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Journal articles on the topic 'Diffuse alopecia areata'

Author: Grafiati

Published: 4 June 2021

Last updated: 10 February 2022

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1

Werner, Betina, and Fabiane Mulinari-Brenner. "Clinical and histological challenge in the differential diagnosis of diffuse alopecia: female androgenetic alopecia, telogen effluvium and alopecia areata - part II." Anais Brasileiros de Dermatologia 87, no. 6 (2012): 884–90. http://dx.doi.org/10.1590/s0365-05962012000600010.

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Diffuse alopecia is mainly caused by telogen effluvium, diffuse androgenetic alopecia (femalepattern hair loss) and diffuse alopecia areata. Differential diagnosis between the three disorders may be difficult in several occasions. In this second part of our study, chronic telogen effluvium and diffuse alopecia areata are discussed in detail, including clinical, dermoscopic and histological aspects. A flowchart presents a practical and objective differential diagnostic approach to diffuse alopecia.

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Yong, Angeline Anning, and Robin Unger. "Resistance of Transplanted Hair Follicles to the Onslaught of Diffuse Alopecia Areata." American Journal of Cosmetic Surgery 34, no. 2 (2017): 70–72. http://dx.doi.org/10.1177/0748806817699926.

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A 55-year-old man who previously underwent a successful hair transplantation for androgenetic alopecia now presents with rapid onset hair loss over the anterior to mid-scalp areas during a 2-month period. The alopecic area noticeably extended diffusely from anterior hairline to scalp vertex while rows of previously transplanted hair follicles appeared intact. Further dermoscopic features and a scalp biopsy were consistent with alopecia areata incognita. This patient was subsequently successfully treated with intralesional steroid injections. This case report is the first demonstrating the relative resistance of transplanted hair follicles to the process of alopecia areata when compared with local indigenous hairs. Prior to this, a few reports have demonstrated the use of hair transplantation to treat stable areas of alopecia areata resistant to medical treatment with mixed results but at least some initial success. This could be related to the local irritation and inflammatory response resultant from needling during hair transplantation that causes a degree of scarring and fibrosis around each transplanted graft, hence lending a protective barrier to an autoimmune-based T-lymphocyte attack on hair bulbs and subsequent increased survival of transplanted hair follicles. This unexpected observation provides new avenues for investigation into alopecia areata pathophysiology and further supports hair transplantation as a viable option for patients with stable, localized alopecia areata that is recalcitrant to other modalities.

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Kaliebe, K., C. D. Spinner, T. Biedermann, and A. Zink. "Alopecia syphilitica diffusa − eine seltene Manifestationsform der Frühsyphilis." Aktuelle Dermatologie 45, no. 06 (2019): 288–90. http://dx.doi.org/10.1055/a-0881-7949.

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ZusammenfassungDie Syphilis wird als das Chamäleon der Medizin bezeichnet, da sie viele Organe befallen und insbesondere an der Haut viele Erkrankungen imitieren kann. Weniger bekannt sind die durch die Syphilis bedingten Formen des Haarausfalls. Dabei ist die diffuse Form der syphilitischen Alopezie besonders selten und kann leicht übersehen werden.Hier berichten wir über einen jungen, HIV-positiven Mann mit der klinischen Präsentationsform einer Alopecia syphilitica diffusa. Nach erfolgreicher Therapie mit 2,4 Millionen Einheiten Benzylpenicillin i. m. zeigte sich innerhalb weniger Monate eine vollständige Normalisierung des Haarwuchses. Die Alopecia syphilitica präsentiert sich klinisch typischerweise als diffuser Haarverlust, als umschriebener Haarausfall mit fleckig imponierendem, sog. Mottenfraßmuster oder durch eine Kombination von beidem. Dabei kann die syphilitische Alopezie das einzige klinische Symptom einer Syphilisinfektion sein und sowohl klinisch als auch in der Histopathologie eine Alopecia areata imitieren. Die Dermatoskopie oder der immunhistochemische Nachweis von Treponema pallidum im Haarfollikel können weitere hilfreiche Methoden zur Diagnostik des syphilitischen Haarausfalls sein, entscheidend ist jedoch die serologische Diagnostik.

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Pradhan, Manish, Dipa Rai, and Sagar Paudel. "A Study of Serum Ferritin Level in Female Patient with Alopecia." Journal of College of Medical Sciences-Nepal 14, no. 2 (2018): 116–20. http://dx.doi.org/10.3126/jcmsn.v14i2.20217.

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ABSTRACTIntroduction: Total body iron store is an integral factor in the development of hair follicle. Numerous studies have been done seeking for the relationship between body iron store and various forms of chronic diffuse hair loss, with relatively contradictory findings in various reports in these studies. The main objective of this study is to find out if there is any association between total body iron store and various types of chronic diffuse hair loss in females in reproductive age.Materials and Methods: This is a hospital based case control study conducted in Nobel Medical College and Teaching Hospital, Biratnagar, Nepal. Sixty female patients of age group 15-50 years with chronic diffuse hair loss with equal number of age- and sex- matched controls were studied. Both of the study groups were evaluated for various parameters of iron status. Results: The mean value of serum ferritin in cases was significantly lower as compared to controls (p=0.018). Patients with alopecia areata (p=0.008) and androgenetic alopecia (p=0.021) had significantly lower serum ferritin, whereas there was no statistically significant difference in telogen effluvium and controls (p=0.857).The mean value of hemoglobin, hematocrit and mean corpuscular hemoglobin was found to be significantly lower in alopecia areata and androgenetic alopecia. However, there was no statistically significant difference in RBC indices of patients of telogen effluvium and controls.Conclusion: Diffuse chronic hair loss shows definite association with serum ferritin and various RBC indices in female of reproductive age group. Alopecia areata and androgenetic alopecia show major association with total body iron stores. Keywords: alopecia areata; androgenetic alopecia; serum ferritin; telogen effluvium.

