Degree Of Alopecia Research Articles

Co-Relation Between Androgenetic Alopecia and Severity of COVID-19 Disease - A Cross-Sectional Study

Objective: To find the correlation between the degree of androgenetic alopecia and the severity of COVID-19 disease.
 Study Design: Cross-sectional study.
 Place and Duration of the Study: Dermatology department, PEMH, Rawalpindi Pakistan from Feb to Aug 2021.
 Methodology: A total of 227 patients (male and female) of COVID-19 admitted in a Corona ward of Pak Emirates Military Hospital, Rawalpindi, Pakistan were selected randomly. The degree of androgenetic alopecia was assessed with the help of using the Hamilton-Norwood Scale (HNS) for men and the Ludwig Scale (LS) for women, and the severity of COVID-19 was graded based on CT severity score (CTSS).
 Results: Out of the total, 161 (71%) were male, and 66 (29%) were female. Out of 161 males, 31 (19.2%) had no alopecia, and 130 (80.7%) had some degree of alopecia. Out of patients with alopecia, 33 had moderate alopecia, and 97 had severe alopecia. Out of 66 females, 32 (48.5%) had no alopecia, while 34 (51.5%) had some degree of alopecia.
 Conclusion: High frequency of androgenetic alopecia in severely ill-hospitalized patients of COVID-19 suggests that androgen has a vital role in the disease severity of COVID-19.

Clinical Use of Extracellular Vesicles in the Management of Male and Female Pattern Hair Loss: A Preliminary Retrospective Institutional Review Board Safety and Efficacy Study.

BackgroundPattern hair loss is a common disorder in female and male patients. ObjectivesTo assess the safety, efficacy, and satisfaction of a single extracellular vesicle (EV) treatment over 6 months.MethodsA retrospective open-label study among 22 female and 9 male patients who demonstrated early stages of alopecia or were in remission from previous medical and surgical treatments. The amount of undiluted or diluted volumes of EV solution used was determined by the extent and degree of alopecia. Global photography, Patient Global Aesthetic Improvement Scale (PGAIS) and Investigator Global Aesthetic Improvement Scale (IGAIS) questionnaires, and trichoscan measurements were compared at baseline and 6 months in 3 response categories.ResultsFrequent growth responses were observed: older aged females and younger aged males, shorter history of alopecia, earlier stages of hair loss, larger and undiluted volumes of XoFlo, previous positive responses to medical and surgical treatments, and absence or control of disease factors affecting the hair. Global photography, trichoscan for density, follicle diameter, terminal: vellus ratio, and PGAIS/IGAIS satisfaction questionnaires at baseline and 6 months were useful in assessing clinical efficacy. No significant adverse reactions were observed.ConclusionsIntradermal injections with varying doses of EVs were safe and effective among indicated alopecic female and male patients. Findings suggest that the presence of positive factors, absence of conditions known to negatively affect hair growth, and administration of larger volumes of XoFlo may have a significant influence on the use of this new cell-free therapy. Level of Evidence: 4

Abstract PS9-20: Prospective observational study of chemotherapy-induced alopecia after sequential FEC+taxane and the effects of age in breast cancer patients

