Pattern Alopecia Research Articles

Hairy tongue associated with the use of baricitinib therapy for ophiasis pattern alopecia areata

AbstractWe report a case of hairy tongue that developed in a young Caucasian woman during systemic baricitinib therapy for severe alopecia areata. Because she experienced good clinical regrowth of her hair during treatment, she did not want to interrupt therapy. We recommended she use a toothbrush to debride her tongue on a daily basis, which was successful. Hairy tongue most commonly occurs in elderly, debilitated males with poor oral hygiene. It is thought to occur because of overgrowth of chromogenic bacteria and/or yeast on the tongue. This unusual side effect during baricitinib therapy suggests that immune suppression may play a role. Clinicians should be aware of hairy tongue development during baracitinib therapy.

THE PATTERN AND CLINICAL PROFILE OF ALOPECIA AREATA. PANORAMIC REVIEW: UPDATE AND ADVANCES ON ETIOPATHOGENESIS, ASSOCIATED FACTORS, DIAGNOSIS, COMPLICATIONS, MANAGEMENT AND PROGNOSIS IN TREATMENT 2023

Introduction: Alopecia areata (AA) is a chronic disorder in which the immune system affects the hair follicles, nails, and occasionally, the retinal pigment epithelium. The characteristic manifestation of alopecia areata encompasses isolated, smooth, non-scarring surfaces of hair loss on the scalp or anywhere with hair growth. Objective: to detail the current information related to alopecia areata, etiology, epidemiology, pathophysiology, histopathology, manifestations, diagnosis, treatment and complications of the condition. Methodology: a total of 48 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 32 bibliographies were used because the other articles were not relevant for this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: alopecia areata, hair loss, hair follicles, hair loss, Janus kinase. Results: The lifetime risk of presenting alopecia areata is approximately 2%, it is the second most frequent non-scarring alopecia, after male and female pattern alopecia. So far no study has shown whether the prevalence of alopecia areata is different between ethnic groups. The first appearance of this alteration is more common between the third and fourth decades of life, however it can occur in any age group. Recent evidence suggests that the origin of the condition is autoimmune, with a significant genetic contribution. This alteration is related to medical and psychiatric comorbidities such as depression, anxiety and different autoimmune disorders. Conclusions: Alopecia areata is an autoimmune condition that generates a sudden and uneven hair loss, affecting any area of the body. Recently, alopecia areata has been interpreted as an autoimmune disease with a genetic substrate. The hair follicles do not suffer permanent damage, which is positive because of the possibility of regrowth. It is of vital importance to know the etiology, epidemiology, pathophysiology, histopathology, manifestations, diagnosis and treatment of the condition. At the moment there is no cure for alopecia areata, however the use of some medications has contributed to the improvement of the symptomatology, there are multiple treatment options available. More studies are needed to treat this condition more adequately. KEY WORDS: alopecia areata, hair follicles, hair loss, Janus kinase.

Efficacy of Dr. SKS Hair Booster Serum in the Treatment of Female Pattern Alopecia in Patients With PCOS: An Open-Label, Non-randomized, Prospective Study.

Background Many patients with polycystic ovary syndrome (PCOS) exhibit female pattern hair loss (FPHL). A more advanced, efficient, and suitable therapeutic approach is required to effectively manage FPHL in patients with PCOS. Aim Dr. SKS Hair Booster Serum is composed of copper, niacinamide, hyaluronic acid, thiamine, riboflavin, and biotin; each of these constituents has demonstrated individual efficacy in promoting hair growth and enhancing hair quality. We hereby assess the effectiveness of this novel hair formulation in treating FPHL in PCOS. Methods This was an open-label, non-randomized, multicenter, prospective, large study with a wide range of age groups. The study involving 1,000 females aged 25-50 years, diagnosed with PCOS and having complaints of FPHL with Ludwig grades I and II. Each patient received a monthly session of Dr. SKS Hair Booster Serum, with 1 mL of serum administered through injection into the superficial layer (dermis) of the scalp using a tiny infusion via an insulin syringe, mesotherapy, or via a derma roller/derma pen. All the patients were subjected to standard global photography, video microscopic assessment (vellus hair counts, terminal hair counts, and hair shaft diameter), and a subject self-assessment questionnaire at baseline and six months after the treatment. Results After six months of the treatment, the hair shaft diameter, terminal hair counts, and hair growth rate were significantly increased than baseline (p≤0.0001), and a significant reduction was noted in vellus hair counts than baseline measurement (p<0.00001). These findings are suggestive of improved hair regrowth after the treatment. No adverse events were recorded during the study. Statistically significant improvements were observed in hair parameters (overall hair fall rate, hair texture, hair volume, and scalp itching) after six months of treatment than baseline. Conclusion Dr. SKS Hair Booster Serum has been shown to be an effective treatment for FPHL in patients with PCOS. This study marks the first investigation into the use of Dr. SKS Hair Booster Serum in patients with PCOS.

