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JAMA Dermatology Apr 2021
Topics: Alopecia; Dermatologists; Humans
PubMed: 33688909
DOI: 10.1001/jamadermatol.2020.5731 -
Anais Brasileiros de Dermatologia 2016The transforming growth factor-beta 1 (TGFβ1) promotes fibrosis, differentiating epithelial cells and quiescent fibroblasts into myofibroblasts and increasing... (Review)
Review
The transforming growth factor-beta 1 (TGFβ1) promotes fibrosis, differentiating epithelial cells and quiescent fibroblasts into myofibroblasts and increasing expression of extracellular matrix. Recent investigations have shown that PPAR (peroxisome proliferator-activated receptor*) is a negative regulator of fibrotic events induced by TGFβ1. Dehydroepiandrosterone (DHEA) is an immunomodulatory hormone essential for PPAR functions, and is reduced in some processes characterized by fibrosis. Although scarring alopecia characteristically develops in the female biological period in which occurs decreased production of DHEA, there are no data in the literature relating its reduction to fibrogenic process of this condition. This article aims to review the fibrogenic activity of TGFβ1, its control by PPAR and its relation with DHEA in the frontal fibrosing alopecia.
Topics: Alopecia; Dehydroepiandrosterone; Female; Fibroblasts; Fibrosis; Humans; Lichen Planus; PPAR gamma; Transforming Growth Factor beta1
PubMed: 28099600
DOI: 10.1590/abd1806-4841.20165029 -
Acta Dermato-venereologica Aug 2022
Topics: Alopecia; Humans; Hypohidrosis; Nail Diseases; Nails, Malformed; Propylthiouracil
PubMed: 35971830
DOI: 10.2340/actadv.v102.2690 -
Facial Plastic Surgery Clinics of North... May 2023Hair loss is a common problem among men and women. Hair replacement surgery (HRS) has become increasingly popular as technological advancements have been made producing... (Review)
Review
Hair loss is a common problem among men and women. Hair replacement surgery (HRS) has become increasingly popular as technological advancements have been made producing remarkably natural results when performed by a skilled surgeon. Although complications from HRS are low compared with other esthetic surgeries, they can still occur even with the best-trained and qualified surgeon or staff. The process of hair restoration can be a long road for some patients and active patient participation and education is key for successful results. In this article, we seek to discuss the surgical risks of HRS and discuss methods to prevent them in your practice.
Topics: Male; Humans; Female; Hair Follicle; Hair; Alopecia; Surgery, Plastic
PubMed: 37001929
DOI: 10.1016/j.fsc.2023.01.009 -
Journal of Cosmetic Dermatology Jun 2022Trichoscopy in dermatology has opened up the new concept in overcoming the optical challenge faced clinically. It reveals the diagnostic details to the depth of... (Review)
Review
Trichoscopy in dermatology has opened up the new concept in overcoming the optical challenge faced clinically. It reveals the diagnostic details to the depth of superficial dermis, and thereby increasing the clinician's diagnostic accuracy and the level of confidence. The importance of trichoscopy in cicatricial alopecia is very evident in the current scenario for its precise diagnosis. The clinical picture in delineating lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA) from each other and also from other close mimickers such as androgenetic alopecia, alopecia areata, female patterned hair loss, and other cicatricial alopecia is bewildered due to its varied presentation and co-existence with the above disease. The indecisive comparative findings on histopathology make the situation even more perplexed. In this article, we have reviewed the characteristic trichoscopy patterns that can differentiate LPP and FFA and from their close mimickers.
Topics: Alopecia; Alopecia Areata; Cicatrix; Female; Humans; Lichen Planus
PubMed: 34661965
DOI: 10.1111/jocd.14457 -
Journal of Drugs in Dermatology : JDD Jul 2023Alopecia is one of the most common dermatologic conditions affecting black patients, with a significantly negative impact on quality of life.1,2 Timely and accurate...
Alopecia is one of the most common dermatologic conditions affecting black patients, with a significantly negative impact on quality of life.1,2 Timely and accurate diagnosis is therefore critical in order to reverse or halt progression of disease.3 Unfortunately, lack of representation of skin of color (SOC) patients in the current literature may contribute to misdiagnosis as providers may be unfamiliar with the clinical spectrum of alopecia presenting in darker scalps.4 Some scarring alopecia subtypes such as Central Centrifugal Cicatricial Alopecia (CCCA) are more prevalent in certain racial groups. However, focusing solely on patient demographics and gross clinical findings may obscure accurate diagnoses. To distinguish alopecia findings in Black patients, a dedicated approach using a combination of clinical exam findings and patient history, along with trichoscopy and biopsy, is essential to prevent misdiagnosis and improve clinical and diagnostic outcomes. We present three cases of alopecia in patients of color which the initial suspected clinical diagnosis did not correspond with trichoscopic and biopsy results. We challenge clinicians to reexamine their biases and fully evaluate patients of color with alopecia. An examination should include a thorough history, clinical examination, trichoscopy, and potentially a biopsy, particularly when findings do not correlate. Our cases highlight the challenges and disparities that exist in diagnosis of alopecia in Black patients. We emphasize the need for continued research regarding alopecia in skin of color and the importance of a complete workup for alopecia to improve diagnostic outcomes.Balazic E, Axler E, Nwankwo C, et al. Minimizing bias in alopecia diagnosis in skin of color patients. J Drugs Dermatol. 2023;22(7):703-705. doi:10.36849/JDD.7117.  .
