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Areata

Distribution by Scientific Domains
Medical Sciences100%

Kinds of Areata

  • alopecia areata
    		•
  • extensive alopecia areata
    		•

    Selected Abstracts

    IMMUNOTHERAPY OF ALOPECIA AREATA WITH INTRALESIONAL CANDIDA ANTIGEN

    PEDIATRIC DERMATOLOGY, Issue 3 2006
    E. WILLIAM ROSENBERG M.D.
    No abstract is available for this article. [source]

    Bilateral Treatment for Alopecia Areata

    PEDIATRIC DERMATOLOGY, Issue 4 2010
    Daniele Torchia M.D.
    Anthralin 0.1% cream was prescribed for the left side of the scalp, while corticosteroids for the right side. After 4 months, only the right side of the scalp showed hair regrowth. Half-side strategy, that is, treating one side and managing the other , divided by the mid sagittal suture , as an internal control for no treatment, placebo or other treatment, has been commonly used in clinical studies for decades. In everyday practice, bilateral treatment is useful to evaluate the responsiveness to two topically delivered interventions and diminishes the time necessary to identify an effective one. [source]

    Clinical presentations of alopecia areata

    DERMATOLOGIC THERAPY, Issue 4 2001
    Maria 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]

    The histopathology of alopecia areata in vertical and horizontal sections

    DERMATOLOGIC THERAPY, Issue 4 2001
    David A. Whiting
    Alopecia areata (AA) is a relatively common disease affecting 1.7% of Americans by the age of 50 years. The diagnosis is usually made on clinical grounds. In some cases the diagnosis is elusive and biopsies are necessary. In other cases biopsies are useful from a prognostic point of view to determine whether there are enough follicles left for possible future regrowth. In view of the active research being conducted into AA, biopsies provide valuable material for further investigation. The diagnosis of AA is improved by the use of horizontal sections in addition to or instead of vertical sections of scalp biopsies. The histopathologic features favoring the diagnosis of AA include peribulbar and intrabulbar mononuclear infiltrates, degenerative changes in the hair matrix, decreased numbers of terminal anagen follicles, increased numbers of terminal catagen and telogen follicles, an increased number of follicular stelae, an increased number of miniaturized vellus hair follicles, and pigment incontinence of hair bulbs and follicular stelae. Follicular counts with horizontal sections are particularly helpful in making the diagnosis of AA when the biopsy has been taken between acute episodes and the characteristic peribulbar inflammatory infiltrate is absent. [source]

    Serum levels of IL-18 and sIL-2R in patients with alopecia areata receiving combined therapy with oral cyclosporine and steroids

    EXPERIMENTAL DERMATOLOGY, Issue 2 2010
    Deborah Lee
    Please cite this paper as: Serum levels of IL-18 and sIL-2R in patients with alopecia areata receiving combined therapy with oral cyclosporine and steroids. Experimental Dermatology 2010; 19: 145,147. Abstract:, This study was to determine which immunologic factors contribute to the prognosis of patients with alopecia areata (AA) who were receiving oral cyclosporine A and methylprednisolone. Patients with >25% hair regrowth were defined as responders, and patients exhibiting ,25% regrowth were poor-responders. The serum levels of IL-18 and soluble IL-2 receptor (sIL-2R) were measured at baseline in 21 patients with AA and 22 control subjects. The mean serum level of IL-18 in the patients with extensive AA was significantly higher than that in the control subjects. The mean serum concentration of sIL-2R in the AA patients significantly decreased after 1 month of treatment. The mean basal serum level of IL-18 was highest in the responder, whereas the baseline level of sIL-2R was significantly higher in the poor-responder group than other groups. In conclusion, increased serum sIL-2R level and lower IL-18 level at baseline was associated with a poor prognosis in patients with AA. [source]

    Immunoreactivity of corticotropin-releasing hormone, adrenocorticotropic hormone and , -melanocyte-stimulating hormone in alopecia areata

    EXPERIMENTAL DERMATOLOGY, Issue 7 2006
    Hei 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]

    ,Activation-induced cell death': a special program able to preserve the homeostasis of the skin?