Sertoliform endometrioid carcinoma of the right ovary.

Endometrioid carcinomas of the ovary are a subtype of epithelial ovarian tumors, with sertoliform endometrioid carcinomas being a rare variant. We report a case of a previously healthy premenopausal woman presenting with androgenic symptoms in the form of hirsutism and male pattern alopecia. On further testing, she was found to have high levels of luteinizing hormone and total testosterone levels, and imaging revealed a large pelvic abdominal mass in the right ovary. She underwent total hysterectomy with bilateral salpingo-oophorectomy. Microscopy and histopathology confirmed the diagnosis of sertoliform endometrioid carcinoma. Her symptoms improved significantly on follow-up. Androgenic tumors might not be common in premenopausal women; however, it is important to maintain a high level of suspicion in patients presenting with virilizing symptoms especially of rapid progression. Our 47-year-old patient presented with virilizing symptoms that were rapidly progressing, which raises the suspicion of an underlying androgen secreting neoplasm. Sertoliform endometrioid carcinoma (SEC) is an extremely rare variant of endometrioid carcinomas and tend to present at an earlier stage as compared to most endometrioid carcinomas of the ovary. Recognition of SEC in virilizing patients is important as it is a well-differentiated, low-grade malignancy with a good prognosis when confined to the ovary.

PMON281 PERSISTENT VIRILIZATION AND VASOMOTOR SYMPTOMS IN A TRANSMAN 5-YEARS POST TESTOSTERONE WITHDRAWAL

Abstract Introduction Polycystic ovarian syndrome (PCOS) is one of the most common reproductive abnormalities, characterized by irregular menses, hirsutism, and polycystic ovaries (PCO). In cisgender females is associated with insulin resistance and increased risk of metabolic and CV disease. Management of PCOS in transmen has not been established. Case Presentation Twenty-three-year-old transman referred for evaluation of heat intolerance, upper body flushing, sweating, and nausea. Symptoms were severe, non-responsive to lifestyle modifications. He denied change in size of hats, rings or shoes, no easy bruising, no muscular weakness but increased facial hair even after 5-year testosterone withdrawal. He had a normal puberty, menses, breast growth and distribution of fat for assigned female at birth. Testosterone gender affirming care started at age 14 to age 18 but discontinued secondary to irritability and rage. Progesterone and etonogestrel implant were used without success of suppression of menses, requiring hysterectomy with retention of ovaries, to relieve gender dysphoria (GD), in addition to gender affirming bilateral mastectomy. Physical exam is notable for normal vital signs, weight 111 Kg, BMI 33, +male pattern alopecia, terminal facial hair, full beard, acne, supraclavicular fat deposition, and pink thin abdominal stria. Total testosterone and DHEA were elevated at 58.7 ng/dl (13.84-53.35 ng/dL) and 501 ug/dl (18-391 ug/dL) respectively; random estradiol 63 pg/ml; SHBG, LH, FSH, TSH, free T4, T3, IGF1, prolactin, 24-hour urine cortisol and 5-HIAA were normal. Repeat labs were similar, and free testosterone was 26 pg/ml (1-18 pg/mL). Pelvic US showed multi follicular ovaries. A trial of low dose oral estradiol resulted in total resolution of symptomatology. Discussion PCOS was diagnosed based on hirsutism and PCO. He was not bothered by virilization; testosterone was declined as his GD was relieved by gender affirming surgical interventions. We hypothesize that mood disturbances may have been secondary to high endogenous and exogenous androgen levels, as symptomatology resolved upon testosterone withdrawal. We postulate that climacteric symptoms relieved by low dose estradiol may have been the result of an alteration in hormonal feedback. Decreased feedback of testosterone to the hypothalamus has been described during antiandrogen therapy for prostate cancer, as the cause of hot flashes and nausea. Our patient did not have low androgen levels; however, it is possible that drastic fluctuations in androgens, caused "relative hypogonadal" status resulting in his symptomatology. There are no clear guidelines on evaluation and treatment of PCOS in transmen; as virilization is usually not bothersome, however more research is needed on the metabolic effects and CV risk in this population. Our case emphasizes the importance of obtaining baseline hormonal levels before initiation of hormonal affirming care. Transmen are to be screened for PCOS and work up of unexplained hirsutism pursued to treat metabolic and CV risk factors aggressively. Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.