Abstract BACKGROUND: Chemotherapy-induced alopecia (CIA) is a common and quite distressing adverse effects of chemotherapy. CIA, which can occurr not only in the scalp but also in the eyebrows, eyelashes, and pubic hair, has been known to be a transient condition. However, the degree, pattern, phenotype and processes of CIA are not fully known. CIA might be influenced by many factors, such as the specific chemotherapy regimen, drug doses, the patient’s age, and hormonal statuses. There are few detailed observational studies of CIA or of the impact of age on CIA. We performed a prospective observational study to investigate the prevalence and degree of CIA, including CIA of eyebrows, eyelashes, and body, and we examined patient’s recovery from CIA, focusing on age-depending effects. METHODS: We analyzed 68 female Japanese patients with breast cancer (median age 53 years, range 29-76 yrs) who received perioperative adjuvant chemotherapy with fluorouracil/epirubicin/cyclophosphamide (FEC) and taxane. A questionnaire was administered at the point of chemotherapy completion and 6 and 12 months after chemotherapy completion. The data collected by the questionnaire were as follows: the degree of alopecia, including the eyebrows, eyelashes, and body (pubic, leg, and axillary hair), the onset of alopecia, the onset of hair regrowth, and changes in hair characteristics (color, texture, thickness, structure). RESULTS: CIA occurred in all patients, with severe hair loss irrespective of age. CIA occurred mainly in the scalp but also in the eyebrows, eyelashes, and body for most of the patients. There were significant associations between the patient’s age and the onset of hair regrowth in the eyebrows, eyelashes, and body. The onset of eyebrows, eyelash, and body hair growth were significantly shorter in the premenopausal patients. Any hair changes (e.g., thinned diameter, softer texture, curlier structure) were reported by 85.3% of the patients. The changes in hair diameter were significantly more often ‘thinner’ in the menopausal group compared to the premenopausal group, but the changes in texture, structure, and color were not significantly different between these groups. CONCLUSIONS: Our results revealed the clinical process of CIA in early breast cancer patients who received standard chemotherapy. Severe CIA occurred in all 68 patients who received FEC and taxane chemotherapy. The present findings provide the first data demonstrating that age was not associated with the degree or incidence of hair loss, but age affected the recovery from CIA. These findings are important for the provision of more accurate information to patients who may undergo chemotherapy, and our data will contribute to the optimal treatment for CIA. Citation Format: Takaaki Fujii, Kei Ichiba, Chikako Honda, Yuko Nakazawa, Misato Ogino, Sasagu Kurozumi, Sayaka Obayashi, Reina Yajima. Prospective observational study of chemotherapy-induced alopecia after sequential FEC+taxane and the effects of age in breast cancer patients [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS9-20.

Abstract P6-11-06: Efficacy of scalp cooling in preventing chemotherapy-induced alopecia in breast cancer patients: A retrospective, comprehensive review of 330 cases of Brazil

Abstract Background: Chemotherapy-induced alopecia (CIA) is a distressing adverse effect of many chemotherapy (CT) agents. New strategies for prevention of CIA have been studied. Scalp cooling has been reported to prevent CIA. We conducted a retrospective study aimed to assess the efficacy of scalp cooling in preventing CIA among women receiveing chemotherapy for breast cancer. Methods: Was included clinical data of breast cancer patients at the Oncoclinicas Group from July/2015 to March/2017. All patients were elected to use scalp cooling to prevent CIA. Cooling started 30 minutes before infusion and was maintained throughout the infusion of the treatment and extended for 90 minutes after infusion. Degree of hair loss was rated by nurse assessment using CTCAE v4.0 scale in grade zero (without alopecia), 1 (<50%) or 2 (>50%), digital photographs and clinical assessment. Assessments were made before each chemotherapy treatment and at a follow up visit between 3 weeks and 3 months after the completion of chemotherapy. Success was defined when there was G0 or G1 alopecia at the end of the treatment, and failure when finished with G2 alopecia and patient withdrawal due to alopecia. Results: 330 patients were included. 283 with localized breast cancer and 47 with metastatic disease. 188 patients (57.0%) completed all tratment with scalp cooling. 72 patients (21.8%) withdrew from cryotherapy for alopecia of any degreee, 51 patients (15.4%) gave up cryotherapy for complaints unrelated to alopecia and 19 patients (5.8%) had their treatment interrupted due to external factors (progression of disease, change of CT protocol, among others). Among patients who completed chemotherapy (n=188), the degree of alopecia at the end was G0 = 27, G1 = 138, G2 = 23. Thus, the overall success rate with cryotherapy was 63.5%. CT protocols initiated with doxorubicin and cyclophosphamide, followed by taxanes, presented a success rate of 50%. The combintation of docetaxel and cyclophosphamide showed success of 71.9%. Scalp cooling: chemotherapy regimes and alopeciaChemotherapy (CT) regimeCompleted CT G0Completed CT G1Completed CT G2Abandoned SC G1Abandoned SC G2AC02011AC/taxanes65152527AC non sequential11100D alone or combi no AC319221DC6401134EC at 2nd part of CT01000EC at 1rst part of CT00111P alone or combi no AC613014No AC21000AC at 2nd part of CT310310Total27138233438A: doxorubicin; C: cyclophosphamide; D: docetaxel; E: epirubicin; P: paclitaxel; combi: combination In addition to alopecia, headache and cold sensation were common reasons for cryotherapy withdrawal. Conclusions: Scalp cooling appears to be effective in preventing CIA among breast cancer patients who underwent chemotherapy. Studies involving a psychological approach to the expectation and experience of alopecia with cryotherapy and better management of pain are necessary to increase adherence to treatment. Citation Format: Silva GB, Moreira RB, Gimenes DL, Silva ACP, Araújo BRC, Pacheco BP, Paiva RdCP, Sutmoller C, Hammermuller LMJ, Lima RO, Pimentel RVIA, Simões ÂAB, Mathias CMC, Lessa ÂMC, Costa MAD, Martins LCA, Ferrari BL. Efficacy of scalp cooling in preventing chemotherapy-induced alopecia in breast cancer patients: A retrospective, comprehensive review of 330 cases of Brazil [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-11-06.