    EXPERIMENTAL DERMATOLOGY, Issue 1 2002
    Giuseppe De Panfilis
    Abstract: The ,activation-induced cell death' (AICD) is a molecular system leading to death of antigen-activated T lymphocytes, in order to avoid accumulation of harmful cytokine-releasing cells. This article reviews both the molecular mechanisms working in AICD and the role played by such mechanisms in preventing a number of skin diseases. Specifically, because AICD removes activated and autoreactive T cells through a CD95-/CD95-L-mediated suicide, skin diseases were scrutinized in which such valuable machinery could be lacking. Indeed, at least some inflammatory skin diseases, including psoriasis and atopic dermatitis, can be sustained by an increased survival of activated T lymphocytes associated with deficient CD95-/CD95-L-mediated AICD of such strong pro-inflammatory cells. In addition, autoreactive skin diseases, including, e.g. alopecia areata, lichen planus and other lichenoid tissue reactions, can be related to autoreactive T lymphocytes which could be unable to undergo CD95-/CD95-L-mediated AICD. Finally, a lack of AICD may be executive even in favoring cutaneous T cell lymphoma. Thus, because inflammatory, autoreactive and neoplastic skin diseases can be associated with a deficient CD95-/CD95-L-mediated suicide of activated T cells, AICD is likely to represent a fundamental program to preserve the homeostasis of the skin. Therapeutic approaches able to restore the AICD machinery promise to successfully treat such relevant skin diseases. [source]

    A case of patchy alopecia areata sparing lesional greying hairs

    INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 8 2008
    Cheng Tan MD
    No abstract is available for this article. [source]

    Clinical significance of dermoscopy in alopecia areata: analysis of 300 cases

    INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 7 2008
    Shigeki 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]

    Investigation of the functional variant c.-169T > C of the Fc receptor-like 3 (FCRL3) gene in alopecia areata

    INTERNATIONAL JOURNAL OF IMMUNOGENETICS, Issue 6 2006
    N. Schäfer
    A functional variant in the Fc receptor-like 3 (FCRL3) gene has been implicated in susceptibility to autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus and autoimmune thyroid disease. Investigating a large case-control sample of patients with alopecia areata (AA), we found no evidence for the involvement of FCRL3 in susceptibility to AA. [source]

    Alopecia areata in a rhesus monkey (Macaca mulatta)

    JOURNAL OF MEDICAL PRIMATOLOGY, Issue 3 2007
    B. Beardi
    Abstract Background, A 14-year-old female rhesus monkey (Macaca mulatta) of Chinese origin has been suffering from alopecia universalis since childhood. Methods, Recently, the health status of the animal was recorded comprehensively by detailed clinical examination including hematology and serology supplemented by histological and immunohistochemical investigations of skin biopsies and molecular biological techniques to clarify the causes of the persistent hair loss. Results and conclusions, The hairless gene (hr) nonsense mutation was ruled out by polymerase chain reaction and by sequencing of the corresponding gene. Histological examinations revealed a prominent chronic lymphocytic perifolliculitis and folliculitis affecting anagen stage hair follicles as well as miniaturized hair follicles. Immunohistochemistry using the antibodies CD3, CD20 and CD4 confirmed the diagnosis of a T-cell-mediated autoimmune disease resembling alopecia areata universalis in humans. [source]

    Prolactine levels in the patients with alopecia areata

    JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 11 2009
    M Gönül
    [source]

    Alopecia areata in Turkey: demographic and clinical features

    JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 8 2008
    A Kavak
    Abstract Background, Alopecia areata is a complex genetic disease with still many unknown aspects, and many studies have been tried to find some clues about it. Objective, We aimed to investigate the demographic and clinical characteristics of alopecia areata in Turkish patients. Methods, Demographic data, localization, attack number in addition to some parameters such as disease duration, severity, age of onset, family history and ophiasis pattern were evaluated in 539 alopecia areata patients. Results, The male to female ratio was 1.6 : 1. Occipital and beard-moustache areas were mostly affected. Positive family history was noticed in 24.1% of the patients. The age of onset was earlier in women than in men (P = 0.04). Severe forms showed more persistent (, 1 year) disease duration (P = 0.00). Ophiasis was more common in severe, long duration (, 1 year) and early onset (, 18 years) disease (P = 0.00 for all parameters). Childhood alopecia areata (, 18 years) was also associated with long duration of the disease (P = 0.016) and positive family history (P = 0.008) when compared with adult onset (> 18 years) alopecia areata. [source]

    Efficacy and safety of a new clobetasol propionate 0.05% foam in alopecia areata: a randomized, double-blind placebo-controlled trial

    JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 10 2006
    Antonella Tosti
    Abstract Background, Clinical efficacy of topical corticosteroids in alopecia areata (AA) is still controversial. Positive clinical results have been obtained using ointments with occlusive dressing but this approach has a low patient compliance. Recently, a new topical formulation (thermophobic foam: Versafoam®) of clobetasol propionate 0.05% has been introduced on the market (Olux®, Mipharm, Milan, Italy) (CF). This formulation is easy to apply. After application to the skin the foam quickly evaporates without residues and it has a good patient compliance. In vitro studies have also shown that this formulation enhances the delivery of the active compound through the skin. Aim, To evaluate the efficacy, safety and tolerability of CF in the treatment of moderate to severe AA. Subjects and methods, Thirty-four patients with moderate to severe AA (eight men, mean age 40 ± 13 years) were enrolled in a randomized, double-blind, right-to-left, placebo-controlled, 24-week trial. Alopecia grading score (AGS) was calculated at baseline and after 12 and 24 weeks of treatment using a 0,5 score (0 = no alopecia; 5 = alopecia totalis). Clobetasol foam and the corresponding placebo foam (PF) were applied twice a day for 5 days/week for 12 weeks (phase 1) using an intrapatient design (right vs. left). From weeks 13 to 24 each enrolled patient continued only with the treatment (both on the right and left site) that was judged to have a greater efficacy than that on the contralateral side (phase 2). The primary outcome of the trial, evaluated on an intention-to-treat basis, was the hair regrowth rate, which was evaluated using a semiquantitative score (RGS) (from 0: no regrowth, to 4: regrowth of 75%). Results, At baseline the AGS was 4.1 (range: 2,5). Nine (26%) patients prematurely concluded the trial. At the end of phase 1, a greater hair regrowth was observed in 89% of the head sites treated with CF vs. 11% in the sites treated with PF. The RGS was 1.2 ± 1.6 in the CF-treated sites and 0.4 ± 0.8 in the PF-treated sites (P = 0.001). A RGS of 2 (hair regrowth of more than 25%) was observed in 42% CF-treated sites and in 13% of PF-treated sites (P = 0.027). In seven subjects (20%) a RGS of 3 to 4 (hair regrowth of 50%) was observed in CF-treated sites. In three subjects (9%) a RGS of 4 (hair regrowth of 75%) was observed in CF-treated sites. In one patient only, in a PF-treated region, a RGS of 3 was observed. The AS was reduced to 3.8 by CF treatment at the end of phase 1 and to 3.3 at the end of phase 2 (P = 0.01). From weeks 12 to 24 the treatment with CF induced a further increase in the RGS (from 1.2 to 1.5 ± 1.4). Forty-seven per cent of CF-treated patients had a RGS of 2 at the end of the trial. A total of eight patients (25%) at the end of the treatment with CF showed a RGS of 3. Folliculitis occurred in two patients. No significant modifications in cortisol and ACTH blood levels were observed during the trial. Conclusion, This new formulation of clobetasol propionate foam is an effective, safe and well-tolerated topical treatment for AA. This formulation has a good cosmetic acceptance and patient compliance profile. [source]

    Topical immunotherapy with squaric acid dibutylester: unusual hair pigmentary changes in two cases of alopecia areata

    JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 2 2002
    M Mastrolonardo
    [source]

    Treatment of alopecia areata with the 308-nm xenon chloride excimer laser: Case report of two successful treatments with the excimer laser

    LASERS IN SURGERY AND MEDICINE, Issue 2 2004
    Cuneyt Gundogan MD
    Abstract Background and Objectives Alopecia areata is a common disease of unknown etiology; it causes significant cosmetic and psycho-social distress for most of the people it affects. We report on an innovative form of treatment in two patients with typical alopecia areata on the capillitium. Study Design/Patients and Methods We successfully treated two patients whose alopecia areata had worsened progressively for 3 and 14 weeks. The treatment involved the use of a 308 nm xenon chloride excimer laser (dosage 300,2,300 mJ/cm2 per session). Results After 11 and 12 sessions within a 9-week and 11-week period, the entire affected focus showed homogenous and thick regrowth. No relapse was observed during the follow-up period of 5 and 18 months. Conclusions The use of the excimer laser is an effective, elegant, and safe means of treatment and has good tolerability. Analogous to topical treatment of alopecia areata, the immunosuppressive mechanism of the excimer laser can be interpreted as an induction of T-cell apoptosis. This new means of treatment has yet to be discussed in medical literature. Further studies with greater numbers are needed to assess its potential more precisely and evaluate the excimer laser in treating alopecia areata. Lasers Surg. Med. 34:86,90, 2004. © 2004 Wiley-Liss, Inc. [source]