Lichen Planopilaris Mimicking Androgenic Alopecia: The Importance of Using a Dermatoscope

Scarring alopecia (cicatricial alopecia) affects 7% of patients at hair loss specialty clinics. Clinical findings can be subtle and easily overlooked without a thorough physical examination of the scalp. Scarring alopecia can mimic pattern alopecia or coexist and contribute to thinning, so a high index of suspicion and utilization of a dermatoscope is critical to making the diagnosis. Hair restoration surgeons must be aware of the presentation and perform a thorough physical examination in order to avoid the costly mistake of performing surgery in patients who are potentially doomed to fail.

A study on relationship between androgenetic alopecia and cardiovascular risk using high sensitivity C-reactive protein and galectin-3 in men with early onset baldness

Objective In this study, the objective was to evaluate the cardiovascular and metabolic effects in men with male pattern alopecia beginning before 30 years of age. Methods Total of 81 people (41 androgenetic alopecia (AGA) and 40 healthy individuals) were included in the study. Twenty-four-hour ambulatory blood pressure (ABP) measurement, high sensitive C-reactive protein (hsCRP), galectin-3 were studied. Hamilton-Norwood scale (HNS) was used to determine the AGA types of the cases. Results The mean age in the AGA and control groups was 30.3 ± 7.5 and 30.8 ± 6.0, respectively. Twenty-four-hour ABP measurements, hsCRP, and galectin-3 were similar in both groups. There was a positive correlation between HNS grade with age, BMI, triglyceride levels and fasting blood glucose levels in individuals with AGA. Similarly, there was a positive correlation between HNS grade with daytime pulse wave velocity and night-time reflection magnitude. A significant positive correlation was determined between hsCRP with BMI and waist circumference, and between galectin-3 with BMI, waist circumference, hip circumference, HOMA-IR in individuals with AGA. Conclusions This study shows that AGA patients are similar to the normal population in terms of insulin resistance or metabolic syndrome components. However, hsCRP and galectin-3 appear to be associated with cardiovascular disease risk factors in individuals with AGA.

“THE EFFECT OF CYPROTERONE ACETATE AND ETHINYLESTRADIOL COMBINATION ON HYPERANDROGENIC AND OTHER SYMPTOMS IN PCOS”

