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Hair Loss (hair + loss)
Kinds of Hair Loss Selected AbstractsHair Loss: Principles of Diagnosis and Management of Alopecia.AUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 1 2003Jerry Shapiro. No abstract is available for this article. [source] Medical and surgical therapies for alopecias in black womenDERMATOLOGIC THERAPY, Issue 2 2004Valerie D. Callender ABSTRACT:, Hair loss is a common problem that challenges the patient and clinician with a host of cosmetic, psychological and medical issues. Alopecia occurs in both men and women, and in all racial and ethnic populations, but the etiology varies considerably from group to group. In black women, many forms of alopecia are associated with hair-care practices (e.g., traction alopecia, trichorrhexis nodosa, and central centrifugal cicatricial alopecia). The use of thermal or chemical hair straightening, and hair braiding or weaving are examples of styling techniques that place African American women at high risk for various "traumatic" alopecias. Although the exact cause of these alopecias is unknown, a multifactorial etiology including both genetic and environmental factors is suspected. A careful history and physical examination, together with an acute sensitivity to the patient's perceptions (e.g., self-esteem and social problems), are critical in determining the best therapy course. Therapeutic options for these patients range from alteration of current hair grooming practices or products, to use of specific medical treatments, to hair replacement surgery. Since early intervention is often a key to preventing irreversible alopecia, the purpose of the present article is to educate the dermatologist on all aspects of therapy for hair loss in black women,including not only a discussion of the main medical and surgical therapies but also an overview of ethnic hair cosmetics, specific suggestions for alterations of hair-care practices, and recommendations for patient education and compliance. [source] Clinical presentations of alopecia areataDERMATOLOGIC THERAPY, Issue 4 2001Maria K. Hordinsky Alopecia areata (AA) may can occur on any hair-bearing region. Patients can develop patchy nonscarring hair loss or extensive loss of all body hair. Hair loss may fluctuate. Some patients experience recurrent hair loss followed by hair regrowth, whereas others may only develop a single patch of hair loss, never to see the disease again. Still others experience extensive loss of body hair. The heterogeneity of clinical presentations has led investigators conducting clinical therapeutic trials to typically group patients into three major groups, those with extensive scalp hair loss [alopecia totalis (AT)], extensive body hair loss [alopecia universalis (AU)], or patchy disease (AA). Treatment outcomes have been correlated with disease duration and extent. Recently, guidelines were established for selecting and assessing subjects for both clinical and laboratory studies of AA, thereby facilitating collaboration, comparison of data, and the sharing of patient-derived tissue. For reporting purposes the terms AT and AU, though still used are defined very narrowly. AT is 100% terminal scalp hair loss without any body hair loss and AU is 100% terminal scalp hair and body loss. AT/AU is the term now recommended to define the presence of AT with variable amounts of body hair loss. In this report the term AA will be used broadly to encompass the many presentations of this disease. Development of AA may occur with changes in other ectodermal-derived structures such as fingernails and toenails. Some investigators have also suggested that other ectodermal-derived appendages as sebaceous glands and sweat glands may be affected in patients experiencing AA. Whether or not function of these glands is truly impaired remains to be confirmed. Many patients who develop patchy or extensive AA complain of changes in cutaneous sensation, that is, burning, itching, tingling, with the development of their disease. Similar symptoms may occur with hair regrowth. The potential involvement of the nervous system in AA has led to morphologic investigations of the peripheral nervous system as well as analysis of circulating neuropeptide levels. In this article the clinical presentations of AA are reviewed. The guidelines for conducting treatment studies of AA are presented and observations on changes in cutaneous innervation are introduced. Throughout the text, unless otherwise noted, AA will be used in a general way to denote the spectrum of this disease. [source] I love my hair but I don't want rheumatoid arthritisINTERNATIONAL JOURNAL OF RHEUMATIC DISEASES, Issue 1 2007Manjit SALUJA Summary We describe serious and severe hair loss in a young Indian (Asian) woman suffering from rheumatoid arthritis on treatment with leflunomide. Hair loss due to antirheumatic drugs is not too infrequent but needs to be better recognized in rheumatology. In our context, it often has socio-cultural ethnic connotations. [source] Coat condition, housing condition and measurement of faecal cortisol metabolites , a non-invasive study about alopecia in captive rhesus macaques (Macaca mulatta)JOURNAL OF MEDICAL PRIMATOLOGY, Issue 1 2006Hanspeter W. Steinmetz Abstract Background, Previous studies have characterized alopecia in captive rhesus macaques (Macaca mulatta) by a mixed partial to complete alopecia in a bilateral symmetric pattern. Methods, In this study, coat condition assessments were related to exogenous and endogenous factors in captive rhesus macaques under different housing conditions in order to identify disturbances in environmental factors controlling or influencing hair growth. Additionally, the degree of alopecia was investigated in relation to adrenal endocrine function as an indicator of social stress using faecal glucocorticoid measurements. Results, Hair loss was found to vary with season and sex, was most pronounced in adult females during the winter and spring months. Generally, infants were not affected, but alopecia developed during adolescence. However, the housing system, available enclosure space and variations in group size and composition also appeared to influence coat condition. Levels of immunoreactive cortisol metabolites (11-oxoetiocholanolone) in faeces were significantly negatively correlated with alopecia, suggesting