204 research outputs found
Multi-therapies in androgenetic alopecia: review and clinical experiences.
Androgenetic alopecia (AGA) is a genetically determined progressive hair-loss condition
which represents the most common cause of hair loss in men. The use of the medical term
androgenetic alopecia reflects current knowledge about the important role of androgens and genetic
factors in its etiology. In addition to androgen-dependent changes in the hair cycle, sustained
microscopic follicular inflammation contributes to its onset. Furthermore, Prostaglandins have been
demonstrated to have the ability in modulating hair follicle cycle; in particular, PGD2 inhibits hair
growth while PGE2/F2a promote growth. Due to the progressive nature of AGA, the treatment should
be started early and continued indefinitely, since the benefit will not be maintained upon ceasing
therapy. To date, only two therapeutic agents have been approved by the Food and Drug
Administration and European Medicines Agency for the treatment of AGA: topical minoxidil and oral
finasteride. Considering the many pathogenetic mechanisms involved in AGA, various treatment
options are available: topical and systemic drugs may be used and the choice depends on various
factors including grading of AGA, patients’ pathological conditions, practicability, costs and risks. So,
the treatment for AGA should be based on personalized therapy and targeted at the different
pathophysiological aspects of AG
Chemotherapy-induced alopecia management: Clinical experience and practical advice
Background:
Chemotherapy-induced alopecia (CIA) is probably one of the most
shocking aspects for oncological patients and underestimated by physicians. Among
hair loss risk factors, there are treatment-related aspects such as drug dose, admin-
istration regimen, and exposure to X-rays, but also patient-related characteristics. To
the best of our knowledge, no guidelines are available about CIA management.
Aims and methods:
With this study, based on literature background and our clinical
experience, we would like to propose a list of actions in order to estimate the risk
of hair loss before starting chemotherapy and to manage this condition before, dur-
ing, and after drug administration and to create a sort of practical guide for derma-
tologists and oncologists.
Results and conclusion:
There is an urgent need for prospective studies to clarify
the mechanistic basis of alopecia associated with these drugs and consequently to
design evidence-based management strategies
A case of Scalp Rosacea treated with low dose doxycycline and probiotic therapy and literature review on therapeutic options
Rosacea is a common chronic inflammatory disorder showing a wide range of clinical features such as telangiectasia, erythema, papules, and pustules primarily involving the central part of face (forehead, cheeks and nose) although extra facial manifestation have been described. We describe a case of rosacea with predominant scalp involvement successfully treated with a 8-week-course of doxycycline 40 mg once a day and probiotic therapy twice a day (Bifidobacterium breve BR03, Lactobacillus salivarius LS01 1 Ă— 10(9) UFC/dose)
Clinical, Histological and Trichoscopic Correlations in Scalp Disorders
Trichoscopy is the term coined for the dermoscopic imaging of scalp and hair. This diagnostic technique, simple and noninvasive, can be used as a handy bedside tool for the diagnosis and follow-up of hair and scalp disorders. It allows the recognition of morphologic structures not visible by the naked eye and provides the clinician with a range of dermoscopic findings necessary for differential diagnosis. Trichoscopy observation can be broadly grouped as interfollicular patterns and follicular patterns. Recently, a third mixed class, called the follicular plus interfollicular pattern, has been introduced. Some of these features are specific to a certain scalp disease, while others can be found in many hair disorders. Although studies suggest that the use of trichoscopy can improve clinical accuracy, further investigation is needed. This review provides update information on the trichoscopic features of the most common scalp disorders, striving to show a histopathological and clinical correlation
Chemotherapy-induced alopecia: A novel observation
no abstract avaibl
Dermoscopy and methyl aminolevulinate: A study for detection and evaluation of field cancerization
Actinic keratosis (AK) is a keratinocyte intraepidermal neoplasia UV light
–
induced that frequently appears in
sun-exposed areas of the skin. Although historically AK was de
fi
ned as
“
precancerous
”
, actually it is considered
as the earliest stage of squamous cell carcinoma (SCC) in situ. Since AKs can progress into invasive SCC, their
treatment isrecommended. AKsrarely developasa singlelesion;usually multiplelesions commonly affect anen-
tire area of chronically actinic damaged skin. This has led to the concept of
“
fi
eld cancerization
”
, an area chroni-
cally sun-exposed that surrounds peripherally visible lesions, in which are individualized subclinical alterations.
