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Background: Androgenetic alopecia is the most common cause of hair loss that affects over 50% of the world population. It is a condition that is multifactorial in origin, with no specific causative factor, making treatment an enervating experience for the patient as well as the doctor. In recent times, a number of modalities have been introduced for the treatment of alopecia. However, the evidence supporting them is unstructured and sparse. Therefore, this article aims to explore the current trends in minimally invasive treatments for the management of androgenetic alopecia. Methods: An in‐depth literature search on injectables used in the treatment of alopecia in PubMed/MEDLINE, Embase, PsycINFO, TRIP Cochrane Library, and Cochrane Skin databases between January 2000 and May 2023 was performed. The studies included were randomized controlled trials, non‐randomized trials, quasi trials, single arm interventions, and cohort studies. Results: Sixteen of the 1071 studies that were found during the original search were accepted in accordance with the inclusion criteria. Twelve studies assessed the effectiveness of the injectable group by comparing it to a control group consisting of saline, distilled water, and topical minoxidil. In the treatment of alopecia, dutasteride and injectable growth factor formulations achieved clinically significant results. Conclusion: The usage of injectables and topical medicines to treat hair loss has increased in the recent years. Overall results from clinical investigations, pilot studies, and trials looking at the efficacy and safety of these growth factors in the AGA show satisfactory efficacy. [ABSTRACT FROM AUTHOR]

Background: Hair transplant (HT) is the standard treatment for female pattern hair loss (FPHL), but scalp micropigmentation (SMP) is an alternative. Currently, there are no criteria to help choose between HT and SMP. Methods: Forty female patients with FPHL who had successfully undergone HT and SMP, were reviewed to identify factors that might help decide between treatments. Hair density (HD) and hair caliber were measured at the part line and mid‐occipital region by a Folliscope. The sensitivity and specificity of HT and SMP were determined by area under the curve (AUC) and receiver operating characteristic curve. Results: Patients were divided into HT (n = 23) and SMP (n = 17) groups. The follicular unit density (FUD) (HT: 62.06 ± 4.8551/cm2; SMP: 66.59 ± 3.4971/cm2) and HD (HT: 96.16 ± 16.6954/cm2; SMP: 116.08 ± 17.0520/cm2) were significantly different (p < 0.01) between groups. The AUC for FUD was 77.6% with a cutoff value of 66.83 and 87.0% (1–0.412) sensitivity. The AUC for HD was 82.4% with a cutoff value of 96.17 and 69.6% (1–0.118) sensitivity. Conclusions: HD was the most important factor when deciding between HT surgery and SMP. SMP is recommended when the HD is ≥104.6 hairs/cm2 and HT surgery is strongly recommended when the HD is ≤96.17 hairs/cm2. [ABSTRACT FROM AUTHOR]

Background: Disruption of ALX4 causes autosomal dominant parietal foramina and autosomal recessive frontonasal dysplasia with alopecia, but the mechanisms involving ALX4 in craniofacial and other developmental processes are not well understood. Although mice carrying distinct mutations in Alx4 have been previously reported, the perinatal lethality of homozygous mutants together with dynamic patterns of Alx4 expression in multiple tissues have hindered systematic elucidation of the cellular and molecular mechanisms involving Alx4 in organogenesis and disease pathogenesis. Results: We report generation of Alx4f/f conditional mice and show that tissue‐specific Cre‐mediated inactivation of Alx4 in cranial neural crest and limb bud mesenchyme, respectively, recapitulated craniofacial and limb developmental defects as found in Alx4‐null mice but without affecting postnatal survival. While Alx4‐null mice that survive postnatally exhibited dorsal alopecia, mice lacking Alx4 function in the neural crest lineage exhibited a highly restricted region of hair loss over the anterior skull whereas mice lacking Alx4 in the cranial mesoderm lineage exhibited normal hair development, suggesting that Alx4 plays partly redundant roles in multiple cell lineages during hair follicle development. Conclusion: The Alx4f/f mice provide a valuable resource for systematic investigation of cell type‐ and stage‐specific function of ALX family transcription factors in development and disease. Key Findings: We report successful generation and analysis of Alx4 conditional mice.We demonstrate lineage‐specific requirements of Alx4 in craniofacial, limb, and hair development.Our results demonstrate that Alx4 functions in multiple lineages to control hair follicle development.The Alx4 conditional mice provide a valuable and unique resource for systematic characterization of the cellular and molecular mechanisms involving the ALX family transcription factors in development and disease. [ABSTRACT FROM AUTHOR]

Background Hypothesis/Objectives Animals Materials and Methods Results Conclusions and Clinical Relevance While alopecia associated with hair cycle arrest (HCA, Alopecia X) is well‐recognised in Pomeranian dogs, the authors are unaware of reports of concurrent hair fragility.Following the observation of frequent hair shaft abnormalities in alopecic Pomeranians, we hypothesised that hair fragility events would be more frequent in dogs with a phenotype of HCA when compared to dogs with normal coats.Eight alopecic Pomeranian dogs or crosses with a phenotype of HCA and 36 unaffected Pomeranians with owner‐reported normal hair coats.All affected dogs underwent dermatological examination and clinicopathological evaluations. Hair samples, plucked from affected areas or obtained by brushing from unaffected dogs, were examined microscopically for structural abnormalities. Hair fragility events were characterised as trichorrhexis nodosa (TN) or longitudinal splits and were expressed per 10 mg of hair. A reference interval was calculated from the number of hair fragility events in the samples from unaffected dogs.The upper reference limit (with 90% confidence) from samples of 35 unaffected Pomeranians (one outlier excluded) was 9.75 hair fragility events per 10 mg of hair. The median (range) of fragility events in eight dogs with a phenotype of HCA was 66.0 (30.2–166.7) per 10 mg of hair.Clinicians should routinely perform trichography in Pomeranians with HCA because abundant hair abnormalities, particularly TN, may contribute to poor hair coat quality. Further studies are required to establish the pathophysiology of and treatments for these fragility events and to determine their predictive value for HCA. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Aims Methods Results Conclusions Low‐dose oral minoxidil (LDOM) is used to treat hair loss, but the literature on its safety profile is relatively sparse.Using the FDA Adverse Event Reporting System (FAERS) database, we determined signals for adverse events (AEs) with LDOM use.Four sets of case/noncase study disproportionality analyses were conducted to determine reporting odds ratio (ROR) for 10 AEs including pericardial effusion (PE). The oral minoxidil dose ranges were: (i) ≤1.25 mg (i.e., 0–1.25 mg), (ii) ≤2.5 mg (i.e., 0–2.5 mg), (iii) ≤5 mg (i.e., 0–5 mg), and (iv) ≤10 mg (i.e., 0–10 mg).For ≤1.25 mg, we detected a signal for PE (ROR = 16.41, 95% CI: 2.29, 117.37, p < 0.05). For ≤2.5 mg, the analyses detected a signal for PE (ROR = 13.30, 95% CI: 5.96, 29.68, p < 0.05); the ROR in the absence of cardiac impairment was 5.34 (95% CI: 1.33, 21.37, p < 0.05); in the presence of cardiac impairment, the ROR was 49.42 (95% CI: 18.27, 133.66, p < 0.05). A signal for PE was also detected at ≤5 and ≤10 mg. For PE, there was a significant (p < 0.05) association with a patient outcome of “life threatening” only at the ≤10 mg dose range.Our study, the first FAERS‐based signal detection study for LDOM, found significant associations between LDOM use and several AEs. In the absence of causal evidence, these correlations warrant more attention regarding safe use of LDOM. Until more safety data are available, we recommend using LDOM at the lowest effective dose (≤5 mg/day). [ABSTRACT FROM AUTHOR]