a relationship between hypothalamic-pituitary-adrenal (HPA) axis activity and hair loss in captive rhesus macaques. Conclusions, Although the present study demonstrates the influence of the HPA axis on coat condition, it is not known if hair loss is caused by abnormal behaviour or hormonal imbalances of the HPA axis itself. Our data suggest that alopecia in rhesus macaques is a highly complex multicausal disorder. [source] Chemotherapy-induced alopecia and effects on quality of life among women with breast cancer: a literature reviewPSYCHO-ONCOLOGY, Issue 4 2008Julie Lemieux Abstract Background: Alopecia is a common side effect of chemotherapies used in the treatment of breast cancer. The aim of this review is to describe the effects of alopecia on quality of life (QOL) in this population. Methods: We conducted a literature review using Medline, Embase, Cumulative Index to Nursing and Allied Health Literature and PsycInfo databases. We searched for studies on the effects of alopecia on various aspects of QOL in breast cancer patients including anxiety and distress, body image, sexuality, self-esteem, social functioning, global QOL and return to work outcomes. Results: A total of 38 articles were included in the review. Hair loss consistently ranked amongst the most troublesome side effects, was described as distressing, and may affect the body image. Conclusions: We found very little quantitative data on other aspects of QOL. More research is needed to determine the presence and extent of negative effects on chemotherapy-induced alopecia on various aspects of QOL. Copyright © 2007 John Wiley & Sons, Ltd. [source] Histological and Clinical Findings in Different Surgical Strategies for Focal Axillary HyperhidrosisDERMATOLOGIC SURGERY, Issue 8 2008FALK G. BECHARA MD INTRODUCTION Although a variety of different surgical strategies for focal axillary hyperhidrosis (FAH) have proven effective, little is known of intraoperative and postoperative histologies of different surgical methods. OBJECTIVE The objective was to use pre-, intra-, and postoperative histologic findings to evaluate different surgical procedures for FAH in establishing a possible correlation between the interventions and clinical outcome. MATERIAL AND METHODS A total of 40 patients underwent surgery with 15 undergoing liposuction-curettage (LC), 14 radical skin excision (RSE) with Y-plasty closure, and 11 a skin-sparing technique (SST). Before surgery, density and ratio of eccrine and apocrine sweat glands were evaluated with routine histology. Further biopsies were taken directly after surgery in the RSE and SST groups and 1 year postoperatively in all patients. Additionally, gravimetry was performed, side effects were documented, and patients were asked to evaluate the aesthetic outcome of the surgical method by using an analogue scale. RESULTS Preoperatively, the mean density of eccrine glands was 11.1/cm2 compared to 16.9/cm2 apocrine glands (apocrine/eccrine ratio, 1.6). Biopsy specimen directly after surgery showed remaining sweat glands in 7/15 (46.7%) LC patients and in 4/11 (36.4%) of the SST patients. One year after surgery, sweat gland density was significantly reduced in the LC (79.1%) and the SST (74.9%) groups. In the RSE group, only scar formation was present. Gravimetry showed significantly reduced sweat rates 12 months after surgery in all groups (LC, 66.4%; SST, 62.9%; RSE, 65.3% [p<.05]). Most frequent side effects were hematoma (LC, n=3; SST, n=2; RSE, n=3), subcutaneous fibrotic bridles (LC, n=8; SST, n=3; RSE, n=0), skin erosion (LC, n=3; SST, n=4; RSE, n=0), focal hair loss (LC, n=9; SST, n=11; RSE, n=14), and paresthesia (LC, n=4; SST, n=3; RSE, n=5). CONCLUSION Histologic distribution and density of sweat glands were comparable to previous studies. All three surgical procedures evaluated are effective in the treatment of FAH. RSE and SST techniques are associated with a higher risk of side effects and cause more extensive scarring. However, one LC patient (n=1; 6.7%) did not respond to treatment. [source] Hair Growth Induced by Diode Laser TreatmentDERMATOLOGIC SURGERY, Issue 5 2005Eric F. Bernstein MD background. Although hair reduction by long-pulsed red and infrared lasers and light sources is generally quite effective, paradoxical hair growth has rarely been observed following treatment. objective. To report a case of thick hair growth following 810 nm diode laser treatment and its subsequent treatment. methods. A 24-year-old man who had previously had laser hair reduction on his posterior neck was treated to a test area on his upper back. results. Thick terminal hair developed in the treated area subsequent to laser treatment. Further treatment of this area removed the terminal hair but resulted in terminal hair growth in an annular distribution surrounding the treatment site. conclusions. Diode laser treatment rarely stimulates terminal hair growth. This phenomenon should be studied to better understand hair growth cycles and to help develop more effective treatments for hair loss and hair growth. [source] The Potential Role of Minoxidil in the Hair Transplantation SettingDERMATOLOGIC SURGERY, Issue 10 2002Marc R. Avram background. Over the last decade surgical management of hair loss has become an increasingly popular and satisfying procedure for both men and women, as innovations in donor harvesting, graft size, and hairline design have resulted in consistently natural-appearing hair restoration. objective. In addition, a better understanding of the regulation of the hair-growth cycle has led to advances in the pharmacologic treatment of androgenetic alopecia. methods. Currently there are two U.S. Food and Drug Administration (FDA)-approved agents that promote hair regrowth: over-the-counter topical minoxidil solution for men and women and prescription oral finasteride tablets for men. In October 2001, a group of 11 international experts on hair loss and hair transplantation convened to review the physiology and effects of pharmacologic treatments of hair loss and to discuss the value of administering topical minoxidil therapy as an adjunct to hair transplantation. results. This article presents the key findings and consensus points among the participants, including their current use of pharmacologic treatments, strategies for optimal results both pre- and postsurgery, and the importance of realistic