Areas Of Alopecia Research Articles

A previously undescribed cutaneous paraneoplastic syndrome in a cat with thymoma

Exfoliative dermatitis is a well-recognized cutaneous paraneoplastic syndrome (PNS) associated with thymoma in cats, of which the clinical and histopathological presentation has been well-characterized. To describe a novel clinical skin manifestation associated with thymoma in a cat. A 14-year-old neutered female domestic short hair cat. Physical, abdominal ultrasonographic, thoracic radiographic, ultrasonographic and computed tomographic examinations, histopathological assessment of the skin and mediastinal mass. The cat was presented with noninflammatory alopecia, with a dorsal multifocal distribution. Examination of the alopecic areas using a dermascope indicated an apparent lack of follicular ostia. Histopathological assessment of alopecic areas confirmed follicular and epidermal atrophy, trichilemmal keratinization and mild orthokeratotic hyperkeratosis. Diagnostic imaging revealed a mediastinal mass, which was surgically removed. Histopathological and immunohistopathological examination of the mass was consistent with a thymoma, associated with multiloculated cyst formation and multifocal cholesterol granulomas. Following surgery, hair re-growth was noted in the previously alopecic areas. The cat was euthanized 3.5months later because of recurrent chylothorax suspected to be a postoperative complication. The alopecic lesions had improved markedly. Thymoma-associated PNS might not always manifest as an exfoliative dermatitis and should be considered in the differential diagnosis of multifocal noninflammatory alopecia.

Rule of thumb: A simple tool to estimate 1% scalp surface area

Rule of thumb: A simple tool to estimate 1% scalp surface area

Ефективність комплексного лікування при асоціативному перебігу дерматитів у собак

Currently, skin pathology in dogs is often recorded and is approximately 32,5-55,2 %. Associated dermatitis in dogs has a multicomponent structure of the etiological factors associated with active action on the skin of acaro-fungal agents. Clinical manifestation of the disease is characterized by the presence of significant areas of alopecia, lichenization, vesicles, pustules, erosions, ulcers, scabs on the skin in the areas of the muzzle, ears, petioles of the extremities, severe skin itching and prolonged treatment and remission. The purpose of the work is to develop a modern strategy for the treatment of associative dermatitis in dogs caused by the causative agent of demodicosis and trichophytes. The research was carried out on dogs with skin diseases that belonged to the inhabitants of Kharkiv during the period 2018-2019. At the first stage of the research, anamnestic data was collected, taking into account age, breed, conditions of keeping animals, the type of diet, planned antiparasitic treatments. The second stage of the study included general clinical studies and special diagnostic criteria (parasitological and mycological tests). According to the results of parasitological and mycological studies, 35.3% have associated associative etiology dermatitis caused by the causative agents of Demodex canis and dermatophytes of the genus Trichophyton mentagrophytes. The disease was most commonly registered in dogs under the age of 7-9 months and 2-6 years old. Acaricidal therapy included the use of the drug Simparika (active ingredient sarolaner (Zoetis, USA) and avertsectinum ointment. Antifungal therapy consisted of the use of the drug Intraconazole and external treatments with Imaverol (active ingredient - enilconazole, ELANCO, Austria). Antibacterial therapy was presented by «Sinulox RTU» (Zoetis, USA) (acting substance amoxicillin and clavulanic acid). To facilitate the penetration of the drug through the skin, pretreatment of animals was performed using the keratolytic zooshampun «VetExpert» (Poland). For the correction of the immune condition, the drug «PDE» - denatured placenta emulsified, Pharmax, Ukraine) was used. For normalization of the liver function, the drug «Gepavikel» (manufacturer KELA (Belgium) was injected). Control over the course of the disease was carried out on the basis of a study of skin scrapers every 3-4 weeks. The scissors were taken from the same sites that were examined prior to treatment, and further investigated new areas with lesions. Treatment was performed for 2 months until 2 negative scratches of the skin were obtained. After recovery, control was performed at 3-month intervals for 1 year.

