Reported Hair Loss Research Articles

Alopecia as an uncommon side effect of single postoperative instillation of gemcitabine in patients with non-muscle-invasive urothelial carcinoma of the bladder.

274 Background: Single-dose administration of intravesical gemcitabine is a common part of clinical practice following transurethral resection (TURBT) of non-muscle invasive bladder cancer (NMIBC). Although the side effect profile for gemcitabine is well characterized in systemic and local therapy, rare side effects continue to be identified with ongoing use. Here we identify several cases of treatment-related alopecia with adjuvant single dose intravesical administration for NMIBC after TURBT. Methods: Using our single-institutional IRB-approved Cysview registry database, we identified patients who underwent TURBT for NMIBC and received a single dose of intravesical gemcitabine post-TURBT between January 2020 and June 2023 at Keck Hospital of USC. Patients with a history of low grade NMIBC or those undergoing their first TURBT received 2g of gemcitabine dissolved in 100 cc of saline 1h after tumor resection. We reviewed patient-reported adverse events and included patients who reported alopecia following gemcitabine instillation. Patients were questioned on the degree and length of hair loss and information was collected from patient charts. Results: Overall, 9 patients (2 male, 7 female) reported hair loss following single dose intravesical gemcitabine after the TURBT. One patient had an autoimmune disease. The hair loss started within a few days of gemcitabine instillation and resolved spontaneously. The table shows the clinicopathologic characteristics of this cohort in detail. Three patients experienced severe hair loss. The resection extent during TURBT was classified as small (<2 cm), medium (2-5 cm), or large (>5 cm). Three patients had a large resection, 2 patients a medium one and 3 patients a small resection. None of the patients had previous intravesical gemcitabine; however, 2 patients had a history of intravesical BCG and 1 had intravesical mitomycin before. Conclusions: This study demonstrates that hair loss is a rare but possible adverse effect of intravesical gemcitabine after TURBT. Prior to surgery, patients should be counseled regarding this potential side-effect. Additional research and multicenter studies are required to describe the occurrence and cause of this adverse event. Demographic, clinical, and pathologic characteristics of patients. Patient ID Age Sex History of other IVT Pathology of TURBT Number of prior TURBT Resection extent Severity of hair loss Prior UBC 1 73 M None LGTa 1 large moderate LGTa 2 88 M MMC LGTa multiple large severe LGTa 3 76 F BCG CIS multiple small moderate HGT1 in upper tract,HGTa & LGTa in bladder 4 56 F BCG HGTa multiple large severe LG+HGTa 5 66 F None HGTa none small moderate None 6 84 F None LGTa none small severe None 7 62 F None LGTa 1 medium moderate LGTa 8 68 F None HGTa multiple medium mild LGTa 9 64 F None LGTa none medium severe None LG= Low Grade, HG = High Grade.

Perceptions of delayed alopecia among breast cancer survivors

BackgroundRetrospective studies suggest that some breast cancer survivors report treatment-associated hair loss or thinning years after their diagnosis. This study investigates frequency and perceptions of alopecia persisting 6 years after patients’ breast cancer diagnoses. MethodsBreast cancer survivors participating in the Mayo Clinic Breast Disease Registry (MCBDR) were mailed a survey 6 years after diagnosis. They were asked about their degree of bother from hair thinning and hair loss and mental health was explored. ResultsA total of 969 of 1476 participants (65.7%) responded to the survey. Of these, 755 patients were eligible for inclusion and had stage I-III breast cancer. Respondents' median age was 65.6 years (35-95 years). Chemotherapy (± endocrine therapy) was administered to 216 (29%) participants, and 342 (45%) received only endocrine therapy. Nearly half (345, 46%) of respondents reported hair loss and over half (431, 57%) reported hair thinning. Moderate to extreme bother from hair loss was reported by 27% of chemotherapy recipients, by 18% of endocrine therapy only recipients, and by 14% of patients who received neither. Moderate to extreme bother from hair thinning was reported by 31% of chemotherapy recipients, by 21% of endocrine therapy-only recipients, and by 19% of those who had received neither. Hair growth product usage was reported by 31% of chemotherapy recipients and 14% of endocrine therapy-only recipients. ConclusionsHair loss and thinning are frequently reported as persistently bothersome symptoms by breast cancer survivors. Future investigations into the incidence, predictors, and treatment of therapy-associated alopecia are needed.Micro Abstract: Chronic alopecia related to breast cancer treatment is a distressing symptom. In our cohort study of breast cancer survivors 6 years after diagnosis, 46% reported hair loss and 57% reported hair thinning. Moderate to extreme bother from hair loss and thinning was common, especially post-chemotherapy, and 19% of respondents used hair regrowth products. These findings emphasize the need for addressing persistent treatment-associated alopecia.