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Kashutin, S. L., E. I. Tedder, Leonid L. Shagrov, et al. "MORPHOLOGICAL CHARACTERISTICS OF EPIDERMIS AND DERMIS IN PATIENTS WITH DIFFUSE ALOPECIA, ANDROGENETIC ALOPECIA AND ALOPECIA AREATA." Russian Journal of Skin and Venereal Diseases 21, no. 2 (2018): 106–9. http://dx.doi.org/10.18821/1560-9588-2018-21-2-106-109.

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Despite the emergence of non-invasive and very informative techniques, such as trichoscopy and confocal microscopy, it is still necessary to use a skin biopsy of the scalp. Currently, there is a lot of information about hystopathology of the scalp in patients with diffuse alopecia, androgenetic alopecia and alopecia areata [1]. Researches mostly aim to study the follicular unit, whereas data on pathological changes in the epidermis, papillary and reticular dermis in the above-mentioned alopecia are rare and scattered. In this connection, the aim of the research was to study morphological characteristics of epidermis and dermis in patients with diffuse alopecia, androgenetic alopecia and alopecia areata. Material and methods. We examined 25 patients (12 women and 13 men) aged 17 to 60 years with not cicatricial alopecia: androgenetic alopecia was observed in 10 patients, alopecia areata - in 9 patients, diffuse alopecia - in 6 patients. The age of the disease ranged from 1 month to 5 years. The control group consisted of 9 people. The review microscopy and morphometry of samples, taken for investigation, were performed using the eyepiece micrometer MOB-1-15xУ4.2. The following indicators in the dermis were evaluated: the presence of lymphohistiocytic infiltrates in the papillary and reticular dermis, mucoid swelling of sclerosis of the papillary dermis, and signs of destruction of hair follicles. Results. The tendency to increase thickness of the epidermis in patients with diffuse alopecia is associated with thickening of the stratum granulosum and especially the stratum corneum. In case of androgenetic alopecia and alopecia areata the tendency to decrease the thickness of the epidermis is associated with a tendency to reduce the thickness of the stratum lucidum. Regardless of the type of alopecia, the thickness of the stratum basale is statistically higher than in the control group. Regardless of the type of alopecia, changes in the dermis are manifested by the destruction of hair follicles followed by the presence of lymphohistiocytic infiltrates in the papillary and reticular dermis, as well as sclerosis of the papillary dermis. Discussion. It can be anticipated that the presence of lymphohistiocytic infiltrates in the papillary and reticular dermis may indicate the inflammatory process, which is accompanied by abnormal microcirculation and the destruction of the hair follicle which in turn insufficiently stimulates angiogenesis.

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6

Dhurat, Rachita S., Sanober Burzin Daruwalla, Smita Sunil Ghate, Mithali Mahendra Jage, and Aseem Sharma. "Distinguishing Lipedematous Scalp, Lipedematous Alopecia, and Diffuse Alopecia Areata." Skin Appendage Disorders 5, no. 5 (2019): 316–19. http://dx.doi.org/10.1159/000495947.

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7

Dalal, Ashish, Ajay Kumar, Ritambhara Lohan, and Muskaan Ahlawat. "A six-year old girl presenting with alopecia areata incognita: a case report." International Journal of Research in Dermatology 3, no. 1 (2017): 158. http://dx.doi.org/10.18203/issn.2455-4529.intjresdermatol20170807.

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<p class="abstract">A proportion of cases of diffuse hair loss over the scalp mimicking telogen effluvium or androgenetic alopecia are found to have alopecia areata incognita (AAI) on dermascopic examination and histopathology. AAI has commonly been reported in middle aged women who present with a sudden increase in hair shedding with diffuse alopecia developing after several months. Though the typical glabrous patches of hair loss observed in classical alopecia areata are absent, the abrupt and intense hair loss with a positive hair pull test is suggestive of AAI. There are few reports of AAI occurring in children. We are reporting a case of AAI in a 6-year old child. </p>

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8

Werner, Betina, and Fabiane Mulinari-Brenner. "Clinical and histological challenge in the differential diagnosis of diffuse alopecia: female androgenetic alopecia, telogen effluvium and alopecia areata - part I." Anais Brasileiros de Dermatologia 87, no. 5 (2012): 742–47. http://dx.doi.org/10.1590/s0365-05962012000500012.

