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The British Journal of Dermatology Feb 2024
Topics: Humans; Alopecia Areata; Comorbidity; Germany
PubMed: 38366836
DOI: 10.1093/bjd/ljae027 -
Journal of Drugs in Dermatology : JDD Aug 2023The current US Food and Drug Administration (FDA) indications for baricitinib include alopecia areata, rheumatoid arthritis, and COVID-19. However, increasing evidence... (Review)
Review
The current US Food and Drug Administration (FDA) indications for baricitinib include alopecia areata, rheumatoid arthritis, and COVID-19. However, increasing evidence indicates that baricitinib is effective in treating a variety of dermatological conditions. This review article comprehensively presents the available literature on this topic and will be of interest to practitioners in the field. These disorders may be broadly classified as connective tissue diseases, eczematous dermatoses, alopecias, vascular disorders, granulomatous diseases, neutrophilic dermatoses, vitiligo, psoriasis, lichenoid disorders, and other miscellaneous disorders. Shah A, Yumeen S, Qureshi A, et al. Off-label use of baricitinib in dermatology. J Drugs Dermatol. 2023;22(8):795-801. doi:10.36849/JDD.7360.
Topics: Humans; Dermatology; Off-Label Use; COVID-19; COVID-19 Drug Treatment; Psoriasis; Alopecia Areata
PubMed: 37556530
DOI: 10.36849/jdd.7360 -
Italian Journal of Dermatology and... Dec 2023Telogen effluvium (TE) is one of the most common presentations of diffuse non-cicatricial alopecia and is generally self-limited. Multiple causes are associated with TE...
Telogen effluvium (TE) is one of the most common presentations of diffuse non-cicatricial alopecia and is generally self-limited. Multiple causes are associated with TE onset and its maintenance, with stress being felt the most common factor. The multifactorial etiologies involved in TE makes it a complex disorder to diagnose and treat often placing this entity into a "waste basket" diagnosis. By critically assessing the available scientific literature we aimed to review the multifaceted aspects of TE. Our objectives were to review the pathogenesis with the role of stress (including Coronavirus 19-associated TE), as well as to describe the main clinical findings, its differential diagnosis and the current knowledge on TE treatments along with the future treatment's insights.
Topics: Humans; Alopecia Areata; Coronavirus; Coronavirus Infections; Diagnosis, Differential
PubMed: 38015483
DOI: 10.23736/S2784-8671.23.07579-5 -
Frontiers in Immunology 2023Although numerous observational studies have indicated a potential association between autoimmune diseases, such as rheumatoid arthritis (RA) and alopecia areata (AA),...
BACKGROUND
Although numerous observational studies have indicated a potential association between autoimmune diseases, such as rheumatoid arthritis (RA) and alopecia areata (AA), the research reports lack a clear causal relationship. In this study, our objective is to utilize the Mendelian randomization (MR) design to examine the potential causal association between RA and AA.
METHODS
To investigate the causal relationship between RA and AA, we utilized large-scale gene aggregation data from genome-wide association studies (GWAS), including RA (n=58,284) and AA (n=361,822) based on previous observational studies. In our analysis, we mainly employed the inverse variance-weighted (IVW) method of the random effects model, supplemented by the weighted median (WM) method and the MR Egger method.
RESULTS
The findings from the IVW methods revealed a significant association between genetically predicted RA and an increased likelihood of AA, as evidenced by an odds ratio of 1.21 (95%CI = 1.11-1.32; < 0.001. Both the WM method and MR-Egger regression consistently showed significant directional outcomes (Both < 0.05), indicating a robust association between RA and AA. Additionally, both the funnel plot and the MR-Egger intercepts provided evidence of the absence of directional pleiotropy, suggesting that the observed association is not influenced by other common genetic factors.
CONCLUSIONS
The results of the study suggest a possible link between genetically predicted RA and AA. This finding highlights the importance for individuals diagnosed with RA to remain vigilant and aware of the potential development of AA. Regular monitoring and early detection can be crucial in managing and addressing this potential complication.