patient expectations and compliance. conclusions. Based on the surgeons' clinical experience, the use of approved hair regrowth agents in hair transplant patients with viable but suboptimally functioning follicles in the region to be transplanted can increase hair density, speed regrowth in transplanted follicles, and complement the surgical result by slowing down or stopping further hair loss. [source] Androgens and hair growthDERMATOLOGIC THERAPY, Issue 5 2008Valerie Anne Randall ABSTRACT:, Hair's importance in human communication means that abnormalities like excess hair in hirsutism or hair loss in alopecia cause psychological distress. Androgens are the main regulator of human hair follicles, changing small vellus follicles producing tiny, virtually invisible hairs into larger intermediate and terminal follicles making bigger, pigmented hairs. The response to androgens varies with the body site as it is specific to the hair follicle itself. Normally around puberty, androgens stimulate axillary and pubic hair in both sexes, plus the beard, etc. in men, while later they may also inhibit scalp hair growth causing androgenetic alopecia. Androgens act within the follicle to alter the mesenchyme,epithelial cell interactions, changing the length of time the hair is growing, the dermal papilla size and dermal papilla cell, keratinocyte and melanocyte activity. Greater understanding of the mechanisms of androgen action in follicles should improve therapies for poorly controlled hair disorders like hirsutism and alopecia. [source] Cicatricial alopecia: classification and histopathologyDERMATOLOGIC THERAPY, Issue 4 2008Najwa Somani ABSTRACT: Primary cicatricial alopecias are a diagnostically challenging group of disorders characterized by folliculocentric inflammation resulting in destruction of hair follicles and irreversible hair loss. They are classified according to a consensus-issued classification scheme based on the predominant cell type present: lymphocytic, neutrophilic, or mixed. Histopathology is a pivotal component of the diagnostic evaluation. Early diagnosis is critical since timely institution of treatment can halt progression of permanent hair loss. Salient histopathologic findings are presented in this review, along with adjunctive clues derived from interpretation of special stains and direct immunofluorescence studies. Despite careful evaluation, accurate diagnosis may remain elusive in some instances. The primary cicatricial alopecias often share overlapping features. The highest diagnostic yield is procured when histology is correlated with the clinical presentation. [source] Medical and surgical therapies for alopecias in black womenDERMATOLOGIC THERAPY, Issue 2 2004Valerie D. Callender ABSTRACT:, Hair loss is a common problem that challenges the patient and clinician with a host of cosmetic, psychological and medical issues. Alopecia occurs in both men and women, and in all racial and ethnic populations, but the etiology varies considerably from group to group. In black women, many forms of alopecia are associated with hair-care practices (e.g., traction alopecia, trichorrhexis nodosa, and central centrifugal cicatricial alopecia). The use of thermal or chemical hair straightening, and hair braiding or weaving are examples of styling techniques that place African American women at high risk for various "traumatic" alopecias. Although the exact cause of these alopecias is unknown, a multifactorial etiology including both genetic and environmental factors is suspected. A careful history and physical examination, together with an acute sensitivity to the patient's perceptions (e.g., self-esteem and social problems), are critical in determining the best therapy course. Therapeutic options for these patients range from alteration of current hair grooming practices or products, to use of specific medical treatments, to hair replacement surgery. Since early intervention is often a key to preventing irreversible alopecia, the purpose of the present article is to educate the dermatologist on all aspects of therapy for hair loss in black women,including not only a discussion of the main medical and surgical therapies but also an overview of ethnic hair cosmetics, specific suggestions for alterations of hair-care practices, and recommendations for patient education and compliance. [source] Clinical presentations of alopecia areataDERMATOLOGIC THERAPY, Issue 4 2001Maria K. Hordinsky Alopecia areata (AA) may can occur on any hair-bearing region. Patients can develop patchy nonscarring hair loss or extensive loss of all body hair. Hair loss may fluctuate. Some patients experience recurrent hair loss followed by hair regrowth, whereas others may only develop a single patch of hair loss, never to see the disease again. Still others experience extensive loss of body hair. The heterogeneity of clinical presentations has led investigators conducting clinical therapeutic trials to typically group patients into three major groups, those with extensive scalp hair loss [alopecia totalis (AT)], extensive body hair loss [alopecia universalis (AU)], or patchy disease (AA). Treatment outcomes have been correlated with disease duration and extent. Recently, guidelines were established for selecting and assessing subjects for both clinical and laboratory studies of AA, thereby facilitating collaboration, comparison of data, and the sharing of patient-derived tissue. For reporting purposes the terms AT and AU, though still used are defined very narrowly. AT is 100% terminal scalp hair loss without any body hair loss and AU is 100% terminal scalp hair and body loss. AT/AU is the term now recommended to define the presence of AT with variable amounts of body hair loss. In this report the term AA will be used broadly to encompass the many presentations of this disease. Development of AA may occur with changes in other ectodermal-derived structures such as fingernails and toenails. Some investigators have also suggested that other ectodermal-derived appendages as sebaceous glands and sweat glands may be affected in patients experiencing AA. Whether or not function of these glands is truly impaired remains to be confirmed. Many patients who develop patchy or extensive AA complain of changes in cutaneous sensation, that is, burning, itching, tingling, with the development of their disease. Similar symptoms may