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Diffuse androgenetic alopecia (female pattern hair loss), telogen effluvium, and diffuse alopecia areata may have similar clinical manifestations. Subtle details on physical examination and dermoscopy of the scalp may help to identify those disorders. The authors present a practical discussion on how to approach the patient with diffuse alopecia, considering clinical history, physical examination, and dermoscopic findings. If the diagnosis remains unclear after a careful analysis of the clinical signs, a scalp biopsy may help to distinguish between the three diseases. In this first part of our study, an objective review of female androgenetic alopecia is presented and the most important histological changes are discussed.

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9

Mareeva, A. N., G. L. Katunin, and A. B. Rubtsov. "Differential diagnostics of syphilitic alopecia and alopecia areata: The clinical picture and trichoscopic signs." Vestnik dermatologii i venerologii 95, no. 3 (2019): 34–39. http://dx.doi.org/10.25208/0042-4609-2019-95-3-34-39.

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This paper describes a clinical case of secondary syphilis, which was manifested exclusively by syphilitic alopecia.We describe the details of the clinical picture, as well as a differential diagnosis of syphilitic alopecia and alopecia areata on the basis of trichoscopy data.For a patient with scalp lesions typical of syphilis (focal form of alopecia), the trichoscopic picture was represented by hairs broken at different heights from 1 to 5 mm, “empty” follicles (“yellow” dots), anisotrichosis due to the loss of terminal hair. The eyebrow trichoscopy showed “yellow dots”, vellus hairs, hair thinning due to the loss of bristly hair. A comparison of the trichoscopic pictures for alopecia areata and syphilitic areata have revealed the absence in the latter of a number of signs typical of the former, such as pencil-point, ex clamation-point, zigzag, monilethrix and tulip hairs.Patients with a clinical picture of focal, diffuse or mix ed alopecia should be tested for syphilis using serological methods.

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10

Kim, D. Y., P. J. Johnson, and D. Senter. "Diagnostic Exercise: Severe Bilaterally Symmetrical Alopecia in a Horse." Veterinary Pathology 48, no. 6 (2011): 1216–20. http://dx.doi.org/10.1177/0300985810396103.

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A 9-year-old Tennessee Walking Horse gelding was presented for diagnosis of the cause of extensive alopecia. Complete hair loss was noted over the head, neck, shoulder, thigh, and proximal limbs, but the trunk, distal limbs, pelvic area, mane, and tail were unaffected. The alopecic areas were visually noninflammatory with no exudate or crust except on the shoulder and along the back, where multifocal patchy areas of alopecia with scales and crust were evident. The horse was slightly pruritic. Microscopically, the hair bulbs, inner and outer root sheaths of inferior segments, and perifollicular regions were infiltrated by small to moderate numbers of small lymphocytes. Similar inflammation was occasionally evident in isthmus follicular walls as well as some apocrine glands. No sebaceous glands were affected. Immunohistochemistry confirmed that the small lymphocytes were CD3+ T lymphocytes. The epidermis from the skin with scale and crusts along the horse’s back exhibited mild to moderate hyperplasia, mild lymphocytic exocytosis, mild eosinophilic dermatitis, and diffuse parakeratosis with numerous budding yeasts, consistent with Malassezia spp. The final disease diagnosis was made as alopecia areata with Malassezia dermatitis. Alopecia areata could be a contributing underlying factor for Malassezia dermatitis.

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Chavez-Alvarez, Sonia, AL Villarreal-Alfaro-Lopez, Osvaldo Vazquez-Martinez, and Alejandra Villarreal-Martinez. "Diffuse alopecia areata associated with weight-loss pills." International Journal of Trichology 11, no. 6 (2019): 236. http://dx.doi.org/10.4103/ijt.ijt_101_19.

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12

Concha, Josef Symon Salgado, and Victoria P. Werth. "Alopecias in lupus erythematosus." Lupus Science & Medicine 5, no. 1 (2018): e000291. http://dx.doi.org/10.1136/lupus-2018-000291.

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Several patterns of hair loss can occur in lupus erythematosus (LE). Alopecias which show histological characteristics of LE are LE-specific, and include discoid LE (DLE), diffuse or patchy hair loss in acute LE, subacute cutaneous LE, and rarely tumid LE. Lupus hair in SLE is a poorly characterised entity and may be a form of telogen effluvium. Alopecia areata can coexist with LE and may mimic DLE. Non-lupus alopecias such as telogen effluvium and anagen effluvium have a myriad of causes which include disease flares, drugs and stress in the setting of LE. The latest validated Systemic Lupus International Collaborating Clinics classification criteria for SLE includes non-scarring alopecia as a criterion; therefore, recognising the aetiology of hair loss in the setting of LE is crucial in classifying a patient to have systemic disease.

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13

Izumi, Yasumori, Ikuo Kinoshita, Yoshiko Kita, et al. "Myasthenia gravis with diffuse alopecia areata and pemphigus foliaceus." Journal of Neurology 249, no. 10 (2002): 1455–56. http://dx.doi.org/10.1007/s00415-002-0821-2.

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14

Barusco, Marco N. "Complications and Difficult Cases: Diffuse Alopecia Areata (?) after FUE Harvesting." International Society of Hair Restoration Surgery 25, no. 6 (2015): 235–36. http://dx.doi.org/10.33589/25.6.0235.