Monilethrix – Case report of a rare disease

Monilethrix is a rare genetic disorder of hair characterized by beaded appearance of the hair shaft leading to hair fragility and patchy dystrophic alopecia. In this disorder, the hair shaft has alternate widenings (nodes) and constrictions (internodes) that lead to fracture of hair shaft and varying degree of alopecia. We report an eight year old Kashmiri boy who presented with diffuse hair loss since infancy. As monilethrix is a rare disease entity which prompted us to report this case.

A new strategy to prevent chemotherapy and radiotherapy-induced alopecia using topically applied vasoconstrictor.

In a new strategy, we sought to determine whether topically applied vasoconstrictor, with its accompanying transient skin hypoxia and exclusion of systemic drug, would prevent or suppress radiotherapy or chemotherapy-induced alopecia. Topical vasoconstrictor was applied to 1-cm(2) skin patches on the backs of 10-day-old rats and minutes later they received either 7.1 gray (Gy) whole-body radiation or systemic N-nitroso-N-methylurea (MNU) or Cytoxan. The degree of alopecia was scored 10 days later by visual assessment (% coat retention) and hair follicle histologic analysis. Topical application of epinephrine or norepinephrine in an alcohol:water delivery vehicle induced clear skin blanch, and in a dose-dependent manner, topical epinephrine or norepinephrine (20-1,000 mM) applied before 7.1 Gy irradiation conferred 95% of coat retention in the treated skin patches versus 0% coat retention in vehicle controls, or in skin outside the treated patches. By histology, small numbers of dystrophic hair follicles were observed in hairless skin versus the normal density of anagen follicles in the immediately adjacent, drug-protected skin patches at day 20; protected coats were retained into adulthood. Topical epinephrine or norepinephrine before systemic MNU (30 ug/gm body weight) conferred up to 95% of coat retention in treated skin patches versus 0% coat retention elsewhere. Epinephrine-conferred % coat retention dropped to 16% in rats that received systemic Cytoxan, a drug whose plasma half-life is at least 8- to 10-fold longer than MNU. A general strategy is discussed for the use of topical epinephrine or norepinephrine in the clinic to provide an inexpensive and convenient strategy to prevent cancer therapy-induced alopecia.

Association between androgenetic alopecia and coronary artery disease in young male patients.

