Alopecia Lesions Research Articles

Meniere's disease triggered by alopecia areata

A 38-year-old female presented to the Otorhinolaryngology Clinic of Cumhuriyet University Hospital with recurrent fluctuating sensorineural hearing loss, aural pressure, episodic vertigo and tinnitus with duration of 4 years. Personal history revealed that an attack of Meniere's disease occurred 3-4 weeks later from an alopecia lesion emerged. She told that it was fourth sequential episodes of two diseases that she was experiencing within the last four years. Ear, nose and throat examination was normal. Pure tone audiometry showed sensorineural low frequency hearing loss (LFHL). The level of hearing loss was assessed by four frequency pure-tone averages (PTA) ranging from 500 to 3000 Hz. Speech discrimination scores were normal left ear, but right ear that was decreased (% 80). The clinical findings were consistent with the diagnosis of Meniere’s disease. In dermatologic examination there was an alopecia areata lesion in 3 cm diameter on the parietal region of the head (Figure 1). This patient's alopecia areata lesion was seen the last five years. Ig E levels of the subjects were normal, and there was no personal and family history of atopic or allergic diseases.

Type 1 interferon signature in the scalp lesions of alopecia areata

Autoimmune attack of the bulbar region of anagen phase hair follicles by CD8+ T cells and Th1 cytokines has been proposed to result in hair loss in alopecia areata (AA). The initiating stimuli are unknown. As interferon-alpha therapy may trigger AA, we propose that type 1 interferons are involved in the induction of disease. To compare lesional scalp from patients with AA with scalp lesions of cutaneous diseases associated with local type 1 interferon-related protein expression. Lesional scalp of patients with AA, discoid lupus erythematosus, lichen planopilaris and androgenetic alopecia was examined by immunohistochemistry for expression of the type 1 interferon-inducible myxovirus protein A (MxA), the chemokine receptor CXCR3, and the cytotoxic proteins granzyme B (GrB) and T-cell intracytoplasmic antigen 1 (TiA-1). MxA was expressed in the intradermal and subcutaneous compartments of the hair follicle including sebaceous glands in inflammatory AA similar to lesions of cicatricial alopecia (discoid lupus erythematosus, lichen planopilaris) but not in the epidermal compartment of AA, and not at all in noninflammatory AA or androgenetic alopecia. The location of CXCR3-expressing cells correlated with MxA expression. The inflammatory cells around the hair follicle in AA included a lower number of GrB+ and TiA-1+ cells compared with cicatricial alopecia and demonstrated predominant TiA-1+ expression. We demonstrate the expression of type 1 interferon-related proteins in the inflammatory lesions of AA. The distribution pattern of the interferon signature and cytotoxicity-associated proteins in AA differs from cicatricial alopecia.

Ceratose liquenóide em um cão

A ceratose liquenóide é uma rara dermatopatia proliferativa descrita em humanos e cães. Nos cães, a doença caracteriza-se pelo aparecimento de placas hiperceratóticas bem circunscritas nas pinas e, menos freqüentemente, nas virilhas. Este artigo descreve um caso de ceratose liquenóide em um cão macho, Dobermann, de seis anos de idade, com lesões verrucosas e multifocais na face interna das orelhas e lesões alopécicas, hiperpigmentadas, levemente elevadas e descamativas nas axilas e virilhas, ambas com evolução de aproximadamente três meses. O diagnóstico foi realizado com base na associação entre os achados clínicos e histopatológicos.