INTRODUCTION- Polycystic ovarian syndrome (PCOS) is a common, heterogeneous disorder affecting 5-15% of women of reproducing age group and characterized by hyperandrogenic skin symptoms, (acne, Hirsutism and female pattern alopecia,) irregular menstrual bleeding, obesity, dysmenorrhea infertility, and increased risk of metabolic syndrome and endometrial cancer. MATERIAL AND METHOD-The present study was conducted in a private gynecological Clinic Shivpuri, (M.P.). After taking Consent women suffering from PCOS (Fullled the clinical and USG criteria of PCOS(Rotterdam criteria )) along with androgenic symptoms like acne, hirsutism and androgenetic alopecia with or without other symptoms like menstrual irregularities and dysmenorrhea were included in the study.. All patients then received a combination of ethenyl Estradiol (0.035mg) + Cyproterone acetate (2mg). The Patients were followed in the third month, Sixth month, and at about 1 year for improvement in various complaints RESULT- According to presenting symptoms the most common presenting symptom was acne 72.72%, followed by menstrual irregularities 68.18%, hirsutism 50%, alopecia 27.27%, and dysmenorrhea in 27.27%. In acne patients, 37.5% of patients showed improvement after 3 cycles of CPA/EE, 75% showed at 6 months and in 93.75%, improvement was seen at 12 months. In the case of alopecia (83.33%) patient showed improvement after &gt;6 cycles. Patients with hirsutism showed no improvement after 3 months of therapy but 54.54% of the patients showed a change in texture after 6 months of therapy and 72.72% after 9-12 months of therapy. Patients with dysmenorrhea reported a decrease in pain after therapy. The acceptance of the treatment was very good. In 86.36% of patients, good tolerance of drug was seen and in only 3 patients adverse effects (headache and nausea) of the drug were there. All the patients were having good to moderate satisfaction with the therapy. CONCLUSION- Since androgen excess is the prime defect in polycystic ovarian disease, its reduction is the main therapeutic target for most women. Our study found that combined hormonal contraceptives containing ethenyl Estradiol (0.035mg) + Cyproterone acetate (2mg) in a 21/7 regimen had a positive effect in the treatment of acne, hirsutism, menstrual irregularity, and dysmenorrhea in PCOS patients.

Evaluation of efficacy of QR 678 and QR678 neo hair growth factor formulation for the treatment of female pattern alopecia in patients with PCOS-A prospective study.

Hair is an essential identity of women. Femininity, sexuality, attractiveness, and personality are symbolically linked to a woman's hair. Female pattern hair loss is found in 20%-30% of patients with polycystic ovary syndrome (PCOS). The aim of the present study was to evaluate the efficacy of QR678® and QR678 Neo® therapy in the treatment of female alopecia with PCOS. A total of 20 females diagnosed with PCOS in the age 25-50years, with complaints of female pattern alopecia with Ludwig, grades I, and II were selected for the study. At each visit, 1.5ml solution of QR678® was injected in the scalp skin of patients. A total of eight sessions were performed at an interval of 3week each. All the patients were evaluated with standard global photography at baseline, 4th and 8th session, and 2months after 8th session. Marked improvement was seen in the global photographic assessment score (mean=8) which was maintained for over 1year. In videomicroscopic assessment, after four sessions the patients had 8.07 fewer vellus hair, 6.07 more terminal hair, and average hair shaft diameter was 0.82μm wider. After eight sessions, they had 11.66 fewer vellus hair, 13.77 more terminal hair, and hair shaft diameter was 2.86μm wider than at baseline. Intra-dermal injections of QR 678® hair growth factor formulation is an effective option for female pattern alopecia with PCOS. This is the first of its kind study using QR678® and QR678 Neo® in PCOS patients.

Dexpanthenol may be a novel treatment for male androgenetic alopecia: Analysis of nine cases.

Androgenetic alopecia also known as pattern alopecia, is a disorder characterized by the gradual onset of the conversion of terminal hairs into vellus hairs. Dexpanthenol has an anti-oxidative and anti-inflammatory effect and a cellular repair capability. We present nine male cases who had marked improvement after receiving only systemic dexpanthenol treatment for androgenetic alopecia.

Dermoscopic Assessment of Microneedling Alone versus Microneedling with Platelet-Rich Plasma in Cases of Male Pattern Alopecia: A Split-Head Comparative Study.

