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Dermatology Practical & Conceptual Apr 2024The introduction of Janus Kinase inhibitors (JAKi) seems to revolutionize the field of alopecia areata (AA) therapeutics. However, real-world data are still missing.
INTRODUCTION
The introduction of Janus Kinase inhibitors (JAKi) seems to revolutionize the field of alopecia areata (AA) therapeutics. However, real-world data are still missing.
OBJECTIVES
To provide evidence about effectiveness and safety of tofacitinib and baricitinib in AA in real-world settings and describe baseline disease characteristics and patients profiles that are considered good candidates for JAKi in the daily practice. Furthermore, we intended to investigate potential correlations between baseline characteristics and treatment outcomes.
METHODS
We retrospectively reviewed the databases of two tertiary Hospitals in Greece, to identify individuals of any age currently being treated with systemic JAKi for severe AA.
RESULTS
We identified 42 individuals, including 3 adolescents. In our cohort, 52.3% (22/42) were under tofacitinib and 47.6% (20/42) under baricitinib treatment. Efficacy analysis was performed on the subgroup of 30 patients that had completed at least a 3-month follow-up on treatment. In the latter group, mean time on treatment was 10 months. Mean Severity of Alopecia Tool and mean Dermatology Life Quality Index scores decreased from 84.46% and 12.86 at baseline, to 43.26% and 6.63, respectively. Complete response (CR) was recorded in 4 (13.33%), partial in 12 (40%) and no response in 14 patients (46.66%), correspondingly. Seventeen out of 42 (40.5%) individuals in total, reported at least 1 adverse event. No patient required hospitalization. Among 15 patients (35.7%) who got COVID-19, one suffered from serious infection. The 3 adolescents achieved CR with no significant adverse events.
CONCLUSIONS
Real-world data suggest efficacy and safety of JAKi in severe forms of AA. Tolerability is optimal in younger individuals.
PubMed: 38810065
DOI: 10.5826/dpc.1402a73 -
Journal of Cutaneous and Aesthetic... 2024Alopecia areata (AA) is an autoimmune disease characterized most commonly by patchy nonscarring hair loss which may progress to alopecia totalis which has poor...
Alopecia areata (AA) is an autoimmune disease characterized most commonly by patchy nonscarring hair loss which may progress to alopecia totalis which has poor prognosis. Platelet-rich plasma (PRP) therapy along with intralesional triamcinolone acetonide that is modified PRP proved to be beneficial in the case of alopecia totalis and helps in weaning patient off oral immunosuppression.
PubMed: 38800816
DOI: 10.4103/JCAS.JCAS_101_22 -
JAAD International Sep 2024Alopecia areata (AA) and atopic dermatitis (AD) are chronic skin diseases where the suboptimal medication adherence (MA) may result in poor clinical outcomes.
Adult patients with alopecia areata report a significantly better medication adherence compared to those with atopic dermatitis: Results from a large cross-sectional cohort study.
BACKGROUND
Alopecia areata (AA) and atopic dermatitis (AD) are chronic skin diseases where the suboptimal medication adherence (MA) may result in poor clinical outcomes.
OBJECTIVE
To assess the impact of AA on MA among adults compared to AD.
METHODS
Patient reported MA of adults with AA were compared with AD. Patients were identified from the Danish Skin Cohort, a nationwide prospective cohort of dermatological patients in Denmark. We used the Medication Adherence Report Scale- 5, a self-reporting questionnaire, to assess MA. Demographic and disease characteristics were collected. Logistic regression was conducted.
RESULTS
Patients with AA reported higher MA than AD (mean 21.81 vs 18.29). Logistic regression analyses showed AA diagnosis had a statistically significant positive effect on MA (odds ratio = 3.94, 95% CI 2.01-8.89). Men reported significantly higher MA (odds ratio = 1.49, 95% CI 1.14-1.94). Current disease severity did not impact MA.
LIMITATIONS
Data were self-reported by patients. Data regarding the specific treatment undergone by patients were not available.
