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Alopecia

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Jerry Shapiro – 1st expert on this subject based on the ideXlab platform

  • Primary cicatricial Alopecia: Other lymphocytic primary cicatricial Alopecias and neutrophilic and mixed primary cicatricial Alopecias
    Journal of The American Academy of Dermatology, 2016
    Co-Authors: Chantal Bolduc, Leonard C Sperling, Jerry Shapiro

    Abstract:

    Primary cicatricial Alopecias can be frustrating for both patients and physicians. Proper diagnosis guides more successful management of these challenging conditions. Part II will cover the remaining lymphocytic primary cicatricial Alopecias, which include pseudopelade of Brocq, central centrifugal cicatricial Alopecia, Alopecia mucinosa, and keratosis follicularis spinulosa decalvans. It will also discuss the neutrophilic and mixed primary cicatricial Alopecias, namely folliculitis decalvans, dissecting cellulitis, folliculitis keloidalis, folliculitis (acne) necrotica, and erosive pustular dermatosis.

  • primary cicatricial Alopecia
    Journal of The American Academy of Dermatology, 2016
    Co-Authors: Chantal Bolduc, Jerry Shapiro, Leonard C Sperling

    Abstract:

    Both primary and secondary forms of cicatricial Alopecia have been described. The hair follicles are the specific target of inflammation in primary cicatricial Alopecias. Hair follicles are destroyed randomly with surrounding structures in secondary cicatricial Alopecia. This 2-part continuing medical education article will review primary cicatricial Alopecias according to the working classification suggested by the North American Hair Research Society. In this classification, the different entities are classified into 3 different groups according to their prominent inflammatory infiltrate (ie, lymphocytic, neutrophilic, and mixed). Part I discusses the following lymphocytic primary cicatricial Alopecias: chronic cutaneous lupus erythematosus, lichen planopilaris, frontal fibrosing Alopecia, and Graham–Little syndrome.

  • Evaluation and diagnosis of the hair loss patient: part II. Trichoscopic and laboratory evaluations
    Journal of the American Academy of Dermatology, 2014
    Co-Authors: Thamer Mubki, Lidia Rudnicka, Malgorzata Olszewska, Jerry Shapiro

    Abstract:

    The use of trichoscopy for evaluating a number of hair and scalp disorders is gaining popularity. It is a simple and noninvasive in vivo tool for visualizing hair shafts and the scalp. Recently, Alopecias have been classified according to their trichoscopic findings. The second part of this 2-part continuing medical education article reviews recent advances in this field and describes a systematic approach for using the differential diagnostic findings of trichoscopy in Alopecia.

Ramon Grimalt – 2nd expert on this subject based on the ideXlab platform

  • Platelet-Rich Plasma and its Use for Cicatricial and Non-Cicatricial Alopecias: A Narrative Review
    Dermatology and Therapy, 2020
    Co-Authors: Rubina Alves, Ramon Grimalt

    Abstract:

    The concept and description of platelet-rich plasma (PRP) started in the field of hematology and is being extensively used in other fields of medicine. Interest in the application of PRP has been increasing in dermatology, such as in tissue regeneration, wound healing, scar revision, skin-rejuvenating effects, and Alopecia. PRP is an autologous blood product containing high concentrations of platelets in a small volume of plasma. Different preparations of PRP may lead to different volumes of PRP, platelet concentration, and presence or absence of leukocytes. PRP is being used as a new therapy for some types of non-cicatricial Alopecia such as androgenetic Alopecia (AGA) and Alopecia areata (AA) and, recently, new insights refer to the possibility of action in the field of cicatricial Alopecia, like lichen planopillaris (LPP) and frontal fibrosing Alopecia (FFA). This article aims to identify the major indications for the application of PRP in the field of hair disorders, including non-cicatricial and cicatricial Alopecia.

Lidia Rudnicka – 3rd expert on this subject based on the ideXlab platform

  • Cyclosporine With and Without Systemic Corticosteroids in Treatment of Alopecia Areata: A Systematic Review
    Dermatology and Therapy, 2020
    Co-Authors: Joanna Nowaczyk, Mariusz Sikora, Adriana Rakowska, Karolina Makowska, Lidia Rudnicka

    Abstract:

    Introduction Cyclosporine is commonly used in treatment for Alopecia areata. It can be administered as a monotherapy or in combination with systemic corticosteroids, with various outcomes. Methods Efficacy of cyclosporine with and without systemic corticosteroids for Alopecia areata was evaluated by a systematic review. Cochrane, EBSCOhost, Pubmed, Scopus and Web of Science databases were searched. Only studies published before January 2020 were included. Results A total of 2104 studies were initially examined, of which 14 were eligible for the systematic review. Among 340 reported cases, 213 had focal, multifocal or ophiasis form of Alopecia areata, 60 were diagnosed with Alopecia totalis and 67 with Alopecia universalis. The mean response rate in the whole group of patients at the end of treatment was 65.00% (221/340; range 25–100%). Hair regrowth rate was higher in the group with cases of Alopecia areata limited to scalp (124/165; mean 75.15%; range 40–100%) than in the cases with Alopecia totalis (30/46; mean 65.22%; range 25–100%) or Alopecia universalis (24/52; mean 46.15%; range 25–100%). The combined therapy with systemic corticosteroids was superior to the monotherapy (152/219; mean 69.41%; 0–80% vs. 69/121; mean 57.02%; range 6.67–100%) and had a lower recurrence rate (39/108; mean 36.11% vs. 34/46; mean 73.91%, respectively). The combined treatment with methylprednisolone was significantly more effective when compared to the cyclosporine monotherapy (124/183; mean 67.76%; range 0–80% vs. 69/121; mean 57.02%; range 6.67–100%). The mean time of treatment was 6.75 months (range 2–36). Limitations Limitations of our study were the retrospective character of included studies, differences in doses of prescribed drugs, and duration of the treatment and follow-up times. Conclusion Cyclosporine in combination with oral systemic corticosteroids is more effective than in monotherapy for severe Alopecia areata.

  • The value of dermoscopy in diagnosing eyebrow loss in patients with Alopecia areata and frontal fibrosing Alopecia.
    Journal of The European Academy of Dermatology and Venereology, 2018
    Co-Authors: Anna Waśkiel-burnat, Malgorzata Olszewska, Adriana Rakowska, Marta Kurzeja, Joanna Czuwara, Mariusz Sikora, Lidia Rudnicka

    Abstract:

    INTRODUCTION: Alopecia areata and frontal fibrosing Alopecia are common causes of eyebrow loss (madarosis). OBJECTIVE: Assessment of trichoscopic markers of eyebrow loss in Alopecia areata and frontal fibrosing Alopecia. MATERIALS AND METHODS: The analysis included 50 patients with scalp Alopecia areata with madarosis, 50 patients with scalp frontal fibrosing Alopecia with madarosis and 50 healthy controls. In every case, trichoscopy of the eyebrow area was performed. RESULTS: Empty follicular and eccrine duct openings were observed in all patients and presented predominantly as yellow dots. Exclamation mark hairs were only detected in patients with Alopecia areata (30%). Tapered hairs, broken hair, black dots and Pohl-Pinkus constrictions were observed in 14%, 36%, 26% and 4% of patients with Alopecia areata, respectively, 4%, 16%, 2% and 0% of patients with frontal fibrosing Alopecia, respectively, and they were not present in healthy controls. Dystrophic hairs and whitish areas were observed only in patients with frontal fibrosing Alopecia (28% and 32%, respectively). Eyebrow regrowth in distinct directions was present in 32% of patients with frontal fibrosing Alopecia, 8% of patients with Alopecia areata and 4% of healthy controls. Diffuse erythema was detected in 60% of patients with Alopecia areata and frontal fibrosing Alopecia and 56% of healthy controls. Vellus hairs and upright regrowing hairs were observed in patients with Alopecia areata (62% and 58%, respectively), frontal fibrosing Alopecia (60% and 84%, respectively) and healthy controls (100% and 100%, respectively). CONCLUSION: Trichoscopy of the eyebrow area is useful in diagnosing patients with isolated eyebrow loss. The most characteristic trichoscopic features of eyebrow loss in Alopecia areata include exclamation mark hairs, tapered hairs, broken hairs and black dots. Frontal fibrosing Alopecia of the eyebrows is characterized by the presence of dystrophic hairs, white areas and eyebrow regrowth in distinct directions.

  • Evaluation and diagnosis of the hair loss patient: part II. Trichoscopic and laboratory evaluations
    Journal of the American Academy of Dermatology, 2014
    Co-Authors: Thamer Mubki, Lidia Rudnicka, Malgorzata Olszewska, Jerry Shapiro

    Abstract:

    The use of trichoscopy for evaluating a number of hair and scalp disorders is gaining popularity. It is a simple and noninvasive in vivo tool for visualizing hair shafts and the scalp. Recently, Alopecias have been classified according to their trichoscopic findings. The second part of this 2-part continuing medical education article reviews recent advances in this field and describes a systematic approach for using the differential diagnostic findings of trichoscopy in Alopecia.