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Published in Ashfaq A Marghoob, Ralph Braun, Natalia Jaimes, Atlas of Dermoscopy, 2023
Anna Waśkiel-Burnat, Lidia Rudnicka, Małgorzata Olszewska, Adriana Rakowska, Ralph M. Trüeb, Isabel Kolm
Trichotillomania is an impulsive control disorder characterized by a compulsive urge to pull out one's own hair, leading to noticeable hair loss. The most important differential diagnosis is alopecia areata. However, trichotillomania often co-exists with alopecia areata,64 which may pose a special diagnostic challenge.
Therapeutic effectiveness
Published in Dinesh Kumar Jain, Homeopathy, 2022
A study of skin diseases plays a very important role in the analysis of principles of homeopathy. According to homeopathy, suppression of skin diseases by external applications of drugs redirects the diseases internally and creates internal diseases. But in fact the cure of skin diseases has no relation with the development of internal disease. Many skin diseases are resolved spontaneously which confuse Hahnemann who wrongly thought that treatment of skin diseases by external means creates internal pathology. “Alopecia areata is a common condition characterised by a patchy loss of hair without atrophy … It may affect any hairy area of the body and is usually reversible” (Wadhwa et al., 2008, p. 900). Staphylococcal scalded skin syndrome (SSSS) occurs mainly in infants and children under the age of five years. The most common cause of SSSS is Staphylococcus aureus. In this disease, rapid recovery is the rule. Healing takes place in one to two weeks even in the absence of treatment. But in untreated cases, a mortality of 2–3% is present (Singh et al., 2008, pp. 233–234).
Hair and hairy scalp
Published in Richard Ashton, Barbara Leppard, Differential Diagnosis in Dermatology, 2021
Richard Ashton, Barbara Leppard
This is the commonest cause of discrete hair loss in both children and adults. The trigger is often a stressful event and alopecia areata itself is often very distressing especially if it affects a large area. There is no redness or scaling of the underlying scalp. There may be one or several bald patches on the scalp or on any other hairy area (e.g. eyebrows, eyelashes, beard). The hair loss is sudden. While the disease is active, exclamation mark (!) hairs will be seen around the edge of the bald patches. These are short broken off hairs which are thicker and darker at the broken off end. Only pigmented hairs are affected by alopecia areata, so normal white/grey hairs will remain in the middle of a bald area. It can take months or years to grow back and new patches may develop. It will usually regrow white or blonde initially (Fig 3.07), but goes back to its original colour after 6–8 weeks.5% of individuals affected will have total scalp hair loss (alopecia totalis), or total loss of scalp and body hair (alopecia universalis). Alopecia areata is a common auto-immune disease and can occur at any age and in any ethnic group. It is worth asking about a family history of autoimmune disease and checking the HbA1c level and an auto immune profile including thyroid antibodies.
Genetic variant association of PTPN22, CTLA4, IL2RA, as well as HLA frequencies in susceptibility to alopecia areata
Published in Immunological Investigations, 2018
Hamideh Moravvej, Pardis-Sadat Tabatabaei-Panah, Reyhaneh Abgoon, Leyla Khaksar, Masumeh Sokhandan, Saba Tarshaei, Sayyed Mohammad Hossein Ghaderian, Ralf J. Ludwig, Reza Akbarzadeh
Genetic factors are hypothesized to have an essential role in the development of alopecia areata (AA) (Alkhalifah et al., 2010; Biran et al., 2015). The AA is a multifactorial, tissue-specific, and common autoimmune disease with inappropriate T-cell response against hair follicles characterized by patches of non-scarring hair loss and a lifetime risk of approximately 2% (Alkhalifah et al., 2010; Villasante Fricke and Miteva, 2015). Despite the multifactorial basis of AA, the etiopathogenesis of this disease remains enigmatic (Alkhalifah et al., 2010). Various genes of the immune system are contributed to the pathogenesis of AA (Biran et al., 2015). Since AA is thought to be mediated by T cells, genes coding for T lymphocyte and their respective single nucleotide polymorphisms (SNPs) could play a crucial role in the progressing of this disease.
Nail involvement in patients with moderate-to-severe alopecia areata treated with oral tofacitinib
Published in Journal of Dermatological Treatment, 2018
Ji Su Lee, Chang-Hun Huh, Ohsang Kwon, Hyun-Sun Yoon, Soyun Cho, Hyun-sun Park
Alopecia areata (AA) is an autoimmune disease that mainly presents as nonscarring hair loss involving the scalp and/or body. Nails are involved in 7–66% of patients with AA. Nail involvement may cause discomfort and/or limitation of function and was supposed to be a poor prognostic factor (1,2). However, an effective treatment for nail changes associated with AA has yet to be clarified (3). Recently, Janus kinase inhibitors showed promising results in scalp hair regrowth (4–10) and a few anecdotal case reports demonstrated that tofacitinib improved AA associated nail deformity (11–13). This study aimed to investigate the effect of oral tofacitinib monotherapy on nail involvement in patients with AA and evaluate the relationship between nail and hair responses to tofacitinib.
New drugs under investigation for the treatment of alopecias
Published in Expert Opinion on Investigational Drugs, 2019
Jorge Ocampo-Garza, Jacob Griggs, Antonella Tosti
DPCP is a potent contact allergen. The mechanism of action in AA is unclear, but studies have shown that they change the perifollicular CD41/CD81 T-lymphocyte ratio, cause antigenic competition, lead to apoptosis of autoreactive T lymphocytes, and modulate proinflammatory cytokines [3]. An open-labeled study to determine the response and characteristics, safety, and efficacy of DPCP gel (Samcyprone) as a topical immunotherapeutic agent for the treatment of extensive alopecia areata is currently recruiting patients (NCT03651752). Although we do not have information on safety and efficacy of this specific gel, compounded DPCP has been widely used off label for more than 30 years [35], and with good efficacy and safety [36].