Introduction: Male pattern baldness (MPB), also known as androgenetic alopecia, represents the most prevalent form of progressive hair loss in humans. It is characterized by a distinctive pattern of hair loss progression from the scalp; however, its underlying mechanism remains elusive and is influenced by hereditary, immune, and environmental factors. Genome-wide association studies (GWASs) have uncovered numerous risk genes/loci among European individuals with MPB. However, the validation of these susceptibility genes/loci within Han Chinese men remains largely unexplored. The aim of this study was to investigate whether the 71 susceptibility loci identified in a recent GWAS among European men also confer risk for MPB in Chinese men. Methods: Forty-seven single nucleotide polymorphisms (SNPs) previously reported in GWASs of MPB were selected and genotyped in independent individuals comprising 499 Han Chinese cases and 1,489 controls using the Sequenom MassArray system. After stringent quality control measures, 25 SNPs were subjected to statistical analyses. Cochran-Armitage trend test was used to evaluate the association between SNPs and disease susceptibility. To address multiple tests, Bonferroni correction was conducted, setting the threshold for statistical significance at a p-value <2 × 10-3 (0.05/25). Results: The rs13405699 SNP located at 2q31.1 exhibited a significant association with MPB in Han Chinese men (p = 4.84 × 10-5, OR = 1.37, 95% CI: 1.18-1.59). Moreover, the difference in rs13405699 genotype distribution between MPB cases and controls was statistically significant (p = 7.00 × 10-5). Genotype-based association analysis suggested that the recessive model provided the best fit for the rs13405699 polymorphism. Conclusion: This study represents the first confirmation of the association between the rs13405699 SNP at 2q31.1 and MPB within the Han Chinese population, thereby enhancing our understanding of the genetic underpinnings of MPB. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Method Results Conclusion Excess skin laxity over the upper face can contribute to aging over the mid and lower face. We describe an innovative nonsurgical technique of facial rejuvenation by injecting Lanluma V over the scalp's vertex and parietal regions. Lanluma V is a poly‐l‐lactic acid (PLLA)‐based collagen stimulator which contains 210 mg of PLLA, distributed by Sinclair Pharmaceutical. Lanluma V works by stimulating collagen regeneration to provide support for the treated area.A retrospective review of 12 consecutive patients treated with Lanluma V over the vertex and parietal regions of the scalp to achieve nonsurgical rejuvenation of the upper, middle, and lower thirds of the face was conducted. The patients were treated over two sessions, 1 month apart. The treated patients were reviewed by a plastic surgeon and rated under the Global Aesthetic Improvement Scale (GAIS) 6 months after treatment.The patients achieved an overall average of 1.16 grade improvement in GAIS. The average follow‐up period is 6 months following completion of treatment. There was no reported incidence of non‐scarring alopecia, which has been reported in the use of other, more viscous fillers such as calcium hydroxyapatite or high G' hyaluronic acid.This innovative method of combined forehead and temporal lifting with Lanluma V allows for an average 1.16 grade improvement in GAIS. There is no reported incidence of non‐scarring alopecia, which has been associated with other fillers. [ABSTRACT FROM AUTHOR]

Alopecia areata (AA) is a common chronic relapsing nonscarring alopecia. Severe forms of AA commonly manifest during childhood. Treatment of AA is challenging due to the variability of the disease course as well as unpredictable responses to treatment. There is no uniform approved treatment for cure or sustained remission in children till now. Tofacitinib emerged as a novel drug in the treatment of AA, but few studies have been conducted on its safety and efficacy in children. Limitation of this study includes retrospective nature, small sample size, and lack of prolonged follow‐up. Aim. This retrospective study aimed to assess the efficacy and safety of oral tofacitinib in children with AA. Method. In this retrospective study, we included patients aged 18 years or younger with AA. The scalp blandness of included patients was greater than 20% and they were on oral tofacitinib for at least two months. The demographic data, clinical characteristics, tofacitinib efficacy, and adverse effects were recorded. The primary endpoint was the last recorded percent change in the Severity of Alopecia Tool (SALT) score during treatment. Results. We included 26 patients (12 males and 14 females) with AA with a mean age of 11.6 ± 4.42 (3–18) years. Eighteen of them were in the alopecia areata (AA) group, whereas eight patients had alopecia totalis (AT) or alopecia universalis (AU). The mean disease duration before starting treatment with tofacitinib was 3.9 ± 3.3 years. Most of the patients were on a tofacitinib daily dose of 5 mg (53.85%) and 10 mg (38.46%). Patients were on tofacitinib for 6.73 ± 3.79 months. The patients' baseline SALT score was recorded as 68.58 ± 32.65 and the final SALT score was 17.65 ± 23.88. Thus, the patients achieved a 50.92% reduction in the SALT score. Interestingly, there were no statistically significant differences in clinical efficacy between subtypes of AA and AT/AU. Conclusion. Tofacitinib was significantly effective in treating AA and AT/AU in children, with mild tolerable adverse effects, although relapse during treatment and tapering was recorded. Future randomized clinical trials with longer follow‐up periods are needed to evaluate the safety of oral tofacitinib in children. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Objective Material and Methods Results Conclusion Alopecia areata (AA), an autoimmune disorder characterized by hair loss, can be particularly difficult to manage when patients do not respond to standard therapeutic approaches such as topical or injectable corticosteroids, contact immunotherapy, and systemic treatments. In instances where these conventional therapies prove ineffective, alternative or adjunctive treatments are sought. Concentrated growth factor (CGF) and microneedling (MN)‐assisted drug delivery are promising methods for the treatment of different dermatological diseases.This study aimed to assess the practical benefits and the safety aspects of utilizing a dual treatment approach involving CGF and MN‐assisted compound betamethasone for patients suffering from resistant AA that are unresponsive to conventional medical interventions.This retrospective study was based on evaluations of seven patients with refractory AA treated with CGF and MN‐assisted compound betamethasone from July 2021 to December 2023. The efficacy of treatment was assessed by extents of hair regrowth percentages of involved areas.Among the seven enrolled patients with refractory AA, a notable outcome was observed where one patient (14.3%) achieved a regrowth of hair by over 50%, while six patients (85.7%) exhibited complete recovery without any systemic or local adverse effects. Furthermore, the difference in SALT scores between baseline, and the final visit for all patients was found to be statistically significant, substantiating the therapeutic efficacy of the intervention employed.The present study demonstrated that the synergistic application of CGF in conjunction with MN‐assisted compound betamethasone may constitute a promising and well‐tolerated therapeutic modality for refractory AA, offering a potentially efficacious and safe treatment alternative. [ABSTRACT FROM AUTHOR]

Background. Alopecia areata (AA) is a nonscarring alopecia that can affect any hairy area of the body. Excimer light at 308 nm with immunosuppressive effects is recommended as a promising management method for AA. Objectives. To assess the efficacy and safety of excimer light at 308 nm alone versus a combination of tacrolimus 0.1% and excimer light in the treatment of alopecia areata. Methods. Forty patients with AA of the scalp were divided into two groups, group A was treated with an excimer lamp twice per week for three months, and group B was treated with a combination of tacrolimus 0.1% and an excimer light. The efficacy of the treatment was evaluated by the SALT score and serum T‐regulatory cells at the baseline, after 3 months from the baseline, and after 6 months from the beginning of treatment. Results. In group (A), the median SALT decreased from the baseline (13.15) to (6.15) 3 months after the baseline and further decreased after 6 months of follow‐up to (3.3). While in group (B), the median SALT score was decreased from the baseline (11.15) to (0.5) after 6 months from the beginning of treatment. After 3 months, there was improvement in Treg function in both groups A and B (4.98 ± 1.02, 5.50 ± 0.84), respectively. There was a significantly higher improvement in group B (85.19 ± 8.55) than group A (70.05 ± 9.95). Dermoscopic findings reveal decreased signs of activity in group B more than group A. Conclusion. The combination of excimer light and tacrolimus is more effective than excimer light alone in treatment of AA. [ABSTRACT FROM AUTHOR]

Alopecia is a common adverse effect of neoadjuvant or adjuvant chemotherapy in patients with early breast cancer. While hair typically regrows over time, more than 40% of patients continue to suffer from permanent partial alopecia, significantly affecting body image, psychological well-being, and quality of life. This concern is a recognized reason why some breast cancer patients decline life-saving chemotherapy. It is critical for healthcare professionals to consider the impact of this distressing side effect and adopt supportive measures to mitigate it. Among the various strategies investigated to reduce chemotherapy-induced alopecia (CIA), scalp cooling has emerged as the most effective. This article reviews the pathophysiology of CIA and examines the efficacy of different scalp cooling methods. Scalp cooling has been shown to reduce the incidence of CIA, defined as less than 50% hair loss, by 50% in patients receiving chemotherapy. It is associated with high patient satisfaction and does not significantly increase the risk of scalp metastasis or compromise overall survival. Promising new scalp cooling technologies, such as cryogenic nitrogen oxide cryotherapy, offer the potential to achieve and maintain lower scalp temperatures, potentially enhancing therapeutic effects. Further investigation into these approaches is warranted. Research on CIA is hindered by significant heterogeneity and the lack of standardised methods for assessing hair loss. To advance the field, further interdisciplinary research is crucial to develop preclinical models of CIA, establish a uniform, internationally accepted and standardised classification system, and establish an objective, personalised prognosis monitoring system. [ABSTRACT FROM AUTHOR]