Clinical experience with hair transplantation for secondary cicatricial alopecias

Background: Hair transplantation for the treatment of secondary cicatricial alopecia has recently become a more widely used technique. Objective: The aims of this study were to evaluate the results of use of hair transplantation surgery in patients with secondary cicatricial alopecia, to compare the results of the procedure with regard to different etiologies and to evaluate patient satisfaction. Patients and Methods: Forty-five patients with a definitive clinical diagnosis of secondary cicatricial alopecia were included in this retrospective study. Patients' characteristics were obtained retrospectively from medical records. The percentage of amelioration of cicatricial alopecia and patient satisfaction was obtained by interviewing patients. Results: Thirty-nine patients (86.7%) were satisfied and very satisfied with the procedure. While all patients who underwent hair transplantation for the treatment of facial cicatricial alopecic areas were satisfied, patients with hypertrophic scars were not satisfied significantly. Patient satisfaction was correlated to the percentage of amelioration of cicatricial alopecia. While patients with permanent alopecia as a result of developmental defects were satisfied the most, patients with postoperative and posttraumatic scars were satisfied the least. There was no difference between two different hair transplantation methods with regard to patient satisfaction. Conclusion: Hair transplantation done directly into scar tissue could be the first line treatment in selected cases with secondary cicatricial alopecia as this method is less traumatic and easier to perform in comparison with other surgical treatment methods.

A semiquantitative grading scale for frontal and vertex of androgenetic alopecia.

Depending on the severity and region of baldness, numerous researchers proposed different classifications of alopecia. However, these previous classifications have some limitations. The study aimed to establish a semiquantitative grading scale for frontal and vertex androgenetic alopecia (AGA) in both males and females. Standardized pictures from 1,602 AGA cases were obtained. Three sets of reference photographs with different alopecia extents from scale 0 to 5 were developed with detailed description. The photographs covered the vertex, frontal of men, and vertex + frontal (V+F) area of the scalp of women. Hair density and the ratio of vellus and terminal hairs in the alopecia area were quantitatively measured by DermDOC® dermoscopy. Hair coverage rate of alopecia area was calculated by Photoshop software. Multirater consensus method was used to test the reliability and validity of the alopecia scale. Fleiss-Kappa coefficients of the three sets of reference photographs for interobserver analysis reached 0.81-0.89. The overall Kendall's coefficients for intraobserver assessment totaled 0.934-0.963. This new grading scale is a more sensitive and objective quantitative grading scale for alopecia and treatment response compared with the existing classification.

Surgical Treatment of Scarring Alopecia Associated with Acne Keloidalis Nuchae

Acne keloidalis nuchae (AKN) is a relatively rare chronic inflammatory condition that leads to alopecia on the occipital scalp. Multiple large keloids and alopecia associated with long-lasting folliculitis impair the psychosocial functioning of patients. We report successful treatment of alopecia associated with AKN. When a 23-year-old male was referred to us, a large area of alopecia and multiple keloids associated with AKN were found. Following total excision of the lesion, the defect was reconstructed with two rotation flaps elevated bilaterally. Most patients with AKN undergo conservative treatments including oral antibiotics and local steroid injections. As surgical treatments, excision followed by skin grafting or second-intention healing has been reported. However, all of the previously-reported treatments have left alopecia on the occipital region. Although long scars might be left in the scalp, local flap reconstruction would be an option for the treatment of large areas of alopecia associated with AKN.

Sebaceous gland abnormalities in fatty acyl CoA reductase 2 (Far2) null mice result in primary cicatricial alopecia.

In a large scale screen for skin, hair, and nail abnormalities in null mice generated by The Jackson Laboratory’s KOMP center, homozygous mutant Far2tm2b(KOMP)Wtsi/2J (hereafter referrred to as Far2-/-) mice were found to develop focal areas of alopecia as they aged. As sebocytes matured in wildtype C57BL/NJ mice they became pale with fine, uniformly sized clear lipid containing vacuoles that were released when sebocytes disintegrated in the duct. By contrast, the Far2-/- null mice had sebocytes that were similar within the gland but become brightly eosinophilic when the cells entered the sebaceous gland duct. As sebocytes disintegrated, their contents did not readily dissipate. Scattered throughout the dermis, and often at the dermal hypodermal fat junction, were dystrophic hair follicles or ruptured follicles with a foreign body granulomatous reaction surrounding free hair shafts (trichogranuloma). The Meibomian and clitoral glands (modified sebaceous glands) of Far2-/- mice showed ducts dilated to various degrees that were associated with mild changes in the sebocytes as seen in the truncal skin. Skin surface lipidomic analysis revealed a lower level of wax esters, cholesterol esters, ceramides, and diacylglycerols compared to wildtype control mice. Similar changes were described in a number of other mouse mutations that affected the sebaceous glands resulting in primary cicatricial alopecia.

