Management Of Alopecia Areata Research Articles

Research trends in alopecia areata: a cross-sectional bibliometric analysis of the top cited studies.

In the field of alopecia areata research, various focuses including risk factors, epidemiology, molecular pathways, and treatment were constantly improving. However, to date, a bibliometric analysis summarizing the research trend is not available to date. The main objective of this study was to provide researchers with an overview of the research trend on alopecia areata in the past two decades. In Web of Science database, screening and extraction of studies related to alopecia areata has been performed. Within studies related to alopecia areata, the most cited 100 studies were appraised and the information of articles, including the citation amounts, keywords and publication types, was extracted for analyses. On average, each study in the top 100 list was cited 104.72 times. Within the top 100 list, the most focused fields were on the management of alopecia areata (34%), molecular mechanisms (28%) and epidemiological issues (23%). Approximately one third of the management-associated studies focused on Janus kinase (JAK) inhibitors (10 studies) and 5 studies focused on the efficacy of corticosteroids for alopecia areata. According to the results of the keyword analysis, JAK inhibitors had become the most mentioned keywords in the field of alopecia areata research since 2016. The top 100 most referenced papers in the field of alopecia areata mostly focused on essential aspects such as treatment options, pathogenesis, risk factors, and comorbidities. The results of the current study could be considered a potential resource for future research and patient care information.

Effect of Wet Cupping with Rasayana Chikitsa in Management of Alopecia Areata (Indralupt)

Abstract: Alopecia areata, or Indralupt in Ayurveda, is a dermatological condition characterized by localized, non-scarring hair loss. It presents as circular or oval patches of baldness, primarily affecting the scalp. While its exact cause remains unclear, autoimmune factors are thought to play a significant role. Management typically involves a combination of topical and systemic treatments, including corticosteroids and immunomodulators which is not fully preventive or curative. Thus, Vata, Pitta, and Kapha Dosha i.e., Tridosha and Rakta Dushya are the causative factors of Indralupta. Materials and Method: Cup, Cupping pump, cotton ball or Swab, antiseptic solution, sterile lancets or scalpel, gloves. The patient was scheduled for wet cupping therapy, with a seven-day interval between each of the three sessions. Significant hair growth was observed after just one session. Raktamokshan, particularly Prachchanna (blood-letting, primarily scraping) is beneficial for removing vitiated Rakta if it is located in a specific area of the body, such as hair follicles. Result : After undergoing Wet Cupping and internal Rasayan drug for duration of one month, two patches of hair loss affected by alopecia areata were completely removed. Conclusion: This case report investigates the effectiveness of Raktmokshan, a traditional Ayurvedic therapy involving wet cupping, and Rasayan chikitsa in the management of alopecia areata (Indralupt). The case presents a patient with alopecia areata who underwent Raktmokshan therapy and observed outcomes over a defined period.

Management of Alopecia Areata Through Micro Needling Along with Cupping

Ayurveda considered Alopecia areata as a minor ailment but now in this era of presentation looks are very important. Everyone wants to be beautiful and attractive. Hairs and skin are the mirror of beauty. If these two things are healthy and beautiful then the person looks more beautiful. An 18-year-old boy came to OPD with patches of baldness over his scalp. He has taken ‘n’ no. of treatment modalities for Alopecia areata but the results were not mesmerizing. The patient was advised to do microneedling with cupping for his baldness. According to the Pull and Tug test and SALT criteria, the patient had a 40% area of baldness at the center. After obtaining consent, the procedure was done thrice in 15 days. Along with this, internal medication with local application of oil was going on. In Internal medication, Asthimajja pachak (herbal drug combination), Praval Panchamrit (sea-origin calcium supplement), and Krumikurthar rasa (herbs-mineral drug) were given. After 4 months, with 15 sitting of microneedling with cupping, the patient had normal and healthy hair growth. Micro-needling along with internal medication is the best, cost-effective, and less invasive solution for re-growing hairs over high-cost hair treatments and transplantation.