occur with hair regrowth. The potential involvement of the nervous system in AA has led to morphologic investigations of the peripheral nervous system as well as analysis of circulating neuropeptide levels. In this article the clinical presentations of AA are reviewed. The guidelines for conducting treatment studies of AA are presented and observations on changes in cutaneous innervation are introduced. Throughout the text, unless otherwise noted, AA will be used in a general way to denote the spectrum of this disease. [source] Vaccines, Viagra, and Vioxx: medicines, markets, and money,when life-saving meets life-style,DRUG DEVELOPMENT RESEARCH, Issue 2 2005David J. Triggle Abstract In this Commentary, life-style drugs will be termed as "those drugs for which there is a definable and real, but limited, therapeutic need, but a need that has been significantly stimulated by the cycle of pharmaceutical company advertising and pressure and public demand." The key to the continuing expansion of the life-style drug market is a progressive narrowing of the definition of "normal" coupled with campaigns launched by the pharmaceutical industry that persuade both patients and clinicians that a major and treatable disease does exist and that drug treatment, rather than acceptance of hair loss or occasional lack of sexual interest, and so on, is both necessary and appropriate. The expansion of the market for prescription drugs in this manner is now an integral part of the business model of the pharmaceutical industry. For society, the expanding role of these drugs, particularly those directed at "desires rather than diseases," raises ethical issues of our increasing obsession with a medically directed quest for perfection, and financial issues of the cost of this quest on the health care system and its priorities. For the pharmaceutical industry, there are questions of whether its role is life-saving or life-styling for a Huxleyan "Brave New World." Drug Dev Res 64:90,98, 2005. © 2005 Wiley-Liss, Inc. [source] Levetiracetam in the Treatment of Idiopathic Generalized EpilepsiesEPILEPSIA, Issue 2005Richard Grünewald Summary:, Since its introduction into clinical practice in 1999, levetiracetam, the S enantiomer of piracetam, has rapidly found a secure place, initially in the therapy of partial onset seizures and subsequently in the treatment of idiopathic generalized epilepsies (IGE). It has many of the properties of an "ideal" antiepileptic drug, including rapid absorption, linear pharmokinetics, and sparse drug interactions. Tolerabiliy is generally excellent in both adults and children, although tiredness is a common dose-limiting adverse effect. Occasionally the drug can precipitate behavioral abnormalities, especially in patients with learning disability. There is a wide safety margin in overdose. In common with most antiepileptic drugs its mode of action remains uncertain. Levetiracetam binds to a specific site in the brain, influences intracellular calcium currents and reverses negative allosteric modulators of GABA- and glycine-gated currents in vitro. Its effectiveness has been demonstrated in animal models of epilepsy and in clinical trials of partial onset and IGE. Treatment of IGEs may be straightforward, with many patients demonstrating an excellent and robust response to valproate monotherapy. However, there remains a significant minority of patients for whom valproate is unsuitable, including those who experience unacceptable adverse effects (e.g., weight gain or hair loss) and women of childbearing age in whom the teratogenic potential of valproate is unacceptable. Therapeutic response to lamotrigine in this group is often disappointing, and many clinicians now are turning to the choice of levetiracetam. Efficacy in generalized tonic,clonic seizures and myoclonus is usually apparent and some patients experience improvement in typical absences. Experience of combinations of levetiracetam with other antiepileptic drugs is limited in IGE and the responses are largely anecdotal. In our hands, patients with refractory IGEs may respond to combinations of levetiracetam with valproate, lamotrigine, and phenobarbital, and adverse effects when they occur are usually limited to tiredness. Levetiracetam does not interact with the oral contraceptive pill, simplifying treatment in women of childbearing age. Although animal data look encouraging, questions over levetiracetam's teratogenic potential and overall safety in pregnancy will remain for many years to come. [source] Low Serum Biotinidase Activity in Children with Valproic Acid MonotherapyEPILEPSIA, Issue 10 2001K. H. Schulpis Summary: ,Purpose: Valproic acid (VPA) is an effective antiepileptic drug (AED), which is associated with dose-related adverse reactions such as skin rash, hair loss (alopecia), etc. Profound as well as partial biotinidase deficiency causes dermatologic manifestations similar these. Therefore, it was of interest to evaluate serum biotinidase activity in patients receiving VPA monotherapy. Methods: Seventy-five patients with seizures, mean age, 8.6 years (±1.9 years) were divided into three groups. Group A (n = 25) was treated with VPA 28.7 ± 8.5 mg/kg/24 h, group B (n = 25) with 41.6 ± 4.9 mg/kg/24 h, and group C with 54.5 ± 5.8 mg/kg/24 h. Their "trough" VPA serum levels were 40.9 ± 13.2, 86.25 ± 11.5, and 137 ± 14.5 ,g/ml, respectively. Fifty healthy children were the controls. Patients and controls underwent clinical and laboratory evaluations including liver function data, complete blood counts, NH3, and so on, after 45 days of VPA treatment. Biotinidase serum levels were evaluated fluorometrically. Results: Liver function data were found elevated in the groups B and C. On the contrary, biotinidase activity was significantly statistically lowered (p < 0.001) in groups B and C (1.22 ± 1.11, 0.97 ± 0.07 mmol/min/L respectively), as compared with controls (5.20 ± 0.90 mmol/min/L). Strong inverse correlations were observed between liver enzymes and VPA blood levels with the activity of the enzyme. Additionally, no inhibitory effect on biotinidase activity was found, when the enzyme was incubated in vitro with high (1.2 mM) concentrations of the drug. Skin lesions (seborrheic rash, alopecia) were improved in our patients after biotin (10 mg/day) supplementation. Conclusions: It is suggested that VPA impairs the liver mitochondrial