Reduced Hair Growth Research Articles

Efficacy and safety of triple diode laser in hair growth reduction

ABSTRACT Background & Objective: Laser treatment for hair removal is a very common procedure in dermatology. Ruby, diode, alexandrite, Nd yag, and intense pulse light are frequently used for hair reduction. For more effective results a combination of wavelengths is used. The purpose of this study is to determine the efficacy and safety of triple diode lasers in hair growth reduction. Methodology: This interventional longitudinal study comprises of total 82 patients using a non-probability convenience sampling technique, the mean age of the patients was 28.73, the age range was between 17 to 56 years, and all patients in this study were female of skin phenotype between III to V. Each session was done one month apart for four months, and hair growth reduction was assessed by using GAIS (Global Aesthetic Improvement Scale Assessment) score by two independent dermatologists in 4th session. Results: Hair growth reduction was observed in all the enrolled patients from the first session. Out of 82 patients, 63.4% of patients are of skin phenotype IV, 23.2% patients are of skin phenotype III whereas 13.4% are skin phenotype V. After four sessions 41 patients (50%) showed excellent results, and 41 patients (50%) showed good results. None of these patients experienced any long-term side effects. Conclusion: Triple diode laser is a safe and effective modality in hair growth reduction at all body sites in skin phenotype III- V with minimal side effects.

An Open Randomised Clinical Study to Evaluate the Combined Effect of Krishna Tila Kashayam and Shatapuspa Choornam in PCOS

PCOS has ovarian dysfunction along with hyperandrogenism and polycystic ovarian morphology. PCOS is a condition where involvement of Kapha dosha is present along with Vata dosha along with Rasa Dhatu, Medo dhatu and Arthava- the Upadhatu of Rasa is affected. Because of having the properties of Ushna virya, Kashaya Tiktha rasa, Arthava janana properties, Krishna Tila Kashayam and Shatapuspa choornam has been mentioned for the treatment of Arthava kshaya (anovulation and oligomenorrhea) in PCOS. The treatment is fully focused on Vata Kapha hara chikitsa and Arthava vardhaka. The drugs selected for the present study can be easily prepared and administered, cost effective. In this study, Tila kashayam along with Anupanam Gudam and Shatapuspa choornam along with Anupanam Madhu has been given and the results have been noted. In the present study, a total of 40 patients suffering from PCOS were selected from OPD and IPD of SJSACH. The thesis is widely focused on increasing the quantity of flow in amenorrhoea or oligomenorrhea cases, to check the size of the ovarian follicle before and after treatment and to check if there is any reduction in hair growth in hirsutism patients. There was a notable change seen in mild to moderate PCOS cases regarding the interval between 2 cycles, duration of flow between 2 cycles and quantity of flow between 2 cycles. There was a notable change seen in reduction of ovarian cyst volume before and after treatment. Hirsutism, BMI and waist circumference - there was no significant changes noted during these 3-month period.

Formulation and Evaluation of Minoxidil Loaded Submicron Emulsion Based Topical Gel for Treatment of Alopecia

Introduction: Alopecia is a benign hair condition that causes reduced hair growth on the scalp and has afflicted populations worldwide. Aim: The present study is designed to formulate and characterize submicron emulsion-based topical gel containing an anti-hypertensive drug like minoxidil to overcome the adverse effects of conventional oral dosage forms & to provide an improved, targetted therapy for the treatment of alopecia. Methods: The minoxidil-loaded submicron emulsion was prepared by aqueous titration method using a suitable combination of Clove oil (oil phase), Tween 20 (surfactant), and Transcutol P (co-surfactant). Results: The maximum submicron emulsion area obtained after constructing pseudo-ternary phase diagrams was found in S\(_{\text{mix}}\) ratio 4:1. The optimized submicron emulsion formulation (M5) exhibited a pH of 5.4 \(\pm\) 0.17, in vitro release of 95.08 \(\pm\) 0.36%, ex vivo permeation of 79.36 \(\pm\) 0.18%, the particle size of 181.3nm with an uniform particle size distribution \((<1)\) and optimum zeta potential (-8.80 mV). The optimized formulation (M5) was then converted to intogel formulation by adding different concentrations (1%, 1.5%, and 2% w/v) of gelling agents like Carbopol 934. Among them, M5\(_{2 w/v}\) was considered to be the optimized gel formulation based on different evaluation studies. The optimized submicron emulsion-based gel formulation also showed an inherited anti-oxidant potential and remained stable for three months at \(4^{\circ}\). Conclusion: The minoxidil-loaded submicron emulsion-based topical gel formulation could be considered a beneficial nano-approach in contrast to other traditional topical dosage forms for treating alopecia.