One of the main principles endpoint in the management of AKs is the evaluation and the treatment of
fi
eld
cancerization. In this view, in order to detect and quantify
fi
eld cancerization, we employed a method based
on the topical application of methyl aminolevulinate (MAL) and the detection of the
fl
uorescence emitted by
its metabolite Protoporphyrin IX (PpIX); then, considering the extension and the intensity of measured
fl
uores-
cence, we create a score of
fi
eld cancerization. The results show that patients underwent to daylight PDT had a
reduction of total score, from T0 to T2. Whereas in the group untreated we observed a stability of total score or
a slightly worse. So, the method and the score used allows to evaluate with a good approximation the dimension
of
fi
eld cancerization and show the modi
fi
cation of it after treatment
Bacterial biofilm associated with a case of capsular contracture
Capsular contracture is one of the most common complications of implant-based breast augmentation. Despite its prevalence, the etiology of capsular contracture remains controversial although the surface texture of the breast implant, the anatomical position of the prosthesis and the presence of bacterial biofilm could be considered trigger factors. In fact, all medical implants are susceptible to bacterial colonization and biofilm formation. The present study demonstrated the presence of microbial biofilm constituted by cocci in a breast implant obtained from a patient with Baker grade II capsular contracture. This suggests that subclinical infection can be present and involved in low-grade capsular contracture
Clinical and trichoscopic graded live visual scale for androgenetic alopecia
Introduction: Currently, the mostly used classifications of androgenetic alopecia (AGA), only provide a macroscopic and subjective description of this disorder, without evaluating trichoscopic features.
Objective: The aim of this study is to elaborate a graded live visual AGA severity scale including macroscopic and microscopic (trichoscopic) pictures, and to determine the most frequent trichoscopic characteristics associated to each grade.
Methods: A retrospective observational study was conducted on 122 patients (50 females and 72 males) affected by AGA. Macroscopic and trichoscopic photographs were taken at standardized scalp points.
Results: Each picture was ranked from AGA stage I to VII, according to Hamilton scale for men and Savin scale for women, and the most representative images of each severity degree were collected to produce a graded live visual scale. In males, two live visual scales, one for the anterior and one for posterior region of the scalp were created. In females, only one scale of the anterior region was realized. For each stage of severity, the corresponding trichoscopic parameters were statistically analyzed.
Conclusions: We realized new macroscopic and trichoscopic graded live visual scales for male and female patients affected by AGA, which could help physicians in giving an objective evaluation of the disease and in better managing it
Monitoring chemotherapy-induced alopecia with trichoscopy
Background: Chemotherapy-induced alopecia (CIA) ranks among the psychologically most devastating effects of cancer treatment for oncological patients, with an overall incidence of 65%. Nowadays trichoscopy is largely employed in the diagnosis of alopecia, but no description of CIA trichoscopic pattern is present in literature. Aims: We want to create an organic description of CIA trichoscopic aspects. Methods: Oncological patients candidate to chemotherapy drugs, afferent to our trichological outpatient were studied. Anamnesis, clinical exam, clinical global photography, pull test, trichogram, and trichoscopy were conducted at the different moments of therapeutic treatment. Results: A definite trichoscopic pattern in the different phases of treatment was observed. After the first 3 weeks of chemotherapy rare and scattered black dots, broken hairs, flame hairs and pohl pinkus appeared. At the end of chemotherapy besides the features described above, numerous thin hair in regrowth were detected, together to rare terminal hair, scattered black dots and circle hair. Three months after chemotherapy a progressive increase of follicular units and elongation of the existing hair were visible. Conclusions: We propose an description of CIA trichoscopic pattern and its evolution during the different phases of chemotherapy
Black lymph node in tattoo: an easy pitfall
Tattoo is one of the most popular body arts in the world. It may be considered as a sign of belonging to a particular community as well as an expression of masculinity. However, it may also have a mere aesthetic purpose. In the past, whereas tattooing was common for male military personnel, bourgeois society spurned it. Nowadays, it is estimated that more than 24% of American adults have at least a tattoo.1 It is trending so tattooing is increasing social acceptability. The practice is equally common in men and women.
In Italy, this phenomenon is less extensive than in America. However, it is definitely on the rise if we compare it with the past. Tattooing is becoming extremely popular with adolescent
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