Inhibitory effect of angiogenin on the expression of type I collagen and fibronectin in dermal papilla cells from androgenetic alopecia areas

Objective To evaluate effects of angiogenin on the expression of type Ⅰcollagen and fibronectin in dermal papilla cells from androgenetic alopecia areas, and to explore its possible mechanisms. Methods Dermal papilla cells were isolated from androgenetic alopecia areas and cultured. Real-time fluorescence-based quantitative PCR was performed to determine the mRNA expression of androgen receptor in dermal papilla cells of different passages, and cell counting kit-8 (CCK-8) assay to evaluate the effect of angiogenin at different concentrations of 0, 10, 20, 40, 80, 160 μg/L on the proliferative activity of the dermal papilla cells cultured in a medium with or without 0.1 nmol/L dihydrotestosterone. The confluent first-passage dermal papilla cells were divided into 3 groups: control group receiving no treatment, dihydrotestosterone group treated with 0.1 nmol/L dihydrotestosterone, and dihydrotestosterone + angiogenin group treated with 0.1 nmol/L dihydrotestosterone and 80 μg/L angiogenin. After 48-hour treatment, real-time fluorescence-based quantitative PCR was conducted to measure the mRNA expression of type Ⅰ collagen gene, fibronectin and transforming growth factor-β1 (TGF-β1) , and Western blot analysis to determine the protein expression of type I collagen, fibronectin, TGF-β1, phosphorylated Smad2 (p-Smad2) and p-Smad3. Statistical analysis was done by one-way analysis of variance (ANOVA) , least significant difference (LSD) -t test and t test for two independent samples. Results The mRNA expression of androgen receptor significantly decreased during the subcultivation of in vitro cultured dermal papilla cells from androgenetic alopecia areas (P < 0.05) . Cell proliferation assay showed that 20 - 160 μg/L angiogenin could evidently antagonize the inhibitory effect of 0.1 nmol/L dihydrotestosterone on the proliferation of dermal papilla cells (all P < 0.05) . Compared with the control group, the dihydrotestosterone group showed significantly higher mRNA expression of type Ⅰ collagen gene, fibronectin and TGF-β1. However, the mRNA expression of type Ⅰ collagen gene, fibronectin and TGF-β1 was significantly lower in the dihydrotestosterone + angiogenin group than in the dihydrotestosterone group (type Ⅰcollagen gene: 1.563 ± 0.143 vs. 4.329 ± 0.165; fibronectin: 1.290 ± 0.063 vs. 2.156 ± 0.115; TGF-β1: 1.136 ± 0.098 vs. 1.707 ± 0.100; all P < 0.05) . Moreover, angiogenin could obviously suppress the expression of type Ⅰ collagen, fibronectin, TGF-β1, p-Smad2 and p-Smad3 protein by dihydrotestosterone-induced dermal papilla cells (all P < 0.05) . Conclusion Angiogenin can inhibit the expression of type Ⅰ collagen and fibronectin in dermal papilla cells from androgenetic alopecia areas in vitro, which may be associated with the down-regulated expression of TGF-β1 and inhibition of TGF-β1/Smad signaling pathway. Key words: Angiopoietins; Alopecia; Extracellular matrix; Transforming growth factor beta1; Dermal papilla cell

Parry-Romberg Syndrome: an Unusual Case Report

Parry-Romberg syndrome, or progressive hemifacial atrophy, is a rare developmental disorder characterized by a slow unilateral progressing atrophy that may affect skin, fat, muscle, and bone. A 25-year-old man presented with a 3-year disfiguration of the right side of his face. A clinical examination revealed significant facial asymmetry evidenced by atrophy of the chin, upper lip, zygomatic region, and forehead. The nose and mouth were deviated to the affected side. Despite enophthalmia, there was no sight impairment. The atrophic skin over these sites showed areas of slight dyschromia and alopecia. Neurologic complaints, such as seizures, were not present. Computed tomography (CT) and 3-D reconstruction CT examinations showed severe skeletal deformities in the maxilla, zygoma, and mandibular body. Negative Raynaud test ruled out a diagnosis of scleroderma. After initiating therapy with systemic corticosteroids, the patient abandoned the treatment.