Cyclosporine is a potent immunosuppressive drug for various immune-mediated diseases in children. Cyclosporine's expected therapeutic effect also carries a wide range of side effects. One of the most common and intriguing dermatological side effects is hypertrichosis. However, recent reports have recognized alopecia as a potential adverse effect of cyclosporine. Here, we report a case of a 29-month-old boy diagnosed with aplastic anemia. During cyclosporine therapy, the patient presented with hair loss on the scalp, which and subsequently spread to the eyebrows and eyelashes. The alopecic symptoms were not relieved following topical minoxidil liniment interventions. When the cyclosporine was discontinued, a remarkable improvement was observed in the scalp, with complete hair regrowth. Data concerning cyclosporine from the FDA Adverse Event Reporting System (FAERS) database were extracted from January 2004 to January 2023. Within FAERS, our post-marketing pharmacovigilance analysis detected the reporting association of cyclosporine and alopecia. In monotherapy, cyclosporine-induced alopecia was observed in 118 cases, and tacrolimus-induced alopecia signals were detected in 197 cases. Although the potential mechanism of medication-induced hair loss is unclear, we identified a potential correlation between alopecia and cyclosporine, and it is still necessary to adequately recognize and clinically monitor this paradoxical reaction. [ABSTRACT FROM AUTHOR]

Background: The potential link between alopecia areata (AA) and eosinophilia is unclear, as well as its clinical manifestations in these patients' subsets. Methods: This is a monocentric retrospective observational study in which clinical and laboratory data were summarized and evaluated the AA subset with concurrent eosinophilia. Results: In a sample of 205 AA patients, 38 (18.5%) were classified as AA with eosinophilia. Interestingly, this subset of patients had a statistically higher prevalence of atopia and nail abnormalities (p < 0.05) than AA without eosinophilia. AA patients with eosinophilia had a 3.70 higher odds of more severe hair loss versus age‐ and gender‐matched AA without eosinophilia. Conclusions: AA patients with eosinophilia had distinctive clinical and laboratory characteristics, so future studies may potentially explore the use of IL‐5 inhibitors. [ABSTRACT FROM AUTHOR]

Background Materials and Methods Results Conclusion Alopecia areata is an autoimmune condition characterized by rapid hair loss in the scalp, eyebrows and eyelashes, for which treatments are limited. Baricitinib, an oral inhibitor of Janus kinases 1 and 2, has been recently approved to treat alopecia areata.We conducted a retrospective study involving 23 medical centres across Italy, enrolling patients affected by severe alopecia areata (SALT >50), for more than 6 months. Clinical and trichoscopic assessment was performed at each visit and impact on quality of life, anxiety and depression were evaluated using the Skindex‐16 and the Hospital Anxiety and Depression Scale (HADS), respectively.A total of 118 patients were enrolled, with a mean age of 39 years and a mean SALT >95. The mean value of the SALT score decreased from an average of 96.6 (±8.23 sd) to 48 (±35.2 sd) after 24 weeks of treatment and 42.3% of patients achieved a SALT 30, 31.3% a SALT 20 and 20.3% a SALT 10 by Week 24. Trichoscopic signs showed fewer yellow dots and black dots significantly earlier than hair regrowth. Adverse events during the treatment period (mild laboratory test abnormalities) were reported in 12.7% patients. No drop‐out were registered.Data on the effectiveness and safety of baricitinib are promising and support the use of this drug in severe forms of AA, also in the early stages. We also suggest performing trichoscopy in order to reveal early response to therapy. [ABSTRACT FROM AUTHOR]

There is limited information available on pressure‐related neonatal nasal injuries. We present three neonates born with erythema and purpura of the nasal tip that subsequently ulcerated, then evolved into a thick eschar. Each healed well with conservative management but left behind significant scarring. The sharp demarcation and location of the lesions were suggestive of hypoxic tissue damage akin to halo scalp ring alopecia. Further investigation is necessary to elucidate the etiology and optimal management of this condition. [ABSTRACT FROM AUTHOR]

Purpose: We investigated the inhibitory effect of edaravone (EDR) lotion on chemotherapy-induced alopecia (CIA) to improve the quality of life for patients with cancer. Methods: Wistar rats were intraperitoneally injected with cyclophosphamide (CPA, 75 mg/kg) to induce CIA and divided into six groups: (1) Control; (2) EDR 0%; (3) EDR 0.3%; (4) EDR 3%. The TUNEL-positive area was examined histologically, and mRNA expression levels of the apoptosis-related factors, such as B-cell/CLL lymphoma 2 (Bcl-2), and Bcl-2-associated X protein (Bax), were determined. Results: In the three CPA-treated groups, a decrease in the coverage score (percentage of hairs covered) was observed from days 16 to 18. In addition, coverage scores on day 21, the last day of observation, showed a tendency for the suppression of hair loss to increase, though hair loss was observed in all groups. The coverage scores of the EDR 0.3% and 3% groups after day 17 were significantly higher than those of the EDR 0% group. The TUNEL-positive area of skin tissue on day 16 was extensive in the EDR 0% group and decreased in the EDR 0.3% and 3% groups. The mRNA expression ratio of Bcl-2/Bax on day 21 was maintained at the same level as that of the control group only in the EDR 3% group. Conclusion: This study confirmed the use of EDR lotion to inhibit hair loss, indicating that the clinical application of EDR lotion may improve the quality of life for patients with cancer and their willingness to undergo treatment. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the possible association between androgenic alopecia (AGA) and lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). Methods: A total of 148 patients aged over 45 with LUTS secondary to BPH were prospectively enrolled in this study. According to the Norwood–Hamilton classification, the patients were divided into two groups: AGA (n = 69) and non‐AGA (n = 79). In addition, the cases of AGA were categorized as vertex (n = 39) and frontal baldness (n = 30). The International Prostate Symptom Score (IPSS), uroflowmetry parameters, prostate volume, serum total testosterone (TT), and free and total prostate‐specific antigen concentrations of all patients were assessed and compared between the groups. Correlations between the AGA grade and other variables were also investigated. Results: The serum TT level (354 ± 97.1 vs. 308.6 ± 73.1 ng/dL, p = 0.01), total IPSS (16.1 ± 8.1 vs. 13.4 ± 7.7, p = 0.04), IPSS storage subscore (IPSS‐S) (7.1 ± 3.5 vs. 5.8 ± 3.6, p = 0.03), and number of nocturia episodes (2.5 ± 1.4 vs. 1.8 ± 1.4, p < 0.01) were significantly higher in the AGA group than in the non‐AGA group. There were no significant differences in any of the parameters between the patients with vertex and frontal baldness. The AGA grade showed a significant positive correlation with the TT level (r = 0.407, p = 0.003), IPSS‐S (r = 0.164, p = 0.04), and number of nocturia episodes (r = 0.203, p = 0.015). Conclusions: This study demonstrated that among patients with LUTS, those with AGA had worse symptoms and higher TT levels compared with those without AGA of similar age. Furthermore, the AGA grade was positively correlated with the TT level and storage symptoms. [ABSTRACT FROM AUTHOR]

Background: Alopecia areata is a widespread, non-scarring, autoimmune T cell-mediated condition that causes patchy hair loss on the scalp and other regions of the body. This study aimed to the efficacy of excimer laser in the treatment of alopecia areata. Methods: An interventional clinical study was conducted among 15 patients diagnosed with scalp alopecia areata, who received their treatment only as one session of excimer laser per week for 3 months. Treatment of alopecia areata was done according to the study protocol and the follow-up was made by taking photographs every two sessions for evaluation of the percentage of hair regrowth and calculation of SALT II score difference before and after treatment. Results: the duration of treatment required for achieving the treatment in the studied group excimer alone up to 12 weeks. In the complete response to treatment of complete responder (SALT II= 0 after treatment), we recorded 26.7% of the studied group are complete responders (100% hair regrowth) while the non-responders (SALT II before =SALT II after) the studied group recorded a percentage of non-responders (46.7%) hair regrowth =0. Conclusions: Excimer laser is an effective tool in the treatment of patchy alopecia areata of mild to moderate degree. [ABSTRACT FROM AUTHOR]

