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Andrew G. Franks - One of the best experts on this subject based on the ideXlab platform.
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Incidence of Alopecia Areata in lupus erythematosus.
Archives of Dermatology, 1992Co-Authors: Victoria P. Werth, Miguel Sanchez, Wain L. White, Andrew G. FranksAbstract:• Background.— A small percentage of patients with Alopecia Areata have connective diseases such as systemic lupus erythematosus, discoid lupus erythematosus, rheumatoid arthritis, and scleroderma. Lupus erythematosus is associated with a number of different types of Alopecia, but the incidence of Alopecia Areata in lupus erythematosus has not been examined. Observations.— Of our cohort of 39 patients with lupus erythematosus, Alopecia Areata developed in 10% (four patients), in contrast to 0.42% of general dermatologic patients. Biopsy specimens of Alopecia Areata lesions in each of our patients showed continuous granular deposition of IgG at the dermoepidermal junction, a finding usually found in only a minority of Alopecia Areata cases. Intralesional injections of corticosteroids were effective treatment. Conclusions.— The incidence of Alopecia Areata in patients with lupus erythematosus is increased. Recognition of this form of Alopecia allows for specific therapy with intralesional corticosteroids. ( Arch Dermatol. 1992;128:368-371)
Maria K Hordinsky - One of the best experts on this subject based on the ideXlab platform.
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Childhood Alopecia Areata-Data from the National Alopecia Areata Registry.
Pediatric Dermatology, 2018Co-Authors: Iris Wohlmuth-wieser, Joyce S. Osei, Maria K Hordinsky, David A Norris, Vera H. Price, Angela M Christiano, Madeleine DuvicAbstract:BACKGROUND/OBJECTIVES: Alopecia Areata may occur at any age and is the third-most-common dermatosis in children. The objective of this study was to investigate the clinical and epidemiologic features of children and adolescents with Alopecia Areata based on the data of the National Alopecia Areata registry on children and adolescents. METHODS: Two thousand two hundred eighteen children and adolescents with Alopecia Areata self-enrolled in the National Alopecia Areata Registry and completed a web-based, self-administered, short-intake screening questionnaire (first tier). In the second tier, 643 patients participated in a clinical examination and completed a long-form questionnaire. RESULTS: Mean age of onset was 5.9 ± 4.1 years. With a female to male ratio of 1.5:1, Alopecia Areata was more prevalent in girls, but boys were significantly more likely to have a severe type (P = .009). One-fourth of all children had a positive family history, with 8% having more than three affected relatives. The disease most commonly associated with Alopecia Areata was atopic dermatitis (32.7%). CONCLUSION: Childhood Alopecia Areata is more prevalent in girls than in boys, but boys have more extensive Alopecia Areata. Despite the low prevalence, congenital Alopecia Areata is an important differential diagnosis for neonatal hair loss. Alopecia Areata runs in families, suggesting an underlying genetic background. One-quarter of the children reported at least one affected first-degree relative; 8% had more than three affected relatives.
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Overview of Alopecia Areata
Journal of Investigative Dermatology Symposium Proceedings, 2013Co-Authors: Maria K HordinskyAbstract:Alopecia Areata is a complex genetic, immune-mediated disease that targets anagen hair follicles. The disease affects children and adults and is characterized by round or oval patches of hair loss, loss of all scalp hair (Alopecia totalis), body hair (Alopecia universalis), or ophiasis pattern hair loss. Patients may also present with patchy loss in multiple hair-bearing areas. Commonly associated diseases include asthma, allergic rhinitis, atopic dermatitis, thyroid disease, and automimmune diseases, such as thyroiditis and vitiligo. Nail abnormalities may precede, follow, or occur concurrently with hair loss activity. Alopecia Areata has no known age, race, or ethnic preponderance and in contrast to other autoimmune diseases such as thyroiditis or lupus, the hair follicle does not usually sustain permanent injury and maintains its potential to regrow hair. It is estimated that Alopecia Areata affects between six and seven million individuals in the United States. Genes, the immune and nervous systems have all been implicated in the pathogenesis of Alopecia Areata. Although many treatments are available, there is still no cure. Bolstered by new scientific and translational opportunities from recently published genome-wide association studies, an ambitious treatment development program has recently been initiated by the National Alopecia Areata Foundation.