    Acute stress enhances contact dermatitis by promoting nuclear factor-,B DNA-binding activity and interleukin-18 expression in mice

    THE JOURNAL OF DERMATOLOGY, Issue 6 2010
    Jing ZHANG
    Abstract Psychological stress adversely affects the immune system, and aggravates various skin diseases, such as psoriasis, alopecia areata and atopic dermatitis. However, the precise underlying mechanisms remain to be elucidated. The goal of this study was to use a murine restraint stress model to determine the mechanisms by which psychological stress modulates immune response in contact dermatitis. In the present study, mice were sensitized and challenged on the skin with 2,4-dinitrofluorobenzene. Acute restraint stress was administrated to healthy or sensitized mice before challenge, and nuclear factor (NF)-,B DNA-binding activation of nuclear protein and expression of interleukin (IL)-18 mRNA in murine spleen lymphocytes was detected. Chemical sympathectomy was performed using the neurotoxin 6-hydroxy-dopamine to determine the effect of the sympathetic nervous system. The experiment showed that restraint stress induced a series of changes which include increasing of NF-,B DNA-binding activity and IL-18 mRNA expression in spleen lymphocytes and enhancement of contact hypersensitivity response, and these changes may be mediated by the sympathetic nervous system. These findings provide new insights into the roles of the nervous system in the aggravation of skin diseases. [source]

    Fexofenadine hydrochloride enhances the efficacy of contact immunotherapy for extensive alopecia areata: Retrospective analysis of 121 cases

    THE JOURNAL OF DERMATOLOGY, Issue 6 2009
    Shigeki INUI
    ABSTRACT To study the effect of fexofenadine on extensive alopecia areata (AA), we evaluated retrospectively 121 patients with AA having alopecia in more than 50% of the scalp and followed them for at least 6 months. Patients were treated by immunotherapy using diphenylcyclopropenone or squaric acid dibutylester with or without oral fexofenadine. The regrowth score was estimated as decrease of Severity of Alopecia Tool (SALT) score. In AA with atopic background (atopic AA), the mean regrowth score of the fexofenadine group was 1.333 (n = 33) and that of the control 0.471 (n = 34). The fexofenadine group showed significantly better regrowth than control by Mann,Whitney's U -test (P = 0.00213). In non-atopic AA, the mean regrowth score of the fexofenadine group was 1.303 (n = 33) and that of the control 1.048 (n = 21). There was no significant difference by Mann,Whitney's U -test (P = 0.872). Together, fexofenadine is a helpful reagent in the treatment extensive atopic AA with contact immunotherapy. [source]

    Ocular alterations in patients of alopecia areata

    THE JOURNAL OF DERMATOLOGY, Issue 5 2009
    Deepika PANDHI
    ABSTRACT There is paucity of published work on ocular alterations in patients of alopecia areata (AA), especially from the Asian continent. We studied the clinical profile of 83 patients of AA and 80 sex- and age-matched controls to assess and compare the ocular changes, namely punctate opacities, cataract, intraocular tension and retinal changes. The outcome was analyzed with respect to prevalence of atopy, concomitant personal or family history of autoimmune diseases and nail changes in both the groups. The prevalence of atopy and family history of autoimmune diseases was significantly higher in the patient group. Lenticular changes were observed in 40.9% patients (including cataract in 16.9%) and 11.2% controls (P < 0.005). Within the patient group, lenticular involvement occurred with increased frequency in atopics (P = 0.034) and in the presence of family history of autoimmune diseases (P < 0.05). Retinal changes in the form of degenerative changes, pigmentary clumping and abnormal vascular changes were more prevalent (P < 0.001) in the study group. As the ocular changes were not found to correlate with the age, severity or extent of the disease, an initial ophthalmological screening of all patients is suggested. [source]

