scholarly journals Comorbidity in patients with alopecia areata

2020 ◽  
Vol 23 (6) ◽  
pp. 414-421
Author(s):  
Alidzhon Mir-Alievich Baltabaev ◽  
Mir-Ali Kurban-Alievich Baltabaev
Keyword(s):  
Vitamin D ◽  
Autoimmune Diseases ◽  
Blood Serum ◽  
Hair Loss ◽  
Alopecia Areata ◽  
Skin Diseases ◽  
Scientific Data ◽  
Hair Follicles ◽  
Inner Organs ◽  
Ultrasound Investigation

BACKGROUND: Alopecia areata (AA) is a non-scarring hair loss characterized by the immune intolerance of hair follicles, leading to the development of T-cell-mediated inflammation and subsequent hair loss. Different ages of onset, repeated relapses, and changes in the appearance of patients lead to psychoemotional distress and contribute to AA and socially significant skin diseases. Scientific data based on the effect of comorbid disorders in the course of alopecia (atopy, autoimmune diseases, and endocrinopathies) should be considered by dermatologists. This publication contains data of own research. AIM: The study aimed to determine the concomitant pathology and its effect on the course of AA, especially on the content of vitamin D, to optimize further treatment. MATERIALS AND METHODS: The research was based on the clinical materials of 132 patients with different severities of AA and concomitant nosologies. Several allergic (atopic dermatitis) and other autoimmune diseases (vitiligo and autoimmune thyroiditis) present similar pathogenetic mechanisms of development to AA. An ultrasound investigation was carried out, and a number of autoimmune and allergic nosologies accompanying the course of AA and the level of vitamin D in blood serum depending on the disease severity were revealed. RESULTS: The analysis of results of ultrasound investigation of the inner organs was presented and revealed comorbid autoimmune and allergic nosologies affecting the course or associating with AA. The moderate (32.67 0.91 nmol/l; р 0.5) and severe clinical forms (32.9 0.84 nmol/l) of AA vitamin D significantly decreased compared with the mild course of the disease (56.75 0.62 nmol/l). Two clinical cases of patients with AA and concomitant diseases were presented. CONCLUSION: The results revealed that the concomitant pathology of AA correlates with the literature source data and suggest their correction by doctors of narrow specialties. Vitamin D in the blood serum of patients was examined as a possible comorbid factor and predictor of disease activity. The role of trichoscopy as an investigation tool for the visualization and verification of the diagnosis and determination of the activity of AA was outlined.

scholarly journals Alopecia areata is not a risk factor for heart diseases: A 10-year retrospective cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0250216
Author(s):  
Heera Lee ◽  
You Chan Kim ◽  
Jee Woong Choi
Keyword(s):  
Cohort Study ◽  
Alopecia Areata ◽  
Lupus Erythematosus ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Skin Diseases ◽  
Heart Diseases ◽  
Hair Follicles ◽  
Inflammatory Skin Diseases ◽  
Increased Risk

Alopecia areata (AA) is an autoimmune skin disease caused by chronic inflammation of hair follicles. Chronic inflammatory skin diseases such as psoriasis and lupus erythematosus can increase the risk of cardiovascular diseases. However, the relationship between AA and heart diseases (HDs) remains unclear. Therefore, we conducted this retrospective cohort study to evaluate the risk of subsequent HDs in patients with AA. We reviewed 3770 cases of AA and from 18,850 age, sex, and income level-matched controls from the National Health Insurance Service-National Sample Cohort. In the subgroup analysis, patients who suffered from alopecia totalis, alopecia universalis, and ophiasis were designated as patients with severe AA and patients having the disease for over a year were designated as patients with long-standing AA. As a result, we found that AA was not associated with a higher risk of heart failure, angina pectoris, or myocardial infarction. There was no significant increase in the risk of overall HD associated with AA (adjusted hazard ratio: 1.17; 95% confidence interval: 0.93–1.48; p = 0.177). Neither the severity nor the duration of AA was related to an increased risk of HDs. During the study period, AA patients did not show a significantly higher cumulative incidence of HDs than controls (log-rank p = 0.157). In conclusion, AA does not increase the risk of HD.