Chemotherapy-induced alopecia (CIA) is a common and emotionally-taxing side effect of chemotherapy, including taxane agents used frequently in treatment of gynecologic cancers. Scalp hypothermia, also known as "cold caps", is a possible method to prevent severe CIA, studied primarily in the breast cancer population. To compile existing data on scalp hypothermia in cancer patients receiving taxane chemotherapy in order to investigate its application to the gynecologic cancer population. MEDLINE, Embase, CINAHL, ClinicalTrials.gov , and Cochrane were searched through January 31, 2023. Full-text manuscripts reporting on the results of scalp hypothermia in patients receiving taxane-based chemotherapy. Binomial proportions were summed, and random-effects meta-analyses performed. From 1424 records, we included 31 studies, representing 14 different countries. Only 5 studies included gynecologic cancer patients. We extracted the outcome of the proportion of patients with <50% hair loss. Among 2179 included patients, 60.7% were reported to have <50% hair loss (meta-analysis: 60.6%, 95% confidence interval [CI] 54.9–66.1%). Among the 28 studies reporting only on taxane-based chemotherapy, the rate of <50% hair loss was 60.0% (meta-analysis: 60.9%, (95% CI: 54.9–66.7%). In comparative studies, hair loss was significantly less in patients who received scalp hypothermia versus those who did not (49.3% versus 0% with <50% hair loss; OR 40.3, 95% CI: 10.5–154.8). Scalp cooling achieved <50% hair loss in patients receiving paclitaxel (67.7%; meta-analysis 69.9%, 95% CI 64.1–75.4%) and docetaxel (57.1%; meta-analysis 60.5%, 95% CI 50.0–71.6%). Meta-analysis on patient satisfaction in regard to scalp cooling found a satisfaction rate of 78.9% (95% CI 69.1–87.4%). Scalp hypothermia may be an effective method to reduce some cases of CIA due to taxane chemotherapy, especially paclitaxel. More trials need to be done to determine the precise effects of scalp hypothermia in gynecologic cancer patients. • Scalp cooling prevents chemotherapy-induced alopecia from taxane-based chemotherapy. • Hair loss prevention success varies by scalp cooling device. • Patient satisfaction with scalp cooling treatment is high. • Hair loss causes distress in chemotherapy patients. • Patients with gynecologic cancers could benefit from scalp hypothermia devices. [ABSTRACT FROM AUTHOR]

Purpose: Hair loss is often overlooked but psychologically challenging. However, the emergence of online health communities provides opportunities for hair loss patients to seek social support through self-disclosure. Nevertheless, not all disclosures receive the desired support. This research explores what patients disclose within the community and how their health narrative (content, form and linguistic style) regarding self-disclosure influences the social support they receive. Design/methodology/approach: This study investigated a 13-year-old online support group for Chinese hair loss patients with nearly 240,000 members. Using structural topic modeling, Linguistic Inquiry and Word Count, and a negative binomial model, the research analyzed the content of self-disclosure and the interrelationships between social support and three narrative dimensions of self-disclosure. Findings: Self-disclosures are classified into 14 topics, grouped under analytical, informative and emotional categories. Emotion-related self-disclosures, whether in content or effective word use, receive deeper social support. Longer and image-rich posts attract more support in quantity, but not necessarily in quality, while cognitive words have a limited impact. Originality/value: This study addresses the previously overlooked population of hair loss patients within online health communities. It employs a more comprehensive health narrative framework to explore the relationship between self-disclosure and social support, utilizing unsupervised structural topic modeling methods to mine text. The research offers practical implications for how patients seek support and for healthcare professionals in developing doctor-patient communication strategies. [ABSTRACT FROM AUTHOR]

While many gene expression studies have focused on male pattern baldness (MPB), few studies have investigated the genetic differences between bald and non-bald hair follicles in female pattern hair loss (FPHL). This study aimed to identify molecular biomarkers associated with FPHL through genetic analysis of paired bald and non-bald hair follicles from 18 FPHL patients, using next-generation sequencing (NGS) techniques. RNA transcriptome analysis was performed to identify differentially expressed genes (DEGs) between bald and non-bald hair follicles in FPHL. The DEGs were validated using real-time PCR, and protein expression was confirmed through immunohistochemistry and western blot analysis. Our findings suggest that HOXB13, SFRP2, PTGDS, CXCR3, SFRP4, SOD3, and DCN are significantly upregulated in bald hair follicles compared to non-bald hair follicles in FPHL. SFRP2 and PTGDS were found to be consistently highly expressed in bald hair follicles in all 18 samples. Additionally, elevated protein levels of SFRP2 and PTGDS were confirmed through western blot and immunohistochemical analysis. Our study identified SFRP2 and PTGDS as potential biomarkers for FPHL and suggests that they may play a role in inducing hair loss in this condition. These findings provide a foundation for further research on the pathogenesis of FPHL and potential therapeutic targets. [ABSTRACT FROM AUTHOR]

This article examines the diagnosis and treatment of diffuse alopecia areata (AA) in children. Diffuse AA is characterized by widespread hair loss on the scalp and is often misdiagnosed. The study found that there was a delay in diagnosis, possibly due to misdiagnosis or delayed medical help-seeking. Trichoscopy was found to be helpful in distinguishing diffuse AA from other conditions. Topical corticosteroids were the most commonly prescribed treatment, and over half of the patients experienced complete hair regrowth regardless of the treatment used. The study acknowledges its limitations and calls for further research on this unique presentation of AA in children. [Extracted from the article]

This article presents a case series of hair system-induced alopecia in six Caucasian women. The patients experienced exacerbated hair loss in areas where the hair system was attached. Trichoscopy revealed features of both traction alopecia and pressure alopecia, suggesting a combined mechanism of action. The study highlights the need for dermatologists to be aware of this complication and familiar with trichoscopy to differentiate it from other conditions. However, the study has limitations, including a small sample size and lack of histopathological studies. [Extracted from the article]

Background: Alopecia areata (AA) is a recurrent immune‐mediated disorder causing hair loss without any scarring being present. It affects hairs on the head or other parts of the body and can occur at any age and in both genders. It seems that AA is associated with a higher rate of psychological disorders resulting from hair loss and the esthetic and social repercussions of it. Common treatments like corticosteroids do not work for every patient and recent treatment options focusing on the immunologic mechanisms like tofacitinib have shown some promising results. Methods: It's a retrospective study on patients with AA, AT, AU taking oral tofacitinib as a treatment for at least 6 months. Scalp hair loss was assessed before treatment and at each visit using the Severity of Alopecia Tool (SALT) score. Results: Of 97 cases, 69.1% demonstrated over 50% SALT score improvement, with 44.3% having 90% or more decrease in SALT score. Patients who suffered from patchy AA were more responsive compared to patients with AT and AU subtypes and had a greater percent change in SALT score. Tofacitinib was tolerated quite well and no significant adverse events were reported. Conclusions: Tofacitinib should be taken into consideration as an efficacious treatment option for patients with AA, AT and AU. [ABSTRACT FROM AUTHOR]

Background: The evidence base pertaining to the efficacy of monotherapies for androgenetic alopecia (AGA), the most common form of hair loss, is ever expanding—and this warrants a formal comparison therapies' effect on a frequent basis. Aims: The objective of the current study was to determine the comparative effect of relevant monotherapies for male AGA. Patients/Methods: Our aim was achieved by conducting Bayesian network meta‐analysis (NMA), under a random effects model, for two outcomes: 6‐month change in (1) total and (2) terminal hair density in adult (i.e., aged 18 years and above) men with AGA; these analyses were preceded by a systematic search of the peer‐reviewed literature for suitable data. Interventions' surface under the cumulative ranking curve (SUCRA) and pairwise relative effects (quantified as mean differences) were estimated through the NMAs. Results: We determined the comparative effect of 20 active comparators and a control (i.e., placebo/vehicle). "Dutasteride 0.5 mg once daily for 24 weeks" was ranked the most effective in terms of 6‐month change in (1) total hair density (SUCRA = 87%) and terminal hair density (SUCRA = 98%). Our results showed that interventions' effectiveness can be dose dependent. Conclusions: Our updated analyses of the up‐to‐date evidence regarding monotherapies for male AGA showed that the oral form of 5‐alpha reductase inhibitors are more effective than oral minoxidil and other newer agents like Botox, microneedling, and photobiomodulation. Our findings can better inform clinical decision making and design of future research studies. [ABSTRACT FROM AUTHOR]

