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European Journal of Medicinal Chemistry Jan 2024Androgenetic alopecia (AGA) has become a widespread problem that leads to considerable impairment of the psyche and daily life. The currently approved medications for... (Review)
Review
Androgenetic alopecia (AGA) has become a widespread problem that leads to considerable impairment of the psyche and daily life. The currently approved medications for the treatment of AGA are associated with significant adverse effects, high costs, and prolonged treatment duration. Therefore, natural products are being considered as possible complementary or alternative treatments. This review aims to enhance comprehension of the mechanisms by which natural products treat AGA. To achieve this, pertinent studies were gathered and subjected to analysis. In addition, the therapeutic mechanisms associated with these natural products were organized and summarized. These include the direct modulation of signaling pathways such as the Wnt/β-catenin pathway, the PI3K/AKT pathway, and the BMP pathway. Additionally, they exert effects on cytokine secretion, anti-inflammatory, and antioxidant capabilities, as well as apoptosis and autophagy. Furthermore, the review briefly discusses the relationship between signaling pathways and autophagy and apoptosis in the context of AGA, systematically presents the mechanisms of action of existing natural products, and analyzes the potential therapeutic targets based on the active components of these products. The aim is to provide a theoretical basis for the development of pharmaceuticals, nutraceuticals, or dietary supplements.
Topics: Humans; Phosphatidylinositol 3-Kinases; Alopecia; Wnt Signaling Pathway; Gene Expression
PubMed: 38086191
DOI: 10.1016/j.ejmech.2023.116022 -
Veterinary Dermatology Dec 2021The hair follicle is a complete mini-organ with a complex biology. Recent discoveries have shed light on the pathogenesis and genetic basis of a number of hair loss... (Review)
Review
BACKGROUND
The hair follicle is a complete mini-organ with a complex biology. Recent discoveries have shed light on the pathogenesis and genetic basis of a number of hair loss conditions, offering novel treatment alternatives.
OBJECTIVE
To explore the biology and physiology of hair growth, the pathomechanism behind alopecias and emerging therapies.
CONCLUSION AND CLINICAL IMPORTANCE
Hair growth is influenced by numerous physiological moderators. Greater understanding of the biology and physiology of the hair follicle and the pathomechanisms of hair disease facilitates development of targeted treatments. Sublingual minoxidil is a promising therapy in humans where optimised drug delivery enhances efficacy and reduces systemic adverse effects. Janice kinase inhibitors, which disrupt the inflammatory cascade, help maintain the hair follicle, preserve immune privilege, and regrow hair in alopecia areata. As the pathomechanisms of other forms of alopecia become better understood, new targeted therapies with greater efficacy will emerge.
Topics: Alopecia; Alopecia Areata; Animals; Biology; Hair; Hair Follicle; Humans
PubMed: 34431565
DOI: 10.1111/vde.13014 -
Acta Dermatovenerologica Alpina,... Dec 2021Cicatricial alopecia (CA) results from irreversible destruction and fibrosis of hair follicles. Trichoscopy offers a noninvasive method for diagnosis.
INTRODUCTION
Cicatricial alopecia (CA) results from irreversible destruction and fibrosis of hair follicles. Trichoscopy offers a noninvasive method for diagnosis.
METHODS
Thirty-two patients clinically diagnosed with CA were subjected to trichoscopy and histopathology assessment. The sensitivity and specificity of clinical and trichoscopic diagnoses were compared to histopathology.
RESULTS
Thirty-two patients were clinically diagnosed as follows: 12 with discoid lupus erythematosus, four with lichen planopilaris (LPP), two with frontal fibrosing alopecia (FFA), three with folliculitis decalvans (FD), nine with central cicatricial centrifugal alopecia (CCCA), and two with long-term alopecia areata. Trichocopy revealed discoid lupus in 13 patients, LPP in nine, FFA in two, FD in three, central centrifugal alopecia in four, and pseudopelade in one. Histopathology confirmed discoid lupus in 13 patients, LPP in five, FFA in two, FD in three, CCCA in six, pseudopelade in two, and sarcoidosis in one. The sensitivity and specificity of clinical diagnosis were 69.2% and 84.2% in discoid lupus, 40.0% and 92.6% in LPP, 100.0% and 100.0% in FFA, 66.7% and 96.6% in FD, and 66.7% and 80.8% in central centrifugal alopecia. The sensitivity and specificity of trichoscopy were 84.6% and 89.5% in discoid lupus, 100.0% and 85.2% in LPP, 100.0% and 100.0% in FFA and FD, 66.7% and 100.0% in central centrifugal alopecia, and 50.0% and 100.0% in pseudopelade.