Use of Platelet-Rich Plasma in the Management of Alopecia Areata

Introduction Classic treatment options for patients with alopecia areata (AA) include intralesional and topical steroids as well as oral immunotherapy. Although these options can be effective for some patients, topical therapies are often inconvenient, and there can be many side effects with oral medications. Platelet-rich plasma (PRP) is an autologous preparation of concentrated platelets that is an emerging therapy for various conditions such as chronic nonhealing wounds, muscle injuries, and, more recently, hair loss. Case Presentation A 71-year-old woman with diffuse hair loss diagnosed previously as AA presented to our clinic after nonresponse to topical steroids and adverse events with topical minoxidil use. At our clinic, the patient underwent three treatments with PRP injections. Total hair regrowth without relapse was noted 6 months after treatment cessation. Discussion/Conclusion Our case illustrates a situation in which PRP served as an effective, rapid, and safe treatment option in a patient with AA who was unresponsive to previous standard therapies and feared side effects of oral medications.

Diagnosis and Management of Alopecia Areata: A Saudi Expert Consensus Statement (2023).

Alopecia areata (AA) is a complex autoimmune disease manifesting as a chronic inflammatory disease characterized by non-scarring patches of hair loss over the face, scalp, and body. Several treatments have been proposed for AA, but none are curative nor achieve a state of remission. The present consensus statement aims to present the evidence- and experience-based recommendations on the diagnosis and management of AA in Saudi Arabia. The Ministry of Health in Saudi Arabia has opted to initiate a meeting of a multidisciplinary group to discuss and concede on this topic. Eight dermatology experts and clinical pharmacists convened in eight consensus meetings. All content presented in this document was agreed upon by this working group, including diagnosis and severity assessment, prognostic indicators, and therapeutic options for AA. Special consideration was given to special patient populations including pediatric patients and patients with less frequent presentations of AA. Updates of the current recommendations will take place as new evidence evolves in the treatment of AA.

Treatment Patterns and Unmet Needs in the Management of Alopecia Areata: Results of a Physician's Survey in the Middle East.

Alopecia areata (AA) is an autoimmune disease characterized by nonscarring hair loss involving the scalp, face, and/or body. Literature on the prevalence, patient characteristics, management approaches, and challenges faced by patients with AA across the Middle East is limited. Therefore, a greater understanding of the current AA landscape within the region is needed. This cross-sectional study surveyed dermatologists from four countries to assess dermatologists' perspectives on the prevalence of AA within the Middle East, as well as patient characteristics, unmet needs, and management strategies. This blinded, quantitative, observational study surveyed practicing dermatologists in Egypt, Lebanon, Saudi Arabia, and the United Arab Emirates. The survey was conducted between September 2021 and January 2022 and comprised 47 closed-ended, multiple-choice questions as well as Likert scale responses. These questions assessed the characteristics of physicians and the patients in their practices, physicians' familiarity with treatment, and physicians' treatment approaches. The estimated prevalence of AA varied across the region. Across all age groups treated for AA, the majority of patients had AA of mild severity (pediatric: 63%; adolescent: 60%; adult: 54%) and the scalp was reported as the most affected area (65%). Potent topical corticosteroids were the most frequently used treatment for mild to moderate and severe AA (92% and 78%, respectively). There was a lack of awareness of investigative treatments, with only 33% of dermatologists aware of these options. The greatest unmet needs in treating AA included long-term disease control, improved efficacy, faster onset of action, and better safety profiles (62%, 53%, 52%, and 51%, respectively). This study provided insight into the diagnosis and management of AA in the Middle East. Treatment strategies were similar regardless of the severity of AA. Long-term disease control and improved efficacy and safety profiles were identified as key unmet needs in the treatment of AA.