Cyberspace Chat: Correction of Large Defects in Children

1. Robin Unger, MD (drrobinunger{at}yahoo.com) 1. New York, New York, USA ![Figure][1]</img> There were recently several cases presented that involved children with larger areas of alopecia. The causes of the alopecia ranged from burns to radiation to mycotic infection resulting in scars.

Sarcoptic mange (Sarcoptes scabiei) in wild canids (Cerdocyon thous)

ABSTRACT: Crab-eating foxes (Cerdocyon thous) are wild canids found in practically all Brazilian states. They usually live and hunt in pairs, but can be found in small groups, which favors the transmission of diseases such as sarcoptic mange. This study aims to describe the epidemiological, parasitological and pathological findings of two fatal cases of sarcoptic mange in C. thous. Two wild canids were necropsied and cytological examination of skin and crust samples and histologic evaluation of various tissue samples were performed. Gross findings included poor body condition and extensive alopecia with thick skin crusts interspersed by intensely reddened alopecic areas. The cytological examination revealed numerous mites with short gnathosoma and rounded idiosoma that were transversally striated and presented triangular spines on the dorsal surface, terminal anus, and short and thick legs, characteristic of Sarcoptes scabiei. Histologic examination of the skin revealed numerous tunnels into and under the stratum corneum of the epidermis containing high amounts of S. scabiei. The mites were associated with marked acanthosis and hyperkeratosis, and mild superficial dermatitis. The findings reveal that sarcoptic mange is an important disease in wild canids.

Three Cases of Canine Dermatomyositis-Like Disease

Background: Dermatomyositis is an idiopathic, inflammatory/immunemediated disease of the skin, muscles and bloodvessels of hereditary nature and unclear pathogenesis. This familial disease has been described in certain breeds, especially collies and Shetland sheep dogs and is of rare occurrence in mongrel dogs. To describe and discuss three clinical cases of dermatomyositis-like disease and provide a brief review of the literature.Cases: Three young mongrel dogs are included in this report. Case 1: Mandarino, a 4-year-old mongrel dog, having a history of skin lesions for at least a year. Showed an underweight patient, skin ulcers, crusts, alopecia, peri-ocular scarring causing severe lagophthalmia and a corneal ulcer. Muscle atrophy was most notable in the head and legs; the dog haddifficulty and pain walking. Treatment was initialised with cephalexin 30 mg/kg BID, pentoxifylline 25 mg/kg BID, and prednisone 2.2 mg/kg SID. The patient was presented after two weeks for follow up; the anaemia and skin condition had improved, the weight had increased by 2 kg, dysphagia and locomotor abnormalities were not present. Case 2: Milagros,a mongrel female dog approximately two years of age, rescued from a shelter. Physical examination showed facial alopecia, erythema and scarring of the periocular skin, crusting and scaling in alopecic areas, pinnae tip necrosis and crusting, ear alopecia, tail tip necrosis and crusting. Also present were distal limb alopecia, crusting and ulcers in areas of trauma in the hock and carpal surfaces; some nails presented onychorhexis and onychoschizia. The patient has been treated for12 months with a good clinical outcome, with pentoxifylline, azathioprine 2.2 mg/kg EOD alternating with prednisone 1 mg/kg EOD. Case 3: Chuchito, an 11-month-old male mongrel rescued dog had been previously hospitalised due to his skin condition. Physical examination showed depigmented and alopecic areas in the nasal planum, perioral and periocular areas, and inflammation of the palpebral tissues. Necrosis of the distal pinnae, alopecia and scales were evident, along with sloughing of scales and ulcers. Skin lesions were also present in the distal limbs, and alopecia, erythema and some crusting and scales in the carpal, tarsal and digital areas. Onychodystrophy was present in several digits. This study describes the physical examination and the clinical pathological findings, including skin scrapings, fungal cultures, and skin biopsies, in three dogs with dermatomyositis-like disease, as well as the clinical outcomes after slightly different treatment protocols were used. The biopsy results of two dogs showed ischaemic dermatopathy.Discussion: The most common initial signs of the disease are erythema, desquamation and alopecia in the facial area, ears, distal limbs and pinnae in young puppies aged between two and six months of age, followed by pigmentary changes. Muscular lesions are uncommon; when present, they represent the most severe form of this disease. Dysphagia is a common sign and mega-oesophagus may be present. Patients with muscular disease can manifest difficulty walking, with a stiff high gait. The immune mediated pathogenesis of dermatomyositis can relate to triggering factors in some dogs, such as drugs, infections, paraneoplasms, or toxins. Other potential inducing stressors include oestrus, whelping and excessive solar exposure. Dermatomyositis-like or familiar dermatomyositis is diagnosed using clinical findings, histopathologyof skin and muscle, and muscle physiology studies. Electromyography, breed predisposition and genetic background can be helpful in some cases. The clinical findings and response to the treatment of all three cases were compatible with dermatomyositis-like disease in mongrel dogs.Keywords: dermatomyositis, dermatopathy, vascular disease, inflammatory myopathies, mongrel dog.