Disorders of Hair

2013 ◽  
Author(s):  
James Q Del Rosso
Keyword(s):  
Hair Loss ◽  
Alopecia Areata ◽  
Hair Growth ◽  
Growth Cycle ◽  
Hair Follicles ◽  
Common Type ◽  
Diagnosis And Treatment ◽  
Basic Knowledge ◽  
Androgenetic Alopecia ◽  
Broad Overview

A basic knowledge of the hair growth cycle is needed to evaluate disorders of hair growth. This chapter presents a broad overview of the physiology and evaluation of hair growth, as well as discussions of specific types of alopecia. The epidemiology, pathogenesis, diagnosis, and treatment of androgenetic alopecia, the most common type of nonscarring hair loss, are covered. Diffuse hair shedding is generalized hair loss over the entire scalp. Diagnosis and treatment of telogen effluvium, anagen arrest (anagen effluvium), and other causes of diffuse hair shedding are covered in detail. Alopecia areata, typically characterized by patchy hair loss; cicatricial alopecia, which results from permanent scarring of the hair follicles; and miscellaneous causes of hair loss are also discussed. Tables list the causes of diffuse and cicatricial alopecia, telogen effluvium, and miscellaneous chemicals and categories of drugs that can cause alopecia, as well as miscellaneous causes of hair loss. Included is an algorithm outlining the approach to diagnosing nonscarring alopecia, as well as a variety of clinical photographs. This review contains 9 highly rendered figures, 6 tables, and 42 references.

scholarly journals Hair Follicles from Alopecia Areata Patients Exhibit Alterations in Immune Privilege-Associated Gene Expression in Advance of Hair Loss

2010 ◽  
Vol 130 (11) ◽  
pp. 2677-2680 ◽  
Author(s):  
Hoon Kang ◽  
Wen-Yu Wu ◽  
Blanche K.K. Lo ◽  
Mei Yu ◽  
Gigi Leung ◽  
...  
Keyword(s):  
Gene Expression ◽  
Hair Loss ◽  
Alopecia Areata ◽  
Hair Follicles ◽  
Immune Privilege

scholarly journals Trichoscopy of Alopecia Areata: Hair Loss Feature Extraction and Computation Using Grid Line Selection and Eigenvalue

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Sunyong Seo ◽  
Jinho Park
Keyword(s):  
Hair Loss ◽  
Alopecia Areata ◽  
Eating Habits ◽  
Hair Follicles ◽  
Smart Device ◽  
Light Reflection ◽  
Grid Line ◽  
Feature Based ◽  
Line Selection ◽  
Vellus Hairs

Recently, the hair loss population, alopecia areata patients, is increasing due to various unconfirmed reasons such as environmental pollution and irregular eating habits. In this paper, we introduce an algorithm for preventing hair loss and scalp self-diagnosis by extracting HLF (hair loss feature) based on the scalp image using a microscope that can be mounted on a smart device. We extract the HLF by combining a scalp image taken from the microscope using grid line selection and eigenvalue. First, we preprocess the photographed scalp images using image processing to adjust the contrast of microscopy input and minimize the light reflection. Second, HLF is extracted through each distinct algorithm to determine the progress degree of hair loss based on the preprocessed scalp image. We define HLF as the number of hair, hair follicles, and thickness of hair that integrate broken hairs, short vellus hairs, and tapering hairs.

scholarly journals Effective management of indralupta (alopecia areata) with jalaukavacharan - a case report

2018 ◽  
Vol 6 (5th) ◽  
Author(s):  
Likhita Sureshrao Dhage ◽  
Pournima Daware
Keyword(s):  
Case Report ◽  
Hair Loss ◽  
Alopecia Areata ◽  
Hair Follicles ◽  
Effective Management

 Panchkarma is said to be best treatment for disease curing by its root. According to Acharyas it is said that untreatable diseases can be treated with Raktamokshan . Raktamokshan is fifth karma among Panchkarma. Indralupta came under kshudra rogas.  Indralupta (alopecia areata) is the disease where hair loss in patient in the form of patches  over scalp is seen. Considering etiopathogenesis of Indralupta Vyadhi, Raktamokshan is said to be best treatment. In this case report, patient with Indralupta over scalp is treated with Jalaukavacharan. It not only work on localized hair loss but also promote hair follicles to grow new hairs.

Childhood Alopecia Areata: An Overview of Treatment and Recent Patents

2020 ◽  
Vol 14 ◽  
Author(s):  
Kam L. Hon ◽  
David C.K. Luk ◽  
Alexander K.C. Leung ◽  
Chantel Ng ◽  
Steven K.F. Loo
Keyword(s):  
Hair Loss ◽  
Alopecia Areata ◽  
Coal Tar ◽  
Psychological Impact ◽  
Hair Follicles ◽  
The Body ◽  
Whole Body ◽  
Treatment Modalities ◽  
Topical Treatments ◽  
Clinical Queries

