China
Africa
Explore chapters and articles related to this topic
Hypoparathyroidism in pediatric patients
Published in Pallavi Iyer, Herbert Chen, Thyroid and Parathyroid Disorders in Children, 2020
Andrew C. Calabria, Michael A. Levine
The classic triad of APS-1 consists of mucocutaneous candidiasis, hypoparathyroidism, and adrenal insufficiency. The clinical onset of the three principal components of the syndrome typically follows a predictable pattern, in which mucocutaneous candidiasis first appears at a mean age of 5 years, followed by hypoparathyroidism at a mean age of 9 years, and adrenal insufficiency at a mean age of 14 years. Many additional autoimmune features can develop, including endocrinopathies, such as ovarian failure, hypothyroidism, diabetes, and hypophysitis with growth hormone deficiency. Nonendocrine conditions include alopecia, which can start as hairless patches and proceed to alopecia totalis, pernicious anemia, malabsorption, steatorrhea, hepatitis, keratoconjunctivitis, and dystrophic nails. Dental enamel hypoplasia is also common and appears to be unrelated to hypoparathyroidism. Vitiligo, calcifications of the tympanic membranes, and periodic maculopapular, morbilliform, or urticarial rash with fever occur as well as part of the clinical spectrum of APECED. Although most patients with AIRE mutations will manifest multiple features of the APS-1 disorder, some patients with AIRE mutations will manifest only hypoparathyroidism.
Geriatric hair and scalp disorders
Published in Robert A. Norman, Geriatric Dermatology, 2020
Alopecia areata is an inflammatory, non-scarring form of hair loss characterized by round or oval patches of complete hair loss. Any hair-bearing area can be affected. The loss can progress to loss of all scalp hair (alopecia totalis) or complete loss of all hair on the body (alopecia universalis). There are several distinctive forms affecting between 0.1% and 0.2% of the population147. Twelve per cent of cases initially present over the age of 50 years. In these patients it may present with any form seen in other age groups: patchy, ophiasis, reverse ophiasis, reticulate, diffuse, totalis and universalis. In both cases, seen in Figures 19 and 20, this was the patient’s first episode of alopecia areata. The geriatric population is more likely to present with the expression of other autoimmune diseases, if genetically susceptible. It is recognized that alopecia areata may preferentially attack pigmented hairs and may spare white hair. Patients with significant numbers of gray or white hairs may shed pigmented hairs only. Figure 21 (a 8c b) shows sequential hair loss in one individual over some four months; pigmented hairs were lost before unpigmented ones. The patient was left entirely white haired. This may explain the phenomenon of apparent rapid graying of hair. When hair regrows, it may grow as white hair only, initially or permanently (Figure 22). Although alopecia areata tends to be more severe when presenting in younger age groups, it can be extensive and aggressive even in geriatric patients with a first episode.
Hair loss and hair shaft disorders
Published in Giuseppe Micali, Francesco Lacarrubba, Dermatoscopy in Clinical Practice, 2018
Alopecia areata is an autoimmune, nonscarring form of alopecia. A wide range of clinical presentations can occur, from single patch of alopecia to complete loss of scalp hair (alopecia totalis) or hair of the entire body (alopecia universalis). The disease affects most commonly scalp hairs, but it may also involve eyebrows, eyelashes, beard, pubic, axillary, and all body hairs.
Patient characteristics associated with all-cause healthcare costs of alopecia areata in the United States
Published in Journal of Medical Economics, 2023
Wei Gao, Arash Mostaghimi, Kavita Gandhi, Nicolae Done, Markqayne Ray, James Signorovitch, Elyse Swallow, Christopher Carley, Travis Wang, Vanja Sikirica
Alopecia areata (AA) is an autoimmune disease characterized by non-scarring hair loss on the scalp and potentially other areas of the body.1,2 The disease affects approximately 1.14% of individuals in the United States, based on a recent population-based survey with clinician confirmation of diagnosis.3 Estimates from the Global Burden of Disease study placed AA as the 10th most prevalent skin disease in the US in 2017, with an age-adjusted prevalence of 0.51% among females and 0.20% among males, and wide variation across states.4 Its manifestations range from small patches of hair loss to complete loss of scalp hair (alopecia totalis [AT]), or complete loss of scalp, facial, and body hair (alopecia universalis [AU]).5 AA may be accompanied by various inflammatory, autoimmune, metabolic, cardiovascular, and psychiatric comorbidities6–8 that may lead to additional disease burden.
Preparation and optimization of aloe ferox gel loaded with Finasteride-Oregano oil nanocubosomes for treatment of alopecia
Published in Drug Delivery, 2022
Khaled M. Hosny, Waleed Y. Rizg, Eman Alfayez, Samar S. Elgebaly, Abdulmohsin J. Alamoudi, Raed I. Felimban, Hossam H. Tayeb, Rayan Y. Mushtaq, Awaji Y. Safhi, Majed Alharbi, Alshaimaa M. Almehmady
Alopecia is a common disorder that results in hair loss in one or more areas of the body. This condition can manifest in a variety of ways depending on the severity and area affected, ranging from isolated or multiple small patches (Alopecia areata) to a diffuse hair loss on the scalp (Alopecia totalis) or on the entire body skin (Alopecia universalis) (Alopecia universalis) (Amin & Sachdeva, 2013; Safavi et al., 1995). Any hair-bearing area could be impacted by Alopecia, but the scalp is the most prominent part. Alopecia affects 2% of population with no perceivable difference between men and women (Lee et al., 2020). Despite the fact that the underlying causes of Alopecia remain an unknown, several studies have suggested that environmental, immunologic, and genetic factors may play a role in its progress (Darwin et al., 2018). Furthermore, the relationship between the microbial population that inhabits the scalp and hair growth abnormalities such as Alopecia areata (AA) has recently been the focus of attention among researchers and clinicians (Constantinou et al., 2021). It has recently been established that the bacteria Propionibacterium acnes is involved in the pathogenesis of AA (Wang et al., 2012).
Emerging drugs for the treatment of alopecia areata
Published in Expert Opinion on Emerging Drugs, 2022
Hassiel Aurelio Ramírez-Marín, Antonella Tosti
Oral tofacitinib, a pan-JAK inhibitor, is the JAK inhibitor that has been most commonly used in ‘off label’ studies [28,29]. This drug has FDA approval for psoriatic arthritis, rheumatoid arthritis, and ulcerative colitis [13]. A dose of 5 mg twice daily has been most frequently used, but higher doses up to 20 mg day have been utilized in some studies [27,30,31]. Tofacitinib in a clinical trial for adults showed a median percentage change in the SALT score of 21%. Overall, 64% had some hair regrowth at 3 months of treatment, with 32% of patients achieving an improvement in SALT score of greater than 50% [26,32]. In a study of 13 patients aged 12–17 years, 7 with 100% hair loss and 6 with 20–70% scalp hair loss, treatment with tofacitinib at 5 mg twice daily for 2–16 months (median 5 months) led to 93% median improvement in SALT score from baseline [32,33]. In a case series of 11 pediatric patients (range 8–18 years), 6 with alopecia universalis, 4 with alopecia totalis and 4 with patchy AA, who received 5–10 mg twice daily, for a median duration of 32 months, 8 patients (72.7%) experienced hair regrowth, 5 of them with complete regrowth of hair on the scalp, eyebrows and body, 3 patients experienced incomplete responses or minimal regrowth [34]. Clinical response is usually seen after 4 months of treatment, including cases of patchy AA and alopecia totalis/universalis, less efficacy has been described for patients with AA of more than 10 years [6].