Dermatopatias associadas a micose e sarna superficiais em dois gatos-maracajás (Leopardus wiedii) no Zoológico Nacional da Nicarágua

The margay cat inhabits preserved tropical forests. Its geographical distribution extents from the north of Mexico, Central America, Peru, Paraguay, Ecuador and Brazil. We report the therapeutic management and resolution of clinical signs in two margay cats (Leopardus wiedii), who presented skin lesions characterized by areas of alopecia predominantly located on the back, ears, neck and front legs. Microscopic evaluation of skin scrapings revealed the presence of mites identified as Notoedres sp and Sarcoptes sp, as well as the presence of artrospores. Treatment consisted of administration of itraconazole (5 mg/kg PO, 24 h) and ivermectin (300 mcg SC). The animals were transferred to a new enclosure previously treated with iodine and chlorine. After 11 weeks of treatment there was complete remission of lesions, and no recurrence was observed.

A Rare Syndrome With Eye, Skin, and Brain Abnormalities

This boy was born with three skin appendages on the upper eyelid, a linear red plaque on the forehead, and a linear area of alopecia over the left cranium. An ophthalmic evaluation documented sclerocornea in the upper half of the left eye (Fig 1A,B).

Injection of PRP (Platelet-rich plasma) as a treatment for androgenetic alopecia : a systematic review of the literature

Androgenetic alopecia is the most frequent alopecia both in men and women. Despite it affects a large proportion of the population, they are few therapeutic options often restrictive. The injection of PRP in alopecic areas is a new and easy therapeutic option. The aim of this article is to systematically review the literature about this topic by analysing the articles describing the clinical results of this new technique in the treatment of androgenetic alopecia in men and / or women with a follow-up of minimum 6 months. A systematic review of the PRISMA type from several databases was carried out and identified 7 articles meeting the following inclusion criteria: 1) articles describing the clinical results of the injection of PRP for the treatment of androgenetic alopecia, 2 ) in men and / or women, 3) written in English or French, 4) with clinical follow-up of at least 6 months, and 5) with objective criteria for follow-up of patients and observed complications. These prospective clinical studies are analyzed and compared qualitatively. This systematic review of the literature resulted in a qualitative analysis of 7 scientific studies on the effect of PRP injection as a treatment for androgenetic alopecia. Although all the studies concluded in a favorable effect of this new treatment, a larger, rigorous study with objective analysis of the therapeutic effect is necessary.