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15

Lew, Bark-Lynn, Min-Kyung Shin, and Woo-Young Sim. "Acute diffuse and total alopecia: A new subtype of alopecia areata with a favorable prognosis." Journal of the American Academy of Dermatology 60, no. 1 (2009): 85–93. http://dx.doi.org/10.1016/j.jaad.2008.08.045.

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16

Nadesalingam, Kavitha, Mark Goodfield, and Paul Emery. "Halo naevi, vitiligo and diffuse alopecia areata associated with tocilizumab therapy." Oxford Medical Case Reports 2016, no. 8 (2016): omw027. http://dx.doi.org/10.1093/omcr/omw027.

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17

DiPreta, Edward A., Kathleen J. Smith, John Williams, and Henry Skelton. "Histopathologic Findings in the Alopecia Associated with Vogt-Koyanagi-Harada Disease." Journal of Cutaneous Medicine and Surgery 4, no. 3 (2000): 155–59. http://dx.doi.org/10.1177/120347540000400309.

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Background: Vogt-Koyanagi-Harada (VKH) disease is a rare autoimmune disease primarily involving pigmented structures. The commonly associated alopecia usually precedes leukodermic changes seen in the hair and skin. Objective: We present a 46-year-old oriental woman with VKH disease who developed diffuse alopecia followed by the regrowth of nonpigmented hairs. The biopsy specimens showed a peribulbar mononuclear infiltrate with increased telogen/catagemanagen follicles. The most prominent additional histologic finding was melanin pigment release from the matrix into the dermal papillae, fibrous tracks, and surrounding perifollicular sheaths. The peribulbar mononuclear cells showed diffuse immunohistochemical staining of approximately 80 to 90% of the cells for CD3, CD45RO. More than 50% of the mononuclear cells showed positive staining for CD4, whereas approximately 10 to 20% showed staining for TIA with TIA+ cells within the follicular epithelium. Conclusion: Although the histologic features seen in the alopecia associated with VKH are consistent with alopecia areata, the prominent pigment release does suggest that the prime target are the melanocytes and that keratinocytes may be secondarily involved.

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Nguyen, Thu Q., Monica Tsai, Tristan Grogan, and Carolyn Goh. "Thyroid Disease in Alopecia Areata, Lichen Planopilaris, and Frontal Fibrosing Alopecia—A Case Control Study of 144 Patients." US Endocrinology 12, no. 02 (2016): 85. http://dx.doi.org/10.17925/use.2016.12.02.85.

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Background: Hair loss can be a troublesome aspect of thyroid disease for some patients. In addition to diffuse hair thinning, thyroid disease has been associated with clinically significant forms of alopecia, including alopecia areata (AA) and telogen effluvium. The role of thyroid disease in other causes of alopecia, such as lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA), remains unclear. This study retrospectively assessed the role of thyroid dysfunction in AA, LPP and FFA. Methods: A systematic chart review of 144 patients was performed from September 2010 to July 2013. Data were analyzed using multivariate logistic regression to test for a relationship between thyroid disease and type of alopecia. Results: A total of 113 alopecia patients were analyzed. A positive history of thyroid disease was found in 16.0% of AA, 25.0% of FFA, 17.1% of LPP, and 15.1% of control patients. After controlling for age and sex, alopecia was not found to be a statistically significant predictor of thyroid disease. Conclusions: Although alopecia patients in this study had rates of thyroid dysfunction higher than the U.S. population, there were no significant differences in rates of thyroid dysfunction compared to the control group.

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19

Barbach, Younes. "A case of widespread non-pigmented hair regrowth in diffuse alopecia areata." Our Dermatology Online 10, no. 2 (2019): 200–201. http://dx.doi.org/10.7241/ourd.20192.25.

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Dinh, Quan Q., and Alvin H. Chong. "A case of widespread non-pigmented hair regrowth in diffuse alopecia areata." Australasian Journal of Dermatology 48, no. 4 (2007): 221–23. http://dx.doi.org/10.1111/j.1440-0960.2007.00390.x.

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Younes, Barbach, Mohammed Chaouche, Abdellah Dah Cherif, Salim Gallouj, and Fatima Zahra Mernissi. "The Association of Diffuse Alopecia Areata and Psoriasis Vulgaris in a Young Child." Madridge Journal of Dermatology & Research 3, no. 2 (2018): 81–82. http://dx.doi.org/10.18689/mjdr-1000120.

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22

SONGUR, Necla, Pınar YÜKSEL BAŞAK MD, Önder ÖZTÜRK, et al. "Alopecia Areata Associated with Thymoma Presenting as a Diffuse Pleural Dissemination Mimicking Mesothelioma: Rare Concomitant Presentation." Turkiye Klinikleri Journal of Medical Sciences 30, no. 1 (2010): 435–38. http://dx.doi.org/10.5336/medsci.2009-13363.

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23

Rebora, Alfredo. "Acute Diffuse and Total Alopecia of the Female Scalp: A New Subtype of Diffuse Alopecia areata That Has a Favorable Prognosis – A Reply." Dermatology 207, no. 3 (2003): 339. http://dx.doi.org/10.1159/000073108.

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Rinaldi, F., A. Trink, and Y. Ramot. "Diffuse Alopecia Areata Associated with a Solid-Organ Malignancy: Case Report and Literature Review." Journal of Analytical Oncology 3, no. 4 (2014): 201–4. http://dx.doi.org/10.6000/1927-7229.2014.03.04.3.

