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Diseases of the Hair
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Rodney Sinclair, Wei-Liang Koh
Management: Spontaneous regrowth is possible but impossible to predict. Choice of treatment depends on the age of the patient, extent of AA and rate of progression. For limited AA, options include topicals (corticosteroids, minoxidil, dithranol [anthralin] and intralesional steroid injections. For more extensive AA (scalp surface area >30%), topical contact immunotherapy (with diphencyprone [DCP] or squaric acid dibutylester [SADBE]), paint psoralen combined with ultraviolet A (paint PUVA), and systemic immunosuppressants (oral corticosteroids, cyclosporin, methotrexate, azathioprine, JAK-inhibitors [e.g. tofacinitib, baricitinib]) can be considered. Rapidly progressive AA may benefit from a course of oral corticosteroids. Cosmetic camouflage is a helpful adjunct.
Cosmetic Camouflage in Vitiligo
Published in Vineet Relhan, Vijay Kumar Garg, Sneha Ghunawat, Khushbu Mahajan, Comprehensive Textbook on Vitiligo, 2020
Feroze Kaliyadan, Karalikkattil T. Ashique, Ambika Kumar
Cosmetic camouflage for vitiligo is something that needs proper patient guidance to be effective. During the first session it is important that the dermatologist/camouflage specialist works with the patient to choose the most suitable product and to clarify any questions the patient might have.
Childhood versus post-childhood vitiligo
Published in Electra Nicolaidou, Clio Dessinioti, Andreas D. Katsambas, Hypopigmentation, 2019
Electra Nicolaidou, Styliani Mastraftsi
Adequate sun protection should be recommended for children with vitiligo for the prevention of potential burning of vitiliginous skin as well as tanning of perilesional skin, which will increase the contrast with lesions. Cosmetic camouflage may be used to conceal visible affected areas. In case of recognized psychosocial impairment, psychological therapeutic interventions are recommended.
A review of the treatment of male pattern hair loss
Published in Expert Opinion on Pharmacotherapy, 2020
Katherine York, Nekma Meah, Bevin Bhoyrul, Rodney Sinclair
Scalp micro-needling also induces sulfotransferase, which may explain part of its effect in stimulating hair regrowth. LLLT, LED light therapy, fractionated laser and injections of platelet rich plasma may induce hair follicle neogenesis or convert vellus follicles into terminal follicles. Evidence documenting the efficacy of these modalities is emerging, but placebo-controlled data is only available for LLLT. Non-pharmacologic treatments like PRP can be considered in patients refractory to medical treatment. While progress has been made in the medical management of androgenic alopecia and a number of physical therapies are emerging, hair transplantation remains the best treatment for advanced disease. Men with advanced disease unable or unwilling to have a hair transplant may still benefit form cosmetic camouflage and concealment of their hair loss with a wig. The combination of medical and physical therapies seems more successful than monotherapy.
Hereditary leiomyomatosis and acute lymphoblastic leukemia: A link through fumarate dyshydratase mutation?
Published in Acta Clinica Belgica, 2022
Sophie Bailleux, Joan Somja, Marie Martin, Bernard De Prijck, Arjen F. Nikkels
CLMs can be treated by cosmetic camouflage, surgery, CO2 laser ablation, cryotherapy or electrodessication [7,17] according to their number, the pain the patient experiences and the impact on his quality of life scores [24]. The identification of triggering factors can be helpful. First-line medical treatments include alpha-blockers, phenoxybenzamine (20–60 mg/day) or doxazosin (1 mg/day), calcium channel inhibitors like nifedipine (10 mg 3–4x/day), nitroglycerine (0.8–1.6 mg/day) and antidepressants (duloxetine 60 mg/day). Gabapentin (300 mg 1–3 x/day) or pregabalin (300 mg 2x/day) are the next in line options, either as mono or combination therapy. Lidocaine or capsaicin, botulinum toxin and intralesional triamcinolone acetonide are adjuvant options [7,17,24].
Measuring and managing appearance anxiety in patients with systemic sclerosis
Published in Expert Review of Clinical Immunology, 2019
Shadi Gholizadeh, Annie Meier, Vanessa L. Malcarne
Although there has been a call for psychosocial interventions for patients with SSc [42,43] and there are efforts underway to establish such interventions [44], to date there are no interventions specifically available targeting dimensions of body image, such as appearance anxiety in SSc. A stepped-care model has been recommended as the paradigm for the treatment of psychological and social difficulties in patients with this disease [45]. However, with a dearth of evidence-based materials available even for the lowest rungs of the stepped-care approach (e.g. self-guided reading materials) for patients, at present, there are no established materials or interventions that can be recommended specifically for SSc. Given the benefits of social skills training for individuals struggling socially because of their visible differences [15], one option is for patients to turn to general social skills training materials [20]. For clinicians working with patients who are expressing concerns and worries related to their changes in appearance, in the absence of tailored interventions, they may recommend more general self-help materials developed for individuals with visible differences (e.g. FaceIt) [46]. However, clinicians and patients should be wary of materials developed for non-visible differences contexts (i.e. body dysmorphia), as the focus on challenging unrealistic thoughts about appearance may be invalidating and not relevant for patients. Cosmetic camouflage interventions have also been examined in randomized clinical trials with other visible differences populations as a means of improving appearance self-esteem and body confidence [47], however, they have not been explored in SSc or specifically for appearance anxiety. Other interventions designed to directly address the changes in appearance, including plastic surgery treatments as well as occupational therapy treatments (e.g. hand and mouth function exercises) have been tested in SSc, but none have specifically examined impacts on appearance anxiety to the authors’ knowledge.