Introduction:Male pattern alopecia (MPA) is a common disorder hugely impacting the quality of life of affected individuals. The meager number of options available for treatment has their own limitations. Novel therapies are continuously being researched for.Materials and Methods:The present study included thirty male patients with Hamilton Grade II to Grade V. All patients received four sequential treatments with microneedling (MN) on one half of the scalp and platelet-rich plasma (PRP) with MN (MN + PRP) on the other half for 4 months. Three months following the last session, evaluation was done from the vertex and temporal sites in both the groups by dermoscopic microphotographs by a blinded evaluator. In addition, the patients were asked about their satisfaction score on the basis of treatment outcome.Results:Overall hair thickness showed significant increase in both MN and MN + PRP group. Furthermore, the increase in thickness was almost double in the MN group as compared to MN + PRP group (0.006 and 0.003 mm, respectively). Overall hair density also increased significantly in both the study groups but more in MN + PRP group (14.6 hair/cm2) than the MN group (10.8 hair/cm2). However, the difference between the results of both the groups was not statistically significant.Conclusion:To the best of our knowledge, this is the first split scalp study for MPA. We conclude that MN and PRP are both effective in treatment of androgenetic alopecia and improve the hair parameters and patient satisfaction. However, no additional effect of PRP over MN was observed. Both these therapies are safe and well tolerated without any major side effects. Limitations of our study were small sample size and lack of long-term follow-up.

Platelet-Rich Plasma (PRP) Effect on Androgenetic Alopecia and Female Pattern Hair Loss

Background: Androgenetic Alopecia is a chronic form of hair loss affecting both male and female; 20% of Caucasian men and 40% of women, respectively. Plasma Rich Platelet (PRP) is a blood plasma with higher platelet concentration. It seems that in androgenetic alopecia, growth factors have an important role in transformation and development of terminal hair to vellus hair. The growth factors in PRP can affect this process. Methods: This was a case control study that was performed on 120 patients with grade II and III androgenetic alopecia, based on the Hamilton-Norwood classification system and grade 1 to 5 female pattern alopecia. Participants were randomly divided into two groups of 30 patients. The first group was treated with Finastride and the second underwent PRP treatment; with a group of 60 participants who received placebo. Follow-up was performed using macroscopic photography and Pull test base line, monthly for three months, and finally three months after PRP-treatment for patients who received PRP. Results: A total number of 120 participants enrolled in this study; 28 patients in the PRP group, 26 patients in the Finastride group and 60 patients in the control group. The results of one month follow up showed that hair growth and hair loss reduction were not significantly improved in the PRP group compared to the Finastride and control groups (P ≥ 0.05). Significant differences were observed in results of progression of hair growth and reduction of hair loss between groups after three and six months (P value: 00.) Conclusions: PRP-treatment is a novel therapeutic approach. The effective results of PRP-treatment might be due to this eagerness. Furthermore, the time duration of this procedure is short, which is an important factor for the patients since most of the participants are young men who do not tend to undergo long-time treatments, such as Finastride consumption and Minoxidil application.

Skin disease related to metabolic syndrome in women.

Sex hormones are involved in pathways of metabolic syndrome (MetS), an observation supported by animal studies. The relationships of sex hormones with components of MetS, such as insulin resistance and dyslipidemia, have been studied in pre- and postmenopausal women. High testosterone, low sex hormone-binding globulin, and low estrogen levels increase the risks of MetS and type 2 diabetes in women. Cutaneous diseases that are sex hormone mediated, such as polycystic ovary syndrome, acanthosis nigricans, acne vulgaris, and pattern alopecia, have been associated with insulin resistance and increased risk for MetS. Furthermore, inflammatory skin conditions, such as hidradenitis suppurativa and psoriasis, increase the risk for MetS. Patients with such skin conditions should be followed for metabolic complications, and early lifestyle interventions toward these populations may be warranted.

Literature Review

B.L. Rodrigues, . Treatment of male pattern alopecia with platelet-rich plasma: a double-blind controlled study with analysis of platelet number and growth factor levels. J Amer Acad Dermatol . 2019; 80:694-699. P.R. Amable, . Platelet-rich plasma preparation for regenerative medicine:

Persistent radiation-induced alopecia in patients with central nervous system tumors and head and neck sarcomas.