Background: Pattern hair loss, the most common form of hair loss, affects millions in the United States. Americans are increasingly seeking health information from social media. It would appear that healthcare professionals contribute relatively minimally to pattern hair loss content, thereby posing serious concerns for credibility and quality of information available to the general public. Objectives: This study evaluates popular pattern hair loss‐related content on Instagram, TikTok, and YouTube, aiming to understand effective engagement strategies for healthcare professionals on social media. Methods: The top 60 short‐form videos were extracted from Instagram, TikTok, and YouTube, using the search term "pattern hair loss" and inclusion of USA‐based accounts only. Videos were categorized by creator type (healthcare vs. non‐healthcare professional), content type (informational, interactional, and transactional), and analyzed for user engagement and quality, using engagement ratios and DISCERN scores, respectively. Conclusions: Healthcare professionals, especially dermatologists, play a crucial role in delivering credible information on social media, supported by higher DISCERN scores. Multi‐platform presence, frequent activity, and strategic content creation contributes to increased reach and engagement. Duration of short‐form videos does not impact engagement. The "Duet" or "Remix" options on TikTok, Instagram, and YouTube serve as a valuable tool for healthcare professionals to counter misinformation. Our study underscores the importance of optimizing educational impact provided by health care professionals at a time when the public increasingly relies on social media for medical information. [ABSTRACT FROM AUTHOR]

Background: Hair loss is a widespread health problem that affects numerous individuals and is associated with age, lack of sleep, stress, endocrine problems, and other problems. Caffeine exerts various pharmacological effects, particularly after ingestion. The caffeine‐induced inhibition of phosphodiesterases can increase intracellular cAMP concentrations, ultimately resulting in stimulatory effects on cell metabolism and proliferation. Hence, caffeine has been confirmed to inhibit hair loss caused by premature termination of the hair growth phase. Adenosine also improves hair loss by stimulating hair growth and thickening hair shafts. However, further empirical evidence is required to comprehensively assess the efficacy of hair loss treatment and prevention using a formulation of caffeine and adenosine in specific proportions in shampoos. Objectives: This study aimed to evaluate a shampoo with caffeine and adenosine as a daily scalp care product for hair loss in 77 subjects aged 18–60 years. Methods: The overall and local hair densities were assessed using professional cameras and dermoscopes at different magnifications and distances. Five hairs that came off the participant's head were randomly selected to measure hair diameter. The self‐assessment questionnaires were filled on third month of product use. Results: The combination of caffeine and adenosine in the shampoo significantly enhanced hair density compared to that of the baseline. The results revealed a significant reduction in hair loss. The hair diameters of the subjects did not change significantly. Most of the participants (71.05%) were satisfied with their hair after using the product. Conclusions: Shampoos containing caffeine and adenosine have been demonstrated to exert therapeutic benefits for reducing hair loss. [ABSTRACT FROM AUTHOR]

Background: Androgenetic alopecia (AGA) is a prevalent hair loss disorder with psychological repercussions. Traditional treatments have limitations, leading to the exploration of regenerative therapies such as exosomes derived from adipose tissue stem cells (ASC‐Exosomes). Methods: First, using human hair follicle (HF) dermal papilla cells (hDPCs) treated with ASC‐Exosomes, ALP, VCAN, β‐catenin, and LEF‐1 levels with RT‐PCR and p‐GSK3β, GSK3β, β‐catenin, ALP, and β‐actin levels with western blot analysis were assessed. Hair shaft elongation test and assay for ALP, Ki‐67, and β‐catenin were done using human HF organ culture. Patients with AGA had ASC‐Exosomes treatment and were evaluated for hair counts, photographic assessments, subjective satisfaction, and safety profiles. Results: ASC‐Exosomes impact hDPCs, increasing proliferation and the upregulation of hair growth‐related genes, including ALP, VCAN, β‐catenin, and LEF‐1. The Wnt/β‐catenin pathway was activated, indicating their role in promoting hair growth. ASC‐Exosomes also promoted hair shaft elongation and ALP activity, suggesting a potential for hair regeneration. Thirty participants with AGA enrolled and treated over 24 weeks. The subjects experienced a significant increase in total hair density, improved global photographic assessments, and reported higher subjective satisfaction without severe adverse reactions. Conclusion: This research contributes to the growing body of evidence supporting the use of exosomes in hair loss treatment, offering a safe and effective alternative for individuals with AGA. [ABSTRACT FROM AUTHOR]

Filler‐induced alopecia is a transient alopecia characterized by localized hair loss and often attributed to vascular compromise following dermal filler injections in facial regions. Although an uncommon phenomenon, the rising incidence of filler‐induced alopecia underscores the importance of understanding and managing this condition. We performed an extensive PubMed review of articles reporting filler‐induced alopecia and summarizing the implicated filler types, injection areas, hair loss patterns, symptom onset, course progression, treatments, and prognosis. Hyaluronic acid injections were the most implicated in filler‐induced alopecia cases, with calcium hydroxylapatite and autologous fat less frequently associated. No cases involved other dermal filler types. Although recovery times varied depending on the treatment, hyaluronidase (HAase) injections rapidly restored near‐normal hair density within 3–4 months. Minoxidil and platelet‐rich plasma play a more minor role in restoring hair growth but may be used as adjuncts with HAase to facilitate hair growth. Finally, alternative interventions like intralesional triamcinolone, warm compresses, and nitroglycerin warrant exploration, given limited robust clinical data. Our study promotes awareness of filler‐induced alopecia's rising incidence and offers practical insights and evidence‐based recommendations for effective management. By equipping dermatologists with this knowledge, our aim is to improve patient outcomes and reduce adverse events in filler‐based procedures. [ABSTRACT FROM AUTHOR]

More than 80 million people in the United States are affected by hair loss, also known as alopecia. Nonscarring alopecias are categorized as diffuse, patterned, or focal. Diffuse alopecias include telogen and anagen effluvium, are usually self-limited, and depend on stopping the underlying cause (e.g., stress). Patterned hair loss, specifically androgenetic alopecia, is the most common form of alopecia; it is typically genetic, and first-line treatment is minoxidil. Oral finasteride is another treatment available for male patients. Focal hair loss includes alopecia areata, which is typically self-limited and treated with intralesional corticosteroid or oral immunosuppressant therapy; tinea capitis, which is treated with oral antifungals; and traction alopecia, which is treated by decreasing tension on the hair. Hair loss can be caused by several systemic diseases. A comprehensive history and physical examination, with targeted laboratory testing, may elucidate malnutrition, autoimmune diseases, and endocrine disease. Patients with moderate to severe hair loss are more likely to have accompanying anxiety, depression, and lower work productivity and quality-of-life scores. Educating patients about expected hair changes, treatment options, and realistic outcomes can help patients feel that they are being listened to and that their hair loss is being taken seriously. [ABSTRACT FROM AUTHOR]

Generalized hair loss is a problem associated with the loss of the entire coat and is one of the main causes of veterinary visits to animals. In most cases, it is an acquired condition, although there are also congenital forms of hair loss, caused by abnormal development of hair follicles. This article discusses both types of causes of hair loss in dogs. Congenital hair loss can occur in the first weeks of puppies' life, but it does not progress with age. Although not always, most often congenital hair loss has a genetic basis. Dysplasia with bleaching of hair color and follicular dysplasia of black hair are examples of congenital skin neuroectodermal disorders. Acquired hair loss is usually caused by hypothyroidism, hyperadrenocorticism and hyperestrogenism, and occurs in dogs at a later age associated with hormonal disorders. [ABSTRACT FROM AUTHOR]

This chapter advances understandings of emotion work by examining how "doing gender" and "doing health" are implicated in the pursuit of emotional tranquility. The study examines the role of hair loss in women's illness narratives of cancer using in-depth interviews with 16 white women in the US Northwest who vary in age, marital status, diagnoses, and treatments. The absence of women's hair presents an appearance of illness that prevents them from doing femininity, which calls into question their health status because of Western beauty standards. To overcome this barrier, the women use emotion work to manage the effects of their appearance through necessarily co-occurring bodily, cognitive, and expressive strategies (Hochschild, 1979). The required emotion work during women's hair loss makes explicit the symbolic linking of the healthy body with the feminine body through women's head hair. Pursuing treatment for cancer is often seen as a "fight" or a "battle" against the disease and the bodily assaults of such treatments, including unwanted visible bodily changes. A substantial body of empirical work has established the complex web of social psychological problems associated with breasts and breast cancer, but less attention has been given to the side effect of hair loss that is common across cancer types and treatments. [ABSTRACT FROM AUTHOR]