Eflornithine Hydrochloride-Loaded Electrospun Nanofibers as a Potential Face Mask for Hirsutism Application.

Hirsutism is a distressing condition that can affect women's self-esteem due to the excessive amount of hair growth in different body parts, including the face. A temporary managing option is to develop a self-care routine to remove unwanted hair through shaving or waxing. Laser or electrolysis are alternative methods, but in some cases, the use of medications, such as the topical cream Vaniqa®, can help in reducing the growth of unwanted hair. Electrospun fibers have been used in several drug delivery applications, including skin care products, owing to their biocompatibility, biodegradability, high surface area-to-volume ratio, and dry nature that can release the encapsulated drugs with maximum skin penetration. Therefore, polyvinyl pyrrolidone (PVP) fibers were fabricated in combination with hyaluronic acid to deliver the active compound of Vaniqa®, i.e., Eflornithine hydrochloride (EFH), as a face mask to inhibit excess facial hair growth. The prepared drug-loaded fibers showed a diameter of 490 ± 140 nm, with an encapsulation efficiency of 88 ± 7% and a drug loading capacity of 92 ± 7 μg/mg. The in vitro drug release of EFH-loaded fibers exhibited an initial burst release of 80% in the first 5 min, followed by a complete release after 360 min, owing to the rapid disintegration of the fibrous mat (2 s). The in vitro cytotoxicity indicated a high safety profile of EFH at all tested concentrations (500-15.625 μg/mL) after 24-h exposure to human dermal fibroblast (HFF-1) cells. Therefore, this drug-loaded nanofibrous system can be considered a potentially medicated face mask for the management of hirsutism, along with the moisturizing effect that it possesses. Topical applications of the developed system showed reduced hair growth in mice to a certain extent.

Comparison of Effectiveness and Associated Complications Between Conventional Subdermal Excision and Hydrosurgery (VersajetTM) for Osmidrosis.

Recent studies have shown hydrosurgery (Versajet TM II) is a simple and effective tool with reduced complications in surgical treatment of osmidrosis. Since then, hydrosurgery has been widely used for osmidrosis. However, we have experienced that some complications often occur in patients treated with hydrosurgery. We hypothesized that using a hydrosurgery could lead to excessive resection of the tightly attached apocrine glands and thus more complications. We aimed at evaluating the effectiveness and associated complications of the hydrosurgery method for osmidrosis were compared with those of conventional methods with two parallel incisions. We retrospectively analyzed 31 and 16 patients who underwent conventional and hydrosurgery methods, respectively, for osmidrosis from 2010 to 2020. Two parallel long incisions were identical in both groups. Early complications (hematoma, seroma, wound dehiscence, skin necrosis, revision, scar contracture), late complications (scar, pigmentation, comedones/milia, and sebaceous cysts), and effectiveness (subjective satisfaction, malodor elimination, reduced hair growth, and sweating elimination) were evaluated. Skin necrosis was significantly more frequent in the hydrosurgery group than in the conventional group (p = 0.036). No other significant differences were found between the two groups in terms of other complications and effectiveness. As a result of comparing effectiveness, subjective satisfaction (p = 0.306), malodor elimination (p = 1.000), reduced hair growth (p=1.000), and sweating elimination (p = 0.742) did not show any significant difference between the two groups. Osmidrosis treatment with the use of VERSAJET™ Hydrosurgery System yielded similar and satisfactory results as the conventional subdermal excision method. The incidence of skin necrosis was higher in the hydrosurgery group than in the conventional group with two parallel incisions. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

