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Cutis May 1997Alopecia areata is a frequent and physiologically compelling form of hair loss. It is most common in children and young adults, but can affect people of any age.... (Review)
Review
Alopecia areata is a frequent and physiologically compelling form of hair loss. It is most common in children and young adults, but can affect people of any age. Although it is usually limited to patches on the scalp, it may involve the entire scalp and other hair-bearing regions of the body. It may be associated with autoimmune disorders, especially of the thyroid. Its effective treatment often poses a difficult challenge.
Topics: Adolescent; Adult; Alopecia Areata; Child; Child, Preschool; Diagnosis, Differential; Female; Humans; Male; Nails, Malformed; Thyroid Diseases
PubMed: 9169260
DOI: No ID Found -
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 -
Cutis Nov 1992
Review
Topics: Alopecia Areata; Diagnosis, Differential; Humans; Nail Diseases; Recurrence
PubMed: 1468254
DOI: No ID Found -
The Journal of Dermatology Oct 1999Although the results of some studies have proven negative, the influence of psychological factors in the development, evolution and therapeutic management of alopecia... (Review)
Review
Although the results of some studies have proven negative, the influence of psychological factors in the development, evolution and therapeutic management of alopecia areata is, in general, well documented. Life events and intrapsychically generated stress can play an important role in triggering of some episodes. The comorbidity of psychiatric disorders, mainly generalized anxiety disorder, depression, and phobic states, is high. The role of treatment of concomitant psychopathological disorders is a vital one. Indeed this treatment can positively affect how the patient adapts to his/her alopecia and social setting and perhaps can even lead to a better dermatological evolution of the alopecia. Therefore, controlled studies analyzing the possible links between psychiatric symptoms, treatment with antidepressants or benzodiacepines, evolution of alopecia, medium term prognosis, and immune function are necessary. Basic psychotherapeutic support may prove to be of use in many cases and can be carried out by the dermatologist, although a subgroup of patients may need psychopharmacological or psychotherapeutic specialized treatments. Studies using operative diagnostic criteria and structured interviews are still scarce. Therefore, it seems necessary to design studies using modern psychiatric methodology. Controlled clinical trials to test the efficiency of psychoactive drugs and psychotherapy in the disease are also needed. By studying in depth these and other related aspects, we may improve the clinical management of our patients.
Topics: Alopecia Areata; Animals; Comorbidity; Female; Humans; Life Change Events; Male; Mental Disorders; Prognosis; Rabbits; Stress, Psychological
PubMed: 10554427
DOI: 10.1111/j.1346-8138.1999.tb02063.x -
Harefuah Oct 2016Alopecia areata (AA) is an organ specific autoimmune disease. Similar to other autoimmune diseases, its pathogenesis is believed to be an interaction of genetic,... (Review)
Review
Alopecia areata (AA) is an organ specific autoimmune disease. Similar to other autoimmune diseases, its pathogenesis is believed to be an interaction of genetic, environmental and immune factors. Studies have shown that autoreactive lymphocytes affect anagen hair follicles leading to subsequent shedding of hairs and alopecia. Clinically, the disease is characterized by sudden nonscarring hair loss that usually involves the scalp, but may also affect the face and other body areas, and indeed the entire body hair. AA may appear for the first time at any age, affecting both children and adults, but it occurs primarily at a young age with a peak incidence in the second and third decade of life. The disease causes pronounced social and psychological impact. The main therapeutic approaches include immunosuppression through anti-inflammatory agents and immunomodulation based on skin sensitization.
Topics: Alopecia Areata; Autoimmune Diseases; Hair Follicle; Humans; Immunomodulation
PubMed: 28530053
DOI: No ID Found -
Journal of Cutaneous Medicine and... 2019Alopecia areata (AA) is a chronic, immune-mediated disorder that targets hair follicle epithelium, thereby restricting hair growth in localized patches. Although several... (Review)
Review
Alopecia areata (AA) is a chronic, immune-mediated disorder that targets hair follicle epithelium, thereby restricting hair growth in localized patches. Although several therapies for AA have been tested, responses with traditional therapies have been limited. In recent years, numerous reports have been published of patients with AA responding to Janus kinase (JAK) inhibitors. This literature review aims to describe AA pathophysiology, explore how and why JAK inhibitors can be used for AA treatment, and review published case reports, case series, and open-label studies published to date. Pathogenesis of AA includes interactions between genetic, environmental, and immune factors and is mediated by the cytokines interferon-γ and interleukin (IL)-15. JAK inhibition resulting in hair regrowth in some cases supports that AA is associated with the Janus kinase-signal transducer and activator of transcription (JAK-STAT) signaling pathway. The emergence of JAK inhibitors for AA therapy is changing the way health care providers think about and treat AA. A mixture of animal model studies and human case studies have reported the use of baricitinib (JAK 1/2), ruxolitinib (JAK 1/2), and tofacitinib (JAK 1/3) for the management of AA. JAK inhibition has shown potential as an effective AA therapy when used in case studies, case series, and open-label trials. Formal clinical trials are ongoing and will yield more definitive conclusions about the safety and efficacy of JAK inhibitors.