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Kolivras, Athanassios, and Curtis Thompson. "Distinguishing diffuse alopecia areata (AA) from pattern hair loss (PHL) using CD3+ T cells." Journal of the American Academy of Dermatology 74, no. 5 (2016): 937–44. http://dx.doi.org/10.1016/j.jaad.2015.12.011.

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Chemodurova, N. Ye, and V. A. Turkina. "Hair elemental status as a diagnostic parameter: achievements, challenges and opportunities." Acta Medica Leopoliensia 26, no. 2-3 (2020): 80–88. http://dx.doi.org/10.25040/aml2020.02-03.080.

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Aim. To analyze modern scientific approaches to using the achievements of bioelementology in the diagnosis and treatment of various forms of alopecia. Identifying unresolved issues in this area of research. Materials and Methods. Literature search in MEDLINE, Embase, TOXNET databases, specialized journals and thesis papers depositories in Ukraine, Russia and Belarus. The references cited in the identified papers were used as well. The publications period used in the search was 2007-2020. Results and Discussion. The content analysis of scientific literature sources, which highlight the results of studies of homeostasis of trace elements and major elements in the human body, proves the validity of using the data obtained for the diagnosis, treatment and prevention of alopecia. Introduction of modern analytical methods made it possible to expand both qualitative and quantitative characteristics of the content of elements in hair, and then to substantiate the use of the elemental composition of hair as a medical diagnostic criterion. In addition, the analysis of hair for the content of trace elements and major elements is considered a potentially safe, non-invasive diagnostic tool; the samples do not require special equipment for storage and have no shelf life restrictions. At the present stage, an active search for the relationship between the elemental status of hair and alopecia of various origins is being carried out. It was established that all forms of alopecia are characterized by a disturbance of the homeostasis of iron, zinc, copper, and selenium. In addition, the researchers emphasize the importance of excess hair lead and cadmium in alopecia areata, of silicon in diffuse alopecia and androgenetic alopecia, and reduced levels of manganese in all forms of alopecia. The scientific community discusses the implementation of modern analytical methods to determine the elemental composition of biological fluids. The most promising are the methods of determining elements in the organs and human biological fluids using inductively coupled plasma-atomic emission and mass spectrometry. Trace elements and major elements play an important, but not entirely clear role in hair follicles normal development and immune cells function. These studies were mainly concerned with exploring of the cyclic accumulation of mast cells and macrophages in the perifollicular connective tissue. Accordingly, the dyscrasia can represent a modified risk factor, the assessment of which requires further in-depth studies. Conclusions. The content analysis of the published results of the studies of trace and major elements composition of hair showed that with alopecia areata there is a decrease in the content of S, Zn, Se, Mn, Mn, and Fe, and an excess of Pb, Cd, Ni, Cu, Al, Hg; diffuse forms of alopecia are characterized by a deficiency in the content of S, Fe, K, Ca, Zn, Cu, and Se; with androgenetic alopecia in women, there is a decrease in the content of Mn, Zn, Se, Mg, Fe, in men - a decrease in the levels of Zn, Cu, Mn, Mg, and Se; and an increase in the content of Cu and Cr. In order to correct alopecia of various origins, it is necessary to determine the quantitative ratio of trace elements and major elements in the hair and to systematize the results obtained in monitoring studies to establish their reference values in conditions of various geochemical locations. Keywords: hair, alopecia, elemental homeostasis, microelementosis

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González García, Andrés, Emiliano Grillo Fernández, Ignacio Barbolla Díaz, Asunción Ballester, Héctor Pian, and Guadalupe Fraile. "A Rare Case of Zosteriform Cutaneous Metastases from a Nasopharyngeal Carcinoma." Case Reports in Dermatological Medicine 2015 (2015): 1–3. http://dx.doi.org/10.1155/2015/415393.

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From a clinical point of view, the most common presentations of cutaneous metastatic disease are papules and nodules. However, a wide morphological spectrum of lesions has been described, including erythematous patches or plaques, inflammatory erysipelas-like lesions, diffuse sclerodermiform lesions with induration of the skin, telangiectatic papulovesicles, purpuric plaques mimicking vasculitis, and alopecia areata like scalp lesions. The so-called zosteriform pattern has been described to be in few cases and to the best of our knowledge has never been described associated with a metastasis of a nasopharyngeal carcinoma. This case highlights the relevance of including cutaneous metastases in the differential diagnosis of patients with nonhealing herpes zoster-like lesions, especially in those with underlying neoplasm recently diagnosed.

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Alzolibani, Abdullateef A., and Khaled Zedan. "Macrolides in Chronic Inflammatory Skin Disorders." Mediators of Inflammation 2012 (2012): 1–7. http://dx.doi.org/10.1155/2012/159354.

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Long-term therapy with the macrolide antibiotic erythromycin was shown to alter the clinical course of diffuse panbronchiolitis in the late 1980s. Since that time, macrolides have been found to have a large number of anti-inflammatory properties in addition to being antimicrobials. These observations provided the rationale for many studies performed to assess the usefulness of macrolides in other inflammatory diseases including skin and hair disorders, such as rosacea, psoriasis, pityriasis rosea, alopecia areata, bullous pemphigoid, and pityriasis lichenoides. This paper summarizes a collection of clinical studies and case reports dealing with the potential benefits of macrolides antibiotics in the treatment of selected dermatoses which have primarily been classified as noninfectious and demonstrating their potential for being disease-modifying agents.

