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Journal of the American Academy of... Nov 2018
Comparative Study
Topics: Adolescent; Alopecia; Alopecia Areata; Child; Cohort Studies; Databases, Factual; Disease Progression; Female; Hospitals, Pediatric; Hospitals, University; Humans; Male; Philadelphia; Prevalence; Prognosis; Retrospective Studies; Seasons; Severity of Illness Index
PubMed: 30318138
DOI: 10.1016/j.jaad.2018.06.029 -
JAAD International Dec 2023
PubMed: 37711340
DOI: 10.1016/j.jdin.2023.06.016 -
Journal of Drugs in Dermatology : JDD Apr 2023Alopecia Areata (AA) is an autoimmune process that results in varying degrees of hair loss. Currently, there is no single treatment that has proven to be efficacious in...
Alopecia Areata (AA) is an autoimmune process that results in varying degrees of hair loss. Currently, there is no single treatment that has proven to be efficacious in a large cohort of patients. Dupilumab, a human monoclonal antibody recently approved for the treatment of atopic dermatitis, may be a potential treatment option for patients with treatment resistant AA. J Drugs Dermatol. 2023;22(4): doi:10.36849/JDD.6254 Citation: Bur D, Kim K, Rogge M. Dupilumab induced hair regrowth in alopecia totalis. J Drugs Dermatol. 2023;22(4):410-412. doi:10.36849/JDD.6254.
Topics: Humans; Alopecia Areata; Hair; Antibodies, Monoclonal, Humanized; Alopecia
PubMed: 37026876
DOI: 10.36849/JDD.6254 -
JAMA Dermatology Jul 2023Alopecia areata (AA) is associated with diverse autoimmune and psychiatric disorders. However, an investigation on the long-term outcomes for offspring born to mothers...
IMPORTANCE
Alopecia areata (AA) is associated with diverse autoimmune and psychiatric disorders. However, an investigation on the long-term outcomes for offspring born to mothers diagnosed with AA is lacking.
OBJECTIVE
To investigate the risks for autoimmune, inflammatory, atopic, thyroid, and psychiatric outcomes of offspring born to mothers with AA.
DESIGN, SETTING, AND PARTICIPANTS
This retrospective population-based birth cohort study used the linked birth registration database with the Nationwide Health Insurance Service database of Korea. The participants included all newborns born to mothers with 3 or more visits with International Classification of Diseases, Tenth Revision code of L63 and 1:10 birth year, sex, insurance, income, and location of residence-matched control offspring born to mothers without AA during the years from 2003 to 2015. The analysis was conducted from July 2022 to January 2023.
EXPOSURE
Maternal AA.
MAIN OUTCOMES AND MEASURES
The occurrence of the following diseases was measured in newborns from birth to December 31, 2020: AA, alopecia totalis/universalis (AT/AU), vitiligo, psoriasis, inflammatory bowel disease, rheumatoid arthritis, atopic dermatitis, allergic rhinitis, asthma, hyperthyroidism, hypothyroidism, Graves disease, Hashimoto thyroiditis, attention-deficit hyperactivity disorder, mood disorder, and anxiety disorder. Multivariable Cox proportional hazard analyses were performed with the following covariates: birth year, age, insurance type, income level, location of residence, maternal age, mode of delivery, maternal history of atopic disorders, and autoimmune disorders.
RESULTS
In total, 67 364 offspring born to 46 352 mothers with AA and 673 640 controls born to 454 085 unaffected mothers were analyzed. The risk of AA (adjusted hazard ratio [aHR], 2.08; 95% CI, 1.88-2.30), AT/AU (aHR, 1.57; 95% CI, 1.18-2.08), vitiligo (aHR, 1.47; 95% CI, 1.32-1.63), atopic disorders (aHR, 1.07; 95% CI, 1.06-1.09), hypothyroidism (aHR, 1.14; 95% CI, 1.03-1.25), and psychiatric disorders (aHR, 1.15; 95% CI, 1.11-1.20) was significantly increased in offspring born to mothers with AA. Among them, 5088 born to mothers with AT/AU were at much greater risk for the development of AT/AU (aHR, 2.98; 95% CI, 1.48-6.00) and psychiatric disorders (aHR, 1.27; 95% CI, 1.12-1.44).
CONCLUSIONS AND RELEVANCE
In this Korean retrospective population-based birth cohort study, maternal AA was associated with the development of autoimmune/inflammatory, atopic, thyroid, and psychiatric disorders in their offspring. Clinicians and parents need to be aware of the potential for these comorbidities to occur.