Delleman syndrome: A case report from West Africa - features and the challenges of management

Delleman syndrome is a rare congenital disorder. We report an 8-month old female with a history of a fleshy mass covering the left eye since birth. Examination revealed poor vision in the left eye, an upper lid coloboma and an epibulbar dermoid with a large area of alopecia and scalp hypoplasia involving the left frontoparietal region. Transfontanelle ultrasound scan did not reveal any intracranial cyst. Cranial computerised tomography subsequently revealed characteristic cerebral malformations of Delleman syndrome. This report demonstrates clinical and computed tomographic features of a case of Delleman syndrome with emphasis on the usefulness of transfontanelle ultrasonography in assessing for life-threatening intracerebral cysts or hydrocephalus, particularly in resource-limited settings, where neuroimaging is not readily available or affordable.

Fractional Carbon Dioxide Laser in Combination with Topical Corticosteroid Application in Resistant Alopecia Areata: A Case Series.

Introduction:Intradermal steroid injections are used as treatment option in resistant alopecia areata. However, it is difficult and quite painful to treat large areas of alopecia with this modality.Objective:To assess the efficacy and safety profile of a combination of fractional carbon dioxide (CO2) treatment followed by topical corticosteroid application in resistant alopecia areata.Materials and Methods:Ten cases of resistant alopecia areata who had not responded to multiple treatment modalities were treated with fractional CO2 laser followed by topical application of triamcinolone spray (10mg/mL) on the resistant lesions. Patients received 4–8 sessions that were repeated at an interval of 3–4 weeks. Response to treatment was assessed on a quartile physician assessment scale and labeled as excellent (>75% regrowth), good (50%–75% regrowth), fair (26%–50% response), and poor (<25% regrowth).Results:Eight of these ten cases completed the treatment process. Seven of these eight patients had complete recovery of the area treated. One patient however did not show good response even after four sessions. No significant adverse effects were noted in any of the patients.Conclusion:Fractional CO2 laser in combination with topical triamcinolone can prove to be an effective treatment option in resistant alopecia areata.

Frontal Fibrosing Alopecia: A Retrospective Analysis of 72 Patients from a German Academic Center.

Frontal fibrosing alopecia (FFA) describes the scarring, band-like recession of the frontotemporal hairline. Treatment is difficult, and currently, no evidence-based therapy exists. The purpose of this study is to report clinical features and treatment responses in a large cohort of patients with FFA. The authors analyzed a series of 72 patients with a clinical or histologic diagnosis of FFA. A total of 70 patients were female (97.2%), and 2 were male (2.8%). In females, the first onset of FFA was postmenopausal in 81.4% (n = 57). Documented eyebrow loss was present in 61.1% (n = 44), whereas involvement of eyelashes and body hair was reported in only 4.2% (n = 3) and 5.6% (n = 4), respectively. Clinical symptoms were itching (40.3%, n = 29) and trichodynia (4.2%, n = 3) in the alopecic area. Virtually all patients were treated with topical high-potency steroids. Additional treatments were topical tacrolimus, systemic retinoids, and hydroxychloroquine. A total of 48 patients (66.7%) received a combination of high-potency steroids with topical pimecrolimus. In this subgroup, subjective improvement or disease stabilization was reported by 64.6% (n = 31), and the hairline was stabilized on average after 9 to 12 months of therapy. The combination therapy of topical high-potency steroids with pimecrolimus may be an effective and steroid-saving treatment for FFA.

Lesions in the Skin of Cattle Associated to Hairy Vetch Consumption (Vicia villosa)