HERBAL CREAMS OF REISHI EXTRACT AND TEA TREE OIL FOR HIRSUTISM–AN IN VIVO STUDY

Objective: The aim of this work to formulate, evaluate and compare the effectiveness of herbal creams containing extract of reishi and tea tree oil for treating hirsutism.
 Methods: Herbal ingredients were authenticated. Cream base was initially formulated. Three formulations of herbal cream were prepared. Reishi ethanolic extract, tea tree oil, and combination of tea tree oil and reishi extract were added to the cream base and formulated cream were named as RHC, THC and RTC respectively. In vitro evaluations on herbal creams were done for the physicochemical characteristics. In vivo studies were carried out on female Swiss Albino mice for the activity against hair growth by topical application of cream to shaved skin. The histological and morphometric evaluation was carried out. Skin irritancy study was conducted.
 Results: The herbal creams showed desirable physicochemical properties like pH, viscosity and spreadability. Statistical analysis for the length of hair was performed by using one way ANOVA followed by DUNNET’S post hoc test where THC and RTC were found to be significant whereas RHC showed no significant reduction of hair growth compared to control. RTC showed a significant effect at p<0.05 and hair growth reduction was significant for THC at p<0.001 compared to the control group. RTC and THC showed mild to moderate reduction in the size of the hair follicles with a reduction of sebaceous gland size in the histological analysis.
 Conclusion: Topical application of herbal creams to mice showed that hair growth was fastest in group RHC and was slowest in group THC and intermediate with RTC. It can be concluded that these herbal actives can be used as an effective treatment against hirsutism. Within the study period, tea tree oil was found to be more effective than reishi extract and the combination product. Further formulation studies and in vivo studies need to be carried out on reishi to assess its effectiveness against hirsutism.

The Effects of Ischemia and Hyperoxygenation on Hair Growth and Cycle

ABSTRACT Alopecia has several causes, but its relationship with ischemia/hypoxia has not yet been investigated in detail. In this study, we studied the changes of hair follicles induced by ischemia and potential effects of normobaric hyperoxygenation (NBO) on the hair cycle and growth. We found that skin ischemia reduced hair growth rate, hair shaft size, and its pigmentation in the anagen phase of mice, which may reflect an aspect of pathophysiology of hair loss (alopecia) and depigmentation (gray/white hairs). Hyperoxygenation increased hair growth rate in organ culture of both human and murine hair follicles. Systemic NBO promoted hair growth in early anagen and mid-anagen, and delayed catagen onset in mice. However, telogen-to-anagen transition was not affected by NBO as far as non-ischemic skin is concerned. The results of this study indicated that the hair follicle is very sensitive to oxygen tension and oxygen tension affects the regulation of hair growth and cycle in vitro and in vivo. It was suggested that systemic NBO can be safely applied for a long period and can be a noninvasive therapeutic approach to alter hair growth and cycle by manipulating the microenvironment of hair follicles.

Is it getting in the hair? – Cortisol concentrations in native, regrown and segmented hairs of cattle and pigs after repeated ACTH administrations

Adrenocorticotropic hormone (ACTH) is part of the hypothalamic-pituitary-adrenal axis response to stress and induces the release of cortisol, which is commonly used as an indicator in stress and animal welfare research. In recent years, hair cortisol concentration (HCC) gained increasing importance as a promising retrospective indicator for stress in animals. Thus, the aim of our study was to validate HCC as a potential indicator of increased endogenous cortisol release in cattle and pigs by repeated ACTH administrations followed by cortisol analysis in different hair types. For this purpose, 34 cattle and 38 gilts were treated either with repeated i.m. injections of ACTH or saline every second day over a period of 4 weeks. Saliva samples were taken before and after injections once a week from selected animals to verify the endogenous cortisol response. At the end of the treatment (week 4) and after 8 and 12 weeks, samples of natural and regrown hair were taken from the caudo-dorsal region of the back and analyzed for cortisol concentrations. In addition, natural hair was sampled after 12 weeks and cut into segments prior to analysis. Treatment with ACTH revealed a significant increase in salivary cortisol after application in both species, although this increase was attenuated in pigs compared to cattle. In week 4, HCCs were significantly elevated in natural and regrown hair of ACTH-treated animals. In cattle, HCCs significantly increased after ACTH treatment in natural, regrown and segmental hair compared with control animals, indicating that HCC may be a promising indicator of stress, as cortisol levels in all hair types reflected the preceding period with increased cortisol release. In pigs, there were no differences in HCCs between treatments. This may be caused by the lower systemic cortisol response in pigs, but seasonally reduced hair growth and external cross-contamination of hair by saliva and urine under commercial husbandry conditions may also interfere with the validity of HCC in this species.