CONCLUSION
Patients with AA have significantly higher MA compared to patients with AD. The stability of AA patients' symptoms may lead to higher MA due to a desire for disease control. Conversely, the sporadicity of AD symptoms could negatively affect adherence, causing fluctuations in medication use.
PubMed: 38800704
DOI: 10.1016/j.jdin.2024.03.026 -
Genes May 2024Much research has been conducted to determine how hair regeneration is regulated, as this could provide therapeutic, cosmetic, and even psychological interventions for...
Much research has been conducted to determine how hair regeneration is regulated, as this could provide therapeutic, cosmetic, and even psychological interventions for hair loss. The current study focused on the hair growth effect and effective utilization of fatty oil obtained from Bryde's whales through a high-throughput DNA microarray approach in conjunction with immunohistochemical observations. The research also examined the mechanisms and factors involved in hair growth. In an experiment using female C57BL/6J mice, the vehicle control group (VC: propylene glycol: ethanol: water), the positive control group (MXD: 3% minoxidil), and the experimental group (WO: 20% whale oil) were topically applied to the dorsal skin of the mouse. The results showed that 3% MXD and 20% WO were more effective than VC in promoting hair growth, especially 20% WO. Furthermore, in hematoxylin and eosin-stained dorsal skin tissue, an increase in the number of hair follicles and subcutaneous tissue thickness was observed with 20% WO. Whole-genome transcriptome analysis also confirmed increases for 20% WO in filaggrin (), a gene related to skin barrier function; fibroblast growth factor 21 (), which is involved in hair follicle development; and cysteine-rich secretory protein 1 (), a candidate gene for alopecia areata. Furthermore, the results of KEGG pathway analysis indicated that 20% WO may have lower stress and inflammatory responses than 3% MXD. Therefore, WO is expected to be a safe hair growth agent.
Topics: Animals; Mice; Female; Mice, Inbred C57BL; Computational Biology; Filaggrin Proteins; Hair Follicle; Oligonucleotide Array Sequence Analysis; Skin; Hair; Minoxidil; Gene Expression Profiling
PubMed: 38790256
DOI: 10.3390/genes15050627 -
JAAD Case Reports Jun 2024
PubMed: 38783932
DOI: 10.1016/j.jdcr.2024.04.012 -
JPMA. the Journal of the Pakistan... May 2024TTo investigate the level of interleukin-6 in alopecia areata patients.
OBJECTIVE
TTo investigate the level of interleukin-6 in alopecia areata patients.
METHODS
The exploratory study was conducted from September to December 2021 at the Sindh Institute of Skin Disease, Karachi, and comprised alopecia areata patients regardless of age and gender in group A, while healthy controls matched for age and gender formed group B. Alopecia areata classification and severity were done using the Severity of Alopecia Tool. Serum interleukin-6 was measured using enzyme-linked immune sorbent assay. Data was analysed using R statistical software v4.2.1.
RESULTS
Of the 100 subjects, 50(50%) with mean age 15.52±10.14 years were cases in group A; 26(52%) females with mean age 16.78±10.77 years, and 24(48%) males with mean age 16.44±10.3 years. The remaining 50(50%) were controls in group B. Interleukin-6 concentration was significantly higher in group A (p<0.05). The concentration was not significantly different between the genders (p>0.05). The concentration was the highest in patients aged 11-20 years, followed by 21-30 years, 31-40 years and 1-10 years.
CONCLUSION
The concentration of circulatory pro-inflammatory interleukin-6 was significantly higher in alopecia areata patients than in the healthy controls.
Topics: Humans; Alopecia Areata; Interleukin-6; Male; Female; Adolescent; Adult; Young Adult; Child; Case-Control Studies; Child, Preschool; Severity of Illness Index; Pakistan; Infant
PubMed: 38783442
DOI: 10.47391/JPMA.10284 -
Journal of Stroke and Cerebrovascular... May 2024Atherosclerotic burden increases the risk of both extracranial internal carotid artery stenosis (ICS) and intracranial large artery disease (ICAD). However, the...