function, resulting in a low biotinidase activity and or biotin deficiency. Biotin supplementation could restore some of the side effects of the drug. [source] The human orthologue of murine Mpzl3 with predicted adhesive and immune functions is a potential candidate gene for immune-related hereditary hair lossEXPERIMENTAL DERMATOLOGY, Issue 3 2009Peter Racz Abstract:, We have recently reported a mutation within the conserved immunoglobulin V-type domain of the predicted adhesion protein Mpzl3 (MIM 611707) in rough coat (rc) mice with severe skin abnormalities and progressive cyclic hair loss. In this study, we tested the hypothesis that the human orthologue MPZL3 on chromosome 11q23.3 is a candidate for similar symptoms in humans. The predicted conserved MPZL3 protein has two transmembrane motifs flanking an extracellular Ig-like domain. The R100Q rc mutation is within the Ig-domain recognition loop that has roles in T-cell receptors and cell adhesion. Results of the rc mouse study, 3D structure predictions, homology with Myelin Protein Zero and EVA1, comprehensive database analyses of polymorphisms and mutations within the human MPZL3 gene and its cell, tissue expression and immunostaining pattern indicate that homozygous or compound heterozygous mutations of MPZL3 might be involved in immune-mediated human hereditary disorders with hair loss. [source] Interleukin-6 cytokine family member oncostatin M is a hair-follicle-expressed factor with hair growth inhibitory propertiesEXPERIMENTAL DERMATOLOGY, Issue 1 2008Mei Yu Abstract:, The activation of receptor complexes containing glycoprotein 130 (gp130) identifies the interleukin (IL)-6 cytokine family. We examined members of this family for their expression and activity in hair follicles. Quantitative polymerase chain reaction using mRNA derived from microdissected, anagen-stage human hair follicles and comparison to non-follicular skin epithelium revealed higher levels of IL-6 (15.5-fold) and oncostatin M (OSM, 3.4-fold) in hair follicles. In contrast, expression of all mRNAs coding for IL-6 cytokine family receptors was reduced. Immunohistology suggested expression of OSM, gp130, leukaemia inhibitory factor receptor (LIFr) and IL-11r in the hair follicle root sheaths and dermal papilla, while IL-11, IL-6r and OSMr were expressed in root sheaths alone. IL-6 was expressed in the dermal papilla while cardiotrophin-1 (CT-1) and LIF were not observed. OSM and to a lesser extent CT-1 exhibited a dose-dependent growth inhibition capacity on human hair follicles in vitro. OSM and CT-1 incubated with agarose beads and injected subcutaneously at 1 ,g per mouse into telogen skin of 65-day-old mice revealed no capacity to induce anagen hair growth. In contrast, injection of 65-day-old mice in which anagen had been induced by hair plucking revealed a moderate hair growth inhibitory capacity for OSM, but no significant effect for CT-1. The data identify OSM as a modulator of hair follicle growth and suggest other family members may also have some degree of hair growth inhibitory effect. In principle, increased expression of some IL-6 cytokine family members in cutaneous inflammation might contribute to the promotion of hair loss. [source] Immunoreactivity of corticotropin-releasing hormone, adrenocorticotropic hormone and , -melanocyte-stimulating hormone in alopecia areataEXPERIMENTAL DERMATOLOGY, Issue 7 2006Hei Sung Kim Abstract:, Psychological factors are believed to play a role in the pathogenesis of alopecia areata (AA), a frequently encountered hair disorder. In our study, statistically significant elevation of psychological stress was felt by AA patients prior hair loss compared with control, which was strongly believed contributory to hair loss (t -test, P < 0.01). The corticotropin-releasing hormone (CRH) and proopiomelanocortin (POMC) mRNA have been identified in the basal layer of the epidermis and pilosebaceous units of the normal scalp. And with the recent discovery of melanocytes and dermal fibroblasts capable of corticosterone production, the presence of a local stress response system resembling the hypothalamic,pituitary,adrenal (HPA) axis has been suggested. The local stress response system is involved in regulation of the normal hair cycle, but its precise role in AA is unknown. The influence of a local HPA axis or rather, CRH,POMC axis in AA was investigated by analysing immunohistochemically the expression levels of CRH and POMC peptides, including the adrenocorticotropic hormone (ACTH) and , -melanocyte-stimulating hormone (, -MSH), in a number of AA lesions and normal scalp (as control). The epidermis and pilosebaceous units of normal scalp stained weakly with CRH, ACTH and , -MSH, whereas those from the affected sites of the AA group showed intense expression of the peptides (chi-square test, P < 0.01). The meaning of this enhanced expression and their role in the pathogenesis of AA should be further evaluated in future. [source] Hair growth inhibition by psychoemotional stress: a mouse model for neural mechanisms in hair growth controlEXPERIMENTAL DERMATOLOGY, Issue 1 2006Eva M. J. Peters Abstract:, Stress has long been discussed controversially as a cause of hair loss. However, solid proof of stress-induced hair growth inhibition had long been missing. If psychoemotional stress can affect hair growth, this must be mediated via definable neurorendocrine and/or neuroimmunological signaling pathways. Revisiting and up-dating relevant background data on neural mechanisms of hair growth control, we sketch essentials of hair follicle (HF) neurobiology and discuss the modulation of murine hair growth by neuropeptides, neurotransmitters, neurotrophins, and mast cells. Exploiting an established mouse model for stress, we summarize recent evidence that sonic stress triggers a cascade of molecular events including plasticity of the peptidergic peri- and interfollicular innervation and neuroimmune crosstalk. Substance P (SP) and NGF (nerve growth factor) are recruited as key mediators of stress-induced hair growth-inhibitory effects. These effects include perifollicular neurogenic inflammation, HF keratinocyte apoptosis, inhibition of proliferation within the HF epithelium, and premature HF regression (catagen induction). Intriguingly, most of these effects can be abrogated by treatment of stressed mice with SP-receptor neurokinin-1 receptor (NK-1) antagonists or NGF-neutralizing antibodies , as well as, surprisingly, by topical minoxidil. Thus there is now solid in vivo -evidence for the existence of a defined brain- HF axis. This axis can be utilized by psychoemotional and other stressors to prematurely terminate hair growth. Stress-induced hair growth inhibition can therefore serve as a highly instructive model for exploring the brain-skin connection and provides a unique experimental model for dissecting general principles of skin neuroendocrinology and neuroimmunology well beyond the HF. [source] A review of ageing and an examination of clinical methods in the assessment of ageing skin.INTERNATIONAL JOURNAL OF COSMETIC SCIENCE, Issue 5 2008Part 2: Clinical perspectives, clinical methods in the evaluation of ageing skin Synopsis With the advancement of skin research, today's consumer has increased access to technological information about ageing skin and hair care products. As a result, there is a rapidly increasing demand for proof of efficacy of these products. Recognizing these demands has led to the development and validation of many clinical methods to measure and quantify ageing skin and the effects of anti-ageing treatments. Many of the current testing methods used to research and evaluate anti-ageing product claim to employ sophisticated instruments alongside more traditional clinical methods. Intelligent use of combined clinical methods has enabled the development of technologically advanced consumer products providing enhanced efficacy and performance. Of non-invasive methods for the assessment and quantification of ageing skin, there is a plethora of tools available to the clinical researcher as defined by key clinically observed ageing parameters: skin roughness and surface texture; fine lines and wrinkles; skin pigmentation; skin colour; firmness and elasticity; hair loss; and proliferative lesions. Furthermore, many clinical procedures for the evaluation of ageing skin treatments are combined with invasive procedures, which enable added-value to claims (such as identification and alteration of biochemical markers), particularly in those cases where perception of product effect needs additional support. As discussed herein, clinical methods used in the assessment of skin ageing are many and require a disciplined approach to their use in such investigations. Résumé Avec les progrès des recherches sur la peau, les consommateurs aujourd'hui ont un accès accru aux informations technologiques concernant le vieillissement de la peau et les produits de soins capillaires. Il en découle une demande rapidement croissante des preuves d'efficacité de ces produits. La reconnaissance de ces demandes a conduit au développement et à la validation de nombreuses méthodes cliniques pour mesurer et quantifier la peau âgée ou le vieillissement de la peau et les effets des traitements anti-âge. Beaucoup des méthodes de test classiques utilisées pour rechercher et évaluer les revendications des produits antivieillissement reposent sur des instruments sophistiqués, à côté des méthodes cliniques plus traditionnelles. La combinaison intelligente de méthodes cliniques a permis le développement de produits commerciaux aux technologies avancées, possédant une efficacité et une performance améliorées. A partir de méthodes non invasives pour la détermination et la quantification des peaux âgées, une pléthore d'outils utilisables par les chercheurs cliniciens a été développée. Elle repose sur les paramètres cliniques-clés observés lors du vieillissement : rêcheur de la peau et texture de surface, ridules et rides, pigmentation de la peau, couleur de la peau, fermeté et élasticité, chute des cheveux et lésions proliférantes. De plus, de nombreuses procédures cliniques pour l'évaluation des traitements des peaux âgées sont combinées à des procédures invasives qui permettent des revendications à valeur ajoutée comme l'identification et l'altération de marqueurs biochimiques, en particulier dans les cas où la perception de l'effet du produit nécessite une argumentation complémentaire. Comme discuté ici, les méthodes cliniques utilisées pour la détermination du vieillissement de la peau sont nombreuses et nécessitent une approche contrôlée pour pouvoir les utiliser dans de telles recherches. [source] Causes of hair loss and the developments in hair rejuvenationINTERNATIONAL JOURNAL OF COSMETIC SCIENCE, Issue 1 2002D. H. Rushton Synopsis Hair is considered to be a major component of an individual's general appearance. The psychological impact of hair loss results in a measurably detrimental change in self-esteem and is associated with images of reduced worth. It is not surprising that both men and women find hair loss a stressful experience. Genetic hair loss is the major problem affecting men and by the age of 50, up to 50% will be affected. Initial attempts to regenerate the lost hair have centred on applying a topical solution of between 2% to 5% minoxidil; however, the results proved disappointing. Recently, finasteride, a type II 5, reductase inhibitor has been found to regrow a noticeable amount of hair in about 40% of balding men. Further developments in treatments have lead to the use of a dual type I and type II inhibitor where 90% of those treated regrow a noticeable amount of hair. In women the major cause of hair loss before the age of 50 is nutritional, with 30% affected. Increased and persistent hair shedding (chronic telogen effluvium) and reduced hair volume are the principle changes occurring. The main cause appears to be depleted iron stores, compromised by a suboptimal intake of the essential amino acid l -lysine. Correction of these imbalances stops the excessive hair loss and returns the hair back to its former glory. However, it can take many months to redress the situation. Résumé Les cheveux sont considérés comme étant une composante majeure de l'aspect général d'un individu. L'impact psychologique de la perte des cheveux conduit à une diminution mesurable de l'estime de soi et s'associe à des images de contexte négatif. Il n'est pas surprenant que les hommes comme les femmes ressentent la perte de cheveux comme une expérience stressante. La perte génétique des cheveux est le problème principal qui touche les hommes et autour de l'âge de 50 ans, jusqu'à 50% seront concernés. Les premières tentatives de régénération des cheveux perdus