Background: Hairy vetch (Vicia spp.) is a high-protein source forage to cattle. The poisoning is clinically characterized by a systemic granulomatous disease, which causes dermatitis, diarrhea, decreased milk production and weight loss. The specie of hairy vetch related to systemic granulomatous disease in cattle is Vicia villosa. This work aims to describe the epidemiological, clinical, gross, microscopic and immunohistochemistry features of the skin lesions caused by the consumption of V. villosa in cattle affected by the systemic granulomatous disease.Materials, Methods &amp; Results: A retrospective study of necropsy and biopsy exams performed between the period of 2005-2016 aiming for cattle with systemic granulomatous disease after consumption of hairy vetch was carried out in the archives of the Setor de Patologia Veterinária from the UFRGS. Epidemiological data included the sex, age, and breed of the animals affected. Gross and microscopical lesions, in addition to the immunohistochemistry anti-T lymphocytes (CD3), anti-B lymphocytes (CD79a), and anti-macrophages (CD68) features, were evaluated. The histological lesions and immunohistochemistry staining were quantified in mild (+), moderate (++), and severe (+++). The diagnosis of systemic granulomatous disease with skin lesions after consumption of Vicia villosa was observed in eight cattle. All animals were females, with 5-8 year-old (average 6.6 years), Holstein Friesian cattle (7) and Jersey (1) breeds. These cattle had a clinical history of severe pruritus, anorexia, apathy, decreased milk production, weight loss, and hyperthermia. Grossly, lesions were characterized by alopecia (8/8), crusts (7/8), lichenification and seborrhea (2/8), and exudative lesions (2/8), and involved the head (7/8), limbs (5/8), neck (4/8), trunk (4/8), perineum area (3/8), udder (3/8), and tail (3/8). Histology revealed a mild to moderate inflammatory infiltrate (7/7), composed by lymphocytes (7/7), macrophages (7/7), occasional eosinophils, and rare multinucleated giant cells (1/7). It was also classified in mild to severe perivascular dermatitis (7/7), mild to moderate perifolliculitis (4/7), superficial dermatitis (3/7), moderate to severe mural folliculitis (2/7), and hidradenitis (1/7). Another findings were moderate apocrine sweat gland ectasia, mild to moderate orthokeratotic hyperkeratosis, mild to moderate spongiosis, mild to moderate acanthosis, mild to severe serocellular crusts, mild pigmentary incontinence, mild to severe Munro’s microabscesses, mild to moderate hydropic degeneration, apoptosis, ulcers, mild to moderate superficial edema of the dermis, variable epitheliotropism and erosions. Immunohistochemistry of all skin sections had mild to severe staining for T cell (CD3), mild staining for macrophages (CD68), and immunostaining was rare (4/7) or absent (3/7) for B cells (CD79a).Discussion: Cutaneous lesions observed in this study were similar to those previously described by other authors for this condition, and were characterized by focal to coalescent areas of alopecia, lichenification and seborrhea, associated clinically to a severe pruritus. Histologically, these consisted of perivascular dermatitis, and perifolliculitis with an inflammatory infiltrate composed predominantly by lymphocytes, macrophages, with occasional eosinophils and multinucleated giant cells. Immunohistochemistry demonstrates a marked immunostaining for T cells, while it was mild for macrophages, which reinforces the involvement of the delayed type hypersensitivity (type IV) reaction in the pathogenesis of the disease.

Knockout of p16INK4a promotes aggregative growth of dermal papilla cells.

Dermal papilla cells (DPCs) are located in the hair follicles and play an important role in hair growth. These cells have the ability to induce hair follicle formation when they display aggregative behavior. DPCs derived from the androgenetic alopecia (AGA) area undergo premature senescence in vitro, associated with p16INK4a expression. The aim of the current study was to investigate the expression of p16INK4a in aggregative and non-aggregative DPCs and the effect of p16INK4a down-regulation in these cells by adenovirus-mediated RNA interference (RNAi). DPCs were isolated and cultured from healthy human scalp. p16INK4a gene and protein were detected in aggregative and non-aggregative cells. Expression of p16INK4a in DPCs was silenced by infection with rAd5-CDKN1A-1p2shRNA. Cell fate was monitored after infection. The growth of cells was measured by MTT assay. Cell cycle was evaluated by flow cytometry (FCM). DPCs were isolated by digestion and showed aggregative behavior for six passages. The expression of p16INK4a showed a clear upward trend in non-aggregative cells when compared with aggregative group. p16INK4a expression was silenced by rAd5-CDKN1A-1p2shRNA (p<0.05). The p16INK4a-silenced cells grew more rapidly and exhibited a trend towards aggregative growth. There was an increase in the proportion of cells in G1 phase, while those in S phase were reduced after p16INK4a gene silencing (p<0.05). Our results suggest that p16INK4a plays an important role in the premature senescence and aggregative behavior of DPCs. These observations can lead to novel therapeutic strategies for treatment of AGA.