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Ferreira, Sineida Berbert, Morton Scheinberg, Denise Steiner, Tatiana Steiner, Gustavo Longhi Bedin, and Rachel Berbert Ferreira. "Remarkable Improvement of Nail Changes in Alopecia Areata Universalis with 10 Months of Treatment with Tofacitinib: A Case Report." Case Reports in Dermatology 8, no. 3 (2016): 262–66. http://dx.doi.org/10.1159/000450848.

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Alopecia areata (AA) is a chronic, autoimmune disease. The main symptom is massive hair loss, localized or diffuse, in the scalp and the whole body. However, nails may also be involved, and brittleness, fragility and pitting can be signs of nail dystrophy in AA patients. Here, we report the case of a male patient with AA refractory to various treatments, including oral, topical and intralesional corticosteroids, immunosuppressants, cyclosporin and PUVA (oxoralen plus ultraviolet light), all interrupted due to side effects. The patient’s nails had erythematous blotches (striated lunulae) with regular and superficial pitting as well as fragility (trachyonychia), and he could no longer play the guitar because of these symptoms. With patient consent, we introduced tofacitinib (5 mg twice daily), which resulted in remarkable improvements not only regarding hair regrowth but also nail changes, with function recovery within 10 months.

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Zhang, Xingqi, Yanting Ye, Zhaohui Zhu, et al. "Sequential cyclic changes of hair roots revealed by dermoscopy demonstrate a progressive mechanism of diffuse alopecia areata over time." Experimental Dermatology 29, no. 3 (2018): 223–30. http://dx.doi.org/10.1111/exd.13799.

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Sato, Y., R. Takahashi, M. Kimishima, Y. Yamazaki, T. Shiohara, and M. Ohyama. "260 Identification of early predictors of the efficacy of intravenous corticosteroid pulse therapy in rapidly-progressive diffuse alopecia areata patients." Journal of Investigative Dermatology 137, no. 5 (2017): S44. http://dx.doi.org/10.1016/j.jid.2017.02.276.

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Kanameishi, S., T. Dainichi, Y. Endo, A. Otsuka, M. Tanioka, and K. Kabashima. "Successful hair regrowth in an acute diffuse form of alopecia areata during oral tacrolimus treatment in a patient with rheumatoid arthritis." Journal of the European Academy of Dermatology and Venereology 31, no. 3 (2016): e137-e138. http://dx.doi.org/10.1111/jdv.13879.

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Zhang, Xingqi, Bin Zhang, Sillani Caulloo, Xiaohong Chen, Yang Li, and Ying Zhao. "Diffuse alopecia areata is associated with intense inflammatory infiltration and CD8+ T cells in hair loss regions and an increase in serum IgE level." Indian Journal of Dermatology, Venereology, and Leprology 78, no. 6 (2012): 709. http://dx.doi.org/10.4103/0378-6323.102361.

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Künzel, G., U. Kirchdörfer, J. Klobusch, T. Rabe, I. Gerhard, and B. Runnebaum. "Welchen Einfluß hat Quecksilber auf die zelluläre Immunität bei Frauen mit Alopezia areata und Alopezia diffusa?" Archives of Gynecology and Obstetrics 254, no. 1-4 (1993): 277–78. http://dx.doi.org/10.1007/bf02265989.

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Sack, Jason E., Salinee Rojhirunsakool, Jag Bhawan, and Thomas M. Runger. "HIV-Associated Vitiligo Totalis with Minimal Repigmentation and Alopecia Areata Diffusa During Immune-Reconstitution." Open Dermatology Journal 2, no. 1 (2008): 90–92. http://dx.doi.org/10.2174/1874372200802010090.

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Kirchdörfer, U., J. Klobusch, G. Künzel, T. Rabe, I. Gerhard, and B. Runnebaum. "Einfluß von Umweltfaktoren auf die Zellimmunität bei Patientinnen mit Alopicia areata und Alopecia diffusa." Archives of Gynecology and Obstetrics 254, no. 1-4 (1993): 275–77. http://dx.doi.org/10.1007/bf02265988.

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"Diffuse Alopecia Areata Revealing Euthyroid Hashimoto Thyroiditis." ARC Journal of Diabetes and Endocrinology 5, no. 2 (2019). http://dx.doi.org/10.20431/2455-5983.0502002.

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Missall, Tricia A., M. Yadira Hurley, and Nicole M. Burkemper. "Prominent follicular mucinosis with diffuse scalp alopecia resembling alopecia areata." Journal of Cutaneous Pathology, August 2013, n/a. http://dx.doi.org/10.1111/cup.12201.

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Alessandrini, Aurora, Michela Starace, Francesca Bruni, et al. "Alopecia Areata Incognita and Diffuse Alopecia Areata: Clinical, Trichoscopic, Histopathological, and Therapeutic Features of a 5-Year Study." Dermatology Practical & Conceptual, September 24, 2019, 272–77. http://dx.doi.org/10.5826/dpc.0904a05.

