Hypertrichose

Zusammenfassung: Hypertrichose bezeichnet, auf Lokalisation, Alter, Geschlecht und ethnische Provenienz bezogen, übermäßiges, diffuses oder umschriebenes Haarwachstum, das nicht dem Verteilungsmuster der sekundären männlichen Geschlechtsbehaarung entspricht. Sie kann isoliert oder syndromatisch auftreten, mit weiteren kongenitalen Anomalien assoziiert sein oder auf eine innere Krankheit hinweisen. Zur richtigen nosologischen Einordnung sind Manifestationsalter, Haarart, Lokalisation und Behaarungsmuster, Begleitkrankheiten und Medikamente, evtl. assoziierte Anomalien und die Familienanamnese von Bedeutung. Wenngleich vermehrtes Haarwachstum meist eine untergeordnete medizinische Bedeutung hat, ist nicht zuletzt die individuelle psychosoziale Tragweite zu beachten. Aktive Maßnahmen zur Haarentfernung richten sich nach dem individuellen Leidensdruck. Es gibt keine einzelne Methode zur Entfernung unerwünschter Körperhaare, die für alle Patienten und Lokalisationen gleich geeignet ist. Die Therapiewahl hängt von Art, Ausdehnung und Stärke des Haarwuchses sowie von den Vorstellungen des Patienten ab und umfasst kosmetische Haarentfernungsmethoden sowie den Einsatz von Laser- und Blitzlampe

Hormone und Haarwachstum

Zusammenfassung: Der Zusammenhang zwischen Androgenen und androgenetischer Alopezie (AGA) sowie Hirsutismus ist gut bekannt. Entsprechend wurden erfolgreiche Therapien entwickelt, die in den Androgenmetabolismus eingreifen. Ein Zusammenhang zwischen Hormonen und Haarwachstum ist aufgrund klinischer Beobachtungen auch für Hormone jenseits des Androgenhorizontes erkennbar: Östrogen, Prolaktin, Thyroxin, Kortison, Wachstumshormon (GH), Melatonin. Bei der primären GH-Resistenz besteht dünnes Haar, umgekehrt verursacht Akromegalie Hypertrichose. Hyperprolaktinämie kann zu Haarausfall und Hirsutismus führen. Eine Teilsynchronisierung des Haarzyklus in Anagen während der Spätschwangerschaft weist auf die Östrogenwirkung hin, Aromatasehemmer führen umgekehrt zu Haarausfall. Effluvium im Kausalzusammenhang mit Schilddrüsenfunktionsstörungen ist gut belegt. Die senile Involutionsalopezie betrifft im Unterschied zur AGA die Haare diffus. Es stellt sich die Frage, ob die den Hormontherapien im Rahmen der Anti-Aging-Medizin zugrunde liegende Hypothese des Kausalzusammenhangs zwischen der altersassoziierten Reduktion zirkulierender Hormone und einer Funktionseinbuße auch für die Haare gil

Pharmacologic interventions in aging hair

Abstract: The appearance of hair plays an important role in people's overall physical appearance and self-perception. With today's increasing life-expectations, the desire to look youthful plays a bigger role than ever. The hair care industry has become aware of this and is delivering active products directed towards meeting this consumer demand. The discovery of pharmacological targets and the development of safe and effective drugs also indicate strategies of the drug industry for maintenance of healthy and beautiful hair. Hair aging comprises weathering of the hair shaft, decrease of melanocyte function, and decrease in hair production. The scalp is subject to intrinsic and extrinsic aging. Intrinsic factors are related to individual genetic and epigenetic mechanisms with interindividual variation: prototypes are familial premature graying, and androgenetic alopecia. Currently available pharmacologic treatment modalities with proven efficacy for treatment of androgenetic alopecia are topical minoxidil and oral finasteride. Extrinsic factors include ultraviolet radiation and air pollution. Experimental evidence supports the hypothesis that oxidative stress also plays a role in hair aging. Topical anti-aging compounds include photoprotectors and antioxidants. In the absence of another way to reverse hair graying, hair colorants remain the mainstay of recovering lost hair color. Topical liposome targeting for melanins, genes, and proteins selectively to hair follicles are currently under investigation. Keywords: hair weathering, graying, androgenetic alopecia, senescent alopecia, hair antiaging "Aged? But he does not appear aged, just look, his hair has remained young!" -Marcel Proust, Remembrance of Things Past In today's world, physical appearance and the notion of looking young and energetic play a greater role than ever. Hair length, color, and style are important for people's physical appearance and self-perception. The condition and style of hair determine how we discern the people we encounter, and how we are perceived by those we come upon. Hair is not only intended to invoke male recognition of feminine appeal and desirability, but it has even become a predicate upon which social success and career opportunities are based. Our preoccupation with hair is further heightened as our increasing life-expectancy fuels our desire to preserve youthfulness. The study of hair aging focuses on two main streams of interest: on one hand, the aesthetic problem of aging hair and its management, in other words everything that happens outside the skin; on the other hand, the biological problem of aging hair, in terms of microscopic, biochemical (hormonal, enzymatic), and molecular changes, in other words, the "secret life" of the hair follicle in the depth of the skin. Scientists interested in the biology of hair growth and pigmentation have exposed the hair follicle as a highly accessible and unique model that offers unequaled opportunities to the gerontologist for the study of age-related effects