Background: Alopecia Areata (AA) is a systemic autoimmune condition which usually starts in childhood. Objective: This article aims to review genetics, therapy, prognosis and recent patents for AA. Methods: We used clinical queries and keywords of “alopecia areata” AND “childhood” as search engine. Patents were searched using the key term “alopecia areata” in Patents.google.com and freepatentsonline.com. Results: Due to an immune mediated damage of the hair follicles, hair is lost from the scalp and other areas of the body temporarily or even permanently. Children with AA are generally healthy. Evidence of genetic association and increased predisposition for AA was found by studying families with affected members. Pathophysiologically, T- lymphocytes attack hair follicles and cause inflammation and destruction of the hair follicles and hair loss. In mild cases, there would be well demarcated round patchy scalp hair loss. The pathognomonic “exclamation mark hairs” may be seen at lesion periphery. In more severe cases, the hair loss may affect the whole scalp and even the whole body. The clinical course is also variable which may range from transient episodes of recurrent patchy hair loss to an indolent gradually deteriorating severe hair loss. The treatment of AA depends on factors including patients’ age, extent of the hair loss, duration of disease, psychological impact, availability and side effect profile of the treatments. For localized patchy alopecia, topical application of corticosteroids and/or intralesional corticosteroids are the treatment of choice. Other topical treatments include minoxidil, anthralin, coal tar and immunotherapy. In severe resistant cases, systemic immunosuppressants may be considered. Although herbal medicine, acupuncture, complementary and alternative medicine may be tried on children in some Asian communities, the evidence to support these practices are lacking. To date, only few recent patents exist in topical treatments including Il-31, laser and herbal medications. Clinical efficacy is pending for these treatment modalities. Conclusions: None of the established therapeutic options are curative. However, newer treatment modalities including excimer laser, interleukin-31 antibodies and biologics are evolving so that there may be significant advances in treatment in the near future. AA can be psychosocially devastating. It is important to assess the quality of life, degree of anxiety, social phobia and mood of the patients and their families. Psychological support is imperative for those who are adversely affected psychosocially.

scholarly journals EP06 Successful treatment of alopecia universalis with rituximab therapy

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Anuoluwapo R Oke ◽  
Steven Young-Min
Keyword(s):  
B Cell ◽  
Mhc Class I ◽  
Hair Loss ◽  
Alopecia Areata ◽  
Hair Follicles ◽  
Class I ◽  
Whole Body ◽  
Type I ◽  
Alopecia Universalis ◽  
First Report

Abstract Background Alopecia universalis (AU) is a severe subtype of alopecia areata (AA), in which there is non-scarring hair loss affecting the whole body. The pathogenesis involves, increased MHC class I expression in hair follicles, loss of hair follicle immune privilege and autoimmune-mediated damage to pigmented hair. There is no cure for alopecia areata, and though mild cases may have a good chance of either spontaneous or treatment-induced recovery, the prognosis of complete hair loss is poor with less than 10% recovery. Treatment remains a challenge with no reliably effective therapy and in the absence of well-evaluated trials, isolated case reports can influence practice. Here, we present the first report of AU being successfully treated with rituximab with remarkably sustained improvement at 6 years follow up. This case is also the first report of AU developing in adult dermatomyositis (DM) and we speculate upon the implications for the aetiopathogenesis of both conditions. Methods A 55-year-old lady, presented with proximal limb weakness, lethargy, a non-itchy rash, pleurisy and breathlessness. The serum creatinine kinase (3369 u/L) and anti-Jo-1 antibodies were elevated consistent with antisynthetase syndrome and a diagnosis of dermatomyositis was made. There was an initial response to corticosteroids and cyclophosphamide. She then relapsed and was treated with IV rituximab. Seventeen months after her initial presentation, she developed widespread hair loss sparing only white hairs (making Telogen Effluvium unlikely), combined with a concurrent relapse of her dermatomyositis. A diagnosis of alopecia universalis (AU) was made. A further course of IV rituximab therapy administered at this stage led to an excellent response in both her dermatomyositis and AU. At three months review, both the AU and the dermatomyositis had entered remission and this has been sustained 6 years on. Results Please refer to the conclusion section. Conclusion Disease activity in dermatomyositis has been linked with the expression of type I Interferon IFN and this may induce MHC class I expression that is identified on muscle biopsy. It may be that similar type I IFN action on hair follicles may have triggered the development of AU in our case. Whilst this is the first report of AU occurring with adult dermatomyositis, there has been a report of AU occurring in juvenile dermatomyositis. There are also other reports of other combinations of autoimmune conditions occurring with both DM & AU. This case also demonstrates that rituximab, an anti-CD 20 B cell therapy, maybe a useful treatment option in alopecia areata and universalis. This has not been reported elsewhere. Despite postulation that AU is a mainly T cell-driven disease, this case demonstrates that B cells may play a role, in much the same way that we now recognise the importance of B cell involvement in RA. Disclosures A.R. Oke None. S. Young-Min None.