Background and Objectives: Polycystic ovary syndrome (PCOS) is a frequent and complex multidisciplinary disorder. Data regarding the role of genes involved in vitamin D metabolism in PCOS are as-yet elusive but suggest an association of VDR (vitamin D receptor) and vitamin D levels with metabolic, endocrine and cutaneous manifestations. The aim of this study was to evaluate the association between VDR gene polymorphisms and cutaneous manifestations, to find a correlation between hormonal parameters, oxidative stress and skin manifestations in women with PCOS, and to determine the impact of VDR gene polymorphisms on these parameters. Materials and Methods: This case–control study included 39 controls and 46 women with PCOS, matched by age and BMI distribution. Acne, hirsutism, seborrhea, androgenetic alopecia, oxidative stress and androgen hormones were recorded. VDR gene polymorphisms ApaI, FokI and TaqI were examined by polymerase chain reaction restriction fragment length polymorphism, and the androgen hormone (total testosterone, DHEAS), SHBG and malondialdehyde levels were assessed. Results: The most frequent skin manifestations in PCOS cases were acne followed by seborrhea, hirsutism and androgenic alopecia. The VDR-FokI polymorphism CC genotype had a significant protective role in the odds of acne (OR = 0.11, 95% CI: [0.02, 0.70], p = 0.015, p-corrected = 0.040) and seborrhea (OR = 0.15, 95% CI: [0.03, 0.75], p = 0.019, p-corrected = 0.039). The results demonstrated a significant protective effect of the C allele on the odds of acne and seborrhea in PCOS cases. Moreover, the dominant genotype of VDR-TaqI could have a protective role against oxidative stress (lower MDA levels) compared to patients carrying the TT genotype. Conclusions: In summary, this is the first study to demonstrate that the FokI CC genotype may have a protective role against both acne and seborrhea in women with PCOS, while the VDR-TaqI dominant genotype is associated with diminished oxidative stress in PCOS patients. [ABSTRACT FROM AUTHOR]

Alopecia is an undesirable side effect of cancer chemotherapy. The mitigation of alopecia is a desirable adjunct treatment for patients with cancer. FDA-cleared scalp cooling (SC) devices have been successfully used to prevent or reduce chemotherapy-induced alopecia (CIA). This paper provides an understanding of the implementation and value of the new Insurance-Based Billing Model used in the USA for SC and its benefits compared with the original self-pay model. This improved compensation change will result in all patients in need, including underserved and disadvantaged populations, receiving equitable healthcare by allowing access to this valuable supportive care technology. [ABSTRACT FROM AUTHOR]

Background: Tralokinumab, a humanized monoclonal antibody targeting interleukin-13, has been primarily used for the treatment of moderate-tosevere atopic dermatitis. Given its extensive use in clinical practice, understanding its safety profile in the real-world setting is crucial. Methods: This study utilized disproportionality analysis to evaluate the safety of tralokinumab in clinical practice by analyzing all adverse event reports since 2021 in the FDA Adverse Event Reporting System database that identified tralokinumab as the primary suspected drug. Reporting odds ratio, proportional reporting ratio, multi-item gamma Poisson shrinker, and Bayesian confidence propagation neural network were used for disproportionality analyses of adverse events related to tralokinumab. Additionally, the Weibull distribution was employed to model the risk of adverse events over time. Results: Adverse reactions documented on the drug label, such as injection site reactions, conjunctivitis, and upper respiratory infections, displayed positive signals. Additionally, potential adverse reactions not mentioned on the label were also identified, including dizziness, headache, nausea, vomiting, hair loss, and acne. The importance of adverse event monitoring, particularly in the first month after treatment initiation, was emphasized. Conclusion: This study has provided preliminary safety data on the real-world application of tralokinumab, confirming some known adverse reactions and revealing additional potential risks. The findings offer critical safety information for clinicians prescribing tralokinumab to treat atopic dermatitis. [ABSTRACT FROM AUTHOR]

Background: Polycystic ovary syndrome (PCOS) is one of the most prevalent endocrinopathies among young women. Ultrasound evidence of polycystic ovaries is one of its crucial diagnostic criteria. Objectives: Our main objective is to study the contribution of ultrasound data in diagnosing PCOS. In addition, we aim to establish a new cutoff point for the use of ultrasound and to determine its sensitivity as well as its specificity. Design: It was a prospective study, including all patients presenting with clinical hyperandrogenism. Methods: The ultrasound examination of these patients was performed using a novel ultrasound machine (18 MHz) compared to an older ultrasound machine (2 Hz–8 MHz). Inclusion criteria encompassed adult female patients over 18 years presenting symptoms suggestive of PCOS, particularly hyperandrogenism and oligo-anovulation, meeting Rotterdam's diagnostic criteria. Prior to inclusion, assessments were conducted to eliminate other potential causes explaining hyperandrogenism or menstrual disorders in both groups. Results: We examined 92 patients diagnosed with PCOS. Menstrual disorders were the main symptoms, with amenorrhea being more frequent in the PCOS group (G1) (48.9% vs the control group (G2): 11.1%). The follicle number was significantly lower in the control group, as assessed by both ultrasound machines (p < 10−3). The accuracy of the new ultrasound device was evaluated compared to the old one using the receiver operating characteristic (ROC) curve, revealing a cutoff of 18 follicles (sensitivity of 68.1%, specificity of 100%) and an area under the curve of 0.955. We found a significant difference between the median values of the number of follicles (NF) by both ultrasound machines (18 vs 12). It was positively correlated with an index of r = 0.916. For the volume, it was distinctively higher in G1 (p < 10−3). ROC curve analysis revealed an ovarian volume cutoff of 9.25 ml with a sensitivity of 48.9% and a specificity of 100%. Both ultrasound machines were positively correlated with an index of r = 0.979 (p < 10−3). Conclusion: In conclusion, we were able to establish significant correlations between the new and the old ultrasound devices for both the NF and ovarian volume. Our study is distinctive as it represents the first on the African continent to re-evaluate the ultrasound criterion for PCOS. Plain language summary: Validating ultrasound criteria for PCOS in North African patients In this study, we explored patients using ultrasound to better diagnose Polycystic Ovary Syndrome (PCOS) in North African women. Ovarian follicles are small sacs in a woman's ovaries that not only release eggs but also produce important hormones like estrogen and progesterone. These hormones regulate the menstrual cycle, prepare the body for pregnancy, and influence many aspects of a woman's health and well-being. We set new standards for measuring follicles and ovaries to improve diagnosis accuracy. Background: Polycystic Ovary Syndrome (PCOS) is often diagnosed using ultrasound in North African women. Current ultrasound standards may not be accurate enough for this group. This study aimed to improve PCOS diagnosis by setting new standards for measuring ovarian sizes and follicle numbers. Methods: We reviewed a new ultrasound method. We then established new measurement thresholds specific to North African women. These new standards were tested for accuracy in diagnosing PCOS. Results: Our new measurement thresholds were more accurate in diagnosing PCOS. The improved standards led to better identification of PCOS in North African women. This suggests that current ultrasound methods might need adjustments based on population-specific data. Conclusions: Using ultrasound with new measurement standards can improve PCOS diagnosis in North African women. Adjusting diagnostic criteria to specific populations may enhance overall healthcare outcomes. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusions This study was designed to evaluate the safety and efficacy of injections of concentrated growth factors (CGF) for hair growth promotion in androgenetic alopecia (AGA) patients.A retrospective review of AGA patients treated with injections of CGF at our center from October 2021 to April 2023 was performed. A total of 3 injections were administered every 3–4 weeks apart, and evaluation were performed before the first injection and at 3 months, 6 months later. The outcomes were assessed by trichoscopy photomicrographs and the Global Aesthetic Improvement Scale (GAIS).At 3 months after the first injection, the hair density and hair growth ratio were significantly improved. Significant improvements were found in GAIS score by both patients and independent doctors and the hair growth promotion was sustained for 6 months after first treatment.According to this tiny single‐arm trial, the use of CGF injection may help AGA by increasing terminal hair density and hair density. No severe topical or systemic adverse events occurred during the treatment. [ABSTRACT FROM AUTHOR]