Hormone und Haarwachstum

Der Zusammenhang zwischen Androgenen und androgenetischer Alopezie (AGA) sowie Hirsutismus ist gut bekannt. Entsprechend wurden erfolgreiche Therapien entwickelt, die in den Androgenmetabolismus eingreifen. Ein Zusammenhang zwischen Hormonen und Haarwachstum ist aufgrund klinischer Beobachtungen auch für Hormone jenseits des Androgenhorizontes erkennbar: Östrogen, Prolaktin, Thyroxin, Kortison, Wachstumshormon (GH), Melatonin. Bei der primären GH-Resistenz besteht dünnes Haar, umgekehrt verursacht Akromegalie Hypertrichose. Hyperprolaktinämie kann zu Haarausfall und Hirsutismus führen. Eine Teilsynchronisierung des Haarzyklus in Anagen während der Spätschwangerschaft weist auf die Östrogenwirkung hin, Aromatasehemmer führen umgekehrt zu Haarausfall. Effluvium im Kausalzusammenhang mit Schilddrüsenfunktionsstörungen ist gut belegt. Die senile Involutionsalopezie betrifft im Unterschied zur AGA die Haare diffus. Es stellt sich die Frage, ob die den Hormontherapien im Rahmen der Anti-Aging-Medizin zugrunde liegende Hypothese des Kausalzusammenhangs zwischen der altersassoziierten Reduktion zirkulierender Hormone und einer Funktionseinbuße auch für die Haare gilt. ABSTRACT: With respect to the relationship between hormones and hair growth, the role of androgens for androgenetic alopecia (AGA) and hirsutism is best acknowledged. Accordingly, therapeutic strategies that intervene in androgen metabolism have been successfully developed for treatment of these conditions. Clinical observations of hair conditions involving hormones beyond the androgen horizon have determined their role in regulation of hair growth: estrogens, prolactin, thyroid hormone, cortisone, growth hormone (GH), and melatonin. Primary GH resistance is characterized by thin hair, while acromegaly may cause hypertrichosis. Hyperprolactinemia may cause hair loss and hirsutism. Partial synchronization of the hair cycle in anagen during late pregnancy points to an estrogen effect, while aromatase inhibitors cause hair loss. Hair loss in a causal relationship to thyroid disorders is well documented. In contrast to AGA, senescent alopecia affects the hair in a diffuse manner. The question arises, whether the hypothesis that a causal relationship exists between the age-related reduction of circulating hormones and organ function also applies to hair and the aging of hair

Necrobiotic xanthogranuloma successfully treated with autologous stem cell transplantation

Paraproteinemia can be complicated by necrobiotic xanthogranuloma. Therapeutic options for this progressive disease are limited, and there is no agreement on a single best strategy. We report the case of a patient with a massive periorbital infiltration narrowing the palpebral fissure and blinding the patient. Conventional myeloma therapy had only limited benefit in our patient. However, he was successfully treated with high-dose chemotherapy followed by autologous stem cell transplantation, rendering the patient free of symptoms. This is the first report of autologous stem cell transplantation in a patient with necrobiotic xanthogranulom

Estimation of cost-of-illness in patients with psoriasis in Switzerland

BACKGROUND: Evaluation of the current clinical treatment of psoriasis in Switzerland remains to be measured with the parameters cost-of-illness and quality of life. Objective: To obtain data on out-of-pocket expenses, costs of outpatient/office-based care and inpatient care for psoriasis, and to extrapolate total costs by state of severity to the entire Swiss population. METHODS: 1200 retrospective surveys were distributed to patient members of the Swiss Psoriasis and Vitiligo Society, and 400 surveys to office-/hospital-based Swiss dermatologists. The reference year for data collection was 2005. Patients were stratified into three subgroups according to severity of disease. Costs of inpatient care were measured by the amount of hospital days of psoriatic patients from the Swiss Federal Hospital Statistics. RESULTS: 383 patient questionnaires, and 170 cases documented by 57 dermatologists were analyzed. Out-of-pocket expenses/costs for ambulatory care per patient and year ranged from CHF 600-1100 for mild psoriasis to CHF 2400-9900 for severe psoriasis. Including costs for inpatient care of approximately CHF 60 million, the total annual costs for psoriasis in Switzerland in 2004/5 amounted to approximately CHF 314-458 million. CONCLUSIONS: Moderate-to-severe psoriasis is associated with a significant impact on the quality of life and at least 4-fold higher costs than mild psoriasis, indicating the need for efficient control of the disease. This cost-of-illness study provides specific health economic data for future healthcare decision making, particularly with the advent of new therapeutic agents for effective psoriasis control