Laser Treatment in Hirsutism: An Update.

Unwanted hair growth, which is a common aesthetic problem, has traditionally been treated using various techniques such as shaving, waxing, and epilation, but most of these provide only a temporary solution. Laser and light-based technology for hair removal has become one of the fastest growing procedures in modern cosmetic dermatology in the last decade. Clinical experience suggests that in the ideal subject with fair skin and dark hair, laser treatment can reduce hair growth significantly. This article reviews the various laser and light-based devices used for hair removal along with the various laser and patient parameters that affect the outcome of laser treatment for hair removal. Photoepilation, when properly used, offers clear advantages when compared with older, traditional techniques.

A Novel Effect of Acyclovir on Hair Growth in BALB/c Mice: A Promising Future for Finding a New Topical Drug for the Treatment of Hirsutism.

PurposeHirsutism (ie, terminal hair growth on the face and body in a male-like pattern in women) is a common dermatological disorder in women, with psychosocial implications. Consequently, there is demand for finding novel pharmacological treatments and agents that can safely reduce hair growth. This study aimed to investigate the potential effect of topical acyclovir on hair growth in mice.MethodsIn this study, twenty-four female BALB/c mice were randomly divided into three groups in order to evaluate the hair growth-reducing effects of acyclovir (control group, vehicle group, and acyclovir group). Topical acyclovir 5% was applied on the shaved denuded skin of mice. Topical application onto the backs of the animals was performed twice daily for 28 consecutive days. The time (in days) required for hair growth initiation as well as completion of hair growth in dorsal skin of animals were recorded. On day 28, horizontally cut biopsy samples were removed and the numbers of hair follicles were counted, and the diameter of hair follicles was measured under high-field microscopy by a specialist blinded to the treatments.ResultsHair growth initiation time was significantly increased with acyclovir, as compared to control and vehicle groups. The time required for complete hair growth in control and vehicle groups were 18±0.68 and 19±1.41 days, respectively; however, the hair growth completion in acyclovir-treated animals was not observed at the end of the experiment. Furthermore, the length of hairs in treatment group was significantly shorter than the control group at the end of the study (P < 0.001). In histologic examination, the count and the diameter of hair follicles in deep subcutis were significantly decreased.ConclusionThe results of this study, for the first time, showed that topical administration of acyclovir might have inhibitory effects on hair growth in experimental animals; however, further studies are required to understand its mechanism.

Radical treatment of axillary osmidrosis using the VERSAJET™ II Hydrosurgery System or traditional open excision: A prospective cohort study.

Axillary osmidrosis, characterized by an unpleasant odor, renders social life difficult for young adults. This study aimed to compare traditional open excision and use of the VERSAJET™ II Hydrosurgery System for effectiveness and treatment complaints in the treatment of axillary osmidrosis. The current study aimed to assess the curative effect of VERSAJET™ for axillary osmidrosis in a prospective cohort study, comparatively to traditional open excision. In this prospective cohort study, from October 2016 to March 2018, 31 and 34 patients treated with the VERSAJET™ II Hydrosurgery System and traditional open excision, respectively, were recruited and followed up for 6 months post-treatment. Treatment outcomes were assessed, including surgical field size, operation time, postoperative complications, odor elimination, hair growth reduction, scarring, and patient satisfaction. The VERSAJET™ group had significantly shorter operation (P<.001) and lower rates of complications, including hematoma (P=.014), wound dehiscence (P=.048), and epidermal erosion (P=.022) compared with the open excision group. A similar rate of good odor elimination (P=.925) was observed in both groups (96.77% and 97.05% in the VERSAJET™ and open excision groups, respectively). Most patients experienced sparsity of armpit hair following both procedures. Based on a comprehensive consideration of the whole operation process, recovery process, postoperative odor and scar, patients in the VERSAJET™ group were more satisfied compared with those in the open excision group (P=.008). The VERSAJET™ II procedure is shorter, with less postoperative scarring and fewer postoperative complications, compared with the traditional method. Therefore, the VERSAJET™ II procedure is superior to traditional open excision, as a new, radical treatment method for axillary osmidrosis.