Background:Several studies have demonstrated an association between androgenetic alopecia (AGA) and cardiovascular disease. Still controversies exist regarding the association. Are they truly associated?Objective:The purpose of the present study was to assess the prevalence of AGA and establish its association in young (<45 years) Asian Indian Gujarati male patients having coronary artery disease (CAD).Materials and Methods:Case-control prospective multicentric study was carried out on 424 men. Case group consisted of 212 male subjects having CAD (Group 1) and another 212, either sibling or first degree male relative of the case subjects (having no evidence of CAD) were considered as the control group (Group 2). Age, total cholesterol, incidence of diabetes mellitus, and hypertension were similar in both groups. The degree of alopecia was assessed using the Norwood-Hamilton scale for men. Statistical analysis was performed using Chi-square test.Results:AGA was found in 80 (37.73%) young CAD patients (Group 1), whereas 44 (20.7%) of patients had alopecia in the control group (Group 2). There was statistically significant association between male AGA and CAD (P = 0.001). Odds ratio was 2.70 (95% confidence interval [CI], 1.72 ± 4.26). Statistically significant association was found between high grade baldness (Grades IV-VII) and CAD in young men (P < 0.05). Odds ratio = 2.36 (95% CI, 1.108 ± 5.033). There is statistically significant association of AGA in young Asian Gujarati male with CAD and the prevalence of AGA in young CAD patient is 37.73%.Conclusion:This study implies early onset AGA in male is independently associated with CAD, though mechanisms need to be investigated.

Scalp hair loss after transsphenoidal adenomectomy in patients with acromegaly

Scalp hair loss is often encountered in clinical practice in Japan after successful surgery for acromegaly. However, this intriguing issue has not been addressed in the literature. The aim of this study was to examine scalp hair loss after surgery for acromegaly. Postoperative scalp hair loss was surveyed using a mail-back questionnaire given to 511 patients undergoing primary surgery for acromegaly, 484 of whom constitute the patient pool in this study. Of the 484 patients, 263 (54%) patients noticed varying degrees of hair loss between 3 and 6 months after surgery [the degree of alopecia was minimal in 50 patients (10%), moderate in 117 patients (24%), and severe in 96 patients (20%)], although postoperative hair loss was noticed only in six (3·6%) of 167 patients with nonfunctioning adenomas. Postoperative hair loss was significantly more common in female patients, cured patients and patients with severe postoperative growth hormone deficiency. Among those 263 patients, full recovery was reported by 85 patients (32%), incomplete recovery by 88 patients (34%), and hardly any recovery by 90 patients (34%). A lack of hair recovery was significantly more common in male patients or in patients with severe hair loss after surgery. This, the first large-scale, single-centre, clinical study to shed light on the issue of postoperative hair loss after surgery for acromegaly, shows that it is important to prospectively inform patients that varying degrees of hair loss occur in a large number of acromegalic patients, especially after successful surgery.

Generalized dermatitis associated with Malassezia overgrowth in cats: A report of six cases in France

We recently observed six cases of generalized dermatitis associated with Malassezia overgrowth in cats presented to the Veterinary College of Alfort, France. Elevated numbers of yeasts were observed in lesional skin by cytology and culture. Skin lesions occurred on the face, ventral neck, abdomen and ear canals and were characterized by some degree of alopecia, erythema and crusting. In most cases, pruritus was intense. The species M. pachydermatis was systematically isolated.

Prospective cohort study of chemotherapy-induced alopecia with or without scalp cooling.

9138 Background: Scalp cooling can prevent chemotherapy-induced alopecia. Success varies according to the type of chemotherapy. A controversy exists regarding the use of scalp cooling because of the lack of efficacy data with modern chemotherapy regimen and safety data. We present a prospective cohort study design to measure alopecia. Methods: The prospective study was conducted at the Centre des Maladies du Sein Deschênes-Fabia (CMS) in Quebec City (where scalp cooling is offered routinely and 85% of women use it) and at the Centre Hospitalier Universitaire de Montreal (CHUM), in Montreal (where scalp cooling is not available). Women were eligible if they were going to receive neoadjuvant or adjuvant chemotherapy for breast cancer. The study involved completion of questionnaires (on degree of alopecia, hair type, hair care, use of head accessories, tolerance to scalp cooling and questions related to sick leave from work) and having pictures taken at baseline, cycle 3 and at the last cycle of chemotherapy. For the last 43 patients, the EORTC QLQ-C30/BR23 and an adaptation for Hairdex were added. Results: A total of 136 patients were recruited (110 at CMS over 2 years and 26 at the CHUM over a 9-month period). Preliminary efficacy results are shown in the Table (data on quality of life have not yet been analyzed). Hair preservation was defined as a SUCCESS for hair loss (since the beginning of chemotherapy) characterized as “not at all”, “a little” or “moderate” and “FAILURE” when characterized as “a lot” or “all” or “hair shaved”. Overall, in the scalp cooling group, 34% were considered a “success” using hairdresser evaluation and 49% using patient evaluation; for the non scalp-cooling group, these rates were 9% and 4% respectively. Conclusions: Scalp cooling appears to be efficacious for preventing chemotherapy-induced alopecia in this exploratory cohort study. [Table: see text]