Topics: Female; Humans; Infant, Newborn; Alopecia Areata; Mothers; Retrospective Studies; Cohort Studies; Vitiligo; Hypothyroidism
PubMed: 37223925
DOI: 10.1001/jamadermatol.2023.1261 -
Dermatology Reports Jun 2022Dupilumab is an interleukin-4 receptor alpha antagonist that showed significant improvement of atopic dermatitis (AD). Many reports have shown significant resolution of...
Dupilumab is an interleukin-4 receptor alpha antagonist that showed significant improvement of atopic dermatitis (AD). Many reports have shown significant resolution of alopecia areata, alopecia universalis and alopecia totalis after dupilumab treatment for AD. We present one of reported cases that showed improvement of underlying alopecia universalis treated with dupilumab.
PubMed: 35795833
DOI: 10.4081/dr.2022.9359 -
The Journal of Dermatology Oct 2023Alopecia totalis (AT) and alopecia universalis (AU) is known to have a poor prognosis with high relapse rate, and treatment failure is observed in most patients,...
Alopecia totalis (AT) and alopecia universalis (AU) is known to have a poor prognosis with high relapse rate, and treatment failure is observed in most patients, regardless of the type of therapy. Although treatment and the prognosis of AT and AU have improved in recent years, old data are routinely cited in recent review papers without questioning them. The authors aimed to study the clinical characteristics and prognosis of AT and AU to update and compare the results with those of previously reported studies. The authors retrospectively reviewed patients diagnosed with AT and AU from 2006 to 2017 in a single institution. Of the 419 patients, the mean age at first episode was 22.9 years, and 24.6% had early onset (≤13 years). During follow-up, 53.9% had more than 50% hair growth, and 19.6% of patients showed >90% hair growth. Among patients who showed >50% improvement, 36.7% had no recurrence. In early studies conducted in the 1950s and 1960s, the chance of full hair regrowth was reported to be <10%. In our study, patients with >90% improvement in AT and AU accounted for 19.6% of patients. The authors provide an update on data regarding the prognoses of AT and AU.
Topics: Humans; Retrospective Studies; Alopecia Areata; Alopecia; Prognosis; Hair
PubMed: 37208851
DOI: 10.1111/1346-8138.16840 -
International Journal of Trichology 2023Alopecia totalis (AT) and Alopecia universalis (AU) are forms of Alopecia areata (AA) which represent the strongest predictor of poor prognosis since spontaneous...
INTRODUCTION
Alopecia totalis (AT) and Alopecia universalis (AU) are forms of Alopecia areata (AA) which represent the strongest predictor of poor prognosis since spontaneous regrowth is <10%. Topical immunotherapy agent, diphenylcyclopropenone (DPCP) has shown clinical efficacy with limited side effects in severe forms of AA. However, its specific role in AT/AU characterized by complete hair loss over the scalp can help highlight the efficacy of the drug with fewer confounders.
METHODOLOGY
Data were collected from 18 patients diagnosed with AT/AU and treated with topical immunotherapy with DPCP as per protocol by Happle . Baseline Severity of Alopecia Tool (SALT) score and subclass was recorded. In the case of AU, baseline body hair loss score was also recorded. Patients were reassessed after 6 months of treatment in terms of change in SALT score and hair regrowth was assessed using the Global Assessment Score. The side effects during treatment were also assessed and recorded.
RESULTS
Eighteen patients of whom eleven (61.1%) were diagnosed as AU and seven (38.9%) as AT were treated. The mean age was 21.6, with a male: female ratio of 3:2. The comorbidities noted were atopy in six (33.3%), atopy and hypothyroidism in one (5.5%), Down's syndrome in two (11.1%), and hypothyroidism alone in one (5.5%) patient. The mean duration of disease at the time of presentation was 3 years and all patients had remained refractory to various other modalities of treatment. All patients had a baseline SALT score of 100 corresponding to S5. After 6 months of treatment, 27.7% of patients did not show any response (SALT score S5), 16.6% had a score of S4, 11.1% had a score of S3, 11.1% had a score of S2, 22.2% had a score of S1, and 11.1% had a score of S0. On assessing improvement in body hair loss score, 36.3% of patients showed no improvement, 36.3% showed partial improvement, and 27.2% of patients showed complete body hair regrowth. About 55.5% of patients developed notable side effects that included severe local reactions, cervical lymphadenopathy, acne and pigmentation at the site of application as well as untreated sites.
CONCLUSION
The AT/AU subtypes of AA, was amenable to treatment with contact immunotherapeutic agent DPCP with a >75% hair regrowth in 33.3% of patients. The castling phenomenon was seen in 63.6% of AU patients. The adverse effects noted were not severe enough to deter treatment.