An osteopontin-derived peptide inhibits human hair growth at least in part by decreasing fibroblast growth factor-7 production in outer root sheath keratinocytes.

Given that unwanted hair growth (hirsutism, hypertrichosis) can cause major psychological distress, new pharmacological treatment strategies with safe and effective hair growth inhibitors that do not destroy the hair follicle (HF) and its stem cells need to be developed. To establish if osteopontin-derived fragments may modulate human hair growth given that human HFs express the multifunctional, immunomodulatory glycoprotein, osteopontin. Our hypothesis was tested exvivo and invivo by using a newly generated, toxicologically well-characterized, modified osteopontin-derived peptide (FOL-005), which binds to the HF. In organ-cultured human HFs and scalp skin, and in human scalp skin xenotransplants onto SCID mice, FOL-005 treatment (60 nmol L-1 to 3 μmol L-1 ) significantly promoted premature catagen development without reducing the number of keratin 15-positive HF stem cells or showing signs of drug toxicity. Genome-wide DNA microarray, quantitative reverse-transcriptase polymerase chain reaction and immunohistochemistry revealed decreased expression of the hair growth promoter, fibroblast growth factor-7 (FGF7) by FOL-005, while cotreatment of HFs with recombinant FGF7 partially abrogated FOL-005-induced catagen promotion. With caveats in mind, our study identifies this osteopontin-derived peptide as an effective, novel inhibitory principle for human hair growth exvivo and invivo, which deserves systematic clinical testing in hirsutism and hypertrichosis. What's already known about this topic? The treatment of unwanted hair growth (hypertrichosis, hirsutism) lacks pharmacological intervention, with only few and often unsatisfactory treatments available. Osteopontin is prominently expressed in human HFs and has been reported to be elevated during catagen in the murine hair cycle. What does this study add? We tested the effects on hair growth of a novel, osteopontin-derived fragment (FOL-005) exvivo and invivo. In human hair follicles, high-dose FOL-005 significantly reduces hair growth both exvivo and invivo. What is the translational message? High-dose FOL-005 may provide a new therapeutic opportunity as a treatment for unwanted hair growth.

An innovative technique of hydrosurgery in the treatment of osmidrosis

Background We aimed at evaluating the effects of hydrosurgery and traditional surgical approach with two parallel incisions in the treatment of osmidrosis. Methods This prospective study enrolled patients with axillary osmidrosis between January 2015 and November 2016. For hydrosurgery, a 1-cm-long incision was made in the middle of the posterior long axis. The hand piece was turned upside down and processed in a ‘W-O’ way. For traditional method, two 3-cm-long parallel incisions were made transversely. Patient demographics, complications, duration of procedures and the outcomes were collected and compared. All patients had a follow-up period of 24–36 months. Results A total of 93 patients were included: 41 patients in hydrosurgery group and 52 patients in traditional method group. No severe complications occurred in the hydrosurgery group, while necrosis occurred in six sides of axillae of traditional surgical group. No recurrence occurred in both groups. Both groups showed similar odor and hair growth reduction rate. Only one in 82 sides occurred slight scar formation, while in traditional group, 22 sides of axillae formed scars (p < .001). Conclusions The application of hydrosurgery in the treatment of osmidrosis is efficient and effective. Moreover, it has less postoperative complications, and high patient satisfaction rates.

Hair anomalies in syndromic disorders

Genetic diseases with hyper- and hypotrichosis are very heterogeneous, both clinically and genetically. This is especially true for ectodermal dysplasias but also for hereditary syndromes in which, beyond abnormal hair growth, other structures and organs are affected. In this review, we discuss distinct diseases with excessive and reduced hair growth, focusing on the clinical hallmarks and underlying genetic defects.