e23072 Background: Persistent radiation-induced alopecia (pRIA), or incomplete hair regrowth 6 months following radiotherapy (RT) completion, poses a significant quality of life burden, but its clinical characteristics and management outcomes are not well understood. Methods: Retrospective database query of patients with primary central nervous system tumors or head and neck sarcomas evaluated at an oncodermatology clinic and diagnosed with pRIA between 1/1/11 and 9/19/18. Clinical data and standardized clinical photographs were analyzed. Alopecia was graded according to the CTCAE v5. Results: Sixty-two patients with pRIA were identified (mean [SD] age, 33 [19]; 75% female; 18 &lt; 21 years at pRIA diagnosis). The most common diagnoses were medulloblastoma (20, 32%) and glioblastoma multiforme (17, 27%). Mean duration between RT and pRIA diagnosis was 3.1 years (95% CI, 2.3-4.2). Additional cancer therapies included surgery (57, 92%), cytotoxic chemotherapy (35, 57%), and combination cytotoxic + targeted therapy (24, 39%). Cancer type, age, number of chemotherapy agents, and duration between RT and pRIA diagnosis were significantly associated with alopecia type: mixed pattern (localized and diffuse) alopecia was predominant in younger patients with medulloblastoma exposed to greater number of agents (p &lt; .005). Alopecia grade 2 ( &gt; 50% hair loss) was predominant in patients that received concurrent chemotherapy and RT (p = .046). Among 22 patients treated with 5% minoxidil topical solution, a response was noted in 16 (73%) (Table). One patient receiving hair transplantation and one receiving scalp reconstruction had complete resolution of pRIA. Conclusions: Concurrent chemotherapy with RT may be a risk factor for grade 2 pRIA. Topical minoxidil may provide some benefit in pRIA; however, prospective trials are needed to assess efficacy. Procedural interventions should be considered as a viable therapeutic option in a subset of patients. [Table: see text]

Expert consensus on the management of Androgenetic Alopecia in India.

Androgenetic alopecia (AGA), also known as androgenic or pattern alopecia, is a frequently reported disorder that affects both the sexes, with a higher incidence generally reported in men. AGA has immense psychological effects on the patient, irrespective of the age or stage of baldness. This consensus document has been developed taking into account the opinions of leading experts in the field of dermatology. The objective of this article is to provide the dermatologists with an evidence-based platform for choosing efficacious and safe therapy for patients with AGA. This review articulately summarizes the key opinions of the experts on all aspects of treatment for the effective management of AGA.

Beneficial effects of pumpkin seed oil as a topical hair growth promoting agent in a mice model.

Objective:Pumpkin (Cucurbita pepo L.) seed oil mainly consists of saturated and unsaturated fatty acids. Previously, it was reported that oral administration of pumpkin seed oil (PSO) improved hair growth in male pattern alopecia. This study aimed to evaluate hair promoting activity of topical PSO in an animal model.Materials and Methods:Male Swiss mice (25-30 g) were used. Dorsal hair of mice (2 x 2.5 cm) was gently removed. Groups were treated as follows: (A) Intact control (did not receive testosterone) (B) Testosterone solution only (5% w/v); (C) Testosterone (5%) + PSO (5%); (D) Testosterone (5%) + PSO (10%) (E) Testosterone (5%) + minoxidil (2%). Application of drugs (100 µl) was done for six days a week, for 3 weeks. Observational and microscopic examinations were performed and results of different groups were compared.Results:Topical application of testosterone significantly (p<0.01) prevented hair growth (compared with intact control). PSO (10%) increased hair growth score after 3 weeks and histopathological findings confirmed these results. After 3 weeks of treatment, the percentage of follicles in anagen phase was 95±4.6 and 44.4±15 for intact control and testosterone-only treated group, respectively. These percentages for PSO (10%) and minoxidil were 75±5.3 and 91.3±4.4, respectively and they could significantly (p<0.001) reverse the effects of testosterone. Conclusion:In conclusion, as topical application of PSO showed hair growth promotion, it might be regarded as a promising alternative for treatment of male pattern alopecia. Also, considering its composition, free fatty acids and minor components like phytoestrogens and vitamin E may have contributed to this effect.