Alopecia in Rhesus macaques correlates with immunophenotypic alterations in dermal inflammatory infiltrates consistent with hypersensitivity etiology

Although alopecia is a commonly recognized problem affecting many captive Rhesus macaque colonies, there is no consensus as to the underlying etiology or appropriate course of management. We performed skin biopsies to assess underlying pathology in alopecic Rhesus macaques and performed immunohistochemical and metachromatic staining of these biopsies to assess the cellular infiltrates. Alopecia is associated with superficial dermal perivascular mononuclear cell infiltrates and skin pathology consistent with chronic hypersensitivity dermatitis. The inflammation is primarily composed of CD4+ cells admixed with histiocytes and mast cells. Inflammation is correlated with degree of alopecia. Further analysis in different groups of macaques revealed that animals born outdoors or infected with lung mites had reduced dermal inflammatory cell infiltrates and a lower incidence of alopecia. These findings support a hypothesis that an altered housing status resulting in decreased pathogen burden in Rhesus macaque colonies may contribute to dermal immunophenotypic alterations and subsequent development of dermatitis with resultant alopecia.

Coat condition, housing condition and measurement of faecal cortisol metabolites – a non‐invasive study about alopecia in captive rhesus macaques (Macaca mulatta)

Previous studies have characterized alopecia in captive rhesus macaques (Macaca mulatta) by a mixed partial to complete alopecia in a bilateral symmetric pattern. In this study, coat condition assessments were related to exogenous and endogenous factors in captive rhesus macaques under different housing conditions in order to identify disturbances in environmental factors controlling or influencing hair growth. Additionally, the degree of alopecia was investigated in relation to adrenal endocrine function as an indicator of social stress using faecal glucocorticoid measurements. Hair loss was found to vary with season and sex, was most pronounced in adult females during the winter and spring months. Generally, infants were not affected, but alopecia developed during adolescence. However, the housing system, available enclosure space and variations in group size and composition also appeared to influence coat condition. Levels of immunoreactive cortisol metabolites (11-oxoetiocholanolone) in faeces were significantly negatively correlated with alopecia, suggesting a relationship between hypothalamic-pituitary-adrenal (HPA) axis activity and hair loss in captive rhesus macaques. Although the present study demonstrates the influence of the HPA axis on coat condition, it is not known if hair loss is caused by abnormal behaviour or hormonal imbalances of the HPA axis itself. Our data suggest that alopecia in rhesus macaques is a highly complex multicausal disorder.

Distribution of life cycle stages of Sarcoptes scabiei var wombati and effects of severe mange on common wombats in Victoria.