Effectiveness of Preoperative Depilation of the Urethral Donor Site for Phalloplasty: Neourethral Hair Growth and its Effects on Voiding

BackgroundFor transgender men choosing to undergo phalloplasty with urethral lengthening, there is a potential for hair growth in the neourethra. Depilation of the urethral donor site may reduce subsequent intraurethral hair growth. ObjectivesTo evaluate the effectiveness of preoperative laser depilation and assess the correlation between urethral hair density and voiding among transgender men undergoing phalloplasty with urethral lengthening. Design, setting, and participantsThis was a retrospective study of 25 transgender men undergoing phalloplasty with urethral lengthening between July 2010 and April 2015 at the VU University Medical Center in Amsterdam. InterventionPhalloplasty with urethral lengthening using skin with or without preoperative depilation. Outcome measurements and statistical analysisData on preoperative laser depilation treatments were obtained from the local laser center. Intraurethral images were captured via urethroscopy and used to rate hair density. Images of the contralateral forearm were used as a reference. Hair density was rated in terms of the number of hairs per view as zero, low (1–9), moderate (10–19), or high (≥20). Voiding was assessed using the International Prostate Symptom Score (IPSS) questionnaire, a 24-h voiding diary, and uroflowmetry. Results and limitationsTwenty-five patients underwent urethroscopy. In the depilation group (n = 14) the hair reduction was significant and hair density was downgraded on average by 1.0 points (95% confidence interval [CI] 0.5–1.5). The mean number of laser treatment sessions was 6 (range 2–10). In the no-depilation group (n = 11), hair density did not significantly differ between the urethra and the contralateral arm (mean difference 0.18, 95% CI 0.5–0.9). The majority of the patients reported mild voiding complaints (median IPSS score 7, range 2–28) and had a normal functional bladder capacity and a nonobstructed urinary flow with low postvoid volumes. ConclusionsLaser epilation treatment reduces hair growth but does not eliminate hair. Voiding complaints do not seem to be related to hair density in the urethra. Patient summaryFor skin donor sites used in penis construction for transgender men, the amount of hair growth is reduced by preoperative laser depilation, but hair is still present in the new urethra. Hair in the urethra does not cause urinary voiding complaints.

Correlation of vitamin D and vitamin D receptor expression in patients with alopecia areata: a clinical paradigm.

Vitamin D (Vit.D) deficiency has been reported in alopecia areata (AA). Downregulation of Vitamin D receptor (VDR) on hair follicles is associated with reduced hair growth. To correlate serum Vit.D levels with severity, pattern, and duration of AA, and density of VDR expression over hair follicles in AA patients. Prospective study including 30 AA patients and 30 healthy controls. Clinical details and serum Vit.D measurement and scalp biopsy for histopathology and VDR expression was performed in patients and controls at baseline and after 6 months of treatment of AA. Mean age of patients and controls was 28.9 ± 9.96 and 31.17 ± 9.43 years, respectively. Mean SALT score in patients was 35.8 ± 27.5 with a median disease duration of 48 weeks. Mean serum Vit.D levels was 7.65 ± 4.50 ng/ml and 15.8 ± 11.47 ng/ml in patients and controls, respectively. Twenty-nine (96.7%) patients were Vit.D deficient (<20 ng/ml), compared to 22 (73.3%) controls (P = 0.001). Serum Vit.D levels inversely correlated with severity of the disease (r = -256), P = 0.17, and duration of disease but did not correlate with pattern of AA and VDR expression in tissue samples. VDR expression was reduced in all patients and was normal in controls. Inverse correlation of VDR was noted with presence of inflammation on histology (P = 0.02). VDR upregulation post treatment was seen only in 13% of patients and demonstrated no correlation with response to treatment. Vit.D deficiency in AA correlates inversely with disease severity and duration. VDR expression is reduced in AA and inversely correlate with inflammation histologically but does not correlates with serum Vit.D levels, severity, pattern, or duration of illness.

Immune control of hair growth.

Stem Cells Hair follicles in mammalian skin undergo cycles of quiescence and regeneration. Hair follicle stem cells play a role in the regeneration phase. Ali et al. have found that regulatory T cells (Tregs), immune cells known to suppress inflammation, colocalize with stem cells in hair follicles. In a mouse model of hair regeneration, depletion of Tregs reduced hair growth. Analysis of gene expression revealed that Tregs promote the proliferation and differentiation of hair follicle stem cells. Tregs express a high level of Jagged, a ligand of the cell-cell communication system called the Notch signaling pathway that controls stem cell self-renewal and differentiation. The findings may have implications for treating individuals with alopecia areata, a hair loss condition. Cell 10.1016/j.cell.2017.05.002 (2017).