Utility of homoeopathic drug phosphorus in management of alopecia areata: An evidence based case report

Utility of homoeopathic drug phosphorus in management of alopecia areata: An evidence based case report

Homoeopathy In Management of Alopecia Areata – A Narrative Review

Background: Alopecia areata is a form of alopecia that affects hair follicles. It presents with round patch. Many treatments are available and this review highlights the usage of homoeopathy in treatment of alopecia areata. 
 Objective: The review was done to explore the strengths of homoeopathy in management of alopecia areata through online available evidences. 
 Methods: A search was made for homoeopathic management of Alopecia areata in PubMed, AYUSH Research Portal, Google Scholar, Google search engines was done to collect all relevant articles, reports, web pages published till October 2022. The term included was Alopecia homoeopathic treatment, Alopecia homoeopathy, Alopecia areata homoeopathy. Further literature review was also conducted & repertory was also searched. 
 Result: 16 studies were found and all are case reports except one. 
 Conclusion: At present available evidences for homoeopathic management of alopecia are very weak. Further studies are needed for strong evidences.

Alopecia Areata: A Case Report

The frequent asymptomatic condition alopecia areata (AA) is characterized by the sudden start oftotal hair loss in a sharply defined, typically spherical area. Complicated autoimmune diseasesboth hereditary and environmental factors affected the susceptibility to and severity of the dis-ease. About 34-50% of patients experience a spontaneous recovery within a year, while patientsmay go through many alopecia bouts. The purpose of this case report is to go over the identifica-tion and management of alopecia areata.

New Treatment Strategies in Management of Alopecia Areata: Review Article

New Treatment Strategies in Management of Alopecia Areata: Review Article

The Role of Antihistamines and Dupilumab in the Management of Alopecia Areata: A Systematic Review

Approximately 30% to 40% of alopecia areata (AA) patients have atopic dermatitis. Studies suggest that antihistamines and dupilumab may be effective treatments; however, the potential benefit of these therapies as either adjunct or monotherapy has yet to be elucidated. To evaluate the use of antihistamines and dupilumab in the treatment of AA. A literature search was conducted in August 2021 according to PRISMA guidelines. Inclusion criteria were articles describing the use of antihistamines or dupilumab for AA or those discussing AA development as an adverse event of these therapies. Forty-two articles with 395 patients describe the use of antihistamines or dupilumab in AA. The most common antihistamine regimens were oxatomide 30 mg twice a day, fexofenadine 60 or 120 mg/day, and ebastine 10 mg/day; and the majority of cases reported significant hair regrowth, decreased pruritus, and erythema. Studies on the use of dupilumab for AA demonstrated remarkable hair growth in some patients (n=23), no change in others (n=3), and no new hair loss in a patient with resolved alopecia universalis (AU) (n=1). In contrast, dupilumab therapy for AD has been implicated as a cause of AA (n=21), drug-induced alopecia (n=2), and AA-like psoriasis (n=1). Current literature is promising for the use of antihistamines as adjunct treatments for AA, while monotherapy needs to be further explored. The role of dupilumab in AA treatment and/or development also requires further research.J Drugs Dermatol. 2022;21(10):1070-1083. doi:10.36849/JDD.6553.

Status of Serum Vitamin-D Level among the Patients with Alopecia Areata in a Tertiary Care Hospital, Bangladesh