Topics: Humans; Alopecia Areata; Genome-Wide Association Study; Mendelian Randomization Analysis; Arthritis, Rheumatoid
PubMed: 38022630
DOI: 10.3389/fimmu.2023.1269640 -
Dermatitis : Contact, Atopic,... 2024This systematic review and meta-analysis aimed to explore the association between atopic Dermatitis® (AD) and alopecia areata (AA). A comprehensive search was conducted... (Meta-Analysis)
Meta-Analysis Review
This systematic review and meta-analysis aimed to explore the association between atopic Dermatitis® (AD) and alopecia areata (AA). A comprehensive search was conducted in PubMed, Embase, Cochrane, and Web of Science from the inception of each database to November 10, 2022 for relevant studies. As there is a potential bilateral association between the 2 diseases, we assessed the prevalence/incidence of AA in patients with AD and the prevalence/incidence of AD in patients with AA. A total of 29 studies involving 11,233,448 participants were included in this analysis. AA was the exposure factor in 23 studies, AD in 7 studies, and both in 1 study. The meta-analysis revealed that the prevalence of AD was 11.2% (7.7%-15.1%) in patients with AA, and the prevalence of AA was 3.2% (95% confidence interval [CI]: 0.0%-11.5%) in patients with AD. The incidence of AD in AA patients was found to vary with age ( = 0.07). Based on 7 studies, there was a significant association between AD and AA when AA was the exposure factor [odds ratio, OR, = 4.537 (95% CI: 2.409-8.544)]; based on 10 studies, there was also a significant association between AD and AA when AD was the exposure factor [OR = 2.643 (95% CI: 1.737-3.995)]. In conclusion, this meta-analysis demonstrated the 2-way association between AD and AA, providing a clinical reference for disease prevention and control.
Topics: Alopecia Areata; Humans; Dermatitis, Atopic; Prevalence; Incidence
PubMed: 37471232
DOI: 10.1089/derm.2023.0114 -
Journal of Cosmetic Dermatology May 2024Alopecia areata (AA) is a recurrent immune-mediated disorder causing hair loss without any scarring being present. It affects hairs on the head or other parts of the... (Review)
Review
BACKGROUND
Alopecia areata (AA) is a recurrent immune-mediated disorder causing hair loss without any scarring being present. It affects hairs on the head or other parts of the body and can occur at any age and in both genders. It seems that AA is associated with a higher rate of psychological disorders resulting from hair loss and the esthetic and social repercussions of it. Common treatments like corticosteroids do not work for every patient and recent treatment options focusing on the immunologic mechanisms like tofacitinib have shown some promising results.
METHODS
It's a retrospective study on patients with AA, AT, AU taking oral tofacitinib as a treatment for at least 6 months. Scalp hair loss was assessed before treatment and at each visit using the Severity of Alopecia Tool (SALT) score.
RESULTS
Of 97 cases, 69.1% demonstrated over 50% SALT score improvement, with 44.3% having 90% or more decrease in SALT score. Patients who suffered from patchy AA were more responsive compared to patients with AT and AU subtypes and had a greater percent change in SALT score. Tofacitinib was tolerated quite well and no significant adverse events were reported.
CONCLUSIONS
Tofacitinib should be taken into consideration as an efficacious treatment option for patients with AA, AT and AU.
