
| | - Rawiah Alsiary
- King Abdullah International Medical Research Center, Jeddah, Western Region, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Jeddah, Western Region, Saudi Arabia
- Ministry of National Guard Health Affairs, Jeddah, Western Region, Saudi Arabia
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Umar S, Ton D, Carter MJ, Shitabata P. Unveiling a Shared Precursor Condition for Acne Keloidalis Nuchae and Primary Cicatricial Alopecias. Clin Cosmet Investig Dermatol 2023; 16:2315-2327. [PMID: 37649568 PMCID: PMC10464825 DOI: 10.2147/ccid.s422310] [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: 06/12/2023] [Accepted: 08/18/2023] [Indexed: 09/01/2023]
Abstract
Purpose Small observational studies suggest subclinical disease occurrence in the normal-appearing scalp zones of several primary cicatricial alopecias. To aid patient management, we began routinely evaluating the entire scalp of patients with acne keloidalis nuchae (AKN), including trichoscopy-guided biopsies. Patients and Methods This retrospective study evaluated 41 patients sequentially presenting with AKN at a single clinic between June and December 2022. Primary lesions and normal-appearing scalp in the superior parietal scalp at least 5 cm away from AKN-affected zones were clinically evaluated, and areas showing perifollicular erythema or scales/casts on trichoscopy were biopsied and histologically analyzed. Results Forty-one men with AKN, including 20 men of African descent, 17 Hispanic, and 4 European-descended Whites, were evaluated. All patients, including 22% with associated folliculitis decalvans, showed scalp-wide trichoscopy signs of perifollicular erythema or scaling in normal-appearing scalp areas. All patients showed histologic evidence of perifollicular infundibulo-isthmic lymphocytoplasmic infiltrates and fibrosis (PIILIF), with 96% showing Vellus or miniaturized hair absence. PIILIF was often clinically mistaken for seborrheic dermatitis (44-51%). All White patients had mild papular acne keloidalis nuchae lesions mistaken for seborrheic dermatitis. Conclusion PIILIF may be a precursor to a wide spectrum of primary cicatricial alopecias, including AKN and folliculitis decalvans. This finding carries implications for the early diagnosis and management of AKN and other primary cicatricial alopecias.
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Affiliation(s)
- Sanusi Umar
- Department of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
- Division of Dermatology, Department of Medicine, Harbor-UCLA Medical Center, Torrance, CA, USA
- Dr. U Hair and Skin Clinic, Manhattan Beach, CA, USA
| | - Donna Ton
- Dr. U Hair and Skin Clinic, Manhattan Beach, CA, USA
| | | | - Paul Shitabata
- Department of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
- Division of Dermatology, Department of Medicine, Harbor-UCLA Medical Center, Torrance, CA, USA
- Dermatopathology Institute, Torrance, CA, USA
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Kaiser M, Abdin R, Yaghi M, Gaumond SI, Jimenez JJ, Issa NT. Beard Alopecia: An Updated and Comprehensive Review of Etiologies, Presentation and Treatment. J Clin Med 2023; 12:4793. [PMID: 37510908 PMCID: PMC10381635 DOI: 10.3390/jcm12144793] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/15/2023] [Accepted: 07/16/2023] [Indexed: 07/30/2023] Open
Abstract
Facial hair is an important social and psychologic aspect of clinical appearance for men. The purpose of this review is to provide a comprehensive overview of the causes of alopecia of the beard including the prevalence, pathophysiology, clinical presentation, and treatment. In this review, we highlight more common causes of beard alopecia including alopecia areata and pseudofolliculitis barbae, infectious causes such as tinea barbae and herpes simplex folliculitis, and rare causes including dermatopathia pigmentosa reticularis and frontal fibrosing alopecia. This review serves as an important resource for clinicians when faced with patients suffering from beard alopecia.
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Affiliation(s)
- Michael Kaiser
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Rama Abdin
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA
| | - Marita Yaghi
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Simonetta I Gaumond
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Joaquin J Jimenez
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Naiem T Issa
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Forefront Dermatology, Vienna, VA 22182, USA
- Issa Research and Consulting, LLC, Springfield, VA 22152, USA
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