EFFECT OF THYROID DYSFUNCTION ON BODY MASS INDEX AND HORMONAL IMBALANCE IN WOMEN HAVING POLYCYSTIC OVARIAN SYNDROME

Polycystic ovary syndrome (PCOS) is a prevalent gynecological disorder that significantly impacts women of reproductive age. Both PCOS and thyroid dysfunction independently increase the risk of ovarian dysfunction and prenatal complications. International studies have associated thyroid dysfunction with menstrual irregularities in women. Objective: This study aims to understand the influence of thyroid dysfunction on Body Mass Index (BMI) and hormonal imbalance in women diagnosed with PCOS. Methods: A cross-sectional study was conducted at two medical facilities, Sardar Begam Hospital and Cheema Family Hospital, involving participants aged 18 to 43 years. The sample size consisted of women diagnosed with PCOS. Data collection spanned from April 2023 to April 2024. A structured questionnaire was utilized to collect data on participants' history of PCOS, symptoms of irregular menstrual cycles, and BMI. Blood samples were collected to measure thyroid hormone levels, which were analyzed using ELISA. Statistical analysis was performed using [Insert Statistical Software], applying descriptive statistics and comparative analysis to assess the impact of thyroid dysfunction on BMI and hormone levels in PCOS patients. Results: The study findings indicate that 73.33% of women with both PCOS and thyroid dysfunction experienced weight gain, whereas only 26.67% did not report weight gain. Additionally, 80% of the participants reported acne, 60% experienced hirsutism, and 90% had irregular menstrual cycles. Muscle weakness and low energy were prevalent in 63.33% of the women, while 73.33% reported depression, and 66.67% reported hair loss. Significant differences were observed in the levels of Triiodothyronine (T3) and Thyroxine (T4) among women with PCOS with and without thyroid dysfunction. Specifically, for T3 levels, PCOS patients with thyroid dysfunction had a mean level of 7.3213, whereas those without thyroid dysfunction had a mean level of 63.812. Similarly, for T4 levels, PCOS patients with thyroid dysfunction had a mean level of 7.3213, compared to 63.812 in those without thyroid dysfunction. Conclusion: The study highlights the substantial impact of thyroid dysfunction on both T3 and T4 levels in PCOS patients. These findings underscore the importance of routine thyroid function screening in PCOS patients to devise more personalized and effective treatment strategies.

Abstract PO2-13-09: Delayed alopecia among breast cancer survivors

Abstract Background: Retrospective studies suggest that breast cancer survivors report treatment-associated hair loss or thinning years after their initial diagnosis. This study investigates patient perceptions of alopecia persisting 6 years after the diagnosis of breast cancer. Methods: Breast cancer survivors who had signed informed consent for participation in a prospective longitudinal cohort study, the Mayo Clinic Breast Disease Registry (MCBDR), after diagnosis of breast cancer approximately six years prior, were mailed a survey. This survey asked about degree of bother from hair thinning and hair loss on a scale from 0 “not at all” to 4 “extremely” and about use of hair thickening/regrowth products. PROMIS-10 project scales assessed global mental health (5: worst mental health, 20: best mental health). Data were analyzed using descriptive statistics. Results: 969/1476 participants responded (response rate 65.7%); 819 participants were available for analysis. Participant median age was 65.7 years (range 34 -100 years). 604 (73%) had been diagnosed with stage I-II breast cancer, 248 (30%) had received chemotherapy (+/- endocrine therapy), 365 (45%) had received only endocrine therapy, and 206 (25%) had received neither. Nearly half (381, 47%) reported hair loss and over half (468, 57%) reported hair thinning. 155 (19%) used hair regrowth products. Amongst the 526 who were 55 years and older, 270 (51%) reported hair loss and 323 (61%) hair thinning; 111 (38%) of the 291 women under 55 years reported hair loss and 145 (50%) hair thinning. Twenty-eight percent of chemotherapy recipients, 18% of patients who did not receive chemotherapy but received endocrine therapy, and 14% of patients who had received neither reported continued difficulty with moderate to extreme hair loss. Moderate to extreme bother from hair thinning was reported by 34% of chemotherapy recipients, 22% of endocrine therapy-only recipients, and 18% of those who had received neither. See the table for associations between mental health scores and hair loss/thinning. Use of hair growth products was reported by 29% of chemotherapy recipients, 14% of endocrine therapy-only recipients, and 15% of those who had received neither oncologic therapy. Conclusions: Hair loss and thinning are frequently reported as persistently bothersome symptoms from breast cancer survivors. Future investigations into the incidence, predictors, and treatment of chemotherapy and endocrine therapy-associated alopecia are needed. Global mental health scores on PROMIS scale for hair loss and hair thinning Citation Format: Sarah Premji, Kathryn Ruddy, Nicole Larson, Charles Loprinzi, Brittany Dulmage, Maryam Lustberg, Fergus Couch, Janet Olson, Elizabeth Cathcart-Rake. Delayed alopecia among breast cancer survivors [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-13-09.