BACKGROUND AND PURPOSE
Atherosclerotic burden increases the risk of both extracranial internal carotid artery stenosis (ICS) and intracranial large artery disease (ICAD). However, the differences in risk profiles have not been thoroughly investigated.
METHODS
Participants were recruited from the Nagahama study cohort in Japan. Individuals over 60 years old who underwent 1.5-T head and neck magnetic resonance angiography (MRA) between July 2013 and February 2017 were included. ICAD was defined as WASID ≥ 50%, and ICS was defined as NSCET ≥ 30%. The prevalence and association of risk factors, including proatherogenic and proinflammatory factors, and the p.R4810K variant in the RNF213 gene, were investigated. Multivariable logistic regression analyses were performed.
RESULTS
A total of 3089 individuals participated in the study, with a mean age of 68.1 ± 5.3 years, and 36.0% were males. Among them, 52 (1.7%) had ICS, 119 (3.8%) had ICAD, and 15 (0.49%) had both conditions. Alopecia areata was an independent predictor for both ICS (Odds ratio [OR] 3.5; 95% CI 1.3-8.3) and ICAD (OR 2.1; 95% CI 1.0-3.9). Diabetes (OR 3.7; 95% CI 2.0-7.0) and older age (OR 2.4; 95% CI 1.2-4.5) were associated only with ICS, while the RNF213 variant was associated with only ICAD (OR 5.7; 95% CI 1.6-16.0). ICS and ICAD were also independently associated with each other.
CONCLUSIONS
In this MRA-based large scale study, alopecia areata, known as a systemic inflammatory disease, was shown to be a common risk factor for ICS and ICAD. While conventional atherosclerotic factors were associated with ICS, non-atherosclerotic factors appear to contribute to ICAD in Japan.
PubMed: 38777218
DOI: 10.1016/j.jstrokecerebrovasdis.2024.107782 -
JAAD International Sep 2024
PubMed: 38774345
DOI: 10.1016/j.jdin.2024.03.024 -
Amino Acids May 2024In the initial stages of Alopecia Areata (AA), the predominance of hair breakage or exclamation mark hairs serves as vital indicators of disease activity. These signs... (Review)
Review
In the initial stages of Alopecia Areata (AA), the predominance of hair breakage or exclamation mark hairs serves as vital indicators of disease activity. These signs are non-invasive and are commonly employed in dermatoscopic examinations. Despite their clinical salience, the underlying etiology precipitating this hair breakage remains largely uncharted territory. Our exhaustive review of the existing literature points to a pivotal role for cysteine-a key amino acid central to hair growth-in these mechanisms. This review will probe and deliberate upon the implications of aberrant cysteine metabolism in the pathogenesis of AA. It will examine the potential intersections of cysteine metabolism with autophagy, ferroptosis, immunity, and psychiatric manifestations associated with AA. Such exploration could illuminate new facets of the disease's pathophysiology, potentially paving the way for innovative therapeutic strategies.
Topics: Alopecia Areata; Humans; Cysteine; Homeostasis; Hair; Autophagy; Ferroptosis; Animals
PubMed: 38772922
DOI: 10.1007/s00726-024-03395-5 -
International Journal of Trichology 2023A 39-year-old male presented with the complaint of sudden onset and progressive whitening of the scalp hair. The patient documented the situation by regularly taking...
A 39-year-old male presented with the complaint of sudden onset and progressive whitening of the scalp hair. The patient documented the situation by regularly taking selfies starting from the moment he noticed that his hair was starting to turn white. A diagnosis of alopecia areata involving pigmented hair was made with clinical, dermoscopic, histopathological, and immunofluorescence findings. Total regrowth of the pigmented hair was observed at 6 months follow-up without any systemic treatment.
PubMed: 38765728
DOI: 10.4103/ijt.ijt_6_22