General physical examination
Fazal-I-Akbar Danish in 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
Clay J. Cockerell, Antoanella Calame in Cutaneous Manifestations of HIV Disease, 2012
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.
A HAIRY TALE
Rob Norman in The Woman Who Lost Her Skin, 2004
protein and, when dieting, maintaining adequate protein intake. Iron deficiency occasionally produces hair loss. Some people don't have enough iron in their diets or may not fully absorb iron; women who have heavy menstrual periods may develop iron deficiency. Low iron can be detected by laboratory tests and can be corrected by taking iron pills. High doses of vitamin A may also cause hair shedding. "Any medication?" Some prescription drugs may cause temporary hair shedding. Examples include some of the medicines used for the following: gout, arthritis, depression, heart problems, high blood pressure, or stroke. Some cancer treatments will cause hair cells to stop dividing. Hairs become thin and break off as they exit the scalp. This occurs 1-3 weeks after the treatment and patients can lose up to 90% of their scalp hair. The hair will regrow after treatment ends, but patients may want to get wigs before treatment. Women who lose hair while taking birth control pills usually have an inherited tendency for hair thinning. If hair thinning occurs, a woman can consult her gynecologist about switching to another birth control pill. When a women stops using oral contraceptives, she may notice that her hair begins shedding two or three months later. This may continue for six months by which time it usually stops, similar to hair loss after the birth of a child. I have seen people lose their hair in all kinds of ways. Hair loss and hair deformities are part of several, mostly exotic, syndromes. Alopecia areata is quite common, however, and is characterized by single or multiple patches of welldemarcated hair loss. Alopecia totalis occurs when total or near-total scalp alopecia is present, and alopecia universalis results in generalized loss of all body hair. Most alopecia
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.
New drugs under investigation for the treatment of alopecias
Published in Expert Opinion on Investigational Drugs, 2019
Jorge Ocampo-Garza, Jacob Griggs, Antonella Tosti
Apremilast is an oral, small molecule inhibitor of phosphodiesterase 4 (PDE4). Inhibition of PDE4 results in a higher levels of cyclic adenosine monophosphate (cAMP), which reduces the production of many pro-inflammatory mediators [9]. Apremilast is FDA approved for the treatment of psoriasis and psoriatic arthritis, and is currently being tested for AD [42]. In a humanized mouse model of alopecia areata containing human scalp skin, apremilast caused a preservation of hair follicles and downregulation of inflammatory markers [43]. Liu et al. [44] reported a series of nine patients with AA and alopecia universalis treated with apremilast; none of the patients experienced hair growth over a 3- to 6-month treatment. However, Magdaleno-Tapial et al. [42] reported a case of a woman with AA which showed significant scalp hair growth after 15 weeks of treatment with apremilast. A randomized, placebo-controlled, single center pilot study of the safety and efficacy of apremilast in patients with moderate to severe AA is currently in progress (NCT02684123).
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).
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