Hair Loss: A Well-Known Yet Understudied Symptom in Parkinson's Disease Patients During Dopaminergic Therapy.

Hair loss has been reported to occur during dopaminergic therapy in patients with Parkinson's disease. The mechanism by which dopaminergic therapy induces hair loss is not well understood. Dopamine receptors are present in the hair follicle, where they regulate melanin production. However, the role of dopamine receptors in hair growth is still not well understood. This study aimed to evaluate the prevalence of hair loss and identify factors associated with complaints of hair loss in patients with Parkinson's disease. A cross-sectional design involving 495 Parkinson's disease patients was applied to evaluate hair loss status. Patients completed a questionnaire, and scalp/hair examinations were performed. Patients with underlying conditions that could affect hair loss and those prescribed medications known to increase the risk of hair loss were excluded. Finally, 291 patients (58.8%) were included for analysis. Among the 495 patients, 138 (27.9%) reported hair loss. Interestingly, more than half of the patients who complained of hair loss (79 out of 138) did not utilize treatments such as hair products, massage, dietary modifications, or alopecia medications. Hair inspection by a single investigator revealed objective hair loss in 263 patients (53.1%). An analysis of factors associated with hair loss complaints showed that the intake of dopaminergic medications with a levodopa-equivalent daily dose > 448 mg was associated with complaints of hair loss. Dopaminergic medication is associated with hair loss complaints in Parkinson's disease patients.

Antiseizure Medication-Induced Alopecia: A Literature Review.

Background: Adverse effects of antiseizure medications (ASMs) remain one of the major causes of non-adherence. Cosmetic side effects (CSEs) are among the most commonly reported side effects of ASMs. In this context, alopecia is one of the CSEs that has a high intolerance rate leading to poor therapeutical compliance. Methods: We performed a literature review concerning alopecia as a secondary effect of ASMs. Results: There are 1656 individuals reported with ASM-induced alopecia. Valproate (983), lamotrigine (355), and carbamazepine (225) have been extensively reported. Other ASMs associated with alopecia were cenobamate (18), levetiracetam (14), topiramate (13), lacosamide (7), vigabatrin (6), phenobarbital (5), gabapentin (5), phenytoin (4), pregabalin (4), eslicarbazepine (3), brivaracetam (2), clobazam (2), perampanel (2), trimethadione (2), rufinamide (2), zonisamide (2), primidone (1), and tiagabine (1). There were no reports of oxcarbazepine and felbamate with drug-induced alopecia. Hair loss seen with ASMs was diffuse and non-scarring. Telogen effluvium was the most common cause of alopecia. A characteristic feature was the reversibility of alopecia after ASM dose adjustment. Conclusions: Alopecia should be considered one important adverse effect of ASMs. Patients reporting hair loss with ASM therapy should be further investigated, and specialist consultation is recommended.

Traction alopecia: assessing the presentation, management and outcomes in a diverse urban population.

Traction alopecia (TA) is a type of hair loss caused by repetitive tension placed on the hair follicle. An institutional review board-approved retrospective study was conducted at a single institution located in the Bronx, New York. The review identified 216 unique patients with TA and collected information on demographics, patient presentation, history, physical exam, treatment, follow-up and disease improvement. Almost all patients identified as female (98.6%), and most were Black or African American (72.7%). Mean (SD) age was 41.3 (17.1) years (median 40 years; range 1-88). Patients reported hair loss for a mean duration of 35 (51.1) months (median 18 months; range 1-264) prior to presentation. Most patients experienced asymptomatic hair loss. Around half (49.1%) of the patients attended a follow-up, with 42.5% of these patients noting improvement in hair loss or symptoms across all visits. Duration of hair loss was not associated with improvement in hair loss at follow-up visit (P = 0.23).

Performance of an interferon-γ release assay-based test for cell-mediated immunity to SARS-CoV-2.

In search for immunological correlates of protection against acute coronavirus disease 2019 (COVID-19) there is a need for high through-put assays for cell-mediated immunity (CMI) to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We established an interferon-γ release assay -based test for detection of CMI against SARS-CoV-2 spike (S) or nucleocapsid (NC) peptides. Blood samples obtained from 549 healthy or convalescent individuals were measured for interferon-γ (IFN-γ) production after peptide stimulation using a certified chemiluminescence immunoassay. Test performance was calculated applying cutoff values with the highest Youden indices in receiver-operating-characteristics curve analysis and compared to a commercially available serologic test. Potential confounders and clinical correlates were assessed for all test systems. 522 samples obtained from 378 convalescent in median 298 days after PCR-confirmed SARS-CoV-2 infection and 144 healthy control individuals were included in the final analysis. CMI testing had a sensitivity and specificity of up to 89% and 74% for S peptides and 89% and 91% for NC peptides, respectively. High white blood cell counts correlated negatively with IFN-γ responses but there was no CMI decay in samples obtained up to one year after recovery. Severe clinical symptoms at time of acute infection were associated with higher measures of adaptive immunity and reported hair loss at time of examination. This laboratory-developed test for CMI to SARS-CoV-2 NC peptides exhibits excellent test performance, is suitable for high through-put routine diagnostics, and should be evaluated for clinical outcome prediction in prospective pathogen re-exposure.

