Cause Of Alopecia Research Articles

What’s missing from this picture? An approach to alopecia in children

H air loss carries with it a tremendous emotional and psychological burden for the patient. It can also be very daunting both diagnostically and therapeutically for the clinician. With entities...

Enoxaparin-induced alopecia in patients with cerebral venous thrombosis

To report three cases of alopecia induced by the anticoagulant enoxaparin in cerebral venous thrombosis (CVT) patients. Three female patients were treated initially with direct intrasinus urokinase, and then followed by low-molecular-weight heparin (LMWH) enoxaparin at 1 mg/kg given subcutaneously twice daily for 3 weeks. It was switched to oral anticoagulant warfarin at 5 mg daily for another 6 months. Nearly 3 weeks after the initiation of anticoagulation, all of the three patients complained of excessive hair loss with large areas of patchy, non-scarring alopecia. Hair growth returned to normal within 1 month after the completion of enoxaparin. Unfractionated heparin remains the first-line treatment of CVT because of its efficacy, safety and feasibility. Alopecia has been reported as a side effect of LMWHs dalteparin and tinzaparin. The pattern of hair loss, telogen effluvium, involves the induction of the hair follicle into a resting phase without apparent pathologic implication. In addition, this article also reviewed other medications taken by the patients that are possibly associated with hair loss. From the review of literature, there is no report of alopecia caused by urokinase. Using the Naranjo ADR Probability Scale, a score of 6 suggests that enoxaparin was the probable cause of alopecia in our three patients. This report introduces evidence of alopecia as a probable side effect of enoxaparin, but stresses the efficacy and safety of LMWH. As this is not a life-threatening disorder, we hope to increase the awareness of pharmacists and clinicians to this relatively rare but important side effect.

Serum and liver tissue biotinidase enzyme activity in rats which were administrated to valproic acid

Valproic acid (VPA) is an antiepileptic drug widely used and well-tolerated by most of patients. Its non-dose-dependent side effects seen mostly are the temporary gastrointestinal disturbances including anorexia and nausea, and hepatoxicity. As to its dose-dependent side effects are the weight loss, tremor, skin eruption and the alopecia. In this study we aimed to put forward the biotinidase deficiency considered as a possible cause of alopecia in the rats administered with valproic acid, and the correlation between liver and serum biotinidase enzyme activities (BEA) and transaminases, albumin and serum valproic acid levels. In our study, 4 groups of which one of them was a control group, each consisting of 15 male Wistar rats was organized. 200, 400, and 600 mg/kg/day of VPA, and distilled water, two divided doses per day, were administered per orally to VPA-1, VPA-2, VPA-3, and control group, respectively, in 60 days. Their serum and liver biotinidase enzyme activities, serum AST, ALT, albumin, and valproic acid levels were measured. Alopecia was seen in the subjects of 6.6% of VPA-1, 13.3% of VPA-2, and 26.6% of VPA-3. Significant difference in the liver tissues BEA was noted only between VPA-3 and the control group. Reductions were observed both in the liver tissues BEA and the serum BEA levels, which are inversely proportional to the VPA doses. A positive correlation between the liver biotinidase enzyme activities and the serum valproic acid levels, and the negative correlation between the liver tissues biotinidase activities and the serum valproic acid levels were noted, respectively. As a conclusion, the partial alopecia which is an initial symptom of reduced biotinidase activity may also be created depending on the reduction of biotinidase activity during valproic acid therapy. The alopecia which may further be observed in the patients receiving valproic acid therapy may be prevented by means of administration of biotin in a dose of 10 mg/day.

Tacrolimus-Induced Alopecia in Female Kidney-Pancreas Transplant Recipients

Immunosuppressive drugs given to solid organ transplant recipients may be responsible for cosmetic side effects which can endanger patient compliance. Cyclosporine is associated with hirsutism whereas tacrolimus has been associated with rare cases of alopecia. Since 1998, we have included tacrolimus within the immunosuppressive regimen following kidney-pancreas transplantation. The aim of this study was to evaluate the incidence of alopecia in this population and possible risk factors. Between January 1, 1995 and October 31, 2003, 59 consecutive simultaneous kidney-pancreas (SPK) transplants were performed in 58 recipients (27 females and 31 males). The immunosuppressive regimen comprised corticosteroids, calcineurin inhibitor (cyclosporine, n=11; or tacrolimus, n=40) and a purine inhibitor (azathioprine or mycophenolate mofetil). Clinically significant alopecia occurred in 13 patients (28.9%) receiving tacrolimus versus none receiving cyclosporine (P<0.001). Of those who experienced alopecia, 11 were female and two were male (P=0.02). The mean delay between transplantation and alopecia was 422 days (range 100-1,567). Other causes of alopecia were excluded. Treatment of alopecia with topic minoxidil was successful in all cases but one, which required conversion from tacrolimus to cyclosporine. Alopecia is a frequent complication in women receiving tacrolimus therapy following SPK transplantation. Its pathogenesis is unknown. This cosmetic complication must be discussed with patients before transplantation to minimize the risk of noncompliance.