Background: Alopecia areata is a common problem faced by many younger people, which has variety of risk factors. Vitamin D has emerged as a molecule with key role to play in various disorders. Recent evidences suggest inconsistent association between vitamin D deficiency and alopecia areata. We have very few research-oriented data regarding this issue. Aim of the study: The aim of this study was to assess the status of serum Vitamin-D level among the patients with alopecia areata. Methods: This was a prospective case control study which was conducted in the Department of Dermatology & Venereology, Anwer Khan Modern Medical College, Dhaka, Bangladesh during the period from January 2018 to December 2019. In total 30 patients with alopecia areata and 30 healthy people were finalized as the study population. Group of 30 alopecia areata (AA) was denoted as Group A (Case) and group of healthy people was denoted as Group B (Control). All patients were subjected to detailed history taking and examination to detect pattern, severity (SALT score) of AA. Blood samples were taken from all subjects to do complete blood count and to assess serum levels of vitamin-D3, random blood sugar, and calcium. All data were processed, analyzed and disseminated by MS Office and SPSS version 20 as per need. Results: The mean (±SD) vitamin level was found 8.63 ± 2.24 ng/mL among case group patients. On the other hand, it was found 30.26 ± 7.81 ng/mL among control group participants which was significantly higher than that of case group patients (P<0.0001). In analyzing the comparative status of Vitamin D level of several SALT score patients with control group we observed, in comparison with all the S1 patients, S2 patients, S3 patients and S4 patients the P values were found less than 0.0001. So, among all the above cases groups patients the level of vitamin D(ng/mL) were extremely significantly lower than that of control participants (In all comparison the P value were less than 0.0001). Besides among S5 patients, vitamin D level was also significantly lower than that of control group participants where P value was found 0.0002. Conclusion: Deficiency of vitamin D level is a potential factor of alopecia areata. Lower vitamin D levels were observed in patients with alopecia areata and significant inverse correlation exists between vitamin D levels and duration/severity of the disease. These findings may suggest a causal role of vitamin D deficiency in the pathogenesis and therapeutic role of vitamin D supplementation in the management of alopecia areata.

The epidemiology of alopecia areata: a population-based cohort study in UK primary care.

SummaryBackgroundThere is a lack of population‐based information on the disease burden and management of alopecia areata (AA).ObjectivesTo describe the epidemiology of AA, focusing on incidence, demographics and patterns of healthcare utilization.MethodsPopulation‐based cohort study of 4·16 million adults and children, using UK electronic primary care records from the Oxford‐Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) network database, 2009–2018. The incidence and point prevalence of AA were estimated. Variation in AA incidence by age, sex, deprivation, geographical distribution and ethnicity was examined. Patterns of healthcare utilization were evaluated in people with incident AA.ResultsThe AA incidence rate was 0·26 per 1000 person‐years. AA point prevalence in 2018 was 0·58% in adults. AA onset peaked at age 25–29 years for both sexes, although the peak was broader in females. People of nonwhite ethnicity were more likely to present with AA, especially those of Asian ethnicity [incidence rate ratio (IRR) 3·32 (95% confidence interval 3·11–3·55)]. Higher AA incidence was associated with social deprivation [IRR most vs. least deprived quintile 1·47 (1·37–1·59)] and urban living [IRR 1·23 (1·14–1·32)]. People of higher social deprivation were less likely to be referred for specialist dermatology review.ConclusionsBy providing the first large‐scale estimates of the incidence and point prevalence of AA, our study helps to understand the burden of AA on the population. Understanding the variation in AA onset between different population groups may give insight into the pathogenesis of AA and its management.

Clinical efficacy of adipocyte-derived stem cells conditioned media combined with micro-injury in refractory patch of alopecia areata.

Management of alopecia areata (AA) is often challenging especially when patients have AA lesion refractory to conventional treatments such as corticosteroids, contact immunotherapy, and systemic therapy. Reports indicate adipocyte-derived stem cell conditioned media (ASC-CM) can activate hair growth and micro-injury using fractional laser or microneedling can also induce wound healing and hair regeneration, which suggests ASC-CM combined with fractional laser or microneedling might provide alternative therapeutic option for a refractory patch of AA. This study aimed to evaluate the clinical efficacy and safety of ASC-CM combined with 10,600nm carbon dioxide fractional laser or microneedling for the treatment of refractory patch of AA. This retrospective study was based on evaluations of 14 patients with a refractory patch of AA treated with ASC-CM, combined with a 10,600nm carbon dioxide fractional laser, or microneedling from March 2017 to August 2020. The efficacy of treatment was assessed by extents of hair regrowth percentages of involved areas. Of the 14 enrolled patients, 9 (64.3%) showed > 50% hair regrowth and 6 patients (42.9%) showed complete recovery. In the responder group (n = 9), mean period to achieve > 50% hair regrowth was 11.3weeks (range 8-16weeks). In the non-responder group (n = 5), 4 patients (28.6%) showed < 25% of hair regrowth and 1 patient show slight hair regrowth (7.1%) after 3months of treatment. This study showed ASC-CM combined with 10,600nm carbon dioxide fractional laser or microneedling may offer effective and safe treatment options for a refractory patch of AA.