Self-Reported Hair Loss Following COVID-19: An Observational Study

Objective: COVID-19 has been significantly associated with both psychosocial stress and physiologic stress, both of which are known to trigger telogen effluvium. This study was performed to estimate the prevalence of hair loss among patients with COVID-19 and to determine the correlation of the severity of COVID-19 with the severity of hair loss. Methods: Data were collected through a self-administered electronic questionnaire that was distributed among social media platforms. Participants were invited to complete the survey using a convenience sampling technique. A multiple response dichotomies analysis and chi-square test of independence were used to analyze data. Results: Among 420 participants who reported a positive PCR result of SARS-CoV-2, 77.6% reported hair loss after COVID-19 development. Notably, the onset of hair loss was within 3 weeks of COVID-19 development in 29% of participants. Most of the participants reported that the duration of hair loss was up to 6 months, and hair regrowth was noticed within 1 year after COVID-19 development. Patients who were admitted to the hospital, who experienced respiratory difficulties, who had lost weight due to COVID-19, and who experienced symptoms for longer than 10 days were significantly more prone to experience severe hair loss following COVID-19 (P < 0.001). Conclusion: This study demonstrated a high frequency of self-reported hair loss after the development of COVID-19. Interestingly, even patients with mild COVID-19 symptoms were significantly more prone to experience moderate hair loss. Unique to COVID-19 infection, the onset of hair loss following the development of COVID-19 was within 3 weeks in one-third of the participants.

Short communication: Comments on hair disorders associated with dupilumab based on VigiBase.

BackgroundDupilumab is a human antibody that blocks the signaling of both interleukin-4 and interleukin-13 receptors. It has been approved for the treatment of moderate-to-severe atopic dermatitis. However, several case reports have reported conflicting effects of dupilumab on alopecia.ObjectivesThis study aimed to examine dupilumab-related hair disorders using the large real-world database, VigiBase.MethodsAll individual case safety reports associated with dupilumab in the Uppsala Monitoring Center VigiBase until December 29, 2019, were analyzed. Hair disorder-related terms were defined in High Level Terms with “alopecias,” “pilar disorders NEC (not elsewhere classified),” and “hypertrichoses,” using the Medical Dictionary for Regulatory Activities Hierarchy. Hair disorder reports associated with dupilumab and other biologics that inhibit the Th2 axis (omalizumab, mepolizumab, reslizumab, and benralizumab) were analyzed to determine their association with hair disorders. Disproportionality analysis was performed based on the proportional reporting ratio, reporting odds ratio, and information components.ResultsAmong the 20,548 total dupilumab adverse event (AE) reports, hair disorders were reported in 462 dupilumab cases (2.2%), most of which reported hair loss, and only eight cases reported an increase in hair growth. The paradoxical trend in hair loss and growth after dupilumab use was confirmed using a disproportionality analysis. Among the other investigated biologics on Th2 immunity, only omalizumab was associated with hair loss. Additionally, hair disorders after dupilumab treatment were more frequently reported in women than in men. The proportion of hair disorder cases was high in Europe, accounting for 20.8% of hair disorder reports, whereas only 9.7% of all dupilumab-related AEs were reported in Europe. In conclusion, our analysis using a large real-world database confirmed that dupilumab is associated with hair disorders.