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Alopecia Areata investigational assessment guidelines part ii
Journal of The American Academy of Dermatology, 2004Co-Authors: Elise A Olsen, Jerry Shapiro, Janet L Roberts, Doug Canfield, Lloyd E. King, Maria K Hordinsky, Madeleine Duvic, Vera H. Price, Anthony J. Mcmichael, Valerie RandallAbstract:Alopecia Areata is an immunologically mediated disease characterized by extreme variability not only in the time of initial onset of hair loss but in the duration, extent and pattern of hair loss during any given episode of active loss. These variables, as well as the unpredictable nature of spontaneous regrowth and lack of a uniform response to various therapies, has made clinical trials in Alopecia Areata difficult to plan and implement. In fact, there are currently no drugs FDA-approved specifically for the indication of Alopecia Areata. To help facilitate well-controlled clinical trials for Alopecia Areata, this National Alopecia Areata Foundation (NAAF) sponsored subgroup of investigators/clinicians experienced in clinical trials and/or in the clinical care of patients with Alopecia Areata has outlined some general principles and potential endpoints for clinical studies in Alopecia Areata.Theseguidelines buildontheAlopeciaAreata
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Autoimmunity: Alopecia Areata
The journal of investigative dermatology. Symposium proceedings, 2004Co-Authors: Maria K Hordinsky, Marna E. EricsonAbstract:Strong direct and indirect evidence supports an autoimmune etiology for Alopecia Areata. T lymphocytes that have been shown to be oligoclonal and autoreactive are predominantly present in the peribulbar inflammatory infiltrate. Alopecia Areata frequently occurs in association with other autoimmune diseases, such as thyroiditis and vitiligo, and autoantibodies to follicular components have been detected. Finally, the use of immune modulating drugs, including corticosteroids and contact sensitizers such as dyphencyprone, can be beneficial in the management of this disease. Recent studies have demonstrated that Alopecia Areata scalp skin grafted onto nude mice with severe combined immunodeficiency grow hair and that infiltrating lymphocytes in the graft are lost. It is now also possible to induce Alopecia Areata in human scalp explants on these mice by injecting T lymphocytes with scalp homogenate. Neuropeptides produced by cutaneous nerves are known to modify immune reactivity and, in all likelihood, affect the Alopecia Areata process. Future studies may show that modulation of neuropeptide expression is associated with hair regrowth. Likewise, testing the efficacy of the newly developed immunomodulatory agents in patients with Alopecia Areata may lead to the introduction of novel therapies for this immune-mediated disease of the hair follicle.
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Alopecia Areata investigational assessment guidelines
Journal of The American Academy of Dermatology, 1999Co-Authors: Elise A Olsen, Jerry Shapiro, Susan Mcdonaldhull, Janet L Roberts, Maria K Hordinsky, Vera H. Price, Kurt S. StennAbstract:From Duke University Medical Center, Durhama; University of Minnesota, Minneapolisb; Pontefract General Infirmaryc; University of California at San Franciscod; Northwest Cutaneous Research Specialists, Portlande; The University of British Columbia, Vancouverf; and Johnson & Johnson, Skin Biology Research Center, Skillman.g Reprint requests: Elise A. Olsen, MD, Professor of Medicine, Duke University Medical Center, Box 3294, Durham, NC 27710. J Am Acad Dermatol 1999;40:242-6. *Developed from the Alopecia Areata Consensus meeting sponsored by the National Alopecia Areata Foundation at the First Tricontinental Meeting of the Hair Research Societies, Brussels, Belgium, Oct 8, 1995. Participants are listed at the end of the guidelines. Copyright © 1999 by the American Academy of Dermatology, Inc. 0190-9622/99/$8.00 + 0 16/1/95940 I. PURPOSE To establish criteria for selecting and assessing subjects for both clinical and laboratory studies of Alopecia Areata, thereby facilitating collaboration, comparison of data, and the sharing of patient-derived tissue II. DEFINITION OF Alopecia Areata Alopecia Areata is a dermatologic disease characterized in its limited form by circumscribed round or oval patches of Alopecia with well-demarcated borders between normal and affected scalp. There is no scale or induration of the scalp and no loss of follicular markings. Disease extent may progress from this limited form to complete loss of hair on the scalp and/or body. III. INCLUSION CRITERIA These guidelines apply only to terminal hair loss or growth on the scalp. These guidelines focus on the major forms of Alopecia Areata (patchy Alopecia Areata, Alopecia totalis, and Alopecia universalis) and their expression on the scalp. The terms