    Scalp dermoscopy of androgenetic alopecia in Asian people

    THE JOURNAL OF DERMATOLOGY, Issue 2 2009
    Shigeki INUI
    ABSTRACT Although dermoscopy is used mainly for diagnosing pigmented skin lesions, this device has been reported to be useful in observing alopecia areata and frontal fibrosing alopecia. Herein, we investigated the dermoscopic features and their incidence of androgenetic alopecia (AGA; n = 50 men) and female AGA (FAGA; n = 10 women) in Asian people. More than 20% hair diameter diversity (HDD), which reportedly is an early sign of AGA and corresponds to hair follicle miniaturization, was observed in the affected area of all AGA and FAGA cases, suggesting that HDD is an essential feature to diagnose AGA and FAGA. Peripilar signs, corresponding to perifollicular pigmentation, were seen in 66% (33/50) of AGA and 20% (2/10) of FAGA women. This incidence in the present study was lower than previously reported in white subjects possibly because the Asian skin color conceals slight peripilar pigmentation. Yellow dots were observed in 26% (13/50) of AGA and 10% (1/10) of FAGA cases and the number of yellow dots in AGA and FAGA was limited to 10 on the overall hair loss area. Yellow dots possibly indicate the coincidence of AGA and enlargement of the sebaceous glands caused by common end-organ hypersensitivity to androgen. In conclusion, dermoscopy is useful to diagnose AGA and FAGA and provides insights into the pathogenesis of AGA. [source]

    Fexofenadine, an H1-receptor antagonist, partially but rapidly inhibits the itch of contact dermatitis induced by diphenylcyclopropenone in patients with alopecia areata

    THE JOURNAL OF DERMATOLOGY, Issue 2 2006
    Kazumoto KATAGIRI
    ABSTRACT Antihistamines have been used for the treatment of not only allergic diseases such as allergic urticaria and rhinitis, but also of eczematous skin diseases because of their anti-pruritic effects. Moreover, the pruritus associated with eczematous diseases is considered to be induced, in part, by histamine. However, it is unclear whether antihistamines inhibit the itch of eczematous diseases in the absence of topical corticosteroids. In this study, we investigated the anti-pruritic effect of the antihistamine, fexofenadine, on the itch of contact dermatitis that was induced by topical application of diphenylcyclopropenone for the treatment for alopecia areata. Thirteen patients with alopecia areata, who had been treated weekly with topical immunotherapy with diphenylcyclopropenone for 3 months to 2 years, recorded the severity of their itching on a visual analog scale before and 3, 6, 12, 24, 48 and 72 h after application of diphenylcyclopropenone for 4 consecutive weeks. Seven patients took fexofenadine during the first and third weeks, and six patients took fexofenadine during the second and fourth weeks. The severity of itching reached a maximum 6,12 h after the induction of the contact dermatitis in most of the patients. However, fexofenadine partially but rapidly reduced the severity of itching for 72 h during the entire period of treatment in the absence of topical corticosteroids. Our results suggest that fexofenadine can be beneficial in the daily management of patients with itching due to eczematous disease. [source]

    Increased prevalence of familial autoimmunity in simplex and multiplex families with juvenile rheumatoid arthritis

    ARTHRITIS & RHEUMATISM, Issue 7 2002
    Sampath Prahalad
    Objective To determine if the prevalence of autoimmunity among relatives of patients with juvenile rheumatoid arthritis (JRA) is greater than that among relatives of healthy volunteer control subjects. Methods Interviews were used to obtain histories of the following disorders among living first- and second-degree relatives of 110 patients and 45 controls: alopecia areata, ankylosing spondylitis, dermatomyositis, Graves' disease, Hashimoto thyroiditis, insulin-dependent diabetes mellitus, inflammatory bowel disease, iritis, JRA, multiple sclerosis, psoriasis, RA, systemic lupus erythematosus, and vitiligo. Chi-squares, odds ratios (ORs), and 95% confidence intervals (95% CIs) were calculated. Families of 23 JRA affected sibpairs were interviewed subsequently. Results There were no significant differences between patients and controls with regard to age, sex, ethnicity, or family size. Patients had 1,228 relatives and controls had 496 relatives. Of all the relatives of the patients, 155 had at least 1 autoimmune disorder, compared with 20 relatives of the controls (12.6% versus 4.0%; OR 3.4 [95% CI 2.1,5.7], P < 0.000001). The prevalence of autoimmunity was increased in first-degree and in second-degree relatives of patients (16.1% and 10.6%, respectively). The prevalence of Hashimoto thyroiditis was significantly higher in the relatives of patients (OR 3.5 [95% CI 1.6,7.9], P = 0.0008). The prevalences of other disorders were not significantly different. JRA affected sibpair families had an increased prevalence of autoimmunity (15.0%). A history of arthritis was found significantly more frequently in the JRA affected sibpair families, but not in the simplex families. Conclusion These data demonstrate that the prevalence of autoimmunity is significantly higher among first- and second-degree relatives of JRA patients. This suggests that clinically different autoimmune phenotypes may share common susceptibility genes, which may act as risk factors for autoimmunity. [source]