CONCLUSIONS
Trichoscopy can be equivalent to histopathology for diagnosing some cases of CA.
Topics: Alopecia; Humans
PubMed: 34929988
DOI: No ID Found -
Dermatologic Clinics Jul 2021This article focuses on the assessment and treatment of patients with primary cicatricial alopecia and provides new information regarding the genetics and... (Review)
Review
This article focuses on the assessment and treatment of patients with primary cicatricial alopecia and provides new information regarding the genetics and pathophysiology of this group of diseases.
Topics: Alopecia; Cicatrix; Humans
PubMed: 34053592
DOI: 10.1016/j.det.2021.05.001 -
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 -
Journal of the European Academy of... Apr 2020Alopecia totalis (AT) and universalis (AU) represent the most severe subtypes of alopecia areata with more dramatic features and worse prognosis. The goal of this review... (Review)
Review
Alopecia totalis (AT) and universalis (AU) represent the most severe subtypes of alopecia areata with more dramatic features and worse prognosis. The goal of this review is to identify all studies with long-term prognostic data on patients with AT and AU and provide a long-term outcome estimate. The PubMed database was queried to identify all articles discussing the long-term prognosis of AT and AU. A total of nine articles discussing long-term recovery rates of AT and AU were identified. The articles described 689 (162 = AT, 245 = AU, 282 = not specified) total patients. Six of the nine studies identified complete recovery as a potential end point in a total of 375 (39 = AT, 75 = AU, 261 = not specified) patients. According to these studies 8.5% (32/375) of AT and AU patients achieved complete recovery. A larger proportion of patients will obtain at least transient recovery periods of partial or total hair regrowth. The poor long-term outcomes of AT and AU may cause patients to lose hope with treatment. Response to treatment is often unpredictable, and physicians should be aware of the prognosis and its effects in order to properly counsel patients.
Topics: Alopecia; Hair; Humans; Prognosis
PubMed: 31593606
DOI: 10.1111/jdv.15994 -
Journal of the American Academy of... Jun 2024There is no established standard of care for treating central centrifugal cicatricial alopecia (CCCA), and treatment approaches vary widely.
BACKGROUND
There is no established standard of care for treating central centrifugal cicatricial alopecia (CCCA), and treatment approaches vary widely.
OBJECTIVE
To develop consensus statements regarding the use of various pharmacological therapies in treating adults with CCCA.
METHODS
We invited 27 dermatologists with expertise in hair and scalp disorders to participate in a 3-round modified Delphi study between January and March 2023. Statements met strong consensus if 75% of respondents agreed or disagreed. Statements met moderate consensus if 55% or more but less than 75% agreed or disagreed.
RESULTS
In round 1, 5 of 33 (15.2%) statements met strong consensus, followed by 9 of 28 (32.1%) in round 2. After the final round 3 meeting, strong consensus was reached for 20 of 70 (28.6%) overall statements. Two statements achieved moderate consensus.
LIMITATIONS
This study included only English-speaking, US-based dermatologists and did not consider nonpharmacological therapies.
CONCLUSION
Despite varying opinions among dermatologists, consensus was reached for several statements to help clinicians manage CCCA. We also highlight areas that lack expert consensus with the goal of advancing research and therapeutic options for CCCA.
Topics: Humans; Alopecia; Delphi Technique; Consensus; Cicatrix; Dermatologists
PubMed: 38341148
DOI: 10.1016/j.jaad.2023.12.073 -
Biomedicine & Pharmacotherapy =... Jan 2023We reviewed and summarized the latest reports on the characteristics of stem cells and follicular cells that are under development for hair loss treatment. Compared with... (Review)
Review
We reviewed and summarized the latest reports on the characteristics of stem cells and follicular cells that are under development for hair loss treatment. Compared with conventional medicine, cell therapy could be effective in the long term with a single treatment while having mild adverse effects. Adipose-derived stem cells (ASCs) have the advantages of easy access and large isolation amount compared with dermal papilla cells (DPCs) and dermal sheath cup cells (DSCs), and promote hair growth through the paracrine effect. ASCs have a poor potential in hair neogenesis, therefore, methods to enhance trichogenecity of ASCs should be developed. DSCs can be isolated from the peribulbar dermal sheath cup, while having immune tolerance, and hair inductivity. Therefore, DSCs were first developed and finished the phase II clinical trial; however, the hair growth was not satisfactory. Considering that a single injection of DSCs is effective for at least 9 months in the clinical setting, they can be an alternative therapy for hair regeneration. Though DPCs are not yet studied in clinical trials, we should pay attention to DPCs, as hair loss is associated with gradual reduction of DPCs and DP cell numbers fluctuate over the hair cycle. DPCs could make new hair follicles with epidermal cells, and have an immunomodulatory function to enable allogeneic transplantation. In addition, we can expand large quantities of DPCs with hair inductivity using spheroid culture, hypoxia condition, and growth factor supplement. 'Off-the-shelf' DPC therapy could be effective and economical, and therefore promising for hair regeneration.