PubMed: 38736269
DOI: 10.1111/jocd.16356 -
Frontiers in Immunology 2023Alopecia areata (AA) is an autoimmune disease that has a complex underlying immunopathogenesis characterized by nonscarring hair loss ranging from small bald patches to... (Review)
Review
Alopecia areata (AA) is an autoimmune disease that has a complex underlying immunopathogenesis characterized by nonscarring hair loss ranging from small bald patches to complete loss of scalp, face, and/or body hair. Although the etiopathogenesis of AA has not yet been fully characterized, immune privilege collapse at the hair follicle (HF) followed by T-cell receptor recognition of exposed HF autoantigens by autoreactive cytotoxic CD8 T cells is now understood to play a central role. Few treatment options are available, with the Janus kinase (JAK) 1/2 inhibitor baricitinib (2022) and the selective JAK3/tyrosine kinase expressed in hepatocellular carcinoma (TEC) inhibitor ritlecitinib (2023) being the only US Food and Drug Administration-approved systemic medications thus far for severe AA. Several other treatments are used off-label with limited efficacy and/or suboptimal safety and tolerability. With an increased understanding of the T-cell-mediated autoimmune and inflammatory pathogenesis of AA, additional therapeutic pathways beyond JAK inhibition are currently under investigation for the development of AA therapies. This narrative review presents a detailed overview about the role of T cells and T-cell-signaling pathways in the pathogenesis of AA, with a focus on those pathways targeted by drugs in clinical development for the treatment of AA. A detailed summary of new drugs targeting these pathways with expert commentary on future directions for AA drug development and the importance of targeting multiple T-cell-signaling pathways is also provided in this review.
Topics: Humans; Alopecia Areata; CD8-Positive T-Lymphocytes; Autoimmune Diseases; Autoantigens; Janus Kinase Inhibitors
PubMed: 38022501
DOI: 10.3389/fimmu.2023.1243556 -
Journal of Clinical Medicine Jul 2023Facial 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... (Review)
Review
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.
PubMed: 37510908
DOI: 10.3390/jcm12144793 -
Journal of Cosmetic Dermatology Sep 2023Carboxytherapy is defined as intradermal and/or subcutaneous microinjections of sterile purified carbon dioxide into different parts of the body for therapeutic aims.... (Review)
Review
BACKGROUND
Carboxytherapy is defined as intradermal and/or subcutaneous microinjections of sterile purified carbon dioxide into different parts of the body for therapeutic aims. The vasodilatation effect and intradermal collagen reorganization associated with carboxytherapy have advantages for aesthetic dermatology and cosmetology.
OBJECTIVE
In the current article, we have reviewed some of the most important indications of this modality in dermatology and aesthetic dermatology.
METHOD
Our review is a narrative one which has gathered some of the most important indications of carboxytherapy in dermatology and cosmetology.
RESULTS
Carboxytherapy has successfully been applied for some dermatologic and cosmetic conditions among which skin aging, cellulite, localized fat deposits, striae distensae, infraorbital hyperpigmentation, scar, lymphedema, androgenetic alopecia, alopecia areata, psoriasis, morphea, and vitiligo are the most important.
CONCLUSION
Carboxytherapy can be considered as a safe, minimally-invasive modality used for rejuvenation, restoration, and recondition of the skin.
Topics: Humans; Dermatology; Skin; Striae Distensae; Carbon Dioxide; Alopecia Areata
PubMed: 36999460
DOI: 10.1111/jocd.15741 -
American Journal of Clinical Dermatology Jul 2023Baricitinib (Olumiant), a Janus kinase (JAK) inhibitor, is the first drug approved for the treatment of severe alopecia areata in the USA and the EU. Severe alopecia... (Review)
Review
Baricitinib (Olumiant), a Janus kinase (JAK) inhibitor, is the first drug approved for the treatment of severe alopecia areata in the USA and the EU. Severe alopecia areata is usually difficult to treat and relapse is common. Patients with this disorder are more likely to suffer from anxiety and depression. In two pivotal placebo-controlled phase 3 clinical trials in adults with severe alopecia areata, oral baricitinib once daily was associated with clinically meaningful scalp, eyebrow, and eyelash hair regrowth over 36 weeks. Baricitinib was generally well tolerated with the most common adverse events being infections, headaches, acne, and elevated levels of creatine phosphokinase. While longer-term data will be necessary to more fully understand the benefits and risks of the drug, currently available data suggest that baricitinib is a useful treatment for patients with severe alopecia areata.
Topics: Adult; Humans; Alopecia Areata; Azetidines; Janus Kinase Inhibitors; Pyrazoles; Clinical Trials, Phase III as Topic
PubMed: 37326792
DOI: 10.1007/s40257-023-00799-z