    Topical diphencyprone immunotherapy for cutaneous metastatic melanoma

    AUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 4 2009
    Diona L Damian
    ABSTRACT Topical immunotherapy with contact sensitizers for metastatic melanoma was first reported more than 30 years ago. Diphencyprone (DPCP) immunotherapy is frequently used to treat cutaneous warts and alopecia areata, and we have previously reported the use of DPCP as a single agent to successfully treat extensive, radiotherapy-resistant melanoma metastases on the scalp. We now report DPCP treatment of a further six patients with cutaneous metastatic melanoma. Of seven patients treated with DPCP thus far, four have demonstrated complete responses of their cutaneous lesions and three have had partial responses. The treatment was well-tolerated by all patients. Topical immunotherapy with DPCP is inexpensive and relatively non-invasive and should be considered in patients with locally advanced skin metastases that are unsuitable for other therapies. [source]

    Cicatricial marginal alopecia: is it all traction?

    BRITISH JOURNAL OF DERMATOLOGY, Issue 1 2009
    L.J. Goldberg
    Summary Background, In a specialized hair loss clinic, a group of patients was identified with focal or complete hair loss at the scalp periphery, with a normal scalp surface. Biopsy revealed complete loss of individual hair follicles, indicative of scarring alopecia. Not all patients had a history supportive of a diagnosis of traction alopecia. Objectives, To identify and characterize further patients with scarring alopecia of the scalp margin using a retrospective review. Methods, All biopsies of scarring alopecia carried out by a single clinician between 1 January 1999 and 29 September 2006 were reviewed. Patients in whom the hair loss was located at the periphery of the scalp were selected for retrospective chart review. Results, A total of 15 patients met the study criteria, which included histological scarring alopecia and hair loss of the scalp margin. Six of the patients gave a history of relaxing or straightening their hair. Six denied hair care practices sufficient to cause traction alopecia. In three patients, the hair care history was unknown. Occipital hair loss was a common clinical finding, mimicking alopecia areata. The presence of scarring was often subtle histologically. Conclusions, A group of patients with moderate to severe cicatricial alopecia of the scalp margin is described. The presence of scarring is difficult to diagnose both clinically and histologically. The lack of a history of severe traction or harsh styling practices in half the patients casts doubt on whether or not traction is the only pathogenic factor. [source]

    The autoimmune regulator gene (AIRE) is strongly associated with vitiligo

    BRITISH JOURNAL OF DERMATOLOGY, Issue 3 2008
    R. Tazi-Ahnini
    Summary Background, Vitiligo is an autoimmune disorder that occurs with greatly increased frequency in the rare recessive autoimmune polyendocrinopathy,candidiasis,ectodermal dystrophy syndrome (APECED) caused by mutations of the autoimmune regulator (AIRE) gene on chromosome 21q22·3. We have previously detected an association between alopecia areata and single nucleotide polymorphisms (SNPs) in the AIRE gene. Objectives, To report the findings of an extended study including haplotype analysis on six AIRE polymorphisms (AIRE C,103T, C4144G, T5238C, G6528A, T7215C and T11787C) in vitiligo, another APECED-associated disease. Methods, A case,control analysis was performed. Results, Results showed a strong association between AIRE 7215C and vitiligo [P = 1·36 × 10,5, odds ratio (OR) 3·12, 95% confidence interval (CI) 1·87,5·46]. We found no significant association with the other polymorphisms individually. However, haplotype analysis revealed that the AIRE haplotype CCTGCC showed a highly significant association with vitiligo (P = 4·14 × 10,4, OR 3·00, 95% CI 1·70,5·28). To select the most informative minimal haplotypes, we tagged the polymorphisms using SNP tag software. Using AIRE C,103T, G6528A, T7215C and T11787C as tag SNPs, the haplotype AIRE CGCC was associated with vitiligo (P = 0·003, OR 2·49, 95% CI 1·45,4·26). Conclusions, The link between vitiligo and AIRE raises the possibility that defective skin peripheral antigen selection in the thymus is involved in the changes that result in melanocyte destruction in this disorder. [source]