se sont focalisées sur l'application topique d'une solution comprenant entre 2% et 5% de minoxidil; cependant, les résultats se sont avérés décevants. Récemment, le finastéride, un inhibiteur de la 5,-réductase de type II s'est avéré permettre la repousse d'une quantité significative de cheveux chez environ 40% des hommes dégarnis. Les développements ultérieurs des traitements ont conduit à l'utilisation d'un inhibiteur associant type I et type II pour lequel 90% des personnes traitées constatent une repousse significative des cheveux. Chez les femmes la cause principale de la perte des cheveux avant l'âge de 50 ans est d'origine nutritionnelle, avec 30% de la population affectée. Une perte de cheveux persistante et croissante (telogen effluvium chronique) et un volume des cheveux réduit sont les principaux effets qui se produisent. La cause principale semble être des réserves de fer épuisées, associées à une prise insuffisante de l'acide aminé essentiel L-lysine. La correction de ces déséquilibres stoppe la perte excessive de cheveux et rend aux cheveux leur éclat d'antan. Cependant, plusieurs mois peuvent être nécessaires pour redresser la situation. [source] Clinical significance of dermoscopy in alopecia areata: analysis of 300 casesINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 7 2008Shigeki Inui MD Objective To determine dermoscopic findings of alopecia areata (AA) from a large-scale study that can be used as clinical indicators of disease. Methods Dermoscopic examination of areas of hair loss on the scalp of 300 Asian patients with AA was performed using a DermLite® II pro, which can block light reflection from the skin surface without immersion gels. Using the Spearman rank-order correlation coefficient by rank test, correlations between the incidence of each dermoscopic finding and the severity of disease and disease activity were examined. The sensitivity and specificity of the findings as diagnostic clues for AA were evaluated. Results Characteristic dermoscopic findings of AA included black dots, tapering hairs, broken hairs, yellow dots, and clustered short vellus hairs (shorter than 10 mm) in the areas of hair loss. Black dots, yellow dots, and short vellus hairs correlated with the severity of disease, and black dots, tapering hairs, broken hairs, and short vellus hairs correlated with disease activity. For diagnosis, yellow dots and short vellus hairs were the most sensitive markers, and black dots, tapering hairs, and broken hairs were the most specific markers. Conclusion Dermoscopic characteristics, such as black dots, tapering hairs, broken hairs, yellow dots, and clustered short vellus hairs, are useful clinical indicators for AA. [source] Chronic telogen effluvium or early androgenetic alopecia?INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 11 2004Rodney Sinclair MBBS A 16-year-old girl presented with a 12-month history of generalized hair shedding from the scalp. The onset of shedding coincided with the development of Hashimoto's thyroiditis and iron deficiency. At the time of initial presentation, the Hashimoto's thyroiditis had been treated with Neo-Mercazole and she was euthyroid. Her iron stores were low, with a ferritin level of 13 µg/L. As she was vegetarian, oral iron replacement therapy was commenced without further investigation. On follow-up 6 months later, her iron stores were normal (ferritin, 36 µg/L), but the hair shedding had continued. On examination, there was a positive hair pull test from both the vertex of the scalp and the occipital scalp. There was mild bitemporal recession, but no widening of the central part, and she appeared to have a full, thick head of hair (Fig. 1). Additional investigations at that time revealed normal thyroid function and negative antinuclear antibody (ANA) and syphilis serology. She was on no medication other than Neo-Mercazole. Serum testosterone, dihydroepiandosterone sulphate (DHEAS) and sex hormone binding globulin (SHBG) were normal. Two 4-mm punch biopsies were taken from the vertex of the scalp; one was sectioned horizontally and the other vertically. The vertical section was unremarkable. On the horizontal section, there were 32 hair follicles in total, 30 of which were terminal hairs and two of which were vellus hairs. One hair was in telogen. The ratio of terminal to vellus hairs was 15 : 1. Figure 1. Initial presentation A diagnosis of chronic telogen effluvium was made. The condition was explained to the patient and she was reassured that chronic telogen effluvium is not a progressive condition and does not lead to baldness. No treatment was recommended. At follow-up 12 months later, the hair loss had obviously progressed and the patient was assessed as having Ludwig Stage 1 androgenetic alopecia with widening of the central part (Fig. 2). Repeat blood tests showed normal iron studies, thyroid function, and hormone parameters. Three 4-mm punch biopsies were taken from the vertex of the scalp and all were sectioned horizontally. The terminal to vellus hair ratios were 1 : 1, 2.6 : 1, and 1.9 : 1. A diagnosis of androgenetic alopecia was made and she was commenced on oral spironolactone, 200 mg/day. Figure 2. Presentation after 12 months [source] Male pattern hair loss: prevention rather than regrowthINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 10 2000Marcia Ramos-e-Silva MD First page of article [source] I love my hair but I don't want rheumatoid arthritisINTERNATIONAL JOURNAL OF RHEUMATIC DISEASES, Issue 1 2007Manjit SALUJA Summary We describe serious and severe hair loss in a young Indian (Asian) woman suffering from rheumatoid arthritis on treatment with leflunomide. Hair loss due to antirheumatic drugs is not too infrequent but needs to be better recognized in rheumatology. In our context, it often has socio-cultural ethnic connotations. [source] Decapeptide with fibroblast growth factor (FGF)-5 partial sequence inhibits hair growth suppressing activity of FGF-5JOURNAL OF CELLULAR PHYSIOLOGY, Issue 2 2003Chikako Ito Earlier studies demonstrated that knock-out of fibroblast growth factor-5 gene (Fgf-5) prolonged anagen VI phase of hair cycle, resulting long hairs in the mice. We showed the activities on hair growth of the two Fgf-5 gene products, one of which, FGF-5 suppressed hair growth by inhibiting anagen proceeding and inducing the transition from anagen to catagen, and FGF-5S, a