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Advances in Therapy Jul 2017Alopecia areata is an extremely common autoimmune condition affecting hair. Severe forms of alopecia areata exist, with existing treatments consisting of systemic... (Review)
Review
Alopecia areata is an extremely common autoimmune condition affecting hair. Severe forms of alopecia areata exist, with existing treatments consisting of systemic immunosuppressants with numerous side effects. Recently, breakthroughs have been made in both understanding the pathogenesis of alopecia areata and the treatment thereof, which hold the promise of being able to target severe cases of alopecia areata with more efficacy and better tolerability. This article serves as an introduction to review papers from two of the leading researchers in the field of alopecia areata.
Topics: Alopecia Areata; Drug-Related Side Effects and Adverse Reactions; Humans; Immunosuppressive Agents
PubMed: 28646391
DOI: 10.1007/s12325-017-0544-5 -
Lasers in Medical Science Feb 2023We aim to evaluate the clinical efficacy and safety of using laser and light combined with topical minoxidil for alopecia areata. We searched PubMed, Embase, Web of... (Meta-Analysis)
Meta-Analysis Review
We aim to evaluate the clinical efficacy and safety of using laser and light combined with topical minoxidil for alopecia areata. We searched PubMed, Embase, Web of Science, the Cochrane Library, China National Knowledge Infrastructure (CNKI), China Biomedical Literature Database (CBM), VIP database, and Wanfang Data from their inception to September 18, 2022. The risk of bias of the included RCTs was assessed by the Cochrane Collaboration tool. RevMan 5.3 software and Stata 14.0 software were used to perform the statistical analysis. The GRADE system assessed the quality of evidence. Ten studies were enrolled finally. The results of the meta-analysis showed that compared with topical minoxidil alone, the 308-nm excimer laser/light or He-Ne laser combined with topical minoxidil could reduce the SALT (Severity of Alopecia Tool) score (MD= -5.88, 95% CI [-9.79, -1.98], P=0.003). Whether fractional CO laser (RR=1.29, 95% CI [1.14, 1.46], P<0.0001), 308-nm excimer laser/light (RR=1.32, 95% CI [1.12, 1.55], P=0.001), He-Ne laser (RR=1.69, 95% CI [1.07, 2.69], P=0.03), or NB-UVB (RR=1.35, 95% CI [1.07,1.70], P=0.01) combined with topical minoxidil may improve the treatment response rate, comparing with topical minoxidil only. The recurrence rate of laser and light combined with topical minoxidil was lower than that of the minoxidil alone group (RR=0.54, 95% CI [0.31, 0.93], P=0.03) when follow-up time was 1 year. In addition, the incidence of adverse events including irritant contact dermatitis, erythema, desquamation, pain, and pruritus was no significant difference between the two groups (RR=1.50, 95% CI [0.95, 2.36], P=0.08). The level of evidence for outcomes was classified as very low to moderate. Based on the available evidence, laser and light combined with topical minoxidil therapy may be effective and safe for alopecia areata. However, more high-quality trials are required for comprehensive analysis and further verification.
Topics: Humans; Minoxidil; Alopecia Areata; Randomized Controlled Trials as Topic; Phototherapy; Lasers
PubMed: 36800063
DOI: 10.1007/s10103-023-03734-0 -
The British Journal of Dermatology Nov 2023
Topics: Humans; Alopecia Areata; Scalp; Hair
PubMed: 37972130
DOI: 10.1093/bjd/ljad415 -
Dermatologic Therapy Mar 2021Alopecia areata (AA) is an autoimmune T CD8 cell mediated condition clinically characterized by hair loss from single or few small patches to complete hair loss. The...
Alopecia areata (AA) is an autoimmune T CD8 cell mediated condition clinically characterized by hair loss from single or few small patches to complete hair loss. The management of AA is challenging and all available therapies does not ensure a long-term remission. To assess the safety and efficacy of both systemic and topical brevilin A, a natural compound, in AA patients not responding to other treatments. After obtaining informed consent, we administered off-label brevilin A to 13 adult patients affected by AA, for a period ranging from 6 to 18 months. Medical records for each patient and the severity of alopecia tool (SALT) score before and after brevilin A administration were recorded. The mean SALT score of our patients was 81.03 (SD 34.9) at baseline and 75.8 (SD 37.4) after brevilin A therapy, meaning no statistically significant improvement was observed (P = .2385 Paired t test). However, three multifocal AA (MAA) patients out of four attained an improvement (75%) suggesting that brevilin A may be represent an alternative therapy in this form of AA. Authors conclude that brevilin A could represent in the future a possible effective treatment in MAA forms but further studies are required.