Alopecia totalis and Alopecia universalis imply 100% scalp hair loss. Areas of hair loss other than on the scalp may be assessed and documented in the data collected on each patient. (See Section IV. B) IV. CRITERIA FOR MEASURING EXTENT OF INVOLVEMENT Those data items in boldface type should be filled out in toto. Those data items not in bold are optional and can be filled out as desired by the investigator. A. The proportion of scalp involvement is determined by dividing the scalp into 4 quadrants and estimating the percentage of the scalp surface that all the alopecic areas would occupy if placed together. The following groups will be used: S: Scalp hair loss _____S0 = No hair loss _____S4 = 76%-99% hair loss _____S1 = ≤ 25% hair loss _____a = 76%-95% hair loss _____S2 = 26%-50% hair loss _____b = 96%-99% hair loss _____S3 = 51%-75% hair loss _____S5 = 100% hair loss B. Other areas of Alopecia or involvement by Alopecia Areata may be noted: B: Body hair loss _____B0 = No body hair loss _____B2 = 100% body (excluding scalp) hair loss _____B1 = Some body hair loss N: Nail involvement _____N0 = No nail involvement _____N1 = Some nail involvement _____a. Twenty-nail dystrophy/trachyonychia (must be all 20 nails) SPECIAL ARTICLE
Elise A Olsen - One of the best experts on this subject based on the ideXlab platform.
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Alopecia Areata investigational assessment guidelines part ii
Journal of The American Academy of Dermatology, 2004Co-Authors: Elise A Olsen, Jerry Shapiro, Janet L Roberts, Doug Canfield, Lloyd E. King, Maria K Hordinsky, Madeleine Duvic, Vera H. Price, Anthony J. Mcmichael, Valerie RandallAbstract:Alopecia Areata is an immunologically mediated disease characterized by extreme variability not only in the time of initial onset of hair loss but in the duration, extent and pattern of hair loss during any given episode of active loss. These variables, as well as the unpredictable nature of spontaneous regrowth and lack of a uniform response to various therapies, has made clinical trials in Alopecia Areata difficult to plan and implement. In fact, there are currently no drugs FDA-approved specifically for the indication of Alopecia Areata. To help facilitate well-controlled clinical trials for Alopecia Areata, this National Alopecia Areata Foundation (NAAF) sponsored subgroup of investigators/clinicians experienced in clinical trials and/or in the clinical care of patients with Alopecia Areata has outlined some general principles and potential endpoints for clinical studies in Alopecia Areata.Theseguidelines buildontheAlopeciaAreata
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Alopecia Areata investigational assessment guidelines
Journal of The American Academy of Dermatology, 1999Co-Authors: Elise A Olsen, Jerry Shapiro, Susan Mcdonaldhull, Janet L Roberts, Maria K Hordinsky, Vera H. Price, Kurt S. StennAbstract:From Duke University Medical Center, Durhama; University of Minnesota, Minneapolisb; Pontefract General Infirmaryc; University of California at San Franciscod; Northwest Cutaneous Research Specialists, Portlande; The University of British Columbia, Vancouverf; and Johnson & Johnson, Skin Biology Research Center, Skillman.g Reprint requests: Elise A. Olsen, MD, Professor of Medicine, Duke University Medical Center, Box 3294, Durham, NC 27710. J Am Acad Dermatol 1999;40:242-6. *Developed from the Alopecia Areata Consensus meeting sponsored by the National Alopecia Areata Foundation at the First Tricontinental Meeting of the Hair Research Societies, Brussels, Belgium, Oct 8, 1995. Participants are listed at the end of the guidelines. Copyright © 1999 by the American Academy of Dermatology, Inc. 0190-9622/99/$8.00 + 0 16/1/95940 I. PURPOSE To establish criteria for selecting and assessing subjects for both clinical and laboratory studies of Alopecia Areata, thereby facilitating collaboration, comparison of data, and the sharing of patient-derived tissue II. DEFINITION OF Alopecia Areata Alopecia Areata is a dermatologic disease characterized in its limited form by circumscribed round or oval patches of Alopecia with well-demarcated borders between normal and affected scalp. There is no scale or induration of the scalp and no loss of follicular markings. Disease extent may progress from this limited form to complete loss of hair on the scalp and/or body. III. INCLUSION CRITERIA These guidelines apply only to terminal hair loss or growth on the scalp. These guidelines focus on the major forms of Alopecia Areata (patchy Alopecia Areata, Alopecia totalis, and Alopecia universalis) and their expression on the scalp. The terms Alopecia totalis and Alopecia universalis imply 100% scalp hair loss. Areas of hair loss other than on the scalp may be assessed and documented in the data collected on each patient. (See Section IV. B) IV. CRITERIA FOR MEASURING EXTENT