Changes in the hair growth cycle in women with non-scarring alopecia

One of the key elements in the pathophysiological process of androgenetic alopecia and telogen hair loss is the change of hair cycle. Growth factors controlling the development and cycle of the hair follicle have thus far been established. However, the role of growth factors in the pathogenesis of alopecia remains to be revealed.Objective. This study was aimed at investigating the expression of the VEGF, KGF, EGF and TGF-01 growth factors in women with androgenetic alopecia and telogen hair loss, as well as their role in the development of alopecia.Materials and methods. 60 female patients diagnosed with telogen hair loss (30 women) and androgenetic alopecia (30 women) were observed. In order to investigate the expression of the VEGF, KGF, EGF and TGF-01 growth factors, we conducted an immunofluorescent analysis of skin samples obtained by punch biopsy (4 mm) from the frontoparietal scalp area of patients with androgenetic alopecia and telogen hair loss. 15 samples obtained from healthy people were used as a reference group.Results. A change in the expression of the VEGF, KGF and TGF-01 growth factors in women with androgenetic alopecia and telogen hair loss was established in comparison with healthy individuals. A correlation was found between the expression of the growth factors under study, age (p ≤ 0.05), as well as the character and duration of the disease (p ≤ 0.05) in women with non-scarring alopecia. The expression of the growth factors is found to be dependent on the clinical form of alopecia (p < 0.001).Conclusion. The VEGF growth factor is established to have the most significant effect on the development of androgenetic alopecia in women, with the KGF, TGF-01 and EGF factors being less significant as the predictors of this disorder. The VEGF growth factor is shown to affect telogen hair loss to a greater extent compared to the EGF factor. Our study confirms differences in the pathogenesis of androgenetic alopecia and telogen hair loss in women. The findings suggest that the VEGF and KGF growth factors, as well as TGF-01 inhibitors may be used as potential pharmacological agents for treating patients suffering from androgenetic alopecia and telogen hair loss

Erosive pustular dermatosis of the scalp: a multicentre study

Background: Erosive pustular dermatosis of the scalp (EPDS) is characterized by crusted erosions or superficial ulcerations that lead to scarring alopecia. Objectives and Methods: We performed a multicentre retrospective clinical study including 56 patients (29 females and 27 males, mean age 62.7) with a confirmed EPDS in order to describe epidemiology, clinical findings and therapeutic choices of this disease. Results: Mechanical/chemical trauma was reported in 28.6%, a previous infection in 10.7%, a previous cryotherapy in 5.4% androgenetic alopecia in 48.2% and severe actinic damage in 25%. Trichoscopy showed absence of follicular ostia, tufted and broken hair, crusts, serous exudate, dilated vessels, pustules and hyperkeratosis. Histopathology revealed three different features, depending on the disease duration. The most prescribed therapy was topical steroids (62.5%), followed by the combination of topical steroids and topical tacrolimus (8.9%), systemic steroids (7.1%) and topical tacrolimus (5.4%). A reduction of inflammatory signs was observed in 28 patients (50%) treated with topical steroids and in all three patients treated with topical tacrolimus. Conclusion: The relatively high number of patients collected allowed us to identify a better diagnostic approach, using trichoscopy and a more effective therapeutic strategy, with high-potency steroids or tacrolimus, which should be considered as first-line treatment