A Comprehensive Literature Review of JAK Inhibitors in Treatment of Alopecia Areata.

Alopecia areata (AA) is a chronic, immune-mediated form of nonscarring alopecia that is multifactorial and results in localized patches. It is often described as a self-limiting condition that results in the spontaneous regrowth of hair in most cases. However, this regrowth may take several months or years to occur in some patients, leading to the development of psychoemotional trauma in those that are affected. Although several therapies for AA have been developed and tested, there is no specific treatment that has been approved, leading to the availability of many off-label conventional treatment options, with very limited responses. More recently, with the advancement of pre-clinical and genetic studies, a greater understanding of the pathomechanisms involved in the development of AA has been uncovered. This has resulted in the introduction of targeted therapies that use small molecules to block specific pathways involved in AA pathophysiology. As such, the use of janus kinase (JAK) inhibitors for treatment of AA has emerged. JAK inhibitors block the T-cell mediated inflammatory response thought to be the driving factor behind AA pathogenesis, by inhibiting the janus kinase (JAK) signal transducer and activator of transcription (STAT) signaling pathway, leading to a reversal of hair loss in AA patients. Thus, in an effort to demonstrate the efficacy of JAK inhibitors in the treatment of AA, several studies have been published within recent years. However, the question remains, “Are JAK inhibitors effective and safe in the management of Alopecia Areata?”. This review aims to provide a comprehensive report on the role, efficacy, and outcomes of using JAK inhibitors in the treatment of AA. To competently answer the research question highlighted, the most recent, quality articles published over a 10–15-year period were sourced using PubMed, NCBI, Research gate, Medline, Cochrane Central Register of Controlled Trials, EMBASE and Google scholar. The literature search was primarily focused on randomized controlled trials (RCTs); however, in the absence of such, only the most recently published case reports, case series, clinical trials and open-label studies published to date were included.

A randomised, open label comparative study of hydroxychloroquine with betamethasone oral mini pulse in the management of patients with alopecia areata

Background: Alopecia areata is an autoimmune disorder causing patchy hair loss on scalp and other parts of the body and leading to poor self-esteem and anxiety in patients. Treatment with topical or systemic drugs like steroids or other immunosuppressants is associated with adverse effects. Hydroxychloroquine is an antimalarial drug, with T cell modulating function. This study was undertaken to assess the safety, efficacy and tolerability of Hydroxychloroquine in Alopecia areata compared to betamethasone oral mini pulse (OMP) therapy. Methods: 60 patients with alopecia areata were randomized into two groups of 30 each. Control group received tab. betamethasone 5 mg/day on two consecutive days of week for 12 weeks and Study group received tab. hydroxychloroquine 200 mg/day for 12 weeks. They were followed-up for further 12 weeks. Scale of alopecia tool, dermatology life quality index and global assessment at baseline, 12 weeks and 24 weeks were used to assess the outcome.Results: 94 patients were screened and 60 patients were included. All patients completed the study. At the end of 12 weeks, there was a statistically significant reduction in SALT and DLQI scores in both control and study groups. But at the end of 24 weeks, the study group showed an increase in the scores. Relapses were more in the study group. No significant difference in the incidence of adverse events was noted between the two groups.Conclusions: Hydroxychloroquine 200 mg/day is less efficacious in the management of alopecia areata in comparison to betamethasone oral mini pulse therapy.