OF INVOLVEMENT Those data items in boldface type should be filled out in toto. Those data items not in bold are optional and can be filled out as desired by the investigator. A. The proportion of scalp involvement is determined by dividing the scalp into 4 quadrants and estimating the percentage of the scalp surface that all the alopecic areas would occupy if placed together. The following groups will be used: S: Scalp hair loss _____S0 = No hair loss _____S4 = 76%-99% hair loss _____S1 = ≤ 25% hair loss _____a = 76%-95% hair loss _____S2 = 26%-50% hair loss _____b = 96%-99% hair loss _____S3 = 51%-75% hair loss _____S5 = 100% hair loss B. Other areas of Alopecia or involvement by Alopecia Areata may be noted: B: Body hair loss _____B0 = No body hair loss _____B2 = 100% body (excluding scalp) hair loss _____B1 = Some body hair loss N: Nail involvement _____N0 = No nail involvement _____N1 = Some nail involvement _____a. Twenty-nail dystrophy/trachyonychia (must be all 20 nails) SPECIAL ARTICLE
Vera H. Price - One of the best experts on this subject based on the ideXlab platform.
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Childhood Alopecia Areata-Data from the National Alopecia Areata Registry.
Pediatric Dermatology, 2018Co-Authors: Iris Wohlmuth-wieser, Joyce S. Osei, Maria K Hordinsky, David A Norris, Vera H. Price, Angela M Christiano, Madeleine DuvicAbstract:BACKGROUND/OBJECTIVES: Alopecia Areata may occur at any age and is the third-most-common dermatosis in children. The objective of this study was to investigate the clinical and epidemiologic features of children and adolescents with Alopecia Areata based on the data of the National Alopecia Areata registry on children and adolescents. METHODS: Two thousand two hundred eighteen children and adolescents with Alopecia Areata self-enrolled in the National Alopecia Areata Registry and completed a web-based, self-administered, short-intake screening questionnaire (first tier). In the second tier, 643 patients participated in a clinical examination and completed a long-form questionnaire. RESULTS: Mean age of onset was 5.9 ± 4.1 years. With a female to male ratio of 1.5:1, Alopecia Areata was more prevalent in girls, but boys were significantly more likely to have a severe type (P = .009). One-fourth of all children had a positive family history, with 8% having more than three affected relatives. The disease most commonly associated with Alopecia Areata was atopic dermatitis (32.7%). CONCLUSION: Childhood Alopecia Areata is more prevalent in girls than in boys, but boys have more extensive Alopecia Areata. Despite the low prevalence, congenital Alopecia Areata is an important differential diagnosis for neonatal hair loss. Alopecia Areata runs in families, suggesting an underlying genetic background. One-quarter of the children reported at least one affected first-degree relative; 8% had more than three affected relatives.
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Alopecia Areata investigational assessment guidelines part ii
Journal of The American Academy of Dermatology, 2004Co-Authors: Elise A Olsen, Jerry Shapiro, Janet L Roberts, Doug Canfield, Lloyd E. King, Maria K Hordinsky, Madeleine Duvic, Vera H. Price, Anthony J. Mcmichael, Valerie RandallAbstract:Alopecia Areata is an immunologically mediated disease characterized by extreme variability not only in the time of initial onset of hair loss but in the duration, extent and pattern of hair loss during any given episode of active loss. These variables, as well as the unpredictable nature of spontaneous regrowth and lack of a uniform response to various therapies, has made clinical trials in Alopecia Areata difficult to plan and implement. In fact, there are currently no drugs FDA-approved specifically for the indication of Alopecia Areata. To help facilitate well-controlled clinical trials for Alopecia Areata, this National Alopecia Areata Foundation (NAAF) sponsored subgroup of investigators/clinicians experienced in clinical trials and/or in the clinical care of patients with Alopecia Areata has outlined some general principles and potential endpoints for clinical studies in Alopecia Areata.Theseguidelines buildontheAlopeciaAreata
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Alopecia Areata in infants and newborns
Pediatric dermatology, 2002Co-Authors: Julie Anne Crowder, Ilona J. Frieden, Vera H. PriceAbstract:Alopecia Areata is a common cause of nonscarring hair loss in children and adults. In newborns and very young infants, however, it is thought to be extremely rare. In this article we describe five cases of Alopecia Areata in patients less than 6 months of age and briefly discuss the pertinent differential diagnosis of infants and newborns with both patchy and complete hair loss. We propose that Alopecia Areata may be more common in this age group than the literature suggests.