Controlled Delivery of T-box21 Small Interfering RNA Ameliorates Autoimmune Alopecia (Alopecia Areata) in a C3H/HeJ Mouse Model

Autoimmune alopecia (alopecia areata) is considered to be triggered by a collapse of immune privilege in hair follicles. Here we confirmed that infiltrating CD4 T lymphocytes around hair follicles of patients with alopecia areata were primarily CCR5-positive with few CCR4-positive cells, suggesting a dominant role of Th1 cells in the alopecic lesion. Given this finding, we sought to elucidate the effect of cytokine therapy in C3H/HeJ mice, a mouse model of alopecia areata, by applying recombinant interleukin-4 and neutralizing anti-interferon-gamma antibody. We found that local injections of both interleukin-4 and neutralizing anti-interferon-gamma antibody effectively treated alopecia in C3H/HeJ mice. Results from immunohistochemistry and semiquantitative reverse transcription-polymerase chain reaction demonstrated that intralesional injection of interleukin-4 suppressed CD8 T cell infiltrates around the hair follicles and repressed enhanced interferon-gamma mRNA expression in the affected alopecic skin. Furthermore, Th1 transcription factor T-box21 small interfering RNAs conjugated to cationized gelatin showed mitigating effects on alopecia in C3H/HeJ mice, resulting in the restoration of hair shaft elongation. Taken together, the use of gelatin-small interfering RNA conjugates promises to be a novel, efficient, and safe tool as an alternative gene therapy for the treatment of various human diseases. To our knowledge, this is the first report of effective controlled delivery of small interfering RNA using biodegradable cationized gelatin microspheres in an animal model of disease.

Pulse Corticosteroid Therapy for Alopecia Areata: Study of 139 Patients

Background/Aim: Recent reports of pulse corticosteroid therapy for alopecia areata (AA) show its efficacy for patients with a history of ≤1 year but not for recalcitrant cases or alopecia totalis/universalis. The purpose of this study was to evaluate the efficacy and safety of pulse corticosteroid therapy for recent-onset AA patients. Method: A total of 139 severe AA patients aged >15 years were included in this study. The duration from the onset of active hair loss was within 12 months for 125 (89.9%) of those patients. Results: Of the patients, 72.7% had hair loss on >50% of their scalp area. Among the recent-onset group (duration of AA ≤6 months), 59.4% were good responders (>75% regrowth of alopecia lesions), while 15.8% with >6 months duration showed a good response. Recent-onset AA patients with less severe disease (≤50% hair loss) responded at a rate of 88.0%, but only 21.4% of recent-onset patients with 100% hair loss responded. No serious adverse effects were observed.

Sarcoptic mange in three alpacas treated successfully with amitraz

Sarcoptic mange is a serious skin disease in alpacas that can result in high morbidity and even mortality. Three alpacas were presented with sarcoptic mange that had previously failed to respond to repeated topical applications of eprinomectin, and an injection of doramectin. They were moderately to severely pruritic, had extensive lesions of alopecia, erythema, scaling and crusting, and had lost weight. As no drug is currently licensed for the treatment of sarcoptic mange in alpacas in the UK, they were treated with a topical solution of amitraz (50 mL in 10 L) after initial bathing with antibacterial or keratolytic shampoos. The clinical signs completely resolved with no relapse over a 10-month follow-up period. In this small group of alpacas, amitraz was an effective and well-tolerated treatment for sarcoptic mange.

Bilateral ocular involvement in encephalocraniocutaneous lipomatosis

We report a case of encephalocraniocutaneous lipomatosis (ECCL), a rare congenital neurocutaneous syndrome, with cutaneous, ocular and neurologic malformations. The key features of ECCL are epibulbar choristomas, nevus psiloliparus, and intracranial lipomas. A full-term newborn presented at birth bilateral conjunctival tumours, right facial papulonodular lesions and an alopecic lesion consistent with lipoma on the right frontoparietal area. Brain imaging studies showed arachnoid cyst, enlarged lateral ventricle, cortical dysplasia, lipoma and leptomeningeal angiomatosis in the right hemisphere. The results were consistent with ECCL. Since ocular and skin involvement is a hallmark of the condition, children with epibulbar congenital lesions and skin lesions suggestive for ECCL should undergo a brain imaging study.

