International Journal of Trichology最新文献

Introduction: Diphenylcyclopropenone (DPCP) is an effective treatment in severe alopecia areata (AA). Platelet-rich plasma (PRP) has been introduced as an effective modality in AA. We present the first study to evaluate and compare the efficacy and tolerability of DPCP alone and DPCP in combination with PRP in the treatment of severe AA.

Methods: This is a comparative, randomized, double-blind study that included 14 patients with severe AA. Participants received weekly DPCP plus monthly PRP to treat alopecia patches on one side of their scalp (group 1) and DPCP plus placebo on the other side (group 2). Patient's response was evaluated with the severity of alopecia tool (SALT) score and trichoscopy scores. PRP was injected for 3 times and patients were followed for 6 months.

Results: Among enrolled patients, 7 (50%) experienced a hair regrowth >50%. The mean SALT score and trichoscopy scaled scores decreased over time for both the groups. Nevertheless, there were no significant differences between groups. The side effect was not noticeable in either group.

Conclusions: This is the first study to investigate a synergistic effect with DPCP and PRP. According to this study, PRP is ineffective as an adjunct to DPCP for augmenting its effectiveness.

Topical hair growth supplements in the form of hair growth serums, oils, and shampoos have flooded the cosmeceutical market. The gullible masses are targeted with sponsored marketing gimmicks through social media platforms. This review article brings to light the most hyped active ingredients or peptides in these products along with their clinical evidence available in the literature. The topical actives include Redensyl, Procapil, Capixyl, Baicapil, AnaGain, onion juice, coffee extract, saw palmetto extract, pumpkin seed oil (PSO), and rosemary oil. PubMed, Google Scholar, and Google databases were searched with the keywords: topical, hair growth, hair loss, and the respective active agents. Twenty-four relevant articles and technical files were extracted and reviewed. They have been studied mostly as combined formulations with other agents in randomized controlled trials or prospective cohort studies and have shown promising results. However, most of the studies have limited sample size, lack of comparison with standard therapies, nonuniformity between study groups, nondisclosure of the type of alopecia treated, and conflicts of interest. These topicals with their less significant side effect profile may find their use as an add-on therapy or as an alternative in patients not tolerating standard therapies. In this fast-growing commercialized world, it is imperative that we remain vigilant and understand the pros and cons of these products and ultimately guide our patients to the right track.

Background: Patchy/focal alopecia can be noncicatricial or cicatricial. Trichopathology may play an important role in confirming and/or establishing the diagnosis of cicatricial alopecia.

Aims: The aim of this study was to study the trichopathologic features of common cicatricial conditions presenting with patchy scalp alopecia.

Materials and methods: This cross-sectional study was conducted over a period of 1 year in the department of dermatology and pathology in a tertiary care hospital in North India. Adult patients (age >18 years) presenting with patchy cicatricial alopecia as well as clinically doubtful noncicatricial conditions over the