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Alopecia Areata investigational assessment guidelines
Journal of The American Academy of Dermatology, 1999Co-Authors: Elise A Olsen, Jerry Shapiro, Susan Mcdonaldhull, Janet L Roberts, Maria K Hordinsky, Vera H. Price, Kurt S. StennAbstract:From Duke University Medical Center, Durhama; University of Minnesota, Minneapolisb; Pontefract General Infirmaryc; University of California at San Franciscod; Northwest Cutaneous Research Specialists, Portlande; The University of British Columbia, Vancouverf; and Johnson & Johnson, Skin Biology Research Center, Skillman.g Reprint requests: Elise A. Olsen, MD, Professor of Medicine, Duke University Medical Center, Box 3294, Durham, NC 27710. J Am Acad Dermatol 1999;40:242-6. *Developed from the Alopecia Areata Consensus meeting sponsored by the National Alopecia Areata Foundation at the First Tricontinental Meeting of the Hair Research Societies, Brussels, Belgium, Oct 8, 1995. Participants are listed at the end of the guidelines. Copyright © 1999 by the American Academy of Dermatology, Inc. 0190-9622/99/$8.00 + 0 16/1/95940 I. PURPOSE To establish criteria for selecting and assessing subjects for both clinical and laboratory studies of Alopecia Areata, thereby facilitating collaboration, comparison of data, and the sharing of patient-derived tissue II. DEFINITION OF Alopecia Areata Alopecia Areata is a dermatologic disease characterized in its limited form by circumscribed round or oval patches of Alopecia with well-demarcated borders between normal and affected scalp. There is no scale or induration of the scalp and no loss of follicular markings. Disease extent may progress from this limited form to complete loss of hair on the scalp and/or body. III. INCLUSION CRITERIA These guidelines apply only to terminal hair loss or growth on the scalp. These guidelines focus on the major forms of Alopecia Areata (patchy Alopecia Areata, Alopecia totalis, and Alopecia universalis) and their expression on the scalp. The terms Alopecia totalis and Alopecia universalis imply 100% scalp hair loss. Areas of hair loss other than on the scalp may be assessed and documented in the data collected on each patient. (See Section IV. B) IV. CRITERIA FOR MEASURING EXTENT OF INVOLVEMENT Those data items in boldface type should be filled out in toto. Those data items not in bold are optional and can be filled out as desired by the investigator. A. The proportion of scalp involvement is determined by dividing the scalp into 4 quadrants and estimating the percentage of the scalp surface that all the alopecic areas would occupy if placed together. The following groups will be used: S: Scalp hair loss _____S0 = No hair loss _____S4 = 76%-99% hair loss _____S1 = ≤ 25% hair loss _____a = 76%-95% hair loss _____S2 = 26%-50% hair loss _____b = 96%-99% hair loss _____S3 = 51%-75% hair loss _____S5 = 100% hair loss B. Other areas of Alopecia or involvement by Alopecia Areata may be noted: B: Body hair loss _____B0 = No body hair loss _____B2 = 100% body (excluding scalp) hair loss _____B1 = Some body hair loss N: Nail involvement _____N0 = No nail involvement _____N1 = Some nail involvement _____a. Twenty-nail dystrophy/trachyonychia (must be all 20 nails) SPECIAL ARTICLE
John J. Voorhees - One of the best experts on this subject based on the ideXlab platform.
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Sulfasalazine for Alopecia Areata.
Journal of the American Academy of Dermatology, 2002Co-Authors: Charles N. Ellis, Margaret F. Brown, John J. VoorheesAbstract:Abstract Sulfasalazine is used as a therapy for various autoimmune conditions, including psoriasis; its effectiveness is presumed to be the result of its immunomodulatory effects. We have treated patients with severe Alopecia Areata with sulfasalazine as part of our dermatology practice and have noticed cosmetically acceptable regrowth in 23% of patients in whom a response could be determined. In view of its good safety profile, sulfasalazine may be considered for systemic treatment of severe Alopecia Areata. (J Am Acad Dermatol 2002;46:541-4.)