Transdermal delivery of a new hair growth promoting solution in patients with hair loss

Introduction: Male pattern alopecia or hair loss has been treated using various treatment approaches including hair transplantation, oral medications, sprays, mesotherapy and stem cell therapy. However, response rates to such treatments are variable. Case Series: In this case series, 6 Korean patients (5 males and 1 female) with hair loss were treated for three months with hair growth promoting Mr. Care Hair Vital Ampoule® or Mr. Care Hair Vital Ampoule plus® (Mr. Care Co., Seoul, South Korea) using the high-pressure transdermal delivery system JetPeel™ (TavTech Ltd., Yehud, Israel). Either Mr. Care Hair Vital Ampoule or Mr. Care Hair Vital Ampoule plus was sprayed on the affected area(s) of the scalp once a week for three months via the Jet Peel™ system. Conclusion: We found that all the patients had less hair loss and thicker hair after this treatment. Based on our findings, we believe that additional placebo-controlled studies are needed to evaluate the efficacy of our combination treatment.

Treatment of male pattern alopecia with platelet-rich plasma: A double-blind controlled study with analysis of platelet number and growth factor levels

Promisingresults with platelet-rich plasma (PRP) in androgenetic alopecia that could be associated with platelet number and growth factor levels were described. Analyze the platelet countand growth factor levels in PRP and their correlation with hair growth parameters evaluated by using the TrichoScan (Tricholog GmbH, Freiburg, Germany). A total of 26 patients were randomized to receive 4 subcutaneous injections of PRP or saline. Hair growth, hair density, and percentage of anagen hairs were evaluated by using the TrichoScan method before injection, 15days after the last injection, and again 3months after the last injection. Growth factors (platelet-derived growth factor, epidermal growth factor, and vascular endothelial growth factor) were measured by the Luminex method (Millipore, Bedford, MA). We demonstrated a significant increase in hair count (P= .0016), hair density (P=.012) and percentage of anagen hairs (P=.007) in the PRP group versus in the control group, without correlation with platelet counts or quantification of the growth factors in PRP. Other growth factors that could be related to response to PRP were not evaluated. Our data favor the use of PRP as a therapeutic alternative in the treatment of androgenetic alopecia. The lack of association between platelet count, platelet-derived growth factor, epidermal growth factor, and vascular endothelial growth factor levels and clinical improvement suggest that other mechanisms could be involved in this response.

Endocrine Therapy–Induced Alopecia in Patients With Breast Cancer

Endocrine therapy-induced alopecia (EIA) has been anecdotally reported but not systematically described. To characterize EIA in patients with breast cancer. Retrospective cohort study of 112 patients with breast cancer, diagnosed with EIA from January 1, 2009, to December 31, 2016, the patients were examined at the dermatology service in a large tertiary care hospital and comprehensive cancer center. The clinical features, alopecia-related quality of life (QoL), and response to minoxidil of EIA in patients with breast cancer were assessed. Data from the Hairdex Questionnaire was used to assess the impact of the alopecia on patients QoL. Higher score indicates lower QoL (0-100 score). Efficacy of minoxidil was measured at 3 or 6 months by a single-blinded investigator through standardized clinical photographs of the scalp. A total of 112 female patients with breast cancer were included (median [range] age, 60 [34-90] years). A total of 104 patients (93%) had standardized clinical photographs; of these, 59 patients (53%) had trichoscopy images available at baseline, and 46 patients (41%) were assessed for response to minoxidil. Alopecia was attributed to aromatase inhibitors in 75 patients (67%) and tamoxifen in 37 (33%). Severity was grade 1 in 96 of 104 patients (92%), and the pattern was similar to androgenetic alopecia. The predominant trichoscopic feature at baseline was the presence of vellus hairs and intermediate- and thick-diameter terminal hair shafts. A negative impact on QoL was reported, with a higher effect in the emotion domain according to the Hairdex score (mean [SD], 41.8 [21.3]; P < .001). After treatment with topical minoxidil, moderate or significant improvement in alopecia was observed in 37 of 46 patients (80%). Endocrine therapies are associated with a pattern alopecia similar to androgenetic-type, consistent with the mechanism of action of causal agents. A significant negative impact on QoL was reported by patients, despite mostly mild alopecia severity.