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Alopecia totalis

Ola Ahmed Bakry, Shawky M El Farargy, Maathir K El Shafiee, Amira Soliman
BACKGROUND: Alopecia areata (AA) is a common, recurrent, autoimmune hair disorder. It has been found that vitamin D deficiency is associated with many autoimmune diseases. AIMS: The current study aimed to estimate serum levels of 25-hydroxy vitamin D in patients with AA. MATERIALS AND METHODS: This case-control study included 60 patients with AA and 60 age, gender, skin phototype, and body mass index-matched healthy subjects as a control group...
September 2016: Indian Dermatology Online Journal
Milène Kennedy Crispin, Justin M Ko, Brittany G Craiglow, Shufeng Li, Gautam Shankar, Jennifer R Urban, James C Chen, Jane E Cerise, Ali Jabbari, Mårten C G Winge, M Peter Marinkovich, Angela M Christiano, Anthony E Oro, Brett A King
BACKGROUND: Alopecia areata (AA) is an autoimmune disease characterized by hair loss mediated by CD8(+) T cells. There are no reliably effective therapies for AA. Based on recent developments in the understanding of the pathomechanism of AA, JAK inhibitors appear to be a therapeutic option; however, their efficacy for the treatment of AA has not been systematically examined. METHODS: This was a 2-center, open-label, single-arm trial using the pan-JAK inhibitor, tofacitinib citrate, for AA with >50% scalp hair loss, alopecia totalis (AT), and alopecia universalis (AU)...
September 22, 2016: JCI Insight
S Vañó-Galván, P Fernández-Crehuet, R Grimalt, M J Garcia-Hernandez, R Rodrigues-Barata, S Arias-Santiago, A Molina-Ruiz, E Garcia-Lora, J Dominguez-Cruz, A Brugues, J Ferrando, C Serrano-Falcón, S Serrano, J Paoli, F Camacho
BACKGROUND: Alopecia areata totalis (AAT) and universalis (AAU) pose a therapeutic challenge. OBJECTIVE: To describe the clinical and epidemiological features, therapeutic response and prognostic factors in a large series of patients diagnosed with AAT and AAU. METHODS: This retrospective multicenter study included patients diagnosed with AAT/AAU with a minimum follow-up of 12 months. Response was assessed based on the regrowth of scalp hair...
October 6, 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
D Saceda-Corralo, R Grimalt, P Fernández-Crehuet, A Clemente, C Bernárdez, M J García-Hernandez, S Arias-Santiago, A R Rodrigues-Barata, A Rodríguez-Pichardo, E García-Lora, P Jaén, F M Camacho, S Vañó-Galván
BACKGROUND: Alopecia areata on the beard area (BAA) is a common clinical manifestation, but there are no studies about its characteristics. OBJECTIVE: To describe the epidemiology, comorbidities, clinical presentation, evolution, diagnostic findings and therapeutic choices in a series of patients with BAA. METHODS: This retrospective multicentre review included patients diagnosed with BAA as the first and unique clinical manifestation with at least 12 months of follow-up...
August 8, 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
Ali Jabbari, Jane E Cerise, James C Chen, Julian Mackay-Wiggan, Madeleine Duvic, Vera Price, Maria Hordinsky, David Norris, Raphael Clynes, Angela M Christiano
Alopecia areata (AA) is an autoimmune disease typified by nonscarring hair loss with a variable clinical course. In this study, we conducted whole genome gene expression analysis of 96 human scalp skin biopsy specimens from AA or normal control subjects. Based on gene expression profiling, samples formed distinct clusters based on the presence or absence of disease as well as disease phenotype (patchy disease compared with alopecia totalis or universalis). Differential gene expression analysis allowed us to robustly demonstrate graded immune activity in samples of increasing phenotypic severity and generate a quantitative gene expression scoring system that classified samples based on interferon and cytotoxic T lymphocyte immune signatures critical for disease pathogenesis...
May 2016: EBioMedicine
A K Gupta, J L Carviel, W Abramovits
BACKGROUND: Autoimmune-triggered non-scarring hair loss is a feature of alopecia areata (AA). Initially patchy and often self-limited, severe hair loss forms include the complete loss of scalp hair or alopecia totalis (AT) and complete loss of all hair or alopecia universalis (AU). For AT and AU a reliable treatment has remained elusive. The targeted kinase inhibitor tofacitinib, in current use for treatment of other immune diseases, has been hypothesized as a viable option for AA, AT and AU therapy and a few case reports support this...
