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PubMed1978

[The histodynamic of alopecia areata in the dependence on the griseofulvin-induced epithelial proliferation (author's transl)].

The histodynamic of the alopecia areata--without or with the medicamentous induction of the hair growth respectively--was investigated comparatively. 1. Griseofulvin induced an epithelial proliferation in alopecia areata, which is noticeable in the surface epithelium as well as in the follicular epithelium. 2. Under the influence of griseofulvin a deeper penetration of the follicles into the fatty tissue--in connexion with a cutan-subcutaneous volume increase--results; at the same time the supra- and infraseboglandular follicular areas are lengthened. 3. The matter for discussion is that these epithelial changes originate from an increase of metabolic activity or blood supply respectively in the adjacent cutan- and subcutaneous tissue.

Alopecia Areata↗

PubMed1978

Alopecia areata: immunofluorescence and other studies.

In a study of 24 patients with alopecia areata, scalp biopsies were examined for immunofluorescence; all were negative. A number of other tests also failed to confirm an auto-immune aetiology for this disease. A possible explanation lies in the heterogeneity of alopecia areata, only a small proportion of cases being of the auto-immune type.

Adolescent↗

PubMed1975

Male pattern alopecia a histopathologic and histochemical study.

Three hundred and forty-seven tissue specimens were studied from 23 patients with male pattern alopecia. Characteristic features of pattern alopecia included: the presence of miniature or vellus follicles; a marked enlargement of the sebaceous glands and arrectores pilorum muscles; the presence of connective tissue streamers beneath the vellus follicles; and the thinning of the dermis. A mild perivascular infiltrate of mononuclear cells and mild capillary dilatation was sometimes seen. An increased number of mast cells was often a prominent feature. Histochemical procedures were performed for glycogen, acid mucosaccharides, inorganic substances, and enzymes including alkaline phosphatase, acid phosphatase, beta glucuronidase, cholinesterase, aminopeptidase, oxidases and dehydrogenases. Histochemical studies did not reveal any significantly abnormal enzyme changes other than the altered vascular and nerve supply to the the miniature follicles.

Adult↗

PubMed1979

Immunological studies in patients with alopecia areata.

Cellular and humoral immune parameters were studied in 10 patients with alopecia areata totalis and universalis. Trends to low normal immunoglobulins levels and in vitro lymphocyte transformation to concanavalin A were observed. Serum CH-50 levels and skin test responses to mumps, candida, trichophytin and dinitrochlorobenzene (DNCB) not found in vitro. 1 patient with alopecia universalis of 33 years duration developed hair at the site of DNCB skin testing. The findings point to rather subtle immune defects in patients with this disease.

Adolescent↗

PubMed1978

A syndrome of progressive muscle spasm, alopecia, and diarrhea.

A syndrome of progressive muscle spasm, alopecia, and diarrhea was seen in 15 patients. The syndrome was characterized by painful intermittent muscle spasm, alopecia, amenorrhea, and malabsorption, and was sometimes associated with epiphyseal destruction and retarded growth. Symptoms began at age 10 and were more common in women than men. Muscle cramps affected the limbs first and then, several years after onset, the neck, trunk, and masticatory muscles. The course was progressive and led to malnutrition. Four patients died from 5 to 18 years after onset. Autopsy revealed polypoid changes throughout the gastrointestinal tract.

Adolescent↗

PubMed1976

Alopecia areata and Down syndrome.

The skin of 214 institutionalized patients with the Down syndrome was carefully examined. There were 19 cases of alopecia areata and four cases of vitiligo. Since persons with the Down syndrome are predisposed to immunological deficiency in thymus-dependent (T-cell) function, findings from the skin examinations suggest that immunologic factors might contribute to the increased incidence of vitiligo and alopecia areata seen in the Down syndrome. Syringoma was also common and affected female patients twice as frequently as male patients.

Adenoma↗

PubMed1978

Dinitrochlorobenzene therapy for alopecia areata.

Ninety patients with alopecia areata were treated with weekly applications to one side of the head of dinitrochlorobenzene (DNCB) dissolved in acetone, the other side of the head serving as control region. In 80 patients (89%) hair regrew either exclusively on the treated side, or considerably faster and denser on this side. The difference was noted, in the majority of cases, within eight weeks. The initial response, however, could not be maintained in all of these patients. Persistent response was observed in 72 patients (80%). Peribulbar round cell infiltrates were found to be more constant and denser on the treated side, suggesting that topically applied DNCB affects the peribulbar infiltrate present in alopecia areata. Possibly, the therapeutic result is due to altered local immunoregulation.

Adolescent↗

PubMed1979

Hypopigmentation in alopecia mucinosa.

Alopecia mucinosa was found in the hypopigmented skin of two black patients. Alopecia mucinosa should be included in the differential diagnosis of hypopigmented papular skin lesions.