Abstract P4-10-17: Alopecia among breast cancer survivors

Abstract Funding Source: Institutional funds at Mayo Clinic. Background: While alopecia is a common and distressing acute side effect of chemotherapy, chronic hair thinning is also reported by some survivors during endocrine therapy. The purpose of the current study was to evaluate real world experiences of late/long-term alopecia among breast cancer survivors. Methods: Breast cancer survivors participating in the ongoing prospective Mayo Clinic Breast Disease Registry (MCBDR) were mailed a survey six years after diagnosis, between June and November 2020. Respondents were asked to report how bothered they are by hair thinning and hair loss over the last year on a scale from 0 “not at all” to 4 “extremely”. They were also asked whether they used any hair thickening or regrowth products. Results: 552/899 survivors responded (response rate 61%); 403 survivors’ responses were available for analysis. Respondents’ median age was 66 years, and median time since diagnosis was 78 months. Seventy patients (17%) were diagnosed with stage 0 breast cancer, 195 (48%) were diagnosed with stage 1 cancer, 104 (26%) with stage 2, 25 (6%) with stage 3; 6 (1%) had been diagnosed with metastatic or recurrent disease at the time of this survey. 139 (34%) patients had received chemotherapy. Of the patients who received chemotherapy, 82 (59%) had received doxorubicin and cyclophosphamide, 41 (29%) received docetaxel and cyclophosphamide, 77 (55%) received paclitaxel, and 27 (19%) received carboplatin. 258 (64%) received endocrine therapy. Of these patients who received endocrine therapy, 131 (51%) received Tamoxifen and 186 (72%) received aromatase inhibitors. 309 survivors (77%) were 55 years or older. 189 (47%) of all patients reported that they were bothered by chronic hair loss, and 225 (56%) reported that they were bothered by hair thinning; 71 (18%) reported use of thickening/regrowth products. There did not appear to be differences in chronic hair loss or thinning by receipt of chemotherapy: 64 patients (46%) who received chemotherapy reported hair loss and 79 (56%) reported hair thinning, compared with 123 patients (46%) who did not receive chemotherapy and reported hair loss and 142 (54%) who reported hair thinning. Hair thinning or loss did not appear to differ based upon age (Table 1). Symptoms did not appear to be more common amongst current or previous endocrine therapy recipients, with 113 (44%) of that subset bothered by hair loss and 128 (50%) by hair thinning. Conclusion: Hair loss and thinning are frequently reported as bothersome symptoms by long-term breast cancer survivors. Future investigations into treatments for chronic hair thinning during and after cancer therapy are needed. Table 1.< 5555+Bothered by hair loss (n)%Bothered by hair thinning (n)%Bothered by hair loss (n)%Bothered by hair thinning (n)%Not at all5761%4649%15751%13142%Slightly1920%2426%8728%9731%Moderately77%910%3110%4113%BOTHERED BY HAIR LOSS (N)%BOTHERED BY HAIR THINNING (N)%BOTHERED BY HAIR LOSS (N)%BOTHERED BY HAIR THINNING (N)%Quite a bit77%1112%227%268%Extremely44%33%93%103%Missing00%11%31%41% Citation Format: Elizabeth Cathcart-Rake, Charles L Loprinzi, Janet E Olson, Fergus Couch, Brittany Dulmage, Maryam Lustberg, Nicole Larson, Kathryn J Ruddy. Alopecia among breast cancer survivors [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-10-17.

Maintenance, withdrawal, and re-treatment with ritlecitinib and brepocitinib in patients with alopecia areata in a single-blind extension of a phase 2a randomized clinical trial

Maintenance, withdrawal, and re-treatment with ritlecitinib and brepocitinib in patients with alopecia areata in a single-blind extension of a phase 2a randomized clinical trial

Cutaneous manifestations of small fibre polyneuropathy.

Because typical and atypical features of small fibre polyneuropathy (SFN) in the skin have not been fully elucidated, the diagnosis is often made by the exclusion of alternative conditions rather than by its identification as a primary syndrome. The objective of this study was to characterize dermatologic manifestations in patients with SFN. Large retrospective series of biopsy-proven SFN cases seen at the Massachusetts General Hospital and Brigham and Women's Hospital (January 2000 to December 2019). The majority of the 301 participants included presented with at least one cutaneous manifestation [292/301 (97%)]. Pain was most common with 254/301 (84.4%) perceiving this as occurring in the skin. It was frequently described as 'burning' [95/254 (37.4%)] and affected distal [174/254 (68.5%)] slightly more than proximal [111/254 (43.7%)] limbs. Numbness [182/301 (60.5%)], edema [61/301 (20.3%)] and skin colour changes [53/301 (17.6%)], which include redness [23/53 (43%)], also had predominant distal distribution. Characteristic loss of distal hair occurred among 17/29 (59%) those reporting hair loss. Other findings with classic limb involvement, Raynaud's phenomenon [33/301 (11%)] and erythromelalgia [26/301 (8.6%)] were seen. Itch [45/301 (15%)], mostly localized [22/45 (49%)] and localized eczematous dermatitis were also found. SFN has a wide range of clinical features in which the skin is affected, with characteristic findings affecting the extremities.

The first male case with fluoxetine induced hair loss and review of the literature.