Topics: Adult; Alopecia; Alopecia Areata; Crotonates; Humans; Sesquiterpenes; Treatment Outcome
PubMed: 33438308
DOI: 10.1111/dth.14778 -
International Journal of Dermatology Nov 2015Autoimmunity is the main etiopathogenetic factor in alopecia areata. Microchimerism is the existence of allogeneic DNA in a living creature. There are variable studies...
BACKGROUND
Autoimmunity is the main etiopathogenetic factor in alopecia areata. Microchimerism is the existence of allogeneic DNA in a living creature. There are variable studies investigating the role of microchimerism on the etiopathogenesis of autoimmune diseases. To our knowledge, no report has investigated the relationship between microchimerism and alopecia areata.
OBJECTIVE
We aimed to investigate the possible role of microchimerism on alopecia areata.
METHODS
We analyzed SRY gene levels as indicators of fetal microchimerism in our patient group. The patients were 29 women with alopecia areata, over 18 years old, who had visited our clinic between 2010 and 2013. Patients were divided into two groups; group 1 consisted of 14 patients having a son and group 2, 15 patients either nulliparous or having a daughter.
RESULTS
Seventeen of 29 patients (58.6%) and four of 103 controls (3.9%) showed presence of an SRY gene. The difference between the patient and control groups was statistically significant (P < 0.001).
CONCLUSION
As a result of our study, microchimerism may be associated with the etiopathogenesis of alopecia areata. However, we think there is a need for a larger series of studies to support this hypothesis.
Topics: Adolescent; Adult; Alopecia Areata; Case-Control Studies; Chimerism; Female; Genes, sry; Humans; Male; Middle Aged; Nuclear Family; Reproductive History; Young Adult
PubMed: 25773886
DOI: 10.1111/ijd.12795 -
Expert Review of Clinical Immunology Aug 2022Alopecia areata (AA) is a non-scarring, hair loss disorder and a common autoimmune-mediated disease with an estimated lifetime risk of about 2%. To date, the treatment... (Review)
Review
INTRODUCTION
Alopecia areata (AA) is a non-scarring, hair loss disorder and a common autoimmune-mediated disease with an estimated lifetime risk of about 2%. To date, the treatment of AA is mainly based on suppression or stimulation of the immune response. Genomics and transcriptomics studies generated important insights into the underlying pathophysiology, enabled discovery of molecular disease signatures, which were used in some of the recent clinical trials to monitor drug response and substantiated the consideration of new therapeutic modalities for the treatment of AA such as abatacept, dupilumab, ustekinumab, and Janus Kinase (JAK) inhibitors.
AREAS COVERED
In this review, genomics and transcriptomics studies in AA are discussed in detail with particular emphasis on their past and prospective translational impacts. Microbiome studies are also briefly introduced.
EXPERT OPINION
The generation of large datasets using the new high-throughput technologies has revolutionized medical research and AA has also benefited from the wave of omics studies. However, the limitations associated with JAK inhibitors and clinical heterogeneity in AA patients underscore the necessity for continuing omics research in AA for discovery of novel therapeutic modalities and development of clinical tools for precision medicine.
Topics: Alopecia Areata; Autoimmune Diseases; Humans; Janus Kinase Inhibitors; Prospective Studies; Ustekinumab
PubMed: 35770930
DOI: 10.1080/1744666X.2022.2096590 -
Canadian Family Physician Medecin de... Jul 2020In my family practice, several children have presented with alopecia areata. Families are worried about the ongoing hair loss and have been trying several natural...
In my family practice, several children have presented with alopecia areata. Families are worried about the ongoing hair loss and have been trying several natural health products. I understand that corticosteroids are also considered to treat this condition. Which corticosteroid treatments can I consider and how beneficial are they? Alopecia areata is a source of considerable distress to those affected, and although there are many treatment options available, none have been clinically proven to be consistently effective. Steroids are commonly prescribed and can result in hair regrowth. Topical steroids are most commonly used in children, but intralesional, oral, and even intravenous steroids are available, with varying levels of efficacy.