August 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
Ghada A Bin Saif
OBJECTIVES: To assess the significance of thyroid autoimmune screening in alopecia areata (AA) patients in Saudi population, and to determine whether there is a difference in thyroid autoimmune susceptibility between mild and severe AA. METHODS: In a prospective case-control study, we included 50 alopecia totalis (AT) and alopecia universalis (AU) patients, 50 age- and gender-matched patients with localized AA, and 50 age- and gender- matched healthy subjects between March 2015 and August 2015...
June 2016: Saudi Medical Journal
Sergio Vañó-Galván, Ángela Hermosa-Gelbard, Natalia Sánchez-Neila, Laura Miguel-Gómez, David Saceda-Corralo, Rita Rodrigues-Barata, Dong-Lai Ma, Pedro Jaén
No abstract text is available yet for this article.
May 2016: Journal of the American Academy of Dermatology
Christoffer V Nissen, Hans Christian Wulf
No abstract text is available yet for this article.
March 2016: JAAD Case Reports
Leila J Mady, Dare V Ajibade, Connie Hsaio, Arnaud Teichert, Chak Fong, Yongmei Wang, Sylvia Christakos, Daniel D Bikle
The role for 1,25-dihydroxyvitamin D3 and/or calcium in hair follicle cycling is not clear despite their impact on keratinocyte differentiation. We found that calbindin-D9k null (knockout) pups generated from calbindin-D9k knockout females fed a vitamin D-deficient, low-calcium (0.47%) diet develop transient alopecia. The pups appear phenotypically normal until 13 days of age, after which the hair progressively sheds in a caudocephalic direction, resulting in truncal alopecia totalis by 20-23 days, with spontaneous recovery by 28 days...
July 2016: Journal of Investigative Dermatology
Katherine S Chiang, Natasha A Mesinkovska, Melissa P Piliang, Wilma F Bergfeld
Diphenylcyclopropenone (DPCP) is widely considered the most effective topical immunotherapy for refractory or extensive alopecia areata (AA), but questions regarding how long to try DPCP therapy before terminating and what factors are prognostic of therapeutic success still remain unanswered. In this retrospective study of 50 AA patients, we evaluated DPCP efficacy and identified patient factors predictive of therapeutic success/failure. The median duration of DPCP treatment was 3 years, with 47% patients experiencing their first regrowth in the first 6 months of DPCP therapy, 20% between 6 months-1 year, and 8% between 1-2 years...
November 2015: Journal of Investigative Dermatology. Symposium Proceedings
R A Kuin, P I Spuls, J Limpens, E J van Zuuren
AIM: To assess the efficacy and safety of topical diphenylcyclopropenone (DPCP) in patients with alopecia areata. SETTING AND DESIGN: Study selection, data extraction, risk of bias assessment and analyses were carried out independently by two authors. The quality of evidence was rated with Grading of Recommendations Assessment, Development and Evaluation (GRADE). No randomised trials were identified, but 11 case series, conducted in dermatology departments in the Netherlands, UK, Iran, Italy, Egypt and Greece were included...
October 2015: British Journal of Dermatology
Jovan Lalosevic, Mirjana Gajic-Veljic, Branka Bonaci-Nikolic, Milos Nikolic
There are no widely accepted therapy protocols for severe alopecia areata (AA). We treated 65 children/adolescents with AA affecting >30% of scalp. Fourty-three percent of patients had AA plurifocalis (AAP). Fifty-seven percent had AA subtotalis (AAS), AAP+ophiasis (AAP+OPH), and alopecia totalis/universalis (AT/AU). Long-term follow-up (median 96 months) data were available for 69% of patients. Oral dexamethasone (prednisolone 5 mg/kg equivalent) was given once in 4 weeks. Patients received 6, 9, or 12 pulses...
September 2015: Dermatologic Therapy
Bakr Mohamed El-Zawahry, Mervat El Hanafy, Dalia Ahmed Bassiouny, Marwa Mohamed Fawzy, Manal Abdel-Mageed Badawy, Eman Mohamed El-Khateeb
Ultrasound biomicroscopy (UBM) is a non-invasive imaging technique used in examination of several skin diseases but never in imaging hair and scalp diseases. Main objective of this investigation was assessment of the efficacy of UBM for in vivo visualization of hair follicles in cases of alopecia areata (AA) and correlation of findings with histopathological findings. This study included 30 patients with AA. Two areas, one with AA and a control area, were marked, examined by UBM and then biopsied for histopathological examination...