Alopecia↗

PubMed1978

Treatment of alopecia areata with dinitrochlorobenzene.

Persistent refractory alopecia areata in 26 patients was treated topically with dinitrochlorobenzene (DNCB). Sixteen patients have had excellent regrowth of hair; three patients could either not be initially sensitized or an adequate allergic contact dermatitis on the scalp did not develop. Two patients discontinued therapy within two months; hair growth did not develop in five patients despite an adequate trial. Augmentation of the T-lymphocyte pool via DNCB sensitization and challenge may become effective therapy for some patients with severe alopecia areata.

Administration, Topical↗

PubMed1977

Obliteration of alopecia by hair-lifting: a new concept and technique.

A new concept and technique of treatment of male-pattern alopecia are described. The concept is to remove, in serial stages, segments of skin that measure about 3 cm by 7 to 10 cm from the bald area of an alopecic scalp, and to raise the remaining hairy portion into the previously bald area.The technique consists of undermining the skin in the normal plane of cleavage between the galea and the sub-aponeurotic loose connective tissue after each removal of bald skin and "lifting" of hairy skin into the operative defects as they are obliterated by primary closure. By this method, which we call hair-lifting, the patient benefits also from an associated partial face-lift. Whatever remains of baldness after as much hair-lifting as feasible has been performed, is filled with "punch" grafts or free or pedicled strips. Each stage of the procedure is done under local anesthesia. The entire procedure is particularly suitable for tonsure baldness in men and even in the skull-cap type of androgenic alopecia in women.

Alopecia↗

PubMed1979

Lichen sclerosus et atrophicus generalisata, alopecia areata, and polymyalgia rheumatica found in the same patient.

A sixty-eight year old woman with lichen sclerosus et atrophicus since the age of fity-two, alopecia totalis since the age of thirty-six, and polymyalgia rheumatica since the age of fifty-eight is presented. Besides alopecia totalis, the patient has typical lichen sclerosus et atrophicus changes on the trunk, upper arms, and thighs, and at the first visit an ulcer on her left breast. An immunologic link between her three diseases is suspected. As shown in this case Wood's light is of great value in depigmented skin changes.

Aged↗

PubMed1978

Telogen effluvium: a clinically useful concept, with traction alopecia as an example.

Telogen effluvium is the excessive loss of normal club hairs. It can be diagnosed simply by microscopic examination of the hairs that are being shed. These hairs have uniform shaft diameter and normally shaped bulbs that contain no pigment. The causes of telogen effluvium are well known and easily distinguishable. They include parturition, febrile illness, surgical operations and anesthesia, anticoagulant drugs, psychi stress, crash diets, and traction. Traction alopecia often produces recognizable patterns of hair loss and can be diagnosed in many cases with reasonable certainty. It is usually not accompanied by inflammatory changes and the prognosis is excellent provided the causative styling practices-braids, rollers, ponytails, etc-are discontinued. Telogen conversion may be caused by interference with papillary blood flow. Since traction alopecia would seem to be reproducible, it may serve as a model for the study of telogen conversion.

Alopecia↗

PubMed1978

Corticosteroids in the treatment of alopecia totalis. Systemic effects.

Fifteen patients with alopecia totalis (AT) or alopecia universalis (AU) were treated with combined topical, intralesional, and oral corticosteroids. All or virtually all scalp hair regrown on seven patients, and they have been able to discontinue oral corticosteroids without recurrence of AT or AU for periods of three months to 7 1/2 years, with an average remission of 32 months. Two additional patients are currently receiving 5 mg of prednisone every two days. Using topical and intralesional corticosteroids in more resistant areas allowed for more rapid lowering of oral doses and thus side effects were minimized. In view of the usually nearly hopeless prognosis for AT and AU and the results reported here, a trial course of topical, intralesional, and oral corticosteroid treatment would seem to be reasonable for highly motivated patients.

Administration, Oral↗

PubMed2026

Investigation of ACE gene polymorphism and serum ACE activity in relation to alopecia areata among Iraqi patients.