Background: Childhood-onset systemic lupus erythematosus (c-SLE) is a multifaceted autoimmune disorder predominantly affecting the musculoskeletal (MSK) system. This investigation delineated the spectrum and sequelae of MSK involvement in c-SLE patients. Methods: This retrospective analysis included SLE patients aged ≤ 18 years treated at a tertiary center between 2009 and 2019. Data were extracted from electronic health records. Results: The cohort comprised 321 SLE patients (mean age 13.2 ± 2.5 years, 91.3% female). MSK manifestations were observed in 134 (41.7%) individuals, with joint pain universally present, followed by joint swelling in 32.1% and morning stiffness in 9.7%. Arthritis was documented in 52 (38.8%) patients, whereas 82 (61.2%) had arthralgia. Symmetrical joint involvement was observed in 96 (71.7%) subjects. The knees, wrists, and fingers were most commonly affected, with incidences of 43.3%, 40.3%, and 33.6%, respectively. Neither erosive arthritis nor Jaccoud's arthropathy was detected. MSK symptoms were significantly correlated with older age at diagnosis, the presence of non-scarring alopecia, neuropsychiatric manifestations, and elevated SLE disease activity index scores at diagnosis. Over a median follow-up of 53.6 months (IQR 26.1–84.6), five patients developed septic arthritis or osteomyelitis, and avascular necrosis was identified in 16 (4.9%) patients. Conclusions: Nearly half of c-SLE patients demonstrated MSK manifestations, chiefly characterized by symmetrical involvement of both large and small joints without evidence of erosive arthritis or Jaccoud's arthropathy. Avascular necrosis is a critical concern and warrants close monitoring. [ABSTRACT FROM AUTHOR]

BackgroundAimPatients and methodsResultsConclusionAlopecia areata (AA) is a common autoimmune T-cell mediated non-scarring, form of hair loss. It affects people of all ages and sexes.To compare the efficacy of intralesional vitamin D3 injection versus that of intralesional triamcinolone acetonide in the treatment of patchy alopecia areata.This clinical study was carried on 40 adult patients with patchy alopecia areata, the patients were categorized into two groups. Group I involved 20 patients who received 1 ml of intralesional injection of vitamin D3 (cholecalciferol aqueous preparation 200 000 IU/2 ml) every 4 weeks for a maximum of three sessions. Group II involved 20 patients who received 1 ml of intralesional injection of triamcinolone acetonide 40 mg/mL every 4 weeks for a maximum of three sessions. Clinical and trichoscopic evaluations were done at the baseline, each session and for 3 months after the last session.There was no statistically significant difference between the two studied groups regarding the degree of clinical improvement (p = .8). A statistically significant reduction in AA specific trichoscopic signs was detected at the end of the sessions and after 3 months of follow-up in both groups, without any statistically significant difference between them. Also a statistically significant difference was found between both groups regarding the reported adverse effects with a significant better patient satisfaction encountered toward the intralesional vitamin D3 injection.Intralesional vitamin D3 is a promising effective, simple, safe, and inexpensive, therapeutic modality for patchy AA. [ABSTRACT FROM AUTHOR]

Background: Lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA) are the most common causes of lymphocytic scarring alopecia. Itching of the scalp is a common accompanying symptom. The aim of the study was the clinical assessment of pruritus and its correlation with dermoscopic features. Methods: Sixty-one patients with scarring alopecia were analyzed (LPP = 16; FFA = 33; coexisting LPP-FFA = 12). Each patient underwent a trichoscopic examination. Itch severity and characteristics were assessed using a Visual Analogue Scale (VAS), 4-item Itch Questionnaire and 12-item Descriptive Pruritus Assessment Questionnaire. Results: Itching of the scalp occurred in 73.8% of the patients (mean maximal VAS 5.3 ± 3.1 points). Pruritus was most frequently accompanied by tingling (19.7%) or burning (14.8%) sensations. The following factors most frequently increased the severity of pruritus: sweating, heat, stress and hot water. On the other hand, cold water and cold air often relieved symptoms. There was a significant relationship between itch and perifollicular scaling (p = 0.011), hair diameter diversity (p = 0.008) and white halo (p = 0.016). Conclusions: Pruritus was the main subjective complaint reported by patients suffering from LPP and FFA. A better understanding of pruritic features may help in the selection of an effective therapeutic strategy. [ABSTRACT FROM AUTHOR]

Urdhwajatrugata Vyadhi (disease of the supra clavicular region) and Indralupta {Alopecia Areata (AA)} are characterised by patchy hair loss in the area that bears hair, such as the beard and scalp. According to Sushruta Acharya, vitiated pitta and vitiated vata together cause Indralupta (AA), leading to scalp hair loss. Additionally, vitiated Rakta and Kapha obstruct the hair follicles openings, limiting the growth of new hair. In contemporary science, these conditions are related to the clinical features of AA. A five-year-old female child presented to the Department of Kaumarbhritya with complaints of hair falling out in patches on the scalp gradually over six months. In her condition, the Raktamokshana therapy by using the Jalaukavacharana Vidhi technique was adopted for effective results. This age-old procedure described by Acharya Sushrut in Sushrut Samhita is still beneficial in treating the above aforementioned condition. The patient experienced relief from her symptoms after eight sessions and is continuing treatment. Raktamokshana, or therapeutic bloodletting, is one of the Ayurvedic therapy methods for Raktapradoshaja Vikara. Raktamokshana (Bloodletting) through leech treatment is one of the easiest methods to administer, especially for elderly patients, female patients, paediatric patients, individuals who are extremely shy, and those with sensitive constitutions like children. It resulted in fewer complications postprocedure and reduced the risk of symptom recurrence. The therapy was cost-effective, and within short span of three months, it produced positive outcomes in patients. [ABSTRACT FROM AUTHOR]

Background: Female‐pattern hair loss (FPHL) is characterized by decreased scalp hair density, thinning of hair shafts, and progressive miniaturization of hair follicles. Objective: To compare the safety and efficacy of spironolactone versus bicalutamide in female pattern hair loss [FPHL]. Methods: The study design was retrospective, and all eligible females aged between 18 years and 50 years with FPHL were included. We identified 120 patients from our database who fulfilled the inclusion and exclusion criteria, and patients were then categorized into two groups, Group A comprising patients who were taking 100 mg of spironolactone once daily and Group B comprising patients who were taking 50 mg of bicalutamide once daily along with topical minoxidil 2% in both groups. Patient were analysed at approximately at 24 weeks from the commencement of the treatment. Results: Mean reduction in hair loss severity score on Sinclair scale was 19.51% in spironolactone group compared to 28.20% in bicalutamide group at 24 weeks, which was statistically significant. On global photographic assessment, marked improvement was seen in bicalutamide group compared to spironolactone group (p = 0.139). Conclusions: Our study, though limited by its retrospective design and small sample size, showed that bicalutamide has greater efficacy and better safety profile in comparison to spironolactone in the treatment of FPHL. [ABSTRACT FROM AUTHOR]

Introduction: To understand the experiences of adolescent and adult patients living with alopecia areata (AA) in Australia regarding symptom severity and the impact on psychosocial well‐being and work/classroom productivity. Materials and Methods: A cross‐sectional online patient survey among adolescent and adult patients diagnosed with AA was recruited via the Australia Alopecia Areata Foundation. Patient‐reported outcomes were also assessed. Results: A total of 337 patients (49 adolescents; 288 adults), with a mean ± standard deviation age of 14.7 ± 1.55 and 38.9 ± 13.31 years for adolescents and adults, respectively, were included. In the group with extensive hair loss (Scalp Hair Assessment Patient‐Reported Outcome, categories 3 + 4, n = 172), we observed higher emotional symptom and activity limitation scores (Alopecia Areata Patient Priority Outcomes, emotional symptoms: adults 2.5 ± 1.03, adolescents 2.2 ± 1.15; activity limitations: adults 1.4 ± 1.15, adolescents 1.2 ± 0.99). Additionally, in adults, the Alopecia Areata Symptom Impact Scale global score was 4.0 ± 2.10 (symptoms subscale score 4.1 ± 1.91; interference subscale scores 3.8 ± 2.73). Hospital Anxiety and Depression Scale scores were high across participants, irrespective of hair loss extent (adults: anxiety 9.2 ± 3.85, depression 6.6 ± 3.95; adolescents: anxiety 9.7 ± 4.65, depression 5.2 ± 3.59). Work and classroom productivity were substantially impaired due to AA, with 70.5% of adults and 57.1% of adolescents reporting activity impairment, and overall work/classroom impairment reported at 39.2% and 44.9%, respectively. Conclusions: AA impacts the physical, emotional and psychosocial well‐being of both adult and adolescent patients. More extensive hair loss more profoundly impacts those living with AA. Patients may benefit from patient‐centred care approaches addressing the impact of hair loss on mental and emotional well‐being, daily activities and work productivity. [ABSTRACT FROM AUTHOR]