Induction of cellular immunity against hair follicle melanocyte causes alopecia

Alopecia areata (AA) is generally regarded as an organ-specific autoimmune disease. Although it has been hypothesized that the autoimmunity is mediated by T cells and that hair follicle melanocyte is one of the targets, definitive evidence is lacking. We here demonstrate that AA-like lesions can be induced in mice by inducing CD8(+) T-cell-mediated immunity to hair follicle melanocytes. We found that hair loss was induced in mice-bearing interleukin-12-producing B16 melanoma cells by the depletion of CD4(+) T cells, accompanied by vitiligo-like coat color change. The alopecic lesions varied in size from pachy to extensive. In many instances, hair loss developed and was followed by the regrowth of white hairs. Histological analysis revealed that mononuclear cells infiltrated in and around the bulb region of hair follicles. Furthermore, immunohistochemical examination clearly showed the intra-follicular infiltration of CD8(+) T cells. Neither the vitiligo-like coat color nor AA-like lesions were induced when CD8(+) T cells were codepleted. These observations indicate that the induction of CD8(+) T-cell-mediated immunity against hair follicle melanocytes causes alopecia. It is thought that there are many types of AA with different mechanisms, targets etc. Although hair follicle melanocytes have long been thought to be one of the targets of AA, evidence to support the hypothesis is sparse. Therefore, we believe that our observation is significant to support the hypothesis.

A Chinese–Japanese boy with black dot ringworm due to Trichophyton violaceum

A 4-year and 8-month-old Chinese-Japanese boy, who had been visiting Dalian, China frequently, developed multiple alopecia lesions 1 year previously. At his initial visit to our department, multiple patchy alopecia with black dots was observed in the parietal scalp area. Multiple erythematous macules were also seen on the face, nape and right dorsum of the hand. A diagnosis of tinea capitis and tinea corporis was obtained on the basis of potassium hydroxide (KOH) microscopic examination of hair and scales from the lesions. Colonies grown on Sabouraud cycloheximide-chloramphenicol agar culture were examined using Fungi-Tape and MycoPerm-blue, and numerous microconidia and a small number of macroconidia were observed. Trichophyton violaceum was identified as the causative organism on the basis of colony morphology, microscopic morphology and molecular biology technique. As T. violaceum infection is not often seen in Japan, we suspected that the patient was infected by T. violaceum during his stay in Dalian. Conidia formation is rarely observed with T. violaceum, and only five cases with T. violaceum macroconidia formation have been reported in Japan (including this case). We also report the method for visualizing conidia formation of T. violaceum using Fungi-tape and MycoPerm-blue.

Alopecia areata associated with regression of cutaneous melanoma

A 41-year-old white female with a past medical history of hypothyroidism and alopecia universalis presented on January 24, 2002 with a recently changing mole. She indicated changes in size and color of the superior aspect of a mole that had been present for more than 8 years. She had approximately 20 lifetime peeling sunburns due to being a lifeguard. No family or previous personal history of skin cancers, including melanoma or atypical nevi, was reported. Her history of alopecia universalis began 12 years previously and has partially resolved with remaining patchy alopecia of the scalp and eyebrows. On diagnosis of alopecia universalis, she was initially treated with oral prednisone for 1 year and topical minoxidil for 3 months. Currently, she is not being treated for this condition. She denied other previous skin conditions. She had a surgical history of tonsillectomy at the age of 7 years. Her current medication includes levothyroxine (0.015 microg) for hypothyroidism diagnosed 12 years previously. She reported no known drug allergies. During the initial physical examination, she presented with phototype II skin with two adjacent pigmented lesions on her left foot within a 1.3 cm square. The first lesion on the left posterior distal heel was an irregular, brown-black, 0.5 x 0.6 cm macule. The second lesion, on the left posterior proximal heel, was an irregular, brown, speckled, 0.3 x 0.4 cm macule (Fig. 1). The patient had ophiasis of the scalp and total alopecia of the bilateral eyebrows. In keeping with the patient's wishes, alopecia lesions were not biopsied and clinical photographs of the alopecia are not included in this article. Two 3 mm punch biopsies were performed within each lesion. The left posterior proximal lesion showed malignant melanoma, with a Breslow depth of 0.4 mm, anatomic level II, marked lymphocytic response and partial regression (Fig. 2). The left posterior distal lesion showed malignant melanoma in situ, arising in a lentiginous compound nevus, with architectural disorder and cytological atypia. These two lesions were concluded to be one lesion with clinical regression. She underwent local excision with 1-cm margins and sentinel lymph node biopsy owing to the presence of regression, which showed no evidence of metastatic melanoma. Lactate dehydrogenase and chest X-ray were within normal limits. The alopecia areas were not biopsied previously or at that time.