Fractional carbon dioxide laser-assisted topical steroid delivery versus intralesional steroid in the treatment of alopecia areata

Background Alopecia areata is a common disease that affects the psychological well-being of the affected individuals. No single treatment option is proved to be effective and safe in its management. Laser-assisted drug delivery is a new method for the management of different dermatological diseases. Objective To evaluate the effectiveness of fractional carbon dioxide laser-assisted topical steroid delivery in the management of alopecia areata. Patients and methods A total of 30 patients with alopecia areata with two or more nonadjacent patches were included. Patients were randomized and given two separate treatment modalities in two different patches in the same individual. One patch was treated with fractional carbon dioxide laser followed by topical triamcinolone acetonide (group I), and the other was treated with intralesional triamcinolone acetonide (group II). Follow-ups by MacDonald Hull and Norris grading were done every 3 weeks for 3 months. Results The mean grading score in group I patches treated with ablative fractional CO2 laser followed by the topical steroid application at fourth follow-up was 3.37±0.76, and the mean grading score in group II patches treated with intralesional steroid at fourth follow-up was 3.73±0.58. There was significant improvement in the MacDonald Hull and Norris grading score every follow-up in both groups. However, group II patches showed significantly higher mean grading score as compared with group I patches. The mean pain score in group II patches was significantly higher than that in group I patches. Conclusion The use of fractional carbon dioxide laser to assist topical steroid delivery is a promising, safe, and effective method for the treatment of alopecia areata. Although intralesional steroid treatment showed more significant results, we thought that the low pain score in patients treated with laser-assisted drug delivery is more advantage, which increases their compliance to treatment.

18783 The role of antihistamines and dupilumab in the management of alopecia areata: A systematic review

Background: Alopecia areata (AA) is associated with atopy. Though multiple studies suggest that antihistamines may be effective in treating AA, the potential benefit of antihistamines as monotherapy or adjuvant has yet to be elucidated. In addition, given AA patients’ increased prevalence of atopic dermatitis (AD), further exploration on the effects of dupilumab in AA are warranted.

Consensus on the treatment of alopecia areata – Brazilian Society of Dermatology

BackgroundAlopecia areata is a highly frequent disease with an impact on quality of life and several treatment options with little clinical confirmatory evidence. ObjectiveTo disseminate the recommendations of Brazilian dermatologists with expertise in the treatment of alopecia areata. MethodsEight specialists with expertise in alopecia areata from different university centers were appointed by the Brazilian Society of Dermatology to reach a consensus on its treatment. Based on the adapted DELPHI methodology, the relevant elements were considered; then, an analysis of recent literature was carried out and the consensus was written down. Consensus on the management of alopecia areata was defined with the approval of at least 70% of the panel. Results/ConclusionsIntralesional injectable corticotherapy was considered the first option for localized disease in adults. In extensive cases with signs of activity, systemic corticosteroid therapy should be considered and can be used together with immunosuppressants (corticosteroid-sparing agents). The use of an immunosensitizer (diphencyprone) is an option for stable long-term cases. Evaluation of side effects is as important as the rate of hair regrowth.

Alopecia areata treated with dimethyl fumarate: A case series.

Alopecia areata is an autoimmune condition leading to non-scarring hair loss. Clinically, several presentations ranging from single or few small patches to complete hair loss are documented. The management of alopecia areata is challenging and all available treatments do not ensure a long-term remission to assess the safety and efficacy of systemic dimethyl fumarate in alopecia areata patients not responding to other systemic treatments. After obtaining informed consent, we administered off-label dimethyl fumarate to 10 adult patients with alopecia areata, for a period ranging from 4 to 37 weeks. Medical information for each patient and the severity of alopecia tool (SALT) score before and after dimethyl fumarate administration were recorded. During the treatment, 50% of patients (5 patients out of 10) had a slight improvement of hair regrowth; it was mainly as partial hair regrowth (ranging from 8% to 32%) and only one patient (10%) achieved > 50% terminal hair regrowth. Authors conclude that dimethyl fumarate is not advisable as a treatment of alopecia areata, also considering the risk of fumaric acid esters toxicity.