Seven female and three male common wombats (Vombatus ursinus) collected from forested areas of Victoria (Australia) over a 10 mo period, 10 April 1997 to 22 February 1998 had at least 30% of their skin affected by severe hyperkeratotic sarcoptic mange. Mangy wombats were grazing during the day, could be readily approached, were in poor body condition, and lacked subcutaneous fat. The anterolateral surface of the body was most heavily parasitised with Sarcoptes scabiei var wombati followed by the posterolateral surface, the dorsal region between the ears, the ears, ventral abdomen, medial aspect of the legs, axillary and inguinal areas, and the dorsal midline. Larvae were the most prevalent life-cycle stage followed by eggs, nymphs, females, and males. Mite numbers and the severity of clinical signs, namely thickness of scale crust and the degree of alopecia, were correlated and were symmetrical on each side of the body. Fissuring of crust and skin only occurred when scale crust was present. Bacterial infections occurred in three of 10 wombats within lymph nodes or the pleural cavity. Lymphoid depletion did not occur in lymph nodes or spleens and prescapular lymph nodes contained a greater amount of nuclear debris in germinal centres than non-mangy wombats. Seven wombats had fatty change in their livers. Gonads of mature wombats were not active or had minimal activity. Significant histopathological changes were not seen in the gastrointestinal tract, kidney, brain, myocardium, spleen, thyroid, reproductive tract, and gonads. Hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, and concentrations of hemoglobin, lymphocytes, calcium, glucose, creatinine, total solids, total protein, albumin determined both colormetrically and electrophoretically, and globulins were significantly lower and concentrations of neutrophils, monocytes, phosphorus, urea, glutamate dehydrogenase, aspartate aminotransferase and creatine kinase were significantly higher in mangy versus captive wombats. Concentrations of erythrocytes, mean corpuscular hemoglobin, leucocytes, band neutrophils, eosinophils, nucleated erythrocytes, sodium, potassium, chloride, total bilirubin, alkaline phosphatase, and gamma glutamyltransferase for mangy wombats were not significantly different from that reported for captive wombats. Hematological and pathological changes in mangy wombats were consistent with anemia, inflammation, and changes seen with starvation.

Activity of glucose-6-phosphate 1-dehydrogenase in hair follicles with male-pattern alopecia.

Activity of glucose-6-phosphate 1-dehydrogenase (G6PDH) in human hair follicles was measured. A good relationship has been demonstrated between the activity and the ratio of the number of the anagen hairs to that of all the plucked hairs in the frontal-parietal region of the scalp with male-pattern alopecia. As the ratio becomes lower so that the advancing degree of alopecia is higher, the G6PDH activity becomes lower.

Demodicosis in black bears (Ursus americanus) from Florida.

Demodicosis was diagnosed in five black bears (Ursus americanus) from north-central Florida. The first bear examined, a 5-yr-old male, had severe alopecia except for the dorsal neck, paws, and ears. The skin was characterized by moderate orthokeratotic hyperkeratosis, and mild to moderate follicular hyperkeratosis. Superficial dermatitis, follicular pustules, and epidermal pustules were present, but rare. Specimens of Demodex sp. were seen most commonly within hair follicles devoid of hair and at the infundibulum of sebaceous glands. Four additional bears from the same area also had some degree of alopecia and skin scrapings were positive for Demodex sp. This mite may be common, although its prevalence is not known.

An improved "ice-cap" to prevent alopecia caused by adriamycin (doxorubicin).

Cooling the scalp prevents the epilation which is an almost invariable complication of the use of Adriamycin (Edelstyn et al, 1977). This constricts the blood vessels supplying the hair follicles, thereby reducing the concentration of the drug that reaches them. Anderson et al (1981) have described the use of gel packs moulded together with waterproof tape to form a cap on a wig stand. They found this method of great value in preventing alopecia, though some patients had minor hair loss. Some patients with liver damage had severe alopecia in spite of the ice-cap. A recent paper has suggested that the degree of alopecia is temperature-dependent, and the temperature should be below 22°C (Gregory et al, 1982). Another attempt to produce a suitable cap has been made using a thermocirculator to allow precise temperature control (Guy et al, 1982).

Immunopathological studies on alopecia areata.

Anti-endothelial cell antibodies could be removed from circulating lymphocytes by means of acid elution techniques in eight patients with different degrees of alopecia areata. These antibodies were specifically directed against the endothelial cells in the capillary network of the hair bulb, indicating the existence of an antigen, which is unique to these particular endothelial cells. These antibodies do not bind complement "in vitro" and are species-specific. Circulating ANA (speckled type) were only noticed in case with alopecia areata in spots. A significant decrease in circulating T cells was noticed in six of eight patients with a certain degree of alopecia.