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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.
General physical examination
Published in Fazal-I-Akbar Danish, Essential Lists of Differential Diagnoses for MRCP with diagnostic hints, 2017
Diffuse hair loss:1 Alopecia universalis.2 Any severe illness.3 Iron-deficiency anaemia.4 Pregnancy.5 Hypogonadism.6 Cytotoxic drugs.
Hair and Nail Manifestations of HIV Infection
Published in Clay J. Cockerell, Antoanella Calame, Cutaneous Manifestations of HIV Disease, 2012
Gabriela M. Blanco, Frankie G. Rholdon, Clay J. Cockerell
AA is characterized by the sudden onset of focal, nonscarring hair loss, with spontaneous remissions and exacerbations. Various patterns of AA are identifiable: patchy, diffuse, totalis, universalis, and ophiasis. Patchy hair loss is the most common presentation, appearing as well demarcated 1–4 cm oval and round patches most commonly on the scalp.33,34 Body hair such as eyebrows, eyelashes, beard, axillary, and pubic hair may also be affected. Diffuse AA refers to a decrease in the density of hair over the entire scalp. Alopecia totalis is 100% loss of scalp hair. Alopecia universalis is 100% loss of scalp and body hair. Ophiasis refers to a band-like pattern of hair loss in the parietal and temporal scalp area. This pattern of hair loss is rarely reported in HIV-seropositive patients. Alopecia lesions may be isolated or numerous and the scalp is normal in color and morphology. Typically the hair loss in AA is abrupt and asymptomatic but some patients report intense burning, itching, tenderness, and pain.35 The periphery of the patch of alopecia has a distinctive border and may have the pathognomonic ‘exclamation point’ hairs. These short, broken hairs have a broad distal end and a tapered proximal end. Hair pull tests may be positive, that is six or more hair shafts removed with slight pulling, at the border of the patch indicating active disease. Nail dystrophy, especially nail pitting, is commonly associated with AA in non-HIV-infected patients.34,36,37 However, nail changes are not commonly seen in association with AA in patients with HIV infection, perhaps since many of these patients tend to have other nail disorders as manifestations of HIV infection.
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].