Forms Of Alopecia Areata Research Articles

Treatment Response to Diphenylcyclopropenone in Patients with Alopecia Totalis/Universalis.

Alopecia totalis (AT) and Alopecia universalis (AU) are forms of Alopecia areata (AA) which represent the strongest predictor of poor prognosis since spontaneous regrowth is <10%. Topical immunotherapy agent, diphenylcyclopropenone (DPCP) has shown clinical efficacy with limited side effects in severe forms of AA. However, its specific role in AT/AU characterized by complete hair loss over the scalp can help highlight the efficacy of the drug with fewer confounders. Data were collected from 18 patients diagnosed with AT/AU and treated with topical immunotherapy with DPCP as per protocol by Happle et al. Baseline Severity of Alopecia Tool (SALT) score and subclass was recorded. In the case of AU, baseline body hair loss score was also recorded. Patients were reassessed after 6 months of treatment in terms of change in SALT score and hair regrowth was assessed using the Global Assessment Score. The side effects during treatment were also assessed and recorded. Eighteen patients of whom eleven (61.1%) were diagnosed as AU and seven (38.9%) as AT were treated. The mean age was 21.6, with a male: female ratio of 3:2. The comorbidities noted were atopy in six (33.3%), atopy and hypothyroidism in one (5.5%), Down's syndrome in two (11.1%), and hypothyroidism alone in one (5.5%) patient. The mean duration of disease at the time of presentation was 3 years and all patients had remained refractory to various other modalities of treatment. All patients had a baseline SALT score of 100 corresponding to S5. After 6 months of treatment, 27.7% of patients did not show any response (SALT score S5), 16.6% had a score of S4, 11.1% had a score of S3, 11.1% had a score of S2, 22.2% had a score of S1, and 11.1% had a score of S0. On assessing improvement in body hair loss score, 36.3% of patients showed no improvement, 36.3% showed partial improvement, and 27.2% of patients showed complete body hair regrowth. About 55.5% of patients developed notable side effects that included severe local reactions, cervical lymphadenopathy, acne and pigmentation at the site of application as well as untreated sites. The AT/AU subtypes of AA, was amenable to treatment with contact immunotherapeutic agent DPCP with a >75% hair regrowth in 33.3% of patients. The castling phenomenon was seen in 63.6% of AU patients. The adverse effects noted were not severe enough to deter treatment.

Azathioprine in combination with methotrexate: a therapeutic alternative in severe and recalcitrant forms of alopecia areata?

Azathioprine in combination with methotrexate: a therapeutic alternative in severe and recalcitrant forms of alopecia areata?

Differential diagnostic criteria of alopecia areata

Alopecia areata is a poliethiologic immune mediated condition, associated with lesion of the hair follicles, leading to disruption of growing cycle and subsequent hair loss. Taking into account the different age of patients and repeated recurrence despite of the therapy, as well as changes in the appearance of the individual affecting psychosocial status, patchy hair loss refers to the category of socially important disorders. The introduction of computer technologies facilitated diagnostic approaches through developing of specific criteria for the diagnosis of alopecia areata, which improved its differentiation with similar dermatological conditions. This publication intended to review and analyze of clinical cases of several dermatological disorders which remind clinics of different forms of alopecia areata. The importance of trichoscopy was shown to provide differential diagnosis in various hair-loss conditions to evaluate morphometric hair and skin characteristics.

Trace element status of the patients with alopecia areata

The issue of trace elements participation in the pathogenesis of alopecia areata and the mechanisms of change in bio-concentrated trace remains unresolved and requires further consideration. Goal. To rate trace element balance in patients with alopecia areata. Material and methods. The study group consisted of patients with focal forms of alopecia areata (n = 100), the comparison group - healthy individuals (n = 100). The estimate of trace element status was performed by comparative analysis of the contents 11 trace elements (zinc, iron, copper, cobalt, chromium, manganese, nickel, strontium, bismuth, cadmium, lead) in whole blood and hair in the study group. Results. The study reported a significant decrease in the level of zinc and iron in a patient’s blood and an increase in bio-concentrate iron, copper, chromium and nickel in hair ofpatients compared with healthy participants. Trace element analysis of whole blood and hair allowed to suggeste that a cause of an arising microelement imbalance is probably an autoimmune inflammation in the skin ofpatients suffering from alopecia areata. Confirmation of this hypothesis requires further comprehensive studies.