Topics: Humans; Cells, Cultured; Hair; Hair Follicle; Cell- and Tissue-Based Therapy; Alopecia
PubMed: 36370520
DOI: 10.1016/j.biopha.2022.113988 -
Der Hautarzt; Zeitschrift Fur... May 2022Microsurgical autologous hair transplantation, when performed as follicular unit transplantation, may permanently and naturally improve advanced androgenetic alopecia in... (Review)
Review
BACKGROUND AND OBJECTIVES
Microsurgical autologous hair transplantation, when performed as follicular unit transplantation, may permanently and naturally improve advanced androgenetic alopecia in men and women and also non-active scarring alopecias.
MATERIALS, METHODS AND RESULTS
Sufficient donor hair and realistic patient expectations as well as an individual surgical planning of the hair distribution are crucial prerequisites for a sustainable hair restoration. They should be determined and evaluated during a personal pre-examination and consultation with the hair surgeon. Natural results can be achieved by transplanting up to several thousands of follicular units with high densities into small micro-slits. This technique also allows for increasing the hair density without injuring surrounding original pre-existing hairs. In progressive, early or advanced androgenetic alopecia, additional medical therapy is highly recommended to stabilize the condition. Otherwise, depending on supply and demand of donor hair, only a partial hair restoration can be achieved with a satisfying density.
CONCLUSIONS
Since hair transplantation requires a precise sequence of surgical steps and careful handling of the tiny grafts, the skills and experience of the hair surgeon and his or her team are crucial. The medical risks of an assembly-line way of performing this surgery by non-licensed, non-physician staff, as reported from national clinics and medical tourism, should not be underestimated. The German Association of Hair Surgeons and the International Society of Hair Restoration Surgery offer patient information, as well as continuous medical education and guidelines for interested physicians to ensure the highest quality standard of care.
Topics: Alopecia; Female; Hair; Hair Follicle; Humans; Male; Skin Transplantation; Surgeons
PubMed: 35428954
DOI: 10.1007/s00105-022-04985-8 -
The Journal of Investigative Dermatology Sep 2023Because hair follicles (HFs) are highly sensitive to ionizing radiation, radiotherapy-induced alopecia (RIA) is a core adverse effect of oncological radiotherapy. Yet,... (Review)
Review
Because hair follicles (HFs) are highly sensitive to ionizing radiation, radiotherapy-induced alopecia (RIA) is a core adverse effect of oncological radiotherapy. Yet, effective RIA-preventive therapy is unavailable because the underlying pathobiology remains underinvestigated. Aiming to revitalize interest in pathomechanism-tailored RIA management, we describe the clinical RIA spectrum (transient, persistent, progressive alopecia) and our current understanding of RIA pathobiology as an excellent model for studying principles of human organ and stem cell repair, regeneration, and loss. We explain that HFs respond to radiotherapy through two distinct pathways (dystrophic anagen or catagen) and why this makes RIA management so challenging. We discuss the responses of different HF cell populations and extrafollicular cells to radiation, their roles in HF repair and regeneration, and how they might contribute to HF miniaturization or even loss in persistent RIA. Finally, we highlight the potential of targeting p53-, Wnt-, mTOR-, prostaglandin E-, FGF7-, peroxisome proliferator-activated receptor-γ-, and melatonin-associated pathways in future RIA management.
Topics: Humans; Hair Follicle; Alopecia; Drug-Related Side Effects and Adverse Reactions; Stem Cells
PubMed: 37294241
DOI: 10.1016/j.jid.2023.02.041