Alopecia Areata Hair Research Articles

Alopecias in humans: biology, pathomechanisms and emerging therapies.

The hair follicle is a complete mini-organ with a complex biology. Recent discoveries have shed light on the pathogenesis and genetic basis of a number of hair loss conditions, offering novel treatment alternatives. To explore the biology and physiology of hair growth, the pathomechanism behind alopecias and emerging therapies. Hair growth is influenced by numerous physiological moderators. Greater understanding of the biology and physiology of the hair follicle and the pathomechanisms of hair disease facilitates development of targeted treatments. Sublingual minoxidil is a promising therapy in humans where optimised drug delivery enhances efficacy and reduces systemic adverse effects. Janice kinase inhibitors, which disrupt the inflammatory cascade, help maintain the hair follicle, preserve immune privilege, and regrow hair in alopecia areata. As the pathomechanisms of other forms of alopecia become better understood, new targeted therapies with greater efficacy will emerge.

Trichoscopy as an Essential Diagnostic Technique for Hair and Scalp Disorders in Skin of Color

Background: Hair and scalp disorders cause significant morbidity, warranting an early diagnosis and treatment. Trichoscopy has shown great promise in the diagnosis and assessment of these disorders. Aims: The aim of this study was to determine the trichoscopic findings in cases of alopecia and scalp disorders and to determine their statistical significance. Materials and Methods: This was a case–control study in which trichoscopy using a hand-held dermoscope was done in 605 patients and 200 controls. Results: The trichoscopic findings that showed statistical significance in 405 alopecia cases when compared with controls were broken hair, exclamation hair, black dots, yellow dots, vellus hair and pigtail hair in alopecia areata, hair diameter variability, single hair predominance, brown and white peripilar sign in androgenetic alopecia, corkscrew hair, comma hair, morse-code hair and interfollicular scale in tinea capitis, and white dots and peripilar erythema in primary cicatricial alopecia. The findings which had a statistical relevance among scalp disorders included light red background, dots and globules and dermoscopic Auspitz’s sign for psoriasis, dark red background and arborizing vessels for eczemas and yellowish background for verrucae, comedo-like openings, milia-like cysts and moth-eaten borders for seborrheic keratosis, and viable nits for pediculosis capitis. Conclusion: Our study documented many trichoscopic features which were statistically significant among cases of alopecia and scalp disorders when compared with controls. Limitations: Histopathological confirmation of diagnosis was not done in most of the cases. The patients were not subjected to follow-up trichoscopy after treatment.

Non-scarring patchy alopecia in patients with systemic lupus erythematosus differs from that of alopecia areata

Non-scaring patchy alopecia associated with systematic lupus erythematosus (SLE) is sometimes mis-diagnosed as alopecia areata (AA). Our aim was to differentiate non-scarring patchy SLE alopecia features from patchy AA. Clinical, dermatoscopic and histopathological data from 21 SLE patients with patchy alopecia were compared with data from 21 patients with patchy AA. Incomplete alopecia was common in SLE alopecia patches, while AA patches exhibited complete alopecia. Exclamation-mark hairs, black dots, broken hair and yellow dots were common to AA, while hair shaft thinning and hypopigmentation, angiotelectasis, peripilar sign, perifollicular red dots, white dots and honeycomb pigment patterns were more common in SLE. Interfollicular polymorphous vessels were the most common angiotelectasis presentation in the SLE alopecia patches, but interfollicular arborizing vessels were significantly more common in non-hair-loss-affected SLE regions and in AA hair-loss regions. During follow-up, increased vellus hair was the earliest feature that emerged after treatment both in SLE and AA, while the earliest feature that disappeared was hair shaft hypopigmentation in SLE and broken hair in AA. After treatment, no SLE patients had relapse of alopecia, while 41.7% of AA patients did. Distinct clinical, dermatoscopic and histopathological features were found in SLE-associated alopecia regions, which were different from those of AA. Serological autoantibody tests are of value to confirm the differential diagnosis. Local angiotelectasis and vasculitis close to hair follicles may be involved in the pathogenesis of alopecia in SLE.

A importância do exame tricológico no diagnóstico da alopecia areata

In this article we discuss the propedeutic aspects of alopecia areata, especially those found by dermatoscopy, an invaluable tool for diagnosis of the condition. Dermatoscopy facilitates the early detection of the characteristic changes in alopecia areata hair such as exclamation-point hairs, cadaverous hair, fuzzy hair, vellus type hair and yellow spots.

Characterization of infiltrating T cells in human scalp explants from alopecia areata to SCID nude mice: possible role of the disappearance of CD8+ T lymphocytes in the process of hair regrowth.

T cells may play a role in the pathogenesis of alopecia areata (AA). We attempted to elucidate the linkage between infiltrating T cells and hair regrowth processes by grafting scalp skin from the affected region of patients with AA onto severe combined immune deficiency (SCID) nude mice. When the AA scalp was grafted into the mice, the grafts were accepted, and normal hair regrowth was observed. Before grafting, CD4+ and CD8+ T cells had infiltrated into the peribulb area. After grafting, the telogen hair shifted to anagen hair, and the CD4+ and CD8+ T cell infiltrates in the bulb area decreased in all cases. CD8+ T cells had almost disappeared from all portions of the follicles. It has been suggested that CD8+ T cells play a crucial role in the pathogenesis of AA. The absence of CD8+ T lymphocytes that responded to follicular autoantigens may induce hair regrowth in the grafted skin. In addition, the CD4+ human T cells that had infiltrated or still remained in the upper-middle portions including the bulge area accompanied the HLA-DR expression after grafting. Infiltrating or surviving T cell phenotypes and locations changed during the hair cycle in the grafts. These results indicate that the location of infiltrated T cells and their phenotypes may participate not only in hair loss but also in regrowth of hair in AA.

The most common type of fractured hair in alopecia areata in children: another cause of "black dot disease".

SummaryExclamation mark hairs are usually described as the typical type of fractured hair in alopecia areata, but hairs that are fractured close to the scalp are more common in alopecia areata in children. They appear as black dots, similar to those seen in black dot ringworm. The only specific reference to this condition that was found in 40 text books of dermatology is in a book published in 1906.

Morphologic Changes in Pilosebaceous Units and Anagen Hairs in Alopecia Areata

The normal growth of scalp hair is a result of a continuous, rapid proliferation of tissue by the matrix of the hair bulb and a high degree of mitotic activity of the cells thereof. The abrupt loss of hair in alopecia areata represents an acute disruption of this normal proliferative process. The etiologic factors in alopecia areata are unknown. The state of the hair bulb and its environment in alopecia areata are not entirely defined.

On bacterium decalvans: an organism associated with the de­struction of the hair in alopecia areata

Although Gruby,* in the year 1843, announced that the affection of the hairy scalp known as alopecia areata (area celsi) is caused by a fungus, the parasitic theory of the disease has met with comparatively little support. If the patients on whom Gruby made his observations really suffered from this disease and not from ringworm, which in some of its forms is apt to be mistaken for it, this uncertainty is very remarkable.

III. On bacterium decalvans : an organism associated with the destruction of the hair in alopecia areata

The author having in several cases of Alopecia areata found bacteria adherent to the roots of extracted hairs, subjected hairs in six selected cases to processes designed to demonstrate the existence of organisms, should they be present, in the substance of the diseased hairs. In five out of the six cases an object was observed in the hairs which he believes to be a bacterium. It was seen as a rounded or elongated spheroid, and was found frequently in pairs, the long diameter of the two spheroids forming a continuous straight line.