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Background: Alopecia areata is a nonscarring hair loss that usually causes round patches of baldness, but alopecia areata incognita (AAI) and diffuse alopecia areata (DAA) can cause a diffuse and acute pattern of hair loss. Objective: To analyze the clinical, trichoscopic, histological, and therapeutic features of AAI and DAA. Methods: The study was designed to include data of patients with histological diagnosis of AAI and DAA enrolled in our Hair Disease Outpatient Consultations. Results: DAA had a greater involvement of the parietal and anterior-temporal regions, while AAI manifested itself mainly in the occipital-parietal regions. The most frequent pattern was empty yellow dots, yellow dots with vellus hairs, and small hair in regrowth, but the presence of pigtail hair was found almost exclusively in those with AAI. In cases of DDA, the finding of dystrophic hair and black dots was more frequent. The most frequent trichoscopic sign in both diseases was the presence of empty yellow dots, which, however, were described in a higher percentage in cases of DAA. The diseases have a benign course and are responsive to topical steroid therapy. Conclusions: Trichoscopy is very important for the differential diagnosis between the 2 diseases and to select the best site for biopsy. In the presence of diffuse hair thinning, these entities must be considered.

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Cua, Val Constantine S., Felix Paolo J. Lizarondo, and Claudine Y. Silva. "Trichotillomania Masked by Diffuse Alopecia Areata: A Case Report." Acta Medica Philippina 55, no. 5 (2021). http://dx.doi.org/10.47895/amp.vi0.2869.

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An 11-year-old girl previously treated for tinea capitis presented a 3-month history of continuous decrease in hair density on the vertex, frontal, and parieto-temporal areas of the scalp. Hair pull test was negative. Trichoscopic findings showed black dots, micro-exclamation point hairs, regrowing vellus hair, and zigzag hairs. Histopathology showed CD3+ peribulbar lymphocytic infiltrates and occasional eosinophils around the anagen hair follicle consistent with a non-scarring alopecia. A diagnosis of diffuse alopecia areata was made. Patient was given methylprednisolone (0.5 mg/kg/day) for 2 weeks and noted marked increase in hair density except on focal areas of the scalp. Patient eventually admitted to occasional hair pulling. Trichoscopy revealed trichoptilosis, V-sign, tulip hairs, and multiple broken hairs of varying length while a second biopsy showed trichomalacia and pigment casts consistent with trichotillomania. In this case, where co-existence of alopecia areata and trichotillomania is considered to be uncommon, trichoscopy proved to be an important tool in differentiating hair disorders with similar presentation. Knowing key features of hair diseases can help elucidate the diagnosis when presented with an atypical case.

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Biselli, Larissa Magoga, Lara Fileti Arruda, Maisa Fabri Mazza, Maria Cristina Jacomette Maldonado, Domingos Jordão Neto, and Maria Isabel Pereira Soares Takemoto. "Alopecia areata difusa e a teoria dos autoantígenos associada a melanogênese." Surgical & Cosmetic Dermatology 10, no. 3 (2018). http://dx.doi.org/10.5935/scd1984-8773.20181031112.

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Del Rosso, James Q. "Disorders of Hair." DeckerMed Family Medicine, July 1, 2013. http://dx.doi.org/10.2310/fm.1107.

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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.

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Del Rosso, James Q. "Disorders of Hair." DeckerMed Medicine, July 1, 2013. http://dx.doi.org/10.2310/im.1107.

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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.

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Sneha, Kovi, and Jayakar Thomas. "To Study Dermoscopic Findings in Alopecia Areata." Journal of Pharmaceutical Research International, August 3, 2020, 29–35. http://dx.doi.org/10.9734/jpri/2020/v32i1330579.

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Introduction: Alopecia areata is a common chronic autoimmune inflammatory disease that involves hair follicles, characterized by hair loss on the scalp and/or body without scarring. Clinically, the disease presents as smooth, patchy hair loss with various patterns - diffuse or reticulate alopecia, ophiasis, ophiasis inversus, alopecia totalis (loss of hair all the scalp), or alopecia universalis (loss of hair all over the body). Clinical diagnosis of AA is made based on typical pattern of hair loss and the presence of characteristic exclamation mark hair in microscopy. Invasive (punch biopsy) techniques are often required in some cases where the clinical diagnosis is not straight forward Biopsy shows peribulbar lymphocytic infiltrates in a “swarm of bee pattern” which is characteristic of the acute stage of the disease. Dermoscopy is an imaging instrument that immensely magnifies surface features of skin lesions. It works on the principle of illumination and transillumination of skin with different light sources and studying it with a high magnification lens. Dry dermoscopy was done with heine delta 20 dermoscope which was followed by wet dermoscopy. Liquid paraffin was used as the immersion media. It is a noninvasive, repeatable, recordable bedside investigation. Objective: To study dermoscopic findings in alopecia areata. Materials and Methods: Study Design: Cross sectional study; Study Area: Skin Outpatient Department, Sree Balaji Medical College and Hospital; Study Population: All patients with hair loss, attending skin OPD, who are clinically diagnosed as Alopecia Areata; Study Method: Observational study; Sample Size: 30. Results: Clinically, the disease presents as smooth, patchy hair loss with various patterns. Dermoscopy is useful for diagnosis of AA clinically by the presence of cadaverized hairs (black dots), circle hair, coudablity hair, exclamation mark hairs (tapering hairs), broken hairs, yellow dots and clustered short vellus hairs in the hair loss areas. The results wear tabulated.