Androgenetic alopecia, the most common cause of hair loss affecting both men and women, is typically treated using pharmaceutical options, such as minoxidil and finasteride. While these medications work for many individuals, they are not suitable options for all. To date, the only non-pharmaceutical option that the United States Food and Drug Administration has cleared as a treatment for androgenetic alopecia is low-level laser therapy (LLLT). Numerous clinical trials utilizing LLLT devices of various types are available. However, a myriad of other physical treatments for this form of hair loss have been reported in the literature. This review evaluated the effectiveness of microneedling, pulsed electromagnetic field (PEMF) therapy, low-level laser therapy (LLLT), fractional laser therapy, and nonablative laser therapy for the treatment of androgenetic alopecia (AGA). It also explores the potential of multimodal treatments combining these physical therapies. The majority of evidence in the literature supports LLLT as a physical therapy for androgenetic alopecia. However, other physical treatments, such as nonablative laser treatments, and multimodal approaches, such as PEMF-LLLT, seem to have the potential to be equally or more promising and merit further exploration. [ABSTRACT FROM AUTHOR]

Studies on androgenetic alopecia (AGA or patterned hair loss (PHL)) have suggested different underlying pathological mechanisms between males and females. While many genetic factors for male hair loss have been identified through genome-wide association studies (GWASs), the genetic determinants of female hair loss remain unclear. In this study, we analyzed approximately 1000 individuals (436 males and 568 females) to identify sex-specific genetic factors. We conducted three independent GWASs for the total, male-only, and female-only groups, identifying three novel loci (rs7814359, rs2163085, and rs4793158 of the TSNARE1, FZD1, and GJC1 genes, respectively). rs7814359 showed a significant genome-wide association with AGA in the combined sex group and a weak association in both the male-only and female-only groups. The single nucleotide polymorphism (SNP) rs2163085 showed a significant genome-wide association with AGA in the combined group and notable significance in females. The rs4793158 SNP showed a suggestive association with AGA in both the combined and female-only groups. TSNARE1, related to rs7814359, is involved in vesicle transport. FZD1 is a key regulator of the Wnt signaling pathway. GJC1 is a gap junction protein. The associations of FZD1 and GJC1 with female-specific AGA suggest that sex hormones, such as estrogen, may influence FPHL through these genes. These findings will contribute to our understanding of the sex-specific pathophysiology of AGA. [ABSTRACT FROM AUTHOR]

Chemotherapy-induced hair loss is a distressing side effect of cancer treatment, and medical interventions are often needed to address this problem. The objectives of this study were to evaluate the bioactivity of goat placenta (GP) extract on both normal and chemotherapy-induced hair cells and to develop PEGylated liposomes (PL) and microspicule (MS) formulations for promoting hair growth in patients with chemotherapy-induced hair loss. The bioactivities of GP extract on human follicle dermal papilla (HFDP) cells and cells damaged by chemotherapy were assessed. GP extract was incorporated into PLs and MS gel (PL-MS) and then investigated in vitro skin permeation and in vivo studies on the scalps of patients with chemotherapy-induced hair loss. GP extract stimulated HFDP cell proliferation in both normal and cisplatin-damaged cells. PL nanovesicles and MS gel worked synergistically to deliver macromolecular proteins into the skin and hair follicles. The application of GP extract-loaded PL-MS to the scalps of chemotherapy-treated patients for 12 weeks significantly enhanced the hair growth rate, without causing skin irritation. In conclusion, GP extract promoted the proliferation of hair cells damaged by chemotherapy, when this extract, combined with PL-MS, effectively delivered bioactive macromolecules across the skin and hair follicles, resulting in successful regrowth of hair post-chemotherapy. [ABSTRACT FROM AUTHOR]

Alopecia affects patients' appearance and psychology. Mixed-lineage kinase domain-like pseudokinase (MLKL)-mediated necroptosis plays a role in various skin diseases, but its effect on hair growth is unclear. To investigate the effects of MLKL on hair growth and its regulatory mechanisms and to determine the potential clinical value of Necrosulfonamide (NSA, a MLKL-targeting inhibitor) in promoting hair growth and counteracting dihydrotestosterone (DHT) inhibition of hair growth. The expression level of MLKL was detected in the scalp of androgenetic alopecia (AGA) patients and the skin tissues of mice. Knock down MLKL expression or use NSA to observe hair growth in vivo and in vitro. In AGA patients, MLKL expression is elevated in the alopecia areas. In mice, MLKL is significantly expressed in the outer root sheath (ORS) cells of hair follicles, peaking during the catagen phase. Knockdown expression of MLKL in mice skin promoted hair growth. NSA enhanced hair growth and prevented hair follicle regression via the Wnt signaling. Reduced MLKL boosts ORS cell proliferation without directly impacting DPCs' growth. Interestingly, NSA boosts DPCs' proliferation and induction when co-cultured with ORS cells. Besides, NSA alleviated the inhibition of DHT on hair growth in vivo and vitro. NSA inhibited the activation of MLKL in ORS cells, promoted the activation of Wnt signal in DPC cells, and improved the inhibition of hair growth by DHT, illuminating a new alopecia mechanism and aiding anti-alopecia drug development. • MLKL was significantly upregulated in alopecia area in AGA patients. • MLKL knockdown or inhibition promoted hair growth. • NSA inhibits MLKL activation to promote hair growth. • NSA limits MLKL activity in ORS to foster proliferation and induce ability of DPC. • NSA ameliorates DHT-induced hair growth inhibition. [ABSTRACT FROM AUTHOR]

Treatments for breast cancer can have an array of adverse effects, including hair loss, scarring, and irritated skin. These physical outcomes can, in turn, lead to body image concerns, anxiety, and depression. Fortunately, there is growing evidence that certain cosmetic therapies can improve patient self-image. Here we review various cosmetic treatment options including hair camouflage, eyebrow and eyelash camouflage, treatments for hirsutism, nipple and areola tattooing, post-mastectomy scar tattooing, treatments for dry skin/xerosis, removal of post-radiation telangiectasias, and lightening of post-radiation hyperpigmentation. For each patient concern, we report potential procedures, clinical evidence of impact on quality of life, special considerations, and safety concerns. This article aims to equip dermatologists with resources so that they may effectively counsel breast cancer survivors who express treatment-related cosmetic concerns. [ABSTRACT FROM AUTHOR]

Key Clinical Message: In examining any scalp itch or skin lesions, especially in children with long hair, fungal lesions under the hair may not be diagnosed in a timely manner. Additionally, fungal infection of the scalp, known as tinea capitis, is considered a chronic condition and if left untreated, it can lead to alopecia (hair loss) and permanent scarring. Tinea capitis (TC) is a common cutaneous fungal infection in childhood. In this report, we describe the case of an 8‐year‐old child presenting with erythematous scalp lesions accompanied by hair loss. Upon examination, palpation revealed a swollen and tender left parotid gland. Notably, the frontal region of the scalp exhibited erythematous lesions and scaly red plaques resembling yellowish paste‐like dough. Subsequent clinical evaluation and culture analysis confirmed the diagnosis of TC. The patient received treatment with Terbinafine 125 mg for a duration of 8 weeks. Follow‐up examinations conducted after 3 months showed no signs of recurrence. Accurate diagnosis and timely treatment, along with adherence to medication regimens, are crucial in cases of TC, and differential diagnoses should be considered. Treatment should commence promptly upon diagnosis to prevent complications such as scalp baldness and transmission to others. This case report underscores the significance of establishing a precise diagnosis and effective treatment for this dermatophytosis to mitigate the risk of recurrences or therapeutic shortcomings, particularly in infants. [ABSTRACT FROM AUTHOR]

Introduction: Limited epidemiologic data has suggested direct associations between hair pigment, race, and incidence of alopecia areata (AA). Here, we examine the relationship between natural hair color, race, and the lifetime risk alopecia. Methods: In this case–control study, we included UK Biobank patients of all races and self-reported hair color with diagnoses of AA, androgenetic alopecia (AGA), or scarring alopecia (SA). Multivariable logistic regression was used to detect differences in lifetime risk. Results: Findings reveal a significantly increased risk of AA among individuals with black hair compared to dark brown hair (OR 1.71 [95% CI 1.22–2.38], p < 0.001). Those with red or blonde hair showed a decreased risk of AA (0.74 [0.56–0.97]; 0.62 [0.41–0.95], p < 0.05). No racial differences in AA prevalence were observed among individuals with black hair. Conclusions: Darker hair colors may be associated with a higher risk of AA, lighter hair colors with a lower risk, and differences in hair color could contribute to previously noted racial variations in AA incidence, potentially influencing dermatologists' perspectives on the disease's epidemiology. [ABSTRACT FROM AUTHOR]