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Practical Neurology Feb 2023Thallium is a highly toxic tasteless, odourless and water-soluble metal that can be absorbed through the skin, inhaled or ingested. Due to the rarity of thallium...
Thallium is a highly toxic tasteless, odourless and water-soluble metal that can be absorbed through the skin, inhaled or ingested. Due to the rarity of thallium toxicity, it is frequently misdiagnosed or the diagnosis is delayed. We report a 41-year-old male landscaper admitted for acute polyneuropathy and abdominal pain. He was treated for suspected Guillain-Barré syndrome and later autoimmune encephalopathy. However, over the next 42 days, he developed worsening muscle weakness, delirium and alopecia, and was diagnosed with thallium toxicity. After combining Prussian blue, activated charcoal and continuous venovenous haemofiltration, he improved though with neuropsychiatric and neuromuscular sequelae. We highlight the need to manage information disclosure properly and to preserve evidence, when the source of a toxin is unclear.
Topics: Male; Humans; Adult; Thallium; Alopecia; Guillain-Barre Syndrome; Muscle Weakness; Disease Progression
PubMed: 36424143
DOI: 10.1136/pn-2022-003577 -
Journal of the American Academy of... Jan 2024Pressure-induced alopecias (PAs) are an infrequent group of scarring and nonscarring alopecias that occur after ischemic obstruction of capillaries that leads to... (Review)
Review
Pressure-induced alopecias (PAs) are an infrequent group of scarring and nonscarring alopecias that occur after ischemic obstruction of capillaries that leads to circumscribed areas of hair loss. Initially described after prolonged surgeries or immobilization, type 1 PA occurs after sustained external pressure to the skin, mainly the scalp prominences. Alopecia induced by cosmetic procedures, referred in this review as type 2 PA, is reported with increased frequency in literature and predominantly emerges from pressure exerted by the volume of injectables. It is important to differentiate type 2 PA from vascular occlusion-induced alopecia because they represent distinct entities. Clinically, PA may present with erythema, swelling, and tenderness; however, alopecia might be the sole manifestation. Crusts and ulceration are associated with a worse outcome and a higher risk of scarring alopecia. Prompt diagnosis is paramount to prevent complications. Trichoscopy, although considered nonspecific, may provide relevant clues for an accurate diagnosis. Hair regrows in most cases, but prognosis depends on ischemia severity and timely treatment with reperfusion therapies or mobilization. Treatment of hair loss is usually not necessary because the disease in most cases is self-limited and reversible. The role of topical minoxidil and corticosteroids remains unknown.
Topics: Humans; Cicatrix; Alopecia; Hair; Scalp; Skin
PubMed: 37454698
DOI: 10.1016/j.jaad.2023.07.009 -
Clinics in Dermatology 2021Frontal fibrosing alopecia (FFA) is a patterned primary cicatricial alopecia that was first described in 1994. Once rare, the incidence of FFA has increased... (Review)
Review
Frontal fibrosing alopecia (FFA) is a patterned primary cicatricial alopecia that was first described in 1994. Once rare, the incidence of FFA has increased dramatically, representing the current most common cause of cicatricial alopecia worldwide. FFA typically begins in postmenopausal women with symmetrical, progressive recession of the frontotemporal hairline together with bilateral loss of the eyebrows. FFA has a distinctive clinical phenotype, which remains a challenge. The histology is identical to lichen planopilaris (LPP), but only a small number of patients have coincidental LPP, usually of the scalp. The vast majority of patients have no evidence of lichen planus elsewhere, and the symmetry and patterned nature of the hair loss are unusual for LPP. Familial cases of FFA are reported, and gene associations have been identified in population studies; however, the pathophysiology remains controversial. Without treatment, FFA is slowly progressive, and although many treatments have been prescribed, the response is often disappointing. We review the pathogenesis, epidemiology, clinical features, histology, and treatment of FFA.
Topics: Alopecia; Cicatrix; Eyebrows; Female; Humans; Lichen Planus; Scalp
PubMed: 34272007
DOI: 10.1016/j.clindermatol.2020.10.007 -
Journal Der Deutschen Dermatologischen... Jan 2023Pediatric androgenetic alopecia is an underrecognized disorder. A clinical evaluation with trichoscopy should be made in children and adolescents with hair loss and/or... (Review)
Review
Pediatric androgenetic alopecia is an underrecognized disorder. A clinical evaluation with trichoscopy should be made in children and adolescents with hair loss and/or reduced hair density. Diagnosis is usually clinical, by observation of the hair loss pattern and performance of trichoscopy. In some cases, hyperandrogenism should be excluded. Although there is no approved therapy for androgenetic alopecia in pediatric age, topical minoxidil, oral minoxidil and topical finasteride may be very useful. Hair transplant may be an option for girls in selected cases. This article is a review of the current state of evidence concerning pediatric androgenetic alopecia.