Fluoxetine is the drug of choice in the treatment of depression. It is widely preferred due to fewer side effects and greater tolerability. Hair loss is a frequent adverse effect that may occur by psychotropic drug use and that can remit by its cessation. We present the diagnosis and treatment of a 26-year-old male patient. He was diagnosed with depression without psychotic features according to the DSM-V criteria and was administered fluoxetine in a dose of 20 mg/day. Six weeks after the initiation of the fluoxetine treatment, the patient reported hair loss in the frontal area of the skull. These complaints regressed after cessation of drug. Hair loss appears to be a rare side effect of fluoxetine-based treatment. Dermatologists and psychiatrists must be informed about this adverse side effect. There might be differences in the risk of hair loss between the various SSRIs and the risk might be higher in female than in male. This male patient was the first case as far as we know in the literature. It should be kept in mind that hair loss may be observed in patients treated with fluoxetine and should be questioned in both male and female.

Prevalence of alopecia and its contributing factors among primary healthcare attendees in the Jazan region, Saudi Arabia.

Background:Alopecia is a common health condition that can be associated with social and psychological consequences.Aims:This study aims to estimate the prevalence of hair loss and its associated risk factors among primary healthcare center (PHC) attendees in the Jazan region.Methods:This investigation was a cross-sectional study conducted in the Jazan region of southwest Saudi Arabia. A total of 23 PHCs were randomly selected from five governorates in the region. Data were collected via interviewing PHCs attendees and were asked about their demographic characteristics, presence of hair loss, and among attendees who confirmed having hair loss, they were further asked about associated clinical features, healthcare-seeking behavior, and factors that might contribute to the development of their condition.Results:A total of 729 participants consented to be involved in this study. The number of respondents who reported having hair loss was 483, representing 66.3% of the whole sample. Gender appears to have the highest level of variability, with the majority of participants reporting hair loss being female (P < 0.001). The most frequently reported type of hair loss was telogen effluvium, followed by androgenic alopecia. A total of 185 respondents reported taking medications to treat their hair loss, of whom 108 (58.3%) did not seek any medical advice to identify the cause of their condition.Limitations:The main weakness of this investigation is related to relying on a reported presence of hair loss without having it confirmed with a clinical diagnosis.Conclusion:A minority of participants who reported suffering from hair loss were further evaluated by healthcare professionals to learn the cause of their hair loss. This may indicate the presence of poor hair care and the probability of a higher risk of hair loss requiring the development of suitable preventive strategies.

Prolonged and Late-Onset Symptoms of Coronavirus Disease 2019.

Some patients who recover from coronavirus disease 2019 (COVID-19) have prolonged symptoms such as dyspnea, fatigue, cough, and dysosmia for longer than 120 days after symptom onset. In addition, some patients who recovered from COVID-19 reported hair loss a few months after the onset of the disease. Alopecia is a late-onset symptom of COVID-19. The cause of alopecia is unknown; however, androgenic alopecia and telogen effluvium are possible causes.

Hair Loss After Sleeve Gastrectomy and Effect of Biotin Supplements.

Aim: In this study, we aimed to determine the incidence of hair loss in patients who underwent laparoscopic sleeve gastrectomy (LSG), and to observe whether use of Biotin has an impact on hair loss. Methods: This study included 156 female patients who underwent LSG for obesity and completed a 1-year follow-up. All patients with vitamin deficiency were screened in the pre- and postoperative period. Hair loss was defined as the subjective perception of the women of losing a higher amount of hair when compared with normal situation. Results: Hair loss was observed in 72% of the patients after LSG (n = 112). Seventy-nine percent of the patients reported hair loss between the third and fourth-month interval, and continued for an average of 5.5 ± 2.6 months. Permanent alopecia was not observed in any of the patients. Patients who experienced hair loss and Biotin deficiency after LSG were prescribed 1000 mcg/day of Biotin for 3 months. Of these 22 patients; only 5 (23%) patients reported a remarkable decline in hair loss. İn addition, 29 patients were found to take 1000 mcg/day of Biotin for average 2.5 months after onset of hair loss by their own initiative, despite optimal blood Biotin levels. Eleven (38%) patients reported a remarkable decline in hair loss. The effect of biotin use on hair loss in patients with and without biotin deficiency was compared. There was no significant difference (P = .2). Conclusion: Temporary hair loss after LSG is common. It was found that biotin supplementation used to prevent hair loss does provide low efficacy.

1770P - Randomised controlled trial of scalp cooling (SC) for the prevention of chemotherapy induced alopecia (CIA)