Fever of unknown origin in a male patient with systemic lupus erythematosus.

Background:Systemic lupus erythematosus (SLE) is an inflammatory autoimmune disorder which is uncommon in men. It has a wide variety of clinical presentations.Case Report:We report a 21-year-old male presented with one month history of fever, loss of appetite, weight loss and reduced hair growth with an examination revealing an oral ulcer, cervical and axillary lymphadenopathy simulating hematological malignancy. Investigations showed pancytopenia, positive anti-nuclear factor and double-stranded DNA, high erythrocyte sedimentation rate with normal C-reactive protein levels and hypocomplementemia. The diagnosis of systemic lupus erythematosus was made and treatment with oral prednisolone conferred a dramatic clinical and biochemical improvement within one week.Conclusion:In the evaluation of fever of unknown origin, one should be guided by the presenting symptoms and signs of a patient and even though uncommon, SLE is a worthwhile diagnosis to investigate even in a male patient if the clinical picture is suggestive.

211 LRIG1 a regulator of ERBB signaling in skin during development and homeostasis

The leucine-rich repeats and immunoglobulin-like domains (LRIG) family includes transmembrane proteins known to be essential regulators of growth factor receptors like the epidermal growth factor receptor (EGFR/ERBB) family. As ERBBs are involved in cell proliferation, differentiation, death, motility, and adhesion, they are very versatile players during processes such as development, tissue homeostasis and tumorigenesis. The LRIG proteins are thought to regulate ERBBs and also other receptor tyrosine kinases. However, the role of LRIG proteins for regulatory feedback loops is not understood yet and requires further studies. To study LRIG1 in more detail, we generated doxycycline-inducible, skin-targeted (keratin 5 promoter-directed) transgenic (tg) mouse lines overexpressing LRIG1 using the TET-OFF system. As it is known that LRIG1-knockout mice develop a hyperplasia of the epidermis and psoriasis due to a hyperactive EGFR receptor, we anticipated a thinner epidermis in LRIG1 tg mice. Surprisingly, we could not obtain LRIG1 overexpressing mice in the expected rates. Only 9% (6/65) of all born mice were both LRIG1 and tTA positive and 83% (5/6) of these mice died immediately after birth. Only one double transgenic mouse survived for 13 days. The hair coat development of this animal was delayed and it showed reduced hair growth, hyperkeratosis, utricle development and a thicker epidermis compared with control siblings. Initial investigations in LRIG1 tg mice at day P0 suggest that the loricrin positive epidermal layer was increased in this animals. To study the phenotype of LRIG1 tg also in older animals, we suppressed the LRIG1 overexpression until birth by doxycycline treatment of pregnant females. Induction of the LRIG1 expression after birth by discontinued doxycycline application enables the survival of LRIG1 transgenic mice. These mice showed alopecia from three months of age with a significant thicker epidermis and utricles.

Role of Barever Natural Hair Inhibitor in Reducing Unwanted Body Hair Growth; As an Adjuvant Therapy with Waxing and with Normal Hair Removal Cream

Background: Unwanted facial and body hair plays role in one’s cosmetic look, although unwanted hair is not detrimental to health but it is considered to affect the perfect look of person. Unwanted hair on the visible body parts like hands, legs, face and back are perceived as a problem for the picture perfect cosmetic look. People do use various methods so as to reduce the growth of unwanted hair and even tries permanent hair removal techniques. The permanent hair removal techniques tried by individual includes laser hair removals and other home and herbal remedies. Various reports have demonstrated the efficacy of herbal remedies for the reduction of hair growth especially the role of papaya in reduction of hair growth. Papaya contains an enzyme called papain 1 which acts on the hair follicles by wreaking their action to help grow hair. The appropriate combination of papain with other herbal ingredients having role in hair reduction can effectively restricts the growth of hair and help in achieving permanent hair growth reduction. Barever Natural Hair Inhibitor is the scientific combination of herbal ingredients which includes carica papaya, Gymnema Sylvestre and others effectively restricts the growth of the hair resulting in permanent hair growth reduction. Barever natural hair inhibitor if applied after hair removal seeps into the follicle cell level of hair and inhibits the growth of hair. This study examines the effectiveness of Barever natural hair inhibitor in long term hair reduction.