Les teignes à madagascar : enquête dans une école d’Antsirabé

Tinea capitis is a common infection among schoolchildren in developing countries. This condition is still under-reported in Madagascar. In order to assess the prevalence of Tinea capitis in Madagascar, we conducted a study in a primary school in Antsirabe, a town located in the country's high central territories. Samples were taken from 210 children in the 4 school classes aged between 6 and 14 years. Only children with scaling lesions or with alopecia were sampled. No microsporic gray-patch ringworm was found in any of the children. Samples were obtained from a total of 83 children. Cotton swabs moistened with distilled sterilized water were rubbed on the children's scalps for 15 seconds and the scales thus collected were then seeded on 2 separate tubes of Sabouraud-Dextrose-Agar media containing chloramphenicol, one with and the other without cycloheximide. The tubes were incubated at a temperature of 27 degrees C for 4 weeks. All the micromycetes were identified (dermatophytes, yeasts and molds). Three species of dermatophytes were isolated: one anthropophilic species, responsible for black-dot ringworm (Trichophyton tonsurans), and 2 geophilic dermatophytes, unusual in human disease (Microsporum boullardii and Trichophyton terrestre). Of the 83 children sampled, 17 had 20 dermatophytes (in 3 children, 2 different species of dermatophytes were associated). We collected 15 Trichophyton tonsurans (2 Trichophyton tonsurans were associated with Microsporum boullardii, and 1 with Trichophyton terrestre), and 2 Microsporum boullardii. The prevalence of carriers of dermatophytes was 8 p. 100 for all children and 20.5% for the sampled children. Children in Madagascar, unlike those in Central Africa, do not develop microsporic gray-patch ringworm caused by Microsporum langeronii. However, they may present tinea capitis with small alopecic lesions, or they may frequently have Trichophyton tonsurans and seem to have healthy scalps. In contrast with Central Africa, where T. soudanense is the main cause of black-dot ringworm, and with North Africa, where T. violaceum is most frequently seen, these 2 species are not found in Antsirabe. Studies carried out in coastal regions with a more tropical climate could perhaps show other dermatophytes responsible for tinea capitis. Anthropophilic tinea capitis caused by Trichophyton tonsurans is endemic in the Antsirabe area. The lesions are inconspicuous with diffuse scaling, like those reported in surveys conducted in the USA. Mycological investigation followed up by topical treatment with a fungicide could diminish the spread of this anthropophilic, and thus contagious, dermatophyte. Trichophyton tonsurans has also reappeared regularly in France over the past few years.

Postoperative Alopecia in Five Patients after Treatment of Aneurysm Rupture with a Guglielmi Detachable Coil: Pressure Alopecia, Radiation Induced, or Both?

Postoperative pressure alopecia is an uncommon complication of long anesthetic surgical procedures, typically affecting the occiput and resulting from pressure-induced tissue hypoxia. Generally, it develops after procedures of long duration, of more than four hours. Most alopecia is transient, but a few cases are permanent. Guglielmi detachable coil (GDC) coiling is a procedure guided by fluoroscopy that fills an intracranial aneurysm. Our cases were characterized by an unusual distribution of alopecia, short duration of procedure, and radiation exposure. The alopecic lesions of our patients were located on the temporal scalp as well as the occipital scalp. The total time of anesthesia was relatively short, two to three hours. During the procedure, these patients were exposed to ionizing radiation (over 2Gy). These cases are different from previous reports in that the duration of the procedure was short, the temporal scalp was affected in addition to the occipital scalp, and the pathology occurred after GDC coiling.