Topics: Female; Adolescent; Humans; Child; Minoxidil; Treatment Outcome; Alopecia; Finasteride; Hair
PubMed: 36688435
DOI: 10.1111/ddg.14940 -
International Immunology Jul 2019The hair follicle (HF) is a complex mini-organ that constantly undergoes dynamic cycles of growth and regression throughout life. While proper progression of the hair... (Review)
Review
The hair follicle (HF) is a complex mini-organ that constantly undergoes dynamic cycles of growth and regression throughout life. While proper progression of the hair cycle requires homeostatic interplay between the HF and its immune microenvironment, specific parts of the HF, such as the bulge throughout the hair cycle and the bulb in the anagen phase, maintain relative immune privilege (IP). When this IP collapses, inflammatory infiltrates that aggregate around the bulge and bulb launch an immune attack on the HF, resulting in hair loss or alopecia. Alopecia areata (AA) and primary cicatricial alopecia (PCA) are two common forms of immune-mediated alopecias, and recent advancements in understanding their disease mechanisms have accelerated the discovery of novel treatments for immune-mediated alopecias, specifically AA. In this review, we highlight the pathomechanisms involved in both AA and CA in hopes that a deeper understanding of their underlying disease pathogenesis will encourage the development of more effective treatments that can target distinct disease pathways with greater specificity while minimizing adverse effects.
Topics: Alopecia; Animals; Hair Follicle; Humans
PubMed: 31050755
DOI: 10.1093/intimm/dxz039 -
Journal of Drugs in Dermatology : JDD Oct 2023Alopecia areata (AA), an autoimmune disorder of hair follicles, results in varying degrees of scalp, facial, and body hair loss. In addition, it is associated with... (Review)
Review
Alopecia areata (AA), an autoimmune disorder of hair follicles, results in varying degrees of scalp, facial, and body hair loss. In addition, it is associated with profound psychosocial and quality-of-life impairments, which can lead to anxiety and depression. The clinical course is unpredictable, with spontaneous remissions and relapses. There is no cure, and current treatments are limited by their efficacy, safety, and high relapse rates after discontinuation. This article reviews clinician and patient perspectives on AA, based on clinician and physician surveys, and discusses the unmet needs and gaps in care. J Drugs Dermatol. 2023;22(10 Suppl):s5-10.
Topics: Humans; Alopecia Areata; Alopecia; Hair Follicle; Autoimmune Diseases; Scalp; Recurrence
PubMed: 37801523
DOI: 10.36849/JDD.SF396143 -
The Nigerian Postgraduate Medical... Apr 2024This study reviewed the current knowledge on the epidemiology, pathophysiology, clinical presentations, diagnosis, treatment, quality-of-life assessment and recent... (Review)
Review
This study reviewed the current knowledge on the epidemiology, pathophysiology, clinical presentations, diagnosis, treatment, quality-of-life assessment and recent trends in androgenetic alopecia (AGA). Relevant articles on AGA from PubMed, Google Scholar, Medline and Scopus from 1950 to 2024 were obtained and scrutinized.. Key search words included each term like 'androgenetic alopecia', 'androgenic alopecia', 'pattern baldness' and 'pattern hair loss' AND each term like 'epidemiology', 'pathophysiology', 'genetics', 'hormones', 'micronutrient', 'stress and inflammation', 'growth factors', 'clinical features', 'staging', 'cardiovascular associations', 'diagnosis' and 'management' were used in the search. AGA is a non-scarring hair loss that is exemplified by a progressive decline of hair follicles, or non-functional or dead hair follicles in the scalp in a defined pattern. It is the most common hair loss, more common in men but can also present in younger age as premature AGA. Hormones, genetics, micronutrient deficiency, microinflammation and stress have been implicated, while psychosocial distress and cutaneous correlate of cardiovascular diseases have become sources of relentless research. AGA is a patterned hair loss that is more prevalent in Men. It results from the interactions between hormonal, genetic and other factors which determine the extent of hair loss and associated disorders (psychosocial and cardiovascular). As results of more research become available, the extent of AGA, its comorbidities as well as the full spectrum of their manifestations will continue to be sources of health education and more holistic examination by dermatologists and patients.