BackgroundThe only randomized trial of SC to prevent the distressing chemo-toxicity, CIA did not evaluate its effect on hair regrowth (HR) and was conducted in a predominantly taxane (T) treated population. We conducted a randomized trial of SC in a setting of anthracycline (A) and taxane chemotherapy and assessed its effect on CIA and HR. MethodsNon-metastatic breast cancer women undergoing (neo)adjuvant chemotherapy were randomized to receive SC using Paxman scalp cooling system during every cycle of chemotherapy, or no SC. The primary end point was successful hair preservation (HP) assessed clinically and by review of 5 photographs, using the CTCAE version 4.0 scale (defined as grade 0 = no, grade1=< 50% hair loss, not requiring a wig) after the 4 cycles or 12 weeks of chemotherapy. Secondary endpoints were HR at 6 and 12 weeks after completion of chemotherapy, adverse events and comparative quality of life scores. ResultsBetween December 2016 and July 2018, 51 patients, with median age 38 (21-58) years, were randomized to SC (34) or control arm (17) in a 2:1 ratio. 25/51 (49%) patients received A followed by T and two arms were balanced with respect to this factor. Modified intension to treat population (32) comprised of women who received at least one cycle of chemotherapy. HP rate was significantly higher in SC arm (18/32, 56.3%) compared to control arm (0/17, 0%; difference 56.3%, 95% CI 31%-73%, P=0.000004). HR was higher in SC arm compared to control at 6 weeks (89% vs 12%; difference 77%, 95% CI 49%-88%, p<0.001) and 12 weeks (100% vs 59%; difference 41%, 95% CI 8%-64%, p=0.0003). HP after 4 cycles was higher in patients receiving T versus those receiving A (77% vs 33%, p=0.0307). Patient reported hair loss at primary endpoint evaluation landmark was significantly lower in SC versus control arm (45% vs 82%, p=0.016) with compulsive head cover use of 47 % in SC vs 100% in controls (p=0.0001). Of 33 patients who started on SC, 23(69%) patients experienced grade 1-2 cold related adverse effects in SC arm with no grade 3-4 events. ConclusionsWomen with breast cancer receiving A or T chemotherapy were significantly more likely to have <50% hair loss after chemotherapy, had superior hair regrowth and improved patient reported outcomes, if scalp cooling was used. Clinical trial identificationCTRI/2017/02/007896. Legal entity responsible for the studyJyoti Bajpai. FundingOrbis Paxman Hair Loss Prevention System. DisclosureJ. Bajpai: Research grant / Funding (institution), No Personal Financial disclosures to declare: Eli Lilly; Advisory / Consultancy, Research grant / Funding (institution), No Personal Financial disclosures to declare: Novartis; Research grant / Funding (institution), No Personal Financial disclosures to declare: Roche; Research grant / Funding (institution), No Personal Financial disclosures to declare: Samsung Bioepis Co. Ltd; Research grant / Funding (institution), No Personal Financial disclosures to declare: Sun Pharma; Leadership role, No Personal Financial disclosures to declare: Immuno-oncology Society of India(I-OSI); Leadership role, No Personal Financial disclosures to declare: Indian Society of Medical and Paediatric Oncology (ISMPO) ; Leadership role, No Personal Financial disclosures to declare: Indian cooperative Oncology network (ICON); Leadership role, No Personal Financial disclosures to declare: Teenage and Young Cancer Association (TYA). S. Gupta: Advisory / Consultancy, Research grant / Funding (institution), No Personal Financial disclosures to declare: Roche; Advisory / Consultancy, Research grant / Funding (institution), No Personal Financial disclosures to declare: Sanofi; Research grant / Funding (institution), No Personal Financial disclosures to declare: Johnson & Johnson; Research grant / Funding (institution), No Personal Financial disclosures to declare: Amgen; Research grant / Funding (institution), No Personal Financial disclosures to declare: Celltrion; Advisory / Consultancy, Research grant / Funding (institution), No Personal Financial disclosures to declare: Oncosten; Research grant / Funding (institution), No Personal Financial disclosures to declare: Novartis; Research grant / Funding (institution), No Personal Financial disclosures to declare: Intas; Research grant / Funding (institution), No Personal Financial disclosures to declare: Eisai; Research grant / Funding (institution), No Personal Financial disclosures to declare: Biocon; Advisory / Consultancy, No Personal Financial disclosures to declare: DRL; Advisory / Consultancy, No Personal Financial disclosures to declare: Biocon; Advisory / Consultancy, No Personal Financial disclosures to declare: Pfizer; Advisory / Consultancy, No Personal Financial disclosures to declare: Core diagnostics. All other authors have declared no conflicts of interest.

‘How much raltegravir do you take?’ The answer may not be so obvious: an accidental finding from clinical practice