DERMATOLOGIC INVESTIGATION OF ALOPECIA IN RHESUS MACAQUES (MACACA MULATTA)

Coat damage has been reported frequently in captive rhesus macaques (Macaca mulatta), and it is a serious health problem because the hair coat functions as an anatomic and physiologic barrier between the animal and the environment. The purpose of this study was to identify the pathogenesis of coat damage in this species and to exclude the most frequent causes of alopecia. The investigation included clinical, hematologic, bacteriologic, mycologic, parasitologic, and histopathologic evaluations. A broad systematic dermatologic investigation was performed on 156 rhesus macaques, kept under variable environmental conditions, at the German Primate Center, Göttingen. In addition, 27 animals from other primate facilities were incorporated into the study. Clinically, 126 animals showed partial alopecia of varying severity, with complete alopecia in the worst cases. In 88% of the cases, the disorder was bilaterally symmetrical. The back and extremities were most commonly affected. No gross clinical changes of the skin surface were detected. Histologic changes consisted predominantly of mild epidermal hyperkeratosis and mild perivascular dermatitis. The presence and severity of histologic lesions were not correlated to coat damage. Parasitic, bacterial, and mycotic causes of alopecia were ruled out. Overviewing these results, disturbances in environment and behavior controlling or influencing hair growth may lead to hair loss in captive rhesus macaques. Future studies should try to identify disturbances in extrinsic or intrinsic factors influencing hair follicle activity in rhesus macaques.

Congenital alopecia areata

Alopecia areata, the alleged autoimmune process leading to nonscarring hair loss, is not uncommon. It has been classified as an acquired cause of alopecia; however, recently it has been reported in the neonatal period. We report 4 cases of congenital alopecia areata with follow-up from 3 to 5 years. The diagnosis was made clinically in all cases. All patients had prolonged periods of quiescence of hair loss ranging from 6 to 24 months. Treatments used included minoxidil 2% and a range of topical steroids including hydrocortisone 1%, betamethasone valerate 0.05%, fluocinonide 0.05%, and clobetasol propionate 0.05%. The best regrowth observed resulted from the use of clobetasol propionate 0.05%, giving full regrowth in 50% of those treated. Alopecia areata can occur at all ages and, thus, can be classified as both an acquired and a congenital disorder resulting in hair loss.

The water-soluble extract of Illicium anisatum stimulates mouse vibrissae follicles in organ culture.

It is well known that reduced blood flow in the scalp is a cause of alopecia. We have shown previously that the extract of Illicium anisatum increases subcutaneous blood flow in mice. In the present study, we used an organ culture system to examine whether this extract promoted hair follicle elongation. B6C3HF1 mouse vibrissae follicles were cultured in serum-free medium for 7 days at 31 degrees C. Follicles treated with water-soluble (WS) extracts of the leaves, fruits and roots of Illicium anisatum or shikimic acid grew significantly longer than controls. In contrast, ethyl acetate-soluble (AS) extracts and n-hexane-soluble (HS) extracts of the leaves, fruits and roots of the plant inhibited hair follicles and shaft growth. Fractionation of the WS fruit extract showed that the number 1 and number 2 fractions possessed hair follicle elongation activity. GC/MS analysis revealed that the number 1 fraction contained shikimic acid, and that the number 2 fraction was a mixture of many components including glycosides and polysaccharides. Reverse transcription-polymerase chain reaction analysis demonstrated that shikimic acid also induced mRNA expression of insulin-like growth factor-1, keratinocyte growth factor, and vascular endothelial growth factor in the hair follicles. These results suggest that the WS extract of Illicium anisatum promotes hair growth and may be a useful additive in hair growth products.

Clinical relevance of hair microscopy in alopecia.

Hair microscopy can clarify the cause of hair loss in a range of diagnoses. Most of these are associated with hair breakage, the rest are related to lack of growth. Hair breakage may be due to excessive trauma or underlying susceptibility, where structural clues may be present. Lack of growth reflects follicular dynamics and represents the central mechanism of most common causes of alopecia. In such conditions, microscopy only reveals nonspecific confirmation of short anagen. Although this may assist clinical diagnosis, microscopy in alopecia only allows exclusion of diagnoses related to hair breakage. Confidence in the outcome of hair microscopy is based on the size of the sample of hairs, the length of the hair, the characteristics of the observations and the experience of the person undertaking the microscopy.

Trichotillomania

Trichotillomania

Trichotillomania.

Trichotillomania.