Topics: Alopecia Areata; Animals; Humans; Janus Kinase Inhibitors
PubMed: 30688081
DOI: 10.1177/1203475418824079 -
Annales de Dermatologie Et de... May 2002The management of patients with alopecia areata is obviously not restricted to the prescription of a treatment inducing hair growth. It requires thorough exploration... (Review)
Review
The management of patients with alopecia areata is obviously not restricted to the prescription of a treatment inducing hair growth. It requires thorough exploration (history of hair loss, treatments and concomitant pathologies), detailed clinical examination of the integument and palpation of the thyroid. The patient must, systematically, be given a simple explanation of his/her pathology, thus avoiding any feelings of mystery, hopelessness and guilt and hence paradoxically turning alopecia into "just another disease", even if flares are unpredictable and cannot always be treated. Innovations over the past few years have not met dermatologist's expectations: in particular immunosuppressors administered locally have not shown efficacy in human, as opposed to animal models of alopecia areata. Moreover, we must remain critical and rigorous with regard to "false" innovations: several recent publications are, methodologically, open to criticism. Older products provide clear descriptions of their indications and use, and relatively standardize the therapeutic approach to alopecia. Some of them lead to hair growth on the treated area: localized immuno-therapy that in certain cases induces hair growth where other treatments have failed. PUVA-therapy, however, because of frequent relapses on withdrawal and the characteristic recurrence of alopecia, rapidly leads to the use of high cumulative doses; balneo-PUVA therapy is effective with lower doses (PUVA-turban). Recently, UVB TL01 has shown efficacy in anecdotal studies. Local corticosteroids; notably injectable and anthralin, an old treatment which remains a useful therapeutic approach in alopecia areata plaques and in the ophiasic forms in children and adults. Finally, among the available treatment arms, systemic corticosteroids still have a place in recent extended forms: although still under experimentation, the bolus appears efficient during the primary episodes of alopecia areata, when administered within the first three months
Topics: Adolescent; Adrenal Cortex Hormones; Adult; Alopecia Areata; Child; Female; Humans; Immunosuppressive Agents; Male; PUVA Therapy; Patient Education as Topic
PubMed: 12223967
DOI: No ID Found -
North Carolina Medical Journal Sep 1991
Topics: Alopecia Areata; Humans
PubMed: 1922406
DOI: No ID Found -
Archives of General Psychiatry Nov 1967
Topics: Adult; Alopecia Areata; Female; Humans; Male; Psychophysiologic Disorders; Psychotherapy
PubMed: 6054255
DOI: 10.1001/archpsyc.1967.01730290096012 -
The Journal of Dermatology Jan 2012Spontaneous remission occurs in up to 80% of patients with limited patchy alopecia areata (AA) within 1 year. Therefore, not all patients of AA simplex/multiplex need... (Review)
Review
Spontaneous remission occurs in up to 80% of patients with limited patchy alopecia areata (AA) within 1 year. Therefore, not all patients of AA simplex/multiplex need extensive treatments, and "wait and see" is one of the choices for some patients. However, once the hair loss show progressive course, it is really difficult to manage well and may be recalcitrant to any treatment in some cases. Hair loss symptom is not life-threatening but severely decreases quality of life. There have been two widely known guidelines for AA from the British Association of Dermatologists and the National Alopecia Areata Foundation (USA). These guidelines have been substantial and provide clues for dermatologists but needed to be updated. Recently, the Japanese Dermatological Association also published a guideline for the management of AA. This guideline suggests treatments followed by recommendations and evidence levels. Several new treatments are added such as corticosteroid pulse therapy and antihistamine drugs in addition to Japanese historical therapies. Although the highly recommended therapies are still contact immunotherapy and local injection of corticosteroid, it may result in improvement of AA by use of appropriate treatments decided by age, hair loss type, disease course and desire of the AA patient.
Topics: Adrenal Cortex Hormones; Alopecia Areata; Antihypertensive Agents; Biopsy; Dermoscopy; Histamine Antagonists; Humans; Immunotherapy; Minoxidil; Photochemotherapy; Physical Examination; Skin
PubMed: 22211297
DOI: 10.1111/j.1346-8138.2011.01476.x