Topics: Humans; Alopecia; Quality of Life; Scalp; Black or African American; Bias
PubMed: 37410034
DOI: 10.36849/JDD.7117 -
The Oncologist Jan 2018Chemotherapy-induced alopecia (CIA) is the most visibly distressing side effect of commonly administered chemotherapeutic agents. Because psychological health has huge... (Review)
Review
UNLABELLED
Chemotherapy-induced alopecia (CIA) is the most visibly distressing side effect of commonly administered chemotherapeutic agents. Because psychological health has huge relevance to lifestyle, diet, and self-esteem, it is important for clinicians to fully appreciate the psychological burden that CIA can place on patients. Here, for the first time to our knowledge, we provide a comprehensive review encompassing the molecular characteristics of the human hair follicle (HF), how different anticancer agents damage the HF to cause CIA, and subsequent HF pathophysiology, and we assess known and emerging prevention modalities that have aimed to reduce or prevent CIA. We argue that, at present, scalp cooling is the only safe and U.S. Food and Drug Administration-cleared modality available, and we highlight the extensive available clinical and experimental (biological) evidence for its efficacy. The likelihood of a patient that uses scalp cooling during chemotherapy maintaining enough hair to not require a wig is approximately 50%. This is despite different types of chemotherapy regimens, patient-specific differences, and possible lack of staff experience in effectively delivering scalp cooling. The increased use of scalp cooling and an understanding of how to deliver it most effectively to patients has enormous potential to ease the psychological burden of CIA, until other, more efficacious, equally safe treatments become available.
IMPLICATIONS FOR PRACTICE
Chemotherapy-induced alopecia (CIA) represents perhaps the most distressing side effect of chemotherapeutic agents and is of huge concern to the majority of patients. Scalp cooling is currently the only safe option to combat CIA. Clinical and biological evidence suggests improvements can be made, including efficacy in delivering adequately low temperature to the scalp and patient-specific cap design. The increased use of scalp cooling, an understanding of how to deliver it most effectively, and biological evidence-based approaches to improve its efficacy have enormous potential to ease the psychological burden of CIA, as this could lead to improvements in treatment and patient quality-of-life.
Topics: Alopecia; Antineoplastic Agents; Humans; Hypothermia, Induced; Neoplasms; Prognosis
PubMed: 28951499
DOI: 10.1634/theoncologist.2017-0263 -
The Journal of Dermatology Nov 2014Satoyoshi syndrome is a multisystem disorder of suspected autoimmune etiology, characterized predominantly by alopecia, muscle spasms and diarrhea. Antinuclear... (Review)
Review
Satoyoshi syndrome is a multisystem disorder of suspected autoimmune etiology, characterized predominantly by alopecia, muscle spasms and diarrhea. Antinuclear antibodies are present in 60% of patients. The syndrome primarily affects girls and young women. Trichoscopy shows regularly distributed yellow dots, indistinguishable from typical alopecia areata. The condition may be easily misdiagnosed and treated as alopecia areata. On the basis of an in-depth analysis of all published cases we developed diagnostic criteria for Satoyoshi syndrome. We also suggest that two subtypes of the disorder should be distinguished, the ANA-positive Satoyoshi syndrome with generally good response to systemic glucocorticosteroid therapy and the ANA-negative Satoyoshi with less favorable prognosis. In our opinion all patients will alopecia areata (in particular alopecia totalis) should be inquired about muscle spasms and diarrhea and tested for antinuclear antibodies to decrease the risk of missing Satoyoshi syndrome.
Topics: Alopecia; Alopecia Areata; Bone and Bones; Diarrhea; Humans; Spasm
PubMed: 25289915
DOI: 10.1111/1346-8138.12633 -
Facial Plastic Surgery Clinics of North... May 2020Hair restoration in women involves mastering both the medical and the surgical treatment. Preoperatively, women should be thoroughly evaluated for biochemical causes of... (Review)
Review
Hair restoration in women involves mastering both the medical and the surgical treatment. Preoperatively, women should be thoroughly evaluated for biochemical causes of hair loss along with a complete history and physical examination taken. The physician must recognize the clinical presentation of scarring alopecias and maintain a low threshold for biopsy to rule out this condition. Postoperative hair shock loss is a common feature following hair transplant in women, and the surgeon should understand the preoperative counseling and preventative measures needed, the intraoperative methods to reduce the incidence, and the postoperative strategies to handle the situation.
Topics: Alopecia; Biopsy; Combined Modality Therapy; Eyebrows; Female; Hair; Humans; Preoperative Care; Skin; Skin Transplantation; Tissue and Organ Harvesting
PubMed: 32312508
DOI: 10.1016/j.fsc.2020.01.007 -
Indian Journal of Dermatology,... 2017Traction alopecia was first described in 1904 but is still a cause of scarring hair loss in young women worldwide. It is unique in being initially a reversible then an... (Review)
Review
Traction alopecia was first described in 1904 but is still a cause of scarring hair loss in young women worldwide. It is unique in being initially a reversible then an irreversible (scarring) form of alopecia. Linked to tightly-pulled hairstyles, it is seen across all races. The pattern of hair loss depends on the style creating it but most commonly affects the frontotemporal hairline. There are some new examination findings associated with traction alopecia, which are traction folliculitis, the fringe sign and hair casts (pseudonits) on dermatoscopy. These may prove key in prompting early specialist referral. The mainstay of current treatment is cessation of the contributing hairstyles. Camouflage, anti-inflammatory or growth-stimulating topical preparations are second line treatments. In later stages of severe traction alopecia hair transplantation may be the only effective treatment. The evidence basis for medical intervention with topical agents is anecdotal at best. Furthermore, additional research is required to clarify the pathogenesis of this biphasic alopecia. Until then, prompt diagnosis and identification of causative hairstyles are focus of current dermatological practice.
Topics: Alopecia; Hair Preparations; Humans; Traction
PubMed: 29035284
DOI: 10.4103/ijdvl.IJDVL_553_16