Nikolsky’s sign - a rare form of alopecia areata

Two case reports of rare form of alopecia areata - Nikolsky’s sign - were presented. This disease is often associated with nerve system pathology (schizophrenia, epilepsy, hysteroid reactions). A special feature of first monitoring was the combination of Nikolsky’s sign as a form of alopecia areata and Down syndrome. Trichodermatoscopy with detection of characteristic stigmas of alopecia areata can provide assistance in differential diagnostics of this disease and other disorders.

Effects of Psoralen‐UV‐A‐Turban in Alopecia Areata

Psoralen-UV-A (PUVA)-turban is a modification of PUVA-bath therapy used in alopecia areata. The aim of this study was to assess the efficacy of PUVA-turban in different forms of alopecia areata. Twenty patients completed the study: nine with alopecia areata vulgaris and 11 with alopecia areata totalis or universalis. 8-methoxypsoralen in a dilution of 0.0001% (1 mg/L) was administered to the scalp for 20 minutes using a cotton towel as a turban. The application was followed by UV-A radiation. Treatments were performed two or three times weekly. The cumulative doses ranged from 48.2-253.4 J/cm2, and single fractions ranged from 0.3-6.5 J/cm2. Hair regrowth was observed in 15 patients (total regrowth in six patients and partial regrowth in nine patients). Five patients did not respond to the therapy. PUVA-turban was significantly more effective in alopecia areata vulgaris than in alopecia areata totalis or universalis and proved to be a safe, well tolerated method without the systemic side effects of PUVA.

Interleukin-1 Receptor Antagonist Allele 2 and Familial Alopecia Areata

Alopecia areata affects 1%-2% of the population and is hypothesized to be an autoimmune, organ specific T-cell mediated reaction directed against the human hair follicle. It is characterized by loss of hair in patches (alopecia areata) with progression in some individuals to total loss of scalp hair (alopecia totalis) or to loss of all scalp and body hair (alopecia universalis). The interleukin-1 receptor antagonist (IL-1RN) gene was found to be associated with more severe clinical outcome in several chronic inflammatory diseases, including alopecia areata. The IL-1RN*2 allele was found to be associated with alopecia areata severity in a British case-control study. In this paper, we analyzed alopecia areata probands in a family-based sample (n = 131 parent-offspring trios) to study the association between alleles of the IL-1RN and various phenotypes of alopecia areata. In considering all patients with any form of alopecia areata, no association was found with IL-1RN. IL-1RN*2 allele was not associated with alopecia totalis and alopecia universalis. A borderline association was observed between IL-1RN and patchy alopecia areata but it was not statistically significant (p =0.06). We also observed an association between IL1-RN*1 allele and patchy alopecia areata (p =0.045).

Tumor necrosis factor alpha (TNF-?) gene polymorphism in alopecia areata

Tumor necrosis factor alpha (TNF-alpha) phenotypes of two polymorphic systems were determined in 50 patients with alopecia areata, a common inflammatory disease of the skin. The distribution of TNF-alpha T1, T2 phenotypes differed between patients with the patchy form of disease and patients with totalis/universalis disease. There was no significant difference in the distribution of TNF-alpha G,A phenotypes between patient groups. The results of this study provide evidence of genetic heterogeneity between the two forms of alopecia areata, and suggest that the TNF-alpha gene or a closely linked locus within the major histocompatibility complex may play a role in the pathogenesis of the patchy form of disease.

Ophiasis; report of two cases.

Ophiasis is a form of alopecia areata. It is relatively rare, but deserves special mention because of its different morphology, localization, and prognosis. Alopecia areata is one of the earliest known dermatologic entities, having been described in the Papyrus Ebers, which dates back to 1500-2500 B.C.1The special ophiasitic form was recognized by Celsus,2and is so named because of the symmetric bands of alopecia above the ears on the lateral aspects of the scalp, resembling a serpent. It usually begins near the midline of the occiput as an oval plaque of alopecia having the larger axis vertically. Later, secondary plaques form behind the ears and enlarge anterially above and in front of the ears and posterially to fuse with the original plaque.2The spread of the alopecia is confined to a horizontal, symmetric band which rarely exceeds more than 1 to 3 in. (2.5 to 8