Topics: Adrenal Cortex Hormones; Alopecia Areata; Biological Products; Child; Child, Preschool; Humans; Steroids
PubMed: 32675094
DOI: No ID Found -
Acta Dermato-venereologica Aug 2023Alopecia areata is an autoimmune disorder characterized by hair loss, for which there are few treatment options. This claims-based study characterized recent real-world...
Alopecia areata is an autoimmune disorder characterized by hair loss, for which there are few treatment options. This claims-based study characterized recent real-world treatment patterns among patients in the USA with alopecia areata, including the subtypes alopecia totalis and alopecia universalis, in the first year after diagnosis of an episode of alopecia areata. Approximately 5% of all patients (adults (age ≥ 18 years), n = 7,703; adolescents (age 12-17 years), n = 595) had alopecia totalis or alopecia universalis. Corticosteroids were the most common first-line (1L) and second-line (2L) treatments. The mean time from diagnosis of alopecia areata to initiation of 1L treatment was 2.2 days for adults and 2.6 days for adolescents; mean 1L duration was 76.9 and 64.3 days, respectively. For adults (57.5%) and adolescents (59.7%) with 2L therapy, the mean time from 1L discontinuation to 2L initiation was 57.2 and 53.6 days, respectively; the mean duration of 2L treatment was 55.5 and 50.1 days, respectively. More patients with vs without alopecia totalis or alopecia universalis initiated 2L therapy (adults: 71.9% vs 56.8%; adolescents: 71.4% vs 58.9%). The proportion of days covered during the first year post-diagnosis was 36.7% (adults) and 34.1% (adolescents). These results highlight the substantial disease burden of alopecia areata and a need for more effective treatments.
Topics: Adolescent; Adult; Humans; United States; Child; Alopecia Areata; Insurance Claim Review; Retrospective Studies
PubMed: 37622204
DOI: 10.2340/actadv.v103.12445 -
Paediatric Drugs Oct 2017Pediatric alopecia areata is a spectrum of autoimmune non-scarring alopecia in which some patients lose small patches of hair from their scalp but others lose more or... (Review)
Review
Pediatric alopecia areata is a spectrum of autoimmune non-scarring alopecia in which some patients lose small patches of hair from their scalp but others lose more or all of the hair from the scalp and body, including eyebrows and eyelashes. Few studies have looked at therapies for this disorder in children, so much of the data are derived from adult literature and describe off-label use of medication. Generally, topical therapies consisting of topical steroids and topical irritating compounds/contact sensitizers are used. Systemic therapies that block the immune system, including Janus kinase (JAK) inhibitors, have also been used in this disease. This paper reviews the data on therapy for alopecia areata in pediatric patients.
Topics: Adrenal Cortex Hormones; Alopecia Areata; Child; Drug Administration Routes; Humans; Off-Label Use
PubMed: 28551734
DOI: 10.1007/s40272-017-0239-z -
Frontiers in Immunology 2023Cytotoxic T lymphocyte has been a concern for the etiopathogenesis of alopecia areata (AA), some recent evidence suggests that the regulatory T (T) cell deficiency is... (Review)
Review
Cytotoxic T lymphocyte has been a concern for the etiopathogenesis of alopecia areata (AA), some recent evidence suggests that the regulatory T (T) cell deficiency is also a contributing factor. In the lesional scalp of AA, T cells residing in the follicles are impaired, leading to dysregulated local immunity and hair follicle (HF) regeneration disorders. New strategies are emerging to modulate T cells' number and function for autoimmune diseases. There is much interest to boost T cells in AA patients to suppress the abnormal autoimmunity of HF and stimulate hair regeneration. With few satisfactory therapeutic regimens available for AA, T cell-based therapies could be the way forward. Specifically, CAR-T cells and novel formulations of low-dose IL-2 are the alternatives.
Topics: Humans; Alopecia Areata; T-Lymphocytes, Regulatory; Autoimmune Diseases; Autoimmunity
PubMed: 37205097
DOI: 10.3389/fimmu.2023.1111547