scholarly journals Autoantibodies to Hair Follicles in C3H/HeJ Mice With Alopecia Areata–Like Hair Loss

1997 ◽  
Vol 109 (3) ◽  
pp. 329-333 ◽  
Author(s):  
Desmond J. Tobin ◽  
John P. Sundberg ◽  
Lloyd E. King ◽  
Dawnalyn Boggess ◽  
Jean-Claude Bystryn
Keyword(s):  
Hair Loss ◽  
Alopecia Areata ◽  
Hair Follicles

scholarly journals ROLE OF VIRECHANA IN THE MANAGEMENT OF INDRALUPTA - A SINGLE CASE REPORT

2021 ◽  
Vol 9 (8) ◽  
pp. 1913-1916
Author(s):  
Harikrishnan. N. Menon ◽  
Syed Munawar Pasha
Keyword(s):  
Hair Loss ◽  
Alopecia Areata ◽  
Marked Improvement ◽  
Single Case ◽  
Hair Follicles ◽  
Root Cause ◽  
Single Case Report ◽  
Immune Mediated ◽  
The Subject

Introduction: Indralupta is a type of Kapalagata Roga, it occurs when Pitta along with Vata affecting the hair follicles to become thin and fall, later on, due to vitiation of Kapha and Rakta it blocks the regrowth of hairs. It can be correlated to Alopecia. Alopecia areata is one of its types and it is also known as spot baldness. It may be regarded as immune-mediated hair loss and it is the commonest cause of patchy hair loss. Materials and methods: A 20-year-old female patient approached Shalakya Tantra OPD of SJIIM, Bengaluru complaining of patchy hair loss in the parietal region for 6 months, the subject was systemically reviewed and diagnosed as alopecia areata, were administered with Snehapana, Virechana, internal medication and lepa for 2 months. Result: The subject showed marked improvement in assessment criteria’s as we can see in the photo- graphs taken in the different stages of the treatment. Discussion: Usually Indralupta is treated with more bahya Prayogas like prachanna, here in this study we have concentrated more on the root cause of the disease and treating the underlying cause by Internal medications, thus we got a positive result for the same. Keywords: Alopecia areata, Indralupta, Virechana, Ayurveda.

scholarly journals Alopecia areata patients show deficiency of FOXP3+CD39+ T regulatory cells and clonotypic restriction of Treg TCR?-chain, which highlights the immunopathological aspect of the disease

2018 ◽  
Author(s):  
Annika Birgitta Margareta Åstrand ◽  
Fatma N Hamed ◽  
Marta Bertolini ◽  
Alfredo Rossi ◽  
Afsaneh Maleki-Dizaji ◽  
...  
Keyword(s):  
Hair Loss ◽  
Alopecia Areata ◽  
T Regulatory Cells ◽  
Treg Cells ◽  
Hair Follicles ◽  
Regulatory Cells ◽  
T Helper 1 ◽  
Autoimmune Reaction ◽  
Lesional Skin ◽  
Pcr Products

Alopecia areata (AA) is a hair loss disorder resulting from an autoimmune reaction against hair follicles. T-helper 1 cells are a major contributor to this disorder, but little is known about the role of T-regulatory cells (Tregs) in AA. Here, we analysed the distribution of circulating Treg subsets in twenty AA patients with active hair loss and fifteen healthy subjects by flow cytometry. The Treg suppressor HLA-DR+ subpopulation was significantly reduced in the patients (P<0.001) and there were significantly fewer cells expressing CD39 among the CD4+CD25+Foxp3+ Treg subpopulation in patients (P=0.001). FOXP3 CD39 Treg cells were also reduced in hair follicles; by 75% in non-lesional skin and 90% in lesional skin, when compared to control healthy skin. To further characterise Treg cells in AA; Tregs (CD4+CD25+FOXP3+) were investigated for their TCR? sequence. PCR products analysed by Next Generation Sequencing techniques, showed that all frequent public clonotypes in AA Tregs were also present in controls at relatively similar frequencies, excepting two public clonotypes: CATSRDEGGLDEKLFF (V15 D1 J1-4) and CASRDGTGPSNYGYTF (V2 D1 J1-2), which were exclusively present in controls. This suggests that these Treg clonotypes may have a protective effect and that they may be an exciting subject for future therapeutic applications.

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