PubMed: 38765726
DOI: 10.4103/ijt.ijt_2_22 -
Experimental Dermatology Jul 2023Atopy may be a facilitating factor in some alopecia areata (AA) patients with early disease onset and more severe/extensive AA. The underlying immune mechanisms are...
Atopy may be a facilitating factor in some alopecia areata (AA) patients with early disease onset and more severe/extensive AA. The underlying immune mechanisms are unknown, but allergen responses may support a pro-inflammatory environment that indirectly promotes AA. To investigate the long-term effect of allergen immunotherapy (AIT) against house dust mite (HDM) allergy on disease severity and prognosis for AA patients. An observational comparative effectiveness study was conducted on 69 AA patients with HDM allergy. 34 patients received conventional/traditional AA treatment (TrAA) plus AIT (AIT-TrAA), and 35 patients received TrAA alone. Serum total immunoglobulin E (tIgE), HDM specific IgE (sIgE), HDM specific IgG4 (sIgG4) and cytokines (IL-4, IL-5, IL-10, IL-12, IL-13, IL-33, IFNγ) were quantified in these patients, together with 58 non-allergic AA patients and 40 healthy controls. At the end of the 3-year desensitization course, the AIT-TrAA group presented with lower SALT scores than the TrAA group, especially in non-alopecia totalis/universalis (AT/U) patients and pre-adolescent AT/U patients (age ≤ 14). In patients with elevated tIgE levels before AIT, a decrease in tIgE was correlated to reduced extent of AA on completion of the AIT course. After desensitization, elevation of IL-5 and decrease of IL-33 were observed in HDM allergic-AA patients. Desensitization to HDM in allergic AA patients reduces the severity of relapse-related hair loss over the 3-year AIT treatment course, possibly via opposing Th2 dominance. This adjunctive treatment may help reduce disease severity and curtail the disease process in allergic patients with AA.
Topics: Animals; Adolescent; Humans; Allergens; Interleukin-33; Alopecia Areata; Interleukin-5; Antigens, Dermatophagoides; Hypersensitivity; Desensitization, Immunologic; Immunoglobulin E; Pyroglyphidae; Dust Mite Allergy; Dust
PubMed: 37114716
DOI: 10.1111/exd.14819 -
Skin Research and Technology : Official... Aug 2023
Topics: Humans; Azetidines; Purines; Pyrazoles; Alopecia
PubMed: 37632179
DOI: 10.1111/srt.13425 -
Northern Clinics of Istanbul 2022The aim of the study was to determine the clinical profile of the patients with alopecia areata (AA) and whether or not any differences between the AA patients with and...
OBJECTIVE
The aim of the study was to determine the clinical profile of the patients with alopecia areata (AA) and whether or not any differences between the AA patients with and without comorbidity.
METHODS
A total of 218 patients diagnosed with AA between January 1, 2016, and August 31, 2020, in our outpatient clinic were analyzed retrospectively.
RESULTS
The mean age was 27.8±12.3. 61.5% of the patients were male (M/F=1.59). There were AA in 96.3%, alopecia universalis in 3.2%, and alopecia totalis in 0.5% of the patients. Most of them showed unifocal involvement (85.8%) and multifocal involvement to a smaller extent (10.5%). Number of patches was 1 in 75.2%, 2 in 16.7% and 3 or more in 8.1% of AA patients. Average disease duration was 18.1 months. Comorbid diseases were accompanying to 51.8% of the patients. Dermatological diseases were among the most common accompanying diseases (17.9%). However, hypothyroidism (12.8%) was the most frequent comorbid disease. There were thyroidal diseases in 15.1%, allergic disorders in 7.7%, psychiatric disorders in 7.3%, anemia in 5.9%, rheumatic diseases in 2.2%, other endocrine diseases in 1.8%, malignancy in 1.3%, and morbid obesity in 1.3% of the patients. Down syndrome accompanied in 0.9%. Vitamin-D deficiency (38.9%), low ferritin (13.8%), and B12 deficiency (9.6%) were also detected. Female gender (46.9 to 29.5%, p=0.008), extensive disease (p=0.085), Vitamin B12 deficiency (13.3 to 5.7%, p=0.059), and low ferritin level (20.4 to 6.7%, p=0.003) were observed more in patients with comorbidity than those without one.
CONCLUSION
AA accompanies various systemic, autoimmune, and psychiatric diseases. Dermatologists need to recognize potential comorbid diseases, evaluate and manage these patients with a multidisciplinary approach to achieve a better outcome.
PubMed: 36447582
DOI: 10.14744/nci.2022.78790