Morphea‐like lesion in a cat

Scleroderma is a rare chronic disease of connective tissues, involving the skin and/or internal organs in humans, and rarely described in the dog. A case is reported of localised scleroderma in a cat which presented with two well delineated alopecic, sclerotic, raised and shiny lesions localised on the trunk. Diagnosis was made by histopathological examination of skin biopsies which showed the replacement of all dermal components by dense thick collagen bundles. No therapy was instituted and a spontaneous recovery occurred three months later. Clinical and histopathological aspects of this feline dermatosis are compared with human and canine morphea.

Seborrheic skin disorders and their treatment in dogs

Seborrhea is a term used in veterinary medicine to describe a variety of clinical dermatoses ranging from mild scaling to severe, greasy, crusty, alopecic lesions. 1–4 Seborrhea may be a manifestation of an abnormality in keratinization or sebum production/ composition. Seborrhea is a descriptive term and not a specific diagnosis.

Parietal cephalocele: clinical importance of its atretic form and associated malformations.

In this study of atretic cephaloceles, the authors have considered the pedunculated or sessile type of cephalocele and also small nonpedunculated scalp defects developing in the vertex midline. Parietal cephaloceles were found in 15 infants (10 boys and five girls), and accounted for 37.5% of all cephaloceles. They consisted of four encephaloceles, six meningoceles, and five atretic cephaloceles. The clinical and morphological characteristics of parietal cephaloceles were investigated and compared with those arising at other locations. Parietal cephaloceles carried a much less favorable prognosis than those in the occipital region, regardless of the type of cephalocele; they were associated with cerebral malformations more frequently and were more severe than occipital cephaloceles. Grave congenital anomalies were found in 87% of patients with parietal cephalocele, and only two patients (neither of whom had any other malformation) attained normal development. Brain malformations were closely related to the site from which the cephalocele issued, and dorsal cyst malformation was found in eight patients with parietal cephalocele. Two types of atretic cephaloceles were found, each in a different location. The first type was an alopecic lesion occurring in the parietal midline; all five patients with this type had dorsal cyst malformations and none developed normally. The second type was a nodular lesion developing at the occipital midline, not associated with cerebral anomalies; all five patients with this type showed normal development. The pathogenesis of atretic cephaloceles and their associated intracranial malformations are discussed.

Behaviour-associated alopecia areata in mice.

In 5 different mouse strains, we observed alopecic lesions most commonly in male breeding animals kept with C57BL females. Alopecic areas were located most frequently on the head, but were also found over the shoulders, the back and the pelvic regions. Observations gained through time-lapse photography indicate the cause is a slight increase in self-grooming and a dramatic increase in allogrooming by their female partners. The increased frequency of lesions of males kept with C57BL females suggests that the increased grooming activity may be genetically determined.

Increase of mast cells in the alopecia lesion of mice

A histological investigation was made of the quantitative behavior of mast cells in bald areas on mice and in human alopecia areata. C57BL,W/Wv and +/+ mice with alopecia lesions were examined. In C57BL mice and +/+ mice, the number of dermal mast cells (per square mm) in the bald areas was greater than that in controls. The mean number of mast cells was slightly higher in human alopecia areata than in the controls. Since W/Wv mice lacking mast cells developed alopecia lesions, it seems that mast cells are not necessary for the onset of alopecia areata but could play some part in regrowth.

PRURITUS AND HYPERESTHESIA CAUSED BY PARTIAL SENSORY DENERVATION

In 1933 Beeson and Pickett1published a contribution to the experimental study of alopecia areata. In spite of having read my publications2in which I conclusively demonstrated the physiopathologic mechanism of the cutaneous lesion obtained experimentally, the authors confined themselves to repeating on twenty-one cats Max Joseph's operation, the extirpation of the second rachidian ganglion with its corresponding roots. Their conclusions were as vague as those of Joseph, who stated in 1886 that the lesions of alopecia obtained by this operation are similar to those of alopecia areata in human patients, which gives the false impression that the nerve section causes the appearance of the disease in the animal. Besides this, they did not study the physiopathologic process leading to the experimental production of the lesions. Without meaning to be controversial, I think it useful to publish this paper, because I feel that Beeson and Pickett, in