    Topical photodynamic therapy with 5-aminolaevulinic acid does not induce hair regrowth in patients with extensive alopecia areata

    BRITISH JOURNAL OF DERMATOLOGY, Issue 5 2000
    R. Bissonnette
    Background,Photodynamic therapy (PDT) is a new modality involving the administration of a photosensitizer, or photosensitizer precursor, followed by its activation with light to generate a therapeutic effect. 5-Aminolaevulinic acid (ALA) is a photosensitizer precursor that is transformed by cells into protoporphyrin IX (PpIX), which can in turn be activated by red light. Objectives,To investigate the effect of PDT in alopecia areata (AA). Methods,In six patients with extensive AA, topical ALA lotion at 5%, 10% and 20% as well as the vehicle lotion alone were applied separately to different scalp areas, followed 3 h later by exposure to red light at each treatment session. Results,No significant hair growth was observed after 20 twice-weekly treatment sessions. A significant increase in erythema and pigmentation was observed for the three concentrations of ALA lotion vs. the vehicle, implying that a phototoxic PDT effect was achieved in the skin. In vivo fluorescence spectroscopy in one patient showed an increase in red PpIX fluorescence 3 h after ALA application followed by a decrease after light exposure. On fluorescence microscopy, bright red fluorescence was present in the epidermis and sebaceous glands, but not in the inflammatory infiltrate surrounding the hair follicle following ALA application. Conclusions,PDT was ineffective in the treatment of AA. [source]

    Photodynamic therapy with methyl 5-aminolevulinate acid combined with microneedle treatment in patients with extensive alopecia areata

    CLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 5 2010
    J. W. Lee
    No abstract is available for this article. [source]

    Hair diagnoses and signs: the use of dermatoscopy

    CLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 1 2010
    M. P. Wallace
    Summary Background., Hair-shaft examination is diagnostically useful in a range of adult and paediatric conditions. Objective., To evaluate the usefulness of dermatoscopy in hair-shaft microscopy. Methods., Typical examples of selected conditions from an extensive collection of scalp hair were examined using a dermatoscope and a light microscope with paired cross-polarizing filters. Hair-shaft characteristics were photographed using a digital camera. Results., Dermatoscopy was helpful in detecting tapered hairs, weathering, monilethrix, pediculosis capitis, peripilar casts, ,exclamation-mark' hairs of alopecia areata, bubble hair and pili torti. It was less helpful in pili annulati and unhelpful in detecting ,tiger-tail' banding in trichothiodystrophy. Light microscopy provided greater detail in almost all cases; it was necessary for detection of cuticle changes and added significant information in detecting characteristic features of trichothiodystrophy, pili annulati, bubble hair and pili torti. Conclusions., Dermatoscopy is most revealing in conditions resulting in gross changes in shaft outline and colour, where reflected light is valuable. It is unhelpful for detection of features within the shaft or at higher levels of resolution. When added to its ability to aid evaluation of scalp surface characteristics, dermatoscopy provides an excellent first-line method of assessment in clinics. In vivo it may aid screening and selection of hairs of greatest diagnostic yield for further assessment. In some instances, it may obviate the need for obtaining hair specimens and have implications for public health screening. Where detailed or cortical hair-shaft features need assessment, transmitted light microscopy remains the standard tool. [source]

    An unusual association between scalp psoriasis and ophiasic alopecia areata: the Renbök phenomenon

    CLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 3 2007
    P. R. Criado
    No abstract is available for this article. [source]

    Alopecia areata associated with idiopathic primary hypophysitis

    CLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 3 2005
    C. Ajith
    Summary Alopecia areata has been reported in association with various autoimmune diseases. Idiopathic primary hypophysitis is an organ specific autoimmune disease affecting the pituitary gland. We report a case of alopecia areata occurring in a patient of idiopathic primary hypophysitis. The constellation of the two diseases can be explained by autoimmunity, which is a major aetiologic factor in both diseases. To the best of our knowledge, this is the first report of such an association. [source]