shorter polypeptide with FGF-5-antagonizing activity translated from alternatively spliced mRNA, suppressed this activity of FGF-5. As the results suggested that FGF-5 antagonist would increase hair growth, we synthesized various peptides having partial sequences of human FGF-5 and FGF-5S and determined their FGF-5 antagonist activity. Among them, a decapeptide designated P3 (95-VGIGFHLQIY-104) that aligns with receptor binding sites of FGF-1 and FGF-2 suppressed FGF-5-induced proliferation of BALB/3T3 A31 and NIH/3T3 murine fibroblasts, and FGF receptor-1c (FGFR-1c)-transfected Ba/F3 cell line (FR-Ba/F3 cells). IC50s of this peptide on these cell proliferations were 64, 28, 146 ,M, respectively. On the other hand, IC50 of this peptide on binding of FGF-5 to the FGFR-1(IIIc)/Fc chimera was 483 ,M. Examination in dorsal depilated mice revealed that the P3 peptide reduced the activity of FGF-5 to recover hair pigmentation and hair follicle lengths. The classification of histologically observed skin sections showed FGF-5-induced delations of anagen procedure had reduced by the P3 peptide. The anti-Ki67 antibody staining of hair follicles was inhibited by administration of FGF-5, and this inhibition by FGF-5 was recovered by administration of the P3 peptide. The P3 peptide alone did not affect hair follicle length and hair cell proliferation. These results indicate that the decapeptide antagonized FGF-5 activity in vivo, and reduced the inhibition of FGF-5 in hair growth, confirming that FGF-5 inhibitors are promising substances against hair loss and/or for promoting hair growth. J. Cell. Physiol. 197: 272,283, 2003. © 2003 Wiley-Liss, Inc. [source] Psychological aspects of hair diseaseJOURNAL OF COSMETIC DERMATOLOGY, Issue 2 2005Ramon Grimalt Summary Balding men are viewed as less desirable in a physical, personal, and social sense. Given the stereotype, it is not surprising that some men with androgenetic alopecia (AGA) appear to have a lower self-image, depression resulting in increased introversion, and increased feelings of unattractiveness. Ours is a culture that places a premium on physical appearance. In this context, appearance-altering conditions can be psychosocially insidious, especially conditions such as AGA with an uncertain course and a negative social meaning. To date, little or no data have been available regarding the psychosocial and quality-of-life aspects of AGA in a representative sample of community men. It is unknown whether AGA is a causal factor in the development of low self-esteem, depression, introversion, and feeling of unattractiveness, or whether there are underlying problems in certain patients prior to hair loss. Longitudinal studies will be important to investigate the temporal relationships between the degree of hair loss and psychosocial variables associated with AGA. A patient with male pattern baldness will be better treated and consequently more satisfied (better quality of life) if he receives effective anti-alopecia agents and simultaneously is evaluated and treated, if needed, for his psychological disorder. [source] Hair colouring, permanent styling and hair structureJOURNAL OF COSMETIC DERMATOLOGY, Issue 3-4 2003S Harrison Summary Hair is an important component of body image and has immense psychological importance for both men and women. Women, in particular, over the ages have modified their appearance through changing their hair colour or style. Hair can be straight, wavy or curly, blonde, black, brown or red. These natural variations are an important part of our identity that can be manipulated according to the dictates of fashion, culture or society. Different types of hair have varying affinity for the different colouring and waving methods. Damaged hair also has a different affinity for hair products than normal healthy hair. The hair shaft is remarkably strong and resistant to the extremes of nature. Hair cosmetics are widely available and manipulate the structural properties of hair. Whilst most procedures are safe, there is considerable potential for damage to the hair and hair problems of acute onset, including hair breakage, hair loss and loss of condition, are frequently blamed on the last product used on the hair. Hair problems are particularly prevalent among people who repeatedly alter the natural style of their hair. [source] Scarring alopecia and the dermatopathologistJOURNAL OF CUTANEOUS PATHOLOGY, Issue 7 2001Leonard C. Sperling Background: The evaluation of patients with cicatricial alopecia is particularly challenging, and dermatopathologists receive little training in the interpretation of scalp biopsy specimens. Accurate interpretation of specimens from patients with hair disease requires both qualitative (morphology of follicles, inflammation, fibrosis, etc.) and quantitative (size, number, follicular phase) information. Much of this data can only be obtained from transverse sections. In most cases, good clinical/pathologic correlation is required, and so clinicians should be expected to provide demographic information as well as a brief description of the pattern of hair loss and a clinical differential diagnosis. Results: The criteria used to classify the various forms of cicatricial alopecia are relatively imprecise, and so classification is controversial and in a state of evolution. There are five fairly distinctive forms of cicatricial alopecia: 1) chronic, cutaneous lupus erythematosus (discoid LE); 2) lichen planopilaris; 3) dissecting cellulitis (perifolliculitis abscedens et suffodiens); 4) acne keloidalis; and 5) central, centrifugal scarring alopecia (follicular degeneration syndrome, folliculitis decalvans, pseudopelade). Not all patients with cicatricial alopecia can be confidently assigned to one of these five entities, and "cicatricial alopecia, unclassified" would be an appropriate label for such cases. Conclusion: The histologic features of five forms of cicatricial alopecia are reviewed. Dermatopathologists can utilize a "checklist" to catalog the diagnostic features of scalp biopsy specimens. In many, but not all, cases the information thus acquired will "match" the clinical and histologic characteristics of a form of cicatricial alopecia. However, because of histologic and clinical overlap between the forms of cicatricial alopecia, a definitive diagnosis cannot always be rendered. [source] | |||||||||||||