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Hair and hairy scalp
Published in Richard Ashton, Barbara Leppard, Differential Diagnosis in Dermatology, 2021
Richard Ashton, Barbara Leppard
Three types of hair occur in humans: Lanugo hair is the soft silky hair that covers the foetus in utero. It is usually shed before birth.Vellus hair is the short fine unpigmented hair which covers the whole skin surface apart from the palms and soles.Terminal hair is longer, coarser, and pigmented. Before puberty, terminal hair is restricted to the scalp, eyebrows and eyelashes. After puberty, secondary terminal hair develops in response to androgens on the beard area, in the axillae, pubic area and on the front of the chest in men.
Trichoscopy I: Non-Cicatricial Alopecia
Published in Rubina Alves, Ramon Grimalt, Techniques in the Evaluation and Management of Hair Diseases, 2021
Anna Waśkiel-Burnat, Lidia Rudnicka
Hair shaft thickness heterogeneity, also known as “anisotrichosis”), is the most common trichoscopic feature of androgenetic alopecia [3, 4]. It results from progressive miniaturization of hair follicles. Thus, terminal hairs are replaced by vellus hairs. For male pattern hair loss, hair diameter variability > 20% been considered as characteristic [5, 6]. In female pattern hair loss, hair diameter variability > 10% is major diagnostic criteria [2].
Systemic disease and the skin
Published in Rashmi Sarkar, Anupam Das, Sumit Sethi, Concise Dermatology, 2021
This disorder of women may be due to androgen-secreting tumors of the ovaries or the adrenal cortex, but it is usually due to polycystic ovaries in which there is an abnormality of steroid metabolism, leading to an accumulation of androgens. Patients present with acne and increased greasiness of the skin, or hirsutism. Increased hair growth is also a major complaint of patients with androgenization. Vellus hair on forearms, thighs, and trunk is transformed to pigmented, thick, terminal hairs. A masculine distribution of body and limb hair develops.
A novel case of eruptive vellus hair cysts arising during radiation therapy and a brief review of the literature
Published in Acta Oncologica, 2023
Ahava Muskat, Neda Shokrian, Yana Kost, Pooja Srivastava, Bijal Amin, Beth N. McLellan
A 39-year-old woman presented to the oncodermatology clinic for a pruritic, diffuse rash during RT for left breast cancer. During week four of RT (after a cumulative dose of 42 Gy), she developed a new, generalized, cutaneous eruption that appeared similar to ‘insect bites’, per her radiation oncologist. The lesions did not resolve after her RT course was completed. She presented to the oncodermatology clinic two weeks after completion of her RT course. Other than her recent diagnosis of breast cancer treated with lumpectomy, sentinel node biopsy, and RT, her medical history was notable only for Breast Cancer Gene-2 (BRCA-2) positivity. The patient denied any previous dermatologic history, use of new medications, or use of over-the-counter topicals. She did not receive chemotherapy or hormonal therapy. Physical exam at that time showed dozens of subcutaneous nodules with overlying excoriations and hyperpigmentation over the irradiated field (left breast) and extending to the trunk and thighs (Figure 1(A–B)). The differential diagnosis included eruptive lipomas, steatocystomas, vellus hair cysts, and cutaneous metastases. A punch biopsy of a lesion on the patient’s right buttock revealed a cyst lined by infundibular epithelium and filled with orthokeratotic cornified cells. Fragments of small hair shafts found within the dermis led to a conclusive diagnosis of eruptive vellus hair cysts (Figure 2). The patient considered surgical excision of lesions but did not return for follow-up. The eruption persisted for at least nine months after the initial presentation.
Randomized trial of electrodynamic microneedling combined with 5% minoxidil topical solution for treating androgenetic alopecia in Chinese males and molecular mechanistic study of the involvement of the Wnt/β-catenin signaling pathway
Published in Journal of Dermatological Treatment, 2022
Linlin Bao, Haifeng Zong, Sining Fang, Lixiong Zheng, Yuanhong Li
In the present clinical trial, changes in hair density and hair diameter in AGA patients from before to after treatment were observed through objective evaluation. The combination treatment group showed the best treatment efficacy. After treatment, hair loss at the top of the head of the volunteers was significantly improved, and the hair density was significantly increased. During the 6 months of follow-up, only a small amount of regenerated hair was lost in most patients who received the combination treatment. During treatment, the treatment efficacy regarding hair loss at the top of the head was better than that for frontal hair loss, and with a shorter duration of hair loss, the treatment outcome improved. There were no significant differences in the densities of terminal hair, vellus hair, and total hair before and after the treatment between the microneedling only treatment group and the minoxidil only treatment group, while the difference in the average diameter of terminal hair between the two groups was significant. Treating AGA using topical minoxidil has been shown to significantly increase the terminal hair diameter (16), which is consistent with the results of the present study. The vellus hair density in each treatment group decreased after treatment, but the total hair density was significantly increased in groups 1 and 3. The reason may be that the treatment promoted growth from vellus hair to terminal hair.
Platelet-rich plasma as a therapy for androgenic alopecia: a systematic review and meta-analysis
Published in Journal of Dermatological Treatment, 2022
Adam G. Evans, James M. Mwangi, Rand W. Pope, Mirjana G. Ivanic, Mina A. Botros, Gabriella E. Glassman, F. Bennett Pearce, Salam Kassis
Rodrigues et al. (55) conducted an RCT on the efficacy of activated PRP in 26 male patients. The participants in this study received four sessions of either subcutaneous PRP injections, or saline injections in the control arm every 15 days. After final injection, patients were evaluated by TrichoScan (TRICHOLOG GmbH, Freiburg, Germany) at 15 days, and 3 months where there was a significant increase in hair density (p=.012), hair count (p=.016), and percent follicles in anagen phase (p=.007) in the study group, while in the saline control group there were no significant changes to any of these parameters at follow up. No significant differences in terminal to vellus hair ratios were observed. Additionally, the authors measured concentrations of VEGF, PDGF, and EGF within the PRP preparations; however, they were unable to draw a correlation between hair parameters and growth factor concentrations (55).