Maximizing Diagnostic Yield from Alopecia Biopsies

The cause of alopecia can be difficult to determine on histologic sections. Traditional, vertically oriented histologic sections usually contain only a

脱毛症のしん灸治療に関する基礎的，臨床的研究 （Ｉ） 頭皮，全身所見の調査に基づく脱毛症の成因としん灸治療の可能性に関する考察

脱毛症の成因については皮膚科学に於いても明確な説明が得られていない。我々は鍼灸治療の種々の脱毛症に対する有効性を検討し, その治療方針を考案するために従来の成因に関する諸説, 及び鍼灸による治験報告を再考すると共に、その成因を多角的視野で検討するために脱毛症患者534名を対象として, 頭皮所見と脱毛症に伴う身体症状の調査を行った。休止期毛性脱毛症群では頭皮の血行不良と身体的過緊張に深い関係がみられた。成長期毛性脱毛症群では自律神経系の変調を想起させる症状が頭皮と身体の双方に高率に認められた。よって脱毛症は頭皮のみの疾患ではなく, 全身的機能変調の表出と考えられる。

Two new causes of alopecia

Two new causes of alopecia

Major causes of alopecia with suggestions for history taking, workup, and therapy.

A patient's personal and family history can give important clues to the cause of scalp hair loss. In turn, appropriate laboratory studies will determine the optimal course of therapy. Treatment mig...

Oestradiol and Testosterone in Male Dogs with Alopecia and Feminization without Testicular Neoplasia

Plasma oestradiol and testosterone were determined in peripheral and spermatic venous blood of five dogs with alopecia and feminization, without testicular neoplasia, and a control group of seven normal male dogs. The concentrations of oestradiol and testosterone did not differ in the two groups of dogs, neither in the peripheral nor in the spermatic venous blood. Moreover, there was no difference in the concentration ratio of oestradiol to testosterone. The spermatogenesis was normal in four out of five affected dogs and in five out of seven control dogs. The cause of alopecia and feminization in some male dogs without testicular neoplasia is still obscure. On a établi les niveaux d’œstradiol et de testostérone dans le plasma du sang veineux périphérique et spermatique de cinq chiens atteints d’alopécie et de féminisation, sans néoplasie testiculaire, et d’un groupe de contrôle comptant sept chiens mâles normaux. On ne constata aucune différence de concentration d’œstradiol et de testostérone entre les deux groupes, ni dans le sang veineux périphérique, ni dans le sang veineux spermatique. Qui plus est, on ne constata aucune différence entre les rapports de concentration d’œstradiol à testostérone. La spermatogénèse se révéla normale chez quatre des cinq chiens atteints et chez cinq des sept chiens dans le groupe de contrôle. Les causes d’alopécie et de féminisation chez certains chiens mâles sans néoplasie testiculaire demeurent obscures. Oestradiol und Testosteron-Konzentrationen wurden im Plasma des peripheren und des aus der Vene spermatica gewonnenen Blutes bei 5 Hunden bestimmt, die Alopecie und Feminisation ohne testikuläre Neoplasie zeigten, sowie bei einer Kontrollgruppe von sieben normalen Hunden. Die Konzentrationen von Oestradiol und Testosteron unterschieden sich nicht in den zwei Gruppen, weder im peripheren Blut noch in dem aus der Vena spermatica. Ausserdem gabe es keinen Unterschied im Verhältnis der Konzentration von Oestradiol zu der von Testosteron. Die Spermatogenese war normal bei vier von fünf der erkrankten Hunde und bei fünf der sieben Kontrolltiere. Vorläufig ist die Ursache der Alopecie und Feminisation ohne testikuläre Neoplasie noch unklar. Se determinaron el estradiol y la testosterona plasmáticas de la sangre venosa periférica y espermática de cinco perros con alopecia y femenización, sin neoplasia testicular, y de un grupo de control de siete perros machos normales. Las concentraciones de estradiol y de testosterona no diferieron en los dos grupos de perros, ni en la sangre venosa periférica ni en la espermática. Lo que es más, no hubo diferencia alguna en la razón de concentración de estradiol a testosterona. La espermatogenia fue normal en cuatro de los cinco perros afectados y en cinco de los siete perros normales. La causa de la alopecia y feminización en algunos perros, sin neoplasia testicular, es desconocida.

Oral contraceptives and alopecia.

5 cases of diffuse alopecia in women who took oral contraceptives are studied. 3 cases developed male pattern baldness during the time they were taking the pills. 2 cases began losing their hair after having stopped medication and these resembled postpartum baldness. 1 woman did not regain here hair 20 months after having stopped medication . The effects of female sex hormones on hair follicles are discussed. Contraceptives induce a condition of pseudopregnancy, and should be considered as possible toxic causes of alopecia. However, the incidence of alopecia among users of oral contraceptives is very low.