39 research outputs found
Does Complement Have a Role in the Pathogenesis of Alopecia Areata?
Alopecia areata (AA) is an autoimmune disorder in which immune attack of the anagen follicle causes hair loss in approximately 2% of the population. Although the pathogenesis of AA has not been fully determined, most likely it is mediated by a variety of factors including cellular/humoral immunity and genetic predisposition. Researchers have been interested in the possible role of the complement pathway in AA since the 1970s. Given recent evidence suggesting that complement plays a role in many immunologic and inflammatory dermatologic diseases including systemic lupus erythematosus, bullous diseases, angioedema, lipodystrophy, and skin infections, it is likely that complement also contributes to AA pathogenesis. Although early serum studies and immunohistochemical staining have been unimpressive, recent genetics studies may provide evidence that complement does indeed contribute to AA. By determining if complement plays a role in AA, options for novel targeted treatments will become available for those patients with refractory disease
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A Systematic Review of the Outcome of Hair Transplantation in Primary Scarring Alopecia
ImportanceHair loss, or alopecia, is one of the most commonly presented problems in dermatology. Scarring alopecias are considered particularly damaging due to limited success in slowing permanent disease progression, and current treatment methods, such as intralesional and topical steroids and topical minoxidil, are largely ineffective.ObjectiveHair transplantation is a debated treatment option for advanced cases of primary scarring alopecia. This study reviews the efficacy of hair transplantation as a treatment option for primary scarring alopecia.Evidence reviewA primary literature search was conducted using PubMed to identify articles in scarring alopecia and hair transplants published from 1960 to the present time.FindingsFifteen reports with 34 patients were included in this review. Twenty six patients experienced moderate to positive results, while 8 patients experienced negative results or recurrence of disease. Positive hair transplantation results have been reported in patients with central centrifugal cicatricial alopecia, en coup de sabre, discoid lupus erythematous, pseudopelade de brocq, and folliculitis decalvans. Positive and -negative results were observed in patients with lichen planopilaris and frontal fibrosing alopecia.Conclusion and relevanceFindings show that hair transplant surgery can be considered as a treatment option for certain primary scarring alopecias. However, data must be interpreted with caution due to concern for positive-result publication bias
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Combination Therapy Using Radiofrequency Microneedling and Corticosteroids for Hypertrophic Scars: A Case Report.
Dysregulated scar formation can cause hypertrophic scarring, a difficult entity to treat. Although fractionated lasers are a popular therapy for hypertrophic scars, laser-induced epidermal damage might cause pigmentary changes in individuals with darker skin tones. Radiofrequency microneedling delivers ablative energy directly to the dermis and is safe for use in such patients. We present a case of hypertrophic scarring in a patient with Fitzpatrick Skin Type IV treated with a combination of radiofrequency microneedling, topical and intralesional corticosteroids, and intralesional onabotulinumtoxinA. Three weeks posttreatment, scars were significantly improved in both color and texture. The patient did not report any side effects. Based on these results, this novel combination therapy appears to be a promising treatment modality for hypertrophic scars in patients with Fitzpatrick Skin Types IV to VI. However, further large-scale studies will need to be completed to determine long-term efficacy and possible adverse events
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The role of platelet-rich plasma therapy in refractory folliculitis decalvans.
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Alopecia and Associated Toxic Agents: A Systematic Review
Importance/objectiveThere are a number of toxic agents that can cause alopecia. In this review we summarize the known substances that cause alopecia as one of the clinical signs of overdose or toxicity.Evidence reviewA search was conducted using PubMed, EMBASE, and Cochrane for studies describing hair loss of any type as a result of exposure to or ingestion of a toxic agent. The search yielded 856 articles, with 47 studies included in this review.FindingsAgents with the strongest evidence of association to alopecia include thallium, mercury, selenium, and colchicine. Agents with described incidents include boric acid, arsenic, vitamin A, botulinum toxin, Podostroma cornu-damae, and the synthetic opioid MT-45.Conclusions and relevanceNumerous toxic agents have been implicated in alopecia, and the strength of evidence behind each agent varies. Toxic levels of thallium and colchicine have long been established to cause alopecia, as compared to agents such as botulinum toxin A and synthetic recreational drugs which have less literature describing their links to alopecia and will need further investigation to characterize their relationships to hair loss. Knowledge of typical presentations of hair loss will aid in the development of a differential diagnosis for patients presenting with alopecia
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Complementary and Alternative Treatments for Alopecia: A Comprehensive Review
The treatment of alopecia is limited by a lack of therapies that induce and sustain disease remission. Given the negative psychosocial impact of hair loss, patients that do not see significant hair restoration with conventional therapies often turn to complementary and alternative medicine (CAM). Although there are a variety of CAM treatment options on the market for alopecia, only a few are backed by multiple randomized controlled trials. Further, these modalities are not regulated by the Food and Drug Administration and there is a lack of standardization of bioactive in gredients in over-the-counter vitamins, herbs, and supplements. In this article, we provide a comprehensive review of the efficacy, safety, and tolerability of CAM, including natural products and mind and body practices, in the treatment of hair loss. Overall, there is a need for additional studies investigating CAM for alopecia with more robust clinical design and standardized, quantitative outcomes