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Cua, Val Constantine S., Juan Paolo David S. Villena, Felix Paolo J. Lizarondo, and Claudine Yap Silva. "Azathiopine for the Treatment of Extensive Forms of Alopecia Areata: A Systematic Review." Acta Medica Philippina 53, no. 2 (2019). http://dx.doi.org/10.47895/amp.v53i2.172.

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Background. Alopecia areata (AA) is an autoimmune hair disorder, with the clinical variants ophiasis and extensive variants AA totalis and universalis, having poor response to therapy. Oral steroids are used to treat the severe variants, requiring prolonged therapy, which leads to side effects while discontinuation leads to high relapse rate. Azathioprine is a steroid-sparing agent for the severe AA forms. Objective. To review the current evidence on the therapeutic efficacy and adverse effects of azathioprine for severe forms of alopecia areataMethods. Published articles utilizing azathioprine for alopecia areata were obtained until July 2018 from PubMed, MEDLINE, Cochrane Library, TRIP database, HERDIN, and Google Scholar. Results. Seven articles underwent a full-length review. Clinical variants include patchy, diffuse, steroid-resistant, reticulate, totalis, universalis, ophiasis, and sisaipho. Doses ranged from 2 to 2.5 mg/kg/day or weekly 5 mg/kg pulse therapy. Initial response ranged from 6 to 12 weeks, with almost complete resolution by 32 weeks. Response was sustained for 6 months upon discontinuation, with only 14% relapsing at 2.5 months. Adverse effects were gastrointestinal discomfort, elevated liver function tests, and myelosuppression. Conclusion. There is emerging evidence on the efficacy and safety of azathioprine for the treatment of extensive forms of alopecia areata. Randomized-controlled trials are needed to evaluate its efficacy.

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"012. Halo Naevi, Vitiligo and Diffuse Alopecia Areata Associated with Tocilizumab Therapy." Rheumatology, April 20, 2015. http://dx.doi.org/10.1093/rheumatology/kev088.012.

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Rasheed, A. I. E., M. Y. Soltan, and N. N. Mohammed. "Comparative Study on the Efficacy of Diphenylcyclopropenone Alone and in Combination with Intralesional or Systemic Corticosteroids for the Treatment of Extensive or Refractory Alopecia Areata." QJM: An International Journal of Medicine 113, Supplement_1 (2020). http://dx.doi.org/10.1093/qjmed/hcaa046.010.

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Abstract Background Alopecia areata (AA) is an autoimmune disorder characterized by transient, non-scarring hair loss with preservation of the hair follicle. It affects nearly 2% of the general population at some point during their lifetime. Extent of the disease can vary widely from localized hair loss in well-defined patches to diffuse or total hair loss, which can affect all hair-bearing sites. Patchy alopecia areata affecting the scalp is the most common type. Objectives The aim of this study is to evaluate the efficacy and safety of topical diphenylcyclopropenone alone and in combination with intralesional steroids or systemic steroids for the treatment of extensive and/or refractory cases of alopecia areata. Patients and Methods The study included 21 patients suffering from alopecia areata during January 2018 till November 2018. They were recruited from the Outpatient Clinic of Dermatology, Ain Shams University Hospital and El-houd EL-marsoud Hospital. All patients gave written consent to participate in this work after explanation of the technique, expectations, possible side effects and alternative treatments. The study was approved by Research Ethical committee of Ain Shams University. Results We found that about three quarters of AA patients were males and majority were young adults aged 15 to 50 years. The duration of the disease was more than one year and mean age of first onset was 15 years. About half of the patients was of refractory type. All patients recalled previous history of AA and 90% treated by combined therapy. Scalp was affected in all patients and eyebrow in half of them while nails were affected in 10%. Mean SALT score at time of presentation was 59%. Dermoscopic examination revealed that majority of the patients (95%) had yellow dots; two third had black dots and vellous hair; while exclamation and short thin hairs were found in approximately one third of the patients. The study found that there is statistically significant difference between mean SALT scores among the three treatment modality groups at start of treatment course specifically between group II (40.6 (±20.9)) and group III (82.5 (±21.7)) (p = 0.04). Conclusion DPCP is an effective and safe treatment of extensive and refractory AA especially with intralesional steroid. Older age at onset of the disease is good indicator for a better prognosis. No statistical significant difference between treatment modalities regarding response stratified by other demographic and clinical feature of AA patients.

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Romanelli, Caroline. "Overnight Graying? Phenomenon: A case of Widespread Non-Pigmented Hair Regrowth in Diffuse Alopecia Areata." Journal of Pigmentary Disorders 01, no. 03 (2014). http://dx.doi.org/10.4172/2376-0427.1000117.

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Romanelli, Caroline. "?Overnight Graying? Phenomenon: A case of Widespread Non-Pigmented Hair Regrowth in Diffuse Alopecia Areata." Journal of Pigmentary Disorders 01, no. 03 (2014). http://dx.doi.org/10.4172/jpd.1000117.

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