Estimation of cost-of-illness in patients with psoriasis in Switzerland

BACKGROUND: Evaluation of the current clinical treatment of psoriasis in Switzerland remains to be measured with the parameters cost-of-illness and quality of life. Objective: To obtain data on out-of-pocket expenses, costs of outpatient/office-based care and inpatient care for psoriasis, and to extrapolate total costs by state of severity to the entire Swiss population. METHODS: 1200 retrospective surveys were distributed to patient members of the Swiss Psoriasis and Vitiligo Society, and 400 surveys to office-/hospital-based Swiss dermatologists. The reference year for data collection was 2005. Patients were stratified into three subgroups according to severity of disease. Costs of inpatient care were measured by the amount of hospital days of psoriatic patients from the Swiss Federal Hospital Statistics. RESULTS: 383 patient questionnaires, and 170 cases documented by 57 dermatologists were analyzed. Out-of-pocket expenses/costs for ambulatory care per patient and year ranged from CHF 600-1100 for mild psoriasis to CHF 2400-9900 for severe psoriasis. Including costs for inpatient care of approximately CHF 60 million, the total annual costs for psoriasis in Switzerland in 2004/5 amounted to approximately CHF 314-458 million. CONCLUSIONS: Moderate-to-severe psoriasis is associated with a significant impact on the quality of life and at least 4-fold higher costs than mild psoriasis, indicating the need for efficient control of the disease. This cost-of-illness study provides specific health economic data for future healthcare decision making, particularly with the advent of new therapeutic agents for effective psoriasis control

Nirmatrelvir-resistant SARS-CoV-2 is efficiently transmitted in female Syrian hamsters and retains partial susceptibility to treatment.

The SARS-CoV-2 main protease (3CLpro) is one of the promising therapeutic targets for the treatment of COVID-19. Nirmatrelvir is the first 3CLpro inhibitor authorized for treatment of COVID-19 patients at high risk of hospitalization. We recently reported on the in vitro selection of SARS-CoV-2 3CLpro resistant virus (L50F-E166A-L167F; 3CLprores) that is cross-resistant with nirmatrelvir and other 3CLpro inhibitors. Here, we demonstrate that the 3CLprores virus replicates efficiently in the lungs of intranasally infected female Syrian hamsters and causes lung pathology comparable to that caused by the WT virus. Moreover, hamsters infected with 3CLprores virus transmit the virus efficiently to co-housed non-infected contact hamsters. Importantly, at a dose of 200 mg/kg (BID) of nirmatrelvir, the compound was still able to reduce the lung infectious virus titers of 3CLprores-infected hamsters by 1.4 log10 with a modest improvement in the lung histopathology as compared to the vehicle control. Fortunately, resistance to Nirmatrelvir does not readily develop in clinical setting. Yet, as we demonstrate, in case drug-resistant viruses emerge, they may spread easily which may thus impact therapeutic options. Therefore, the use of 3CLpro inhibitors in combination with other drugs may be considered, especially in immunodeficient patients, to avoid the development of drug-resistant viruses

Genetic variability and limited clonality of Mycoplasma hyorhinis in pig herds

Mycoplasma hyorhinis is a common inhabitant of the upper respiratory tract and tonsils of pigs. Its role as a possible pathogen remains controversial. In order to gain more insight into the epidemiology and population structure of M. hyorhinis we genetically characterized 60 isolates by multi locus sequence typing (MLST). The M. hyorhinis strains originated from Swiss and German pig herds with knowledge on the clinical background. The MLST scheme of Tocqueville et al. (J. Clin. Microbiol. 2014) was optimized, primers for the six MLST gene fragments were newly designed to allow amplification and sequencing with a single protocol. A total of 27 ST were observed with the 60 strains, 26 of those were previously unknown types. Generally identical genotypes were observed within a farm but they differed between farms. The identical genotype was also observed in three different Swiss farms. On the other Hand different genotypes within a farm were found with three German farms. The Swiss isolates formed a distinct cluster but otherwise there was no geographical nor a clinical association with specific Clusters observed. Data shows a high variability of M. hyorhinis comparable to what is observed for Mycoplasma hyopneumoniae. Similar to this pathogen the population structure of M. hyorhinis also shows some limited clonality with predominant genotypes within an animal and a single farm but different ones between farms. The comparable population structure of M. hyopneumoniae and M. hyorhinis could indicate a similar evolution of the two species in the common pig host