It has been over a decade since the introduction of raltegravir, which has a well-established efficacy and tolerability profile 1, 2. However, until recently, raltegravir has only been available as twice-daily formulations with, as a result, a lower cumulative compliance to therapy and a higher rate of discontinuation compared with the other agents in the class 3, 4. Following encouraging results from the ONCEMRK trial 5, a new raltegravir formulation of 1200 mg once daily was introduced, and has been available in our centre since May 2018. The new once-daily administration appears promising in improving the compliance to raltegravir-containing regimens. However, during our routine clinical activity, we noticed that some of the patients recently switched to raltegravir 1200 mg once daily were incorrectly taking the drug. We then decided to investigate this issue and to determine how widespread it was and proceeded to recall all patients switched to this therapy in our clinical centre between May 2018 and December 2018. We then asked our patients how they were taking raltegravir and collected their opinions on the ease of administration of the new formulation and the onset of side effects. We contacted 98 patients starting raltegravir 1200 mg once daily during the study period: 63 were male (64.3%) and the median age was 55 years [interquartile range (IQR) 49–59 years]. Sixty-nine of them (70.4%) had previously been taking a regimen containing raltegravir 400 mg twice daily. Reasons for switching to the new formulation were: optimization (71 cases; 76.3%), toxicity [13 cases; 14.0%; two cases of gastrointestinal (GI) toxicity, two of renal toxicity, four of central nervous system (CNS) toxicity and five of dyslipidaemia], drug–drug interaction (three cases; 3.2%) and other reasons (six cases; 6.5%). Further details of the patients’ characteristics can be found in Table 1. We noticed that eight (8.2%) patients (six of whom were raltegravir-experienced) misunderstood the physician's indications about the dosage and took just one pill of raltegravir 600 mg per day. However, as a consequence of the short follow-up, no virological failures were recorded among these patients. Only two raltegravir-experienced patients preferred the 400 mg twice-daily formulation, while most patients were satisfied with the new once-daily formulation, with no problems related to the larger dimensions of the pills. Regarding the reports of side effects collected through the questionnaire, eight patients (8%) complained of GI symptoms (nausea or stomach ache): seven of these patients (10%) had previously been on a well-tolerated raltegravir 400 mg twice-daily-based regimen. One patient complained of insomnia, with an evening administration, and one patient naïve for raltegravir complained of headache and dizziness, with a reported regression of symptoms after being switched to raltegravir 400 mg twice daily. Moreover, three patients reported hair loss (of whom two patients had a previous medical history of alopecia). Finally, we recorded seven treatment discontinuations. One patient stopped after two consecutive HIV RNA determinations > 40 HIV-1 RNA copies/mL; the remaining discontinuations were attributable to simplification in four cases (4.1% of the total population) and to GI toxicity in two cases (2.0%). Our data confirm the good tolerability of raltegravir, even with the new once-daily formulation; however, our experience warrants physicians to stress the correct method of administration of the new raltegravir 1200 mg once-daily formulation, in order to avoid errors that may lead to virological failure. AB reports grants from Bristol-Myers Squibb and Gilead Sciences, and nonfinancial support from Bristol-Myers Squibb, ViiV Healthcare and Janssen-Cilag. SDG reports grants from Bristol-Myers Squibb, nonfinancial support from Bristol-Myers Squibb, personal fees from Bristol-Myers Squibb, Gilead Sciences, Abbott, Boehringer Ingelheim, Janssen-Cilag and ViiV and personal fees from GlaxoSmithKline. All other authors report no disclosures. This study was conducted as part of our routine work.

Self-Assessments of Standardized Scalp Massages for Androgenic Alopecia: Survey Results.

IntroductionStandardized scalp massages (SSMs) improve hair thickness in nonbalding men, but their effects on androgenic alopecia (AGA) have not yet been evaluated. The objective of this study was to investigate the effect of SSMs on self-assessed AGA sufferers (SAGASs).MethodsBetween October 2016 and October 2017, 1899 SAGASs searching online for hair loss treatments beyond AGA management drugs accessed literature explaining SSMs as a potential therapy for AGA, then watched a demonstration video detailing twice-daily, 20-min SSMs segmented by three rotational scalp regions using hand-generated presses, pinches, and stretches. In December 2017, SAGASs were contacted once to participate in a retrospective survey study to assess SSM adherence and hair changes. Age, gender, hair loss region and gradient, diet, supplement and topical use, AGA management drug use, estimations for minutes daily and months of massaging, and self-perceived hair changes were reported. Some participants also submitted photosets documenting hair changes throughout SSM adherence.ResultsA total of 340 (17.9%) respondents completed the survey, and 327 (17.2%) reported attempting the SSMs. SSM participants reported a median daily massage effort of 11–20 min and mean adherence of 7.4 ± 6.6 months, with 68.9% reporting hair loss stabilization or regrowth. Estimated minutes daily, months, and total SSM effort (i.e., minutes daily × months) were positively associated with self-perceived hair changes. On average, perceived hair loss stabilization and regrowth occurred after 36.3 h of SSM effort. Results did not vary across age, gender, Norwood gradient, or concomitant supplement, topical, finasteride, minoxidil, or microneedling use. However, hair change improvements were marginally lower for participants reporting diffuse versus frontal/temporal or vertex thinning.ConclusionsWhile further research is warranted, these results align with previous findings and suggest the potential for SSMs to improve AGA.Electronic supplementary materialThe online version of this article (10.1007/s13555-019-0281-6) contains supplementary material, which is available to authorized users.