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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
Clinical presentation: Patients present with well-demarcated round to oval patches of nonscarring hair loss with no epidermal changes (Figure 23.6). Exclamation mark hairs and a positive hair pull test can be present at the periphery of active patches.
Topical Contact Immunotherapy in Alopecia Areata
Published in Rubina Alves, Ramon Grimalt, Techniques in the Evaluation and Management of Hair Diseases, 2021
Andrea Combalia, Juan Ferrando
Alopecia areata is a chronic and relapsing hair follicle–specific autoimmune disease that leads to non-scarring hair loss. Though many therapies exist for alopecia areata, one of the most unique is topical sensitization, a treatment approach widely used in patients with severe subtypes, such as alopecia totalis and alopecia universalis. Topical contact immunotherapy offers an attractive treatment option, including those who have previously failed more traditional treatments and those who have extensive disease. It was introduced by Rosenberg and Drake in 1976, and consists of the induction and periodic elicitation of allergic contact dermatitis by applying a potent contact allergen onto the scalp (or eyebrows) of patients affected by alopecia areata. As a result, adverse effects such as erythema, pruritus, eczema, and lymphadenopathy, might accompany the treatment, and therefore, careful monitoring of patients is needed throughout treatment. However, despite the frequent and sometimes serious adverse effects of contact immunotherapy, it still remains one of the most commonly used and effective treatments for severe and chronic alopecia areata.
Management of noncicatricial circumscribed alopecia
Published in Pierre Bouhanna, Eric Bouhanna, The Alopecias, 2015
Alopecia areata is a common hair loss condition characterized by an acute onset of nonscarring hair loss in usually sharply defined areas. Any hair-bearing area can be affected, but the most noticeable are the scalp, the beard area, and the eyebrows. The characteristic patch of alopecia areata is usually round or oval and is completely bald and smooth (Figure 9.3a). Some patients lose hair in only a small patch, while others may have more extensive or less frequently diffuse involvement. Some patients show a reticular pattern of alopecia resulting from confluence of multiple small patches of alopecia (Figure 9.3b). Ophiasis is a form of alopecia areata characterized by the loss of hair in the shape of a wave at the circumference of the head (Figure 9.3c). The name derives, again, from the Greek word for snake, because of the apparent similarity to a snake shape and the pattern of hair loss. Occasionally, alopecia areata may progress to complete baldness, which is referred to as alopecia totalis, and when the entire body suffers from complete hair loss, it is referred to as alopecia universalis.
Efficacy of intradermal minoxidil 5% injections for treatment of patchy non-severe alopecia areata
Published in Journal of Dermatological Treatment, 2022
Mahmoud Abd El-Rahim Abdallah, Rasha Shareef, Marwa Y. Soltan
Minoxidil is approved by food and drug administration for androgenetic alopecia; however, it is widely used off-label in other non-scarring hair loss including AA due to its direct follicular effect (3). Apart from its vascular action, minoxidil shortens the telogen phase, prolongs the anagen phase, increases the follicular size, and stimulates follicular proliferation and differentiation (3). In addition, a local immunosuppressive action for minoxidil may strengthen its proposed mechanism in AA (11,12); however, this immunosuppressive action as well as the proficiency of minoxidil in AA is still a matter of debate (13,14). Conflicting results doubt the efficacy of 1, 2, and 3% topical minoxidil solutions in AA (14), and for the 5% concentration, the level of evidence was found to be moderate in a recent meta-analysis study (5). Sardesai et al. found that topical minoxidil preparations failed to show superior results over placebo (15). Intradermal drug delivery is believed to enhance the therapeutic effect, besides its role to overcome bias related to variations in topical application frequency and patient’s adherence to treatment (16).
Association of khellin and 308-nm excimer lamp in the treatment of severe alopecia areata in a child
Published in Journal of Cosmetic and Laser Therapy, 2018
Samy Fenniche, Houda Hammami, Anissa Zaouak
Alopecia areata (AA) is an autoimmune inflammatory disorder of hair, as a result of a T-cell-mediated autoimmune attack on the hair follicles. I i’s characterized by non-scarring hair loss of any hair--bearing region. It can present as a single or multiples patches with good prognosis and self-limited evolution or may be severe and progress to AA totalis of the scalp or AA universalis. It predominates in pediatrics and young adult patients but can occur at any age (1). Several treatments are available for AA such as topical, intralesional, and/or systemic corticosteroids, calcineurin inhibitors, contact sensitizers, or psoralen with ultraviolet A (UVA) (puvatheapy). Most trials have been conducted in adults with limited data in children. The 308-nm excimer laser or lamp has been reported as one effective modality in the treatment of AA (2,3). Khellin is a furanochromone photosensitizer whose chemical structure is close to psoralens and has previously proven its efficacy in vitiligo in association with UVA (4). In the following observation, we associated both treatment to enhance the clinical response in a child presenting a refractory ophiasic AA.
Finasteride for hair loss: a review
Published in Journal of Dermatological Treatment, 2022
A. K. Gupta, M. Venkataraman, M. Talukder, M. A. Bamimore
Androgenetic alopecia (AGA) is the most common non-scarring hair loss in men. It can usually be classified according to the Norwood Hamilton scale, but there are exceptions (1,2). Hair loss may significantly impair quality of life resulting in passive psychological effects (3). In genetically predisposed men, androgens have an effect on hair follicles where they may transform terminal hair into vellus-like miniaturized hair, leading to gradual hair loss (4–6). The conversion of testosterone to dihydrotestosterone (DHT) is mediated by the enzyme 5α-reductase (5AR) (4) (Figures 1 and 2).