Topics: Humans; Alopecia; Quality of Life; Male; Female
PubMed: 38826011
DOI: 10.4103/npmj.npmj_47_24 -
FP Essentials Jun 2022Alopecia affects men and women and can result in significant distress for patients. Alopecias can be categorized as nonscarring or scarring. Nonscarring alopecias...
Alopecia affects men and women and can result in significant distress for patients. Alopecias can be categorized as nonscarring or scarring. Nonscarring alopecias include male and female pattern alopecias, alopecia areata, telogen effluvium, traction alopecia, trichotillomania, and tinea capitis. Scarring alopecias include central centrifugal cicatricial alopecia, lichen planopilaris, frontal fibrosing alopecia, discoid lupus erythematosus, dissecting cellulitis of the scalp, folliculitis decalvans, and acne keloidalis nuchae. Evaluation of patients with alopecia involves assessment of the duration and distribution of hair loss, associated scalp symptoms, and associated conditions. Clinical examination of the hair and scalp may include a hair pull test, tug test, hair mount (ie, trichogram), dermoscopy, laboratory tests, and/or scalp biopsy, depending on the suspected etiology. Hair regrowth cannot occur in established lesions of scarring alopecia, so early identification and prompt initiation of treatment are critical in these cases. Patients with suspected or confirmed alopecias, alopecia areata, or alopecias refractory to treatment may benefit from referral to a dermatologist.
Topics: Alopecia Areata; Cicatrix; Female; Hair; Humans; Lichen Planus; Male
PubMed: 35679467
DOI: No ID Found -
The Medical Clinics of North America Jul 2021Alopecia is a dermatologic condition in which sudden or gradual loss of hair occurs on 1 or more areas of the body, most commonly the scalp. Hair loss can be acute or... (Review)
Review
Alopecia is a dermatologic condition in which sudden or gradual loss of hair occurs on 1 or more areas of the body, most commonly the scalp. Hair loss can be acute or chronic in nature as a result of underlying inflammation, autoimmune processes, stressors, chemotherapy, or hairstyling practices. Alopecia can have substantial psychological consequences, having a negative impact on the quality of life in affected patients. The ability to both recognize and distinguish these condition holds great significance not only in providing adequate and timely treatment to improve outcomes but also meeting patient needs.
Topics: Adolescent; Adult; Alopecia; Child; Cicatrix; Female; Humans; Male; Middle Aged; Prevalence; Quality of Life; Severity of Illness Index; United States; Young Adult
PubMed: 34059240
DOI: 10.1016/j.mcna.2021.04.002 -
Dermatologic Surgery : Official... Aug 2022Cosmetic procedures for antiaging carry inherent risks of adverse events. One that has not yet been well characterized is transitory or permanent alopecia. This is... (Review)
Review
BACKGROUND
Cosmetic procedures for antiaging carry inherent risks of adverse events. One that has not yet been well characterized is transitory or permanent alopecia. This is attributable to numerous mechanisms including pressure, ischemia, inflammation, and necrosis. Cases of postcosmetic procedure alopecia have been reported after mesotherapy as well as hyaluronic acid filler, deoxycholic acid, and botulinum toxin injections.
OBJECTIVE
This review serves to describe the currently known causes of postcosmetic procedure alopecia and the mechanisms by which alopecia is attained. Furthermore, this review highlights the risk of unregulated mesotherapy injections for cosmetic enhancement and to bring attention to the increasing number reports of alopecia after these procedures.
METHODS
A systematic review of the literature from 2000 to 2022 was conducted looking for keywords such as "alopecia," "cosmetic procedures," "mesotherapy," and "hyaluronic acid" in Google Scholar and PubMed.
RESULTS
Ten articles met the criteria set forth in the authors' literature review. Many of the procedures resulted in partial or complete resolution of alopecia.
CONCLUSION
Alopecia after cosmetic injection procedures is an underreported adverse effect. More research is needed to further characterize the risk of alopecia after mesotherapy and other injection procedures.
Topics: Alopecia; Cosmetic Techniques; Humans; Hyaluronic Acid; Mesotherapy
PubMed: 35642921
DOI: 10.1097/DSS.0000000000003498