BACKGROUND: Alopecia areata (AA) is a multifactorial disorder with immune dysregulation and genetic susceptibility, affecting 0.5-2% globally. OBJECTIVE: This study investigated angiotensin converting enzyme (ACE) gene insertion /deletion (I/D) polymorphism and serum ACE activity in Iraqi AA patients and their association with inflammatory cytokines (interleukin [IL]-17) and nutritional markers to understand disease progression. METHODS: This case-control study included 50 AA patients (Male and Female) and 35 healthy controls. ACE gene polymorphism (rs1799752) was analyzed using real-time polymerase chain reaction (qPCR) with high-resolution melting (HRM) analysis. Serum IL-17 levels were determined by enzyme-linked immunosorbent assay (ELISA), and biochemical markers were measured using an automated analyzer. RESULTS: ACE gene polymorphism (rs1799752) showed non-significant genotype distribution between patient and control groups (p > 0.05), though a trend toward DD genotype enrichment was observed in patients. Serum ACE levels were significantly higher in patients versus controls (p < 0.0001) with high diagnostic performance. ACE correlated positively with IL-17 (P < 0.0001) and negatively with vitamin D3 and zinc (P < 0.0001). Female patients had significantly higher ACE levels than males (P < 0.01). CONCLUSIONS: ACE emerges as an immunometabolic hub in AA pathogenesis, integrating inflammation with nutritional deficits, suggesting its potential as a biomarker and therapeutic target.

Humans↗

PubMed1978

Diagnosing the common alopecias.

Ample scalp biopsies, including subcutaneous fat, are easily obtained by excision or punch biopsy. Using a knowledge of normal hair patterns and histologic features, the physician can identify common baldness, trichotillomania, alopecia areata, discoid lupus erythematosus, lichen planopilaris, tinea capitis and follicular mucinosis. While hair loss is usually of more psychologic than physiologic significance, accurate diagnosis can be of great importance.

Alopecia↗

PubMed1975

Testosterone metabolism in the skin. A review of its function in androgenetic alopecia, acne vulgaris, and idiopathic hirsutism including recent studies with antiandrogens.

Current concepts of testosterone metabolism in the human skin are reviewed, and the role of dihydrotestosterone in the pathophysiology of androgenetic alopecia, acne vulgaris, and idiopathic hirsutism is discussed. The hypothesis is submitted that a temporary, increased dihydrotestosterone formation at specific skin target sites at different ages causes the normal development of certain sexual characteristics, as well as the androgen-dependent skin disorders. Future treatment of these conditions is discussed in light of recent studies with antiandrogens.

Acne Vulgaris↗

PubMed2025

Epistasis of ERAP1 With 4 Major Histocompatibility Complex Class I Alleles in Frontal Fibrosing Alopecia: A Genome-Wide Association Study Meta-Analysis.

IMPORTANCE: Frontal fibrosing alopecia (FFA) is an inflammatory and scarring form of hair loss of increasing prevalence that most commonly affects women. An improved understanding of the genetic basis of FFA will support the identification of pathogenic mechanisms and therapeutic targets. OBJECTIVE: To identify novel genomic loci at which common genetic variation affects FFA susceptibility and assess nonadditive effects on genetic risk between susceptibility loci. DESIGN, SETTING, AND PARTICIPANTS: Four genome-wide association studies were combined using an SE-weighted meta-analysis. Within the major histocompatibility complex (MHC) locus, stepwise conditional analysis was undertaken to determine independently associated classical MHC class I alleles. Statistical tests for epistatic interaction were performed between risk alleles at the MHC and endoplasmic reticulum aminopeptidase 1 (ERAP1) loci. MAIN OUTCOMES AND MEASURES: Genome-wide significant locus associated with FFA and nonadditive effects on genetic risk between susceptibility loci. RESULTS: Of 6668 included patients, there were 1585 European female individuals with FFA and 5083 controls. Genome-wide significant associations were identified at 4 genomic loci, including a novel susceptibility locus at 5q15, and the association signal could be fine-mapped to a single nucleotide substitution (rs10045403) in the 5' untranslated region of ERAP1 (rs10045403; odds ratio, 1.30; 95% CI, 1.19-1.43; P = 3.6 × 10-8). Within the MHC, FFA risk was statistically independently associated with HLA-A*11:01, HLA-A*33:01, HLA-B*07:02, and HLA-B*35:01. FFA risk was affected by genetic variation at the ERAP1 locus only in individuals who carried at least 1 of the MHC class I risk alleles. CONCLUSIONS AND RELEVANCE: In this genome-wide meta-analysis, a supra-additive effect of genetic variation was found that affected peptide trimming and antigen presentation on FFA susceptibility. Patients with FFA may benefit from emerging therapeutic approaches that modulate ERAP-mediated processes.

Female↗

PubMed1976

EEG findings, rapid ACTH test and autonomic nervous symptoms in patients with alopecia areata.

Patients of multiple alopecia areata were examined in their EEG findings and rapid ACTH test and described the symptoms concerning the neuroautonomic system. Some abnormal EEG findings were seen in 75 cases out of the examined 105 patients. As to the rapid ACTH test, 10 cases out of 45 subjects were abnormal. A positive correlation was considered between abnormal EEG findings and abnormal value in the rapid ACTH test. It is speculated that the regulation centers in the brainstem and hypothalamus play a great role in pathophysiology of multiple areata.

Adrenocorticotropic Hormone↗