2015: Acta Dermatovenerologica Croatica: ADC
Alexandra Smith, Ralph M Trüeb, Martin Theiler, Valérie Hauser, Lisa Weibel
BACKGROUND: Previous data suggest that early application of intravenous methylprednisolone pulse therapy (IV-MPPT) may improve the disease course of alopecia areata. The objective of this study was to investigate the outcome of IV-MPPT in severe childhood alopecia areata, predominantly with short disease duration. METHODS: Eighteen children (10 girls, 8 boys) younger than 17 years old (median age 7.7 yrs, range 2.1-16.5 yrs) treated with IV-MPPT for severe childhood alopecia areata in a referral center for pediatric dermatology over 3 years (median disease duration 4 mos, range 1-12 mos) were retrospectively evaluated...
July 2015: Pediatric Dermatology
Christine Lux-Battistelli
Spontaneous remission occurs in less than 10% of patients suffering from alopecia areata (AA) totalis for more than 2 years. The efficacy of PUVA therapy is controversial due to recurrence of hair loss after cessation. We report two cases presenting with AA totalis and AA universalis. After hair regrowth, relapse of hair loss occurred upon cessation of PUVA and zinc gluconate combination therapy. However, hair regrowth was noted upon the reintroduction of zinc gluconate and sulfur amino acids without PUVA in the first case and with episodic PUVA in the second case...
July 2015: Dermatologic Therapy
Simona C Senila, Sorina A Danescu, Loredana Ungureanu, Elisabeta Candrea, Rodica M Cosgarea
BACKGROUND: Severe, extensive, therapy resistant alopecia areata represents a clinical challenge. Systemic corticosteroids are a therapeutic tool that still needs to be evaluated. AIM: The purpose of this study was to assess the efficacy and safety of methylprednisolone pulse therapy in alopecia areata and to find prognostic factors for a favourable outcome. METHODS: A total of 32 patients with severe multifocal alopecia areata (more than 40% scalp hair loss), alopecia totalis, and alopecia universalis were treated with infusions of 500 mg methylprednisolone for 3 days every month for 3 consecutive months...
January 2015: Indian Journal of Dermatology, Venereology and Leprology
R R Ranawaka
OBJECTIVES: The objectives were to assess the demographical pattern, clinical presentation and therapeutic response in a cohort of patients with alopecia areata (AA) in Sri Lanka. METHODS: Hospital-based observational study of 290 adults aged 18 years or above. RESULTS: Alopecia areata was commoner in men (M:F=1.3:1). Age of onset was between 20-35 years (median 31 years) in 61%. Those with juvenile-onset AA (≤ 17 years, n=5) showed severe disease with many relapses and resistance to therapy...
December 2014: Ceylon Medical Journal
Brian A Ginsberg, John Montgomery Yost, Jesse Lewin, Christopher S Hale, Shane A Meehan, John A Carucci, Sarika Ramachandran
A 67-year-old man with a three-year history of non-scarring alopecia that progressed to alopecia totalis despite intralesional glucocorticoid injections is presented. He developed 20-nail dystrophy that was recalcitrant to antifungal and anti-inflammatory treatments. Biopsy of the nail matrix showed histopathologic features of lichen planus. Alopecia totalis and isolated lichen planus of the nails are uncommon subtypes of common dermatologic disorders. Rarely reported concurrently, we provide a review of the literature of their association, which is most likely attributed to their autoimmune pathogeneses...
December 2014: Dermatology Online Journal
Maryam Yousefi, Mohammad Reza Namazi, Hoda Rahimi, Shima Younespour, Amir Houshang Ehsani, Safoura Shakoei
INTRODUCTION: Alopecia areata (AA) is a common type of hair loss with an autoimmune basis. As the role of homocysteine (Hcys), folate, and CRP has been considered in some autoimmune diseases. OBJECTIVES: To evaluate homocysteine, folate and CRP level in AA. METHODS: This study was performed on 29 patients who had AA for at least 6 months affecting more than 20% of scalp, and 32 healthy controls. Levels of serum Hcys, blood high-sensitivity CRP, and RBC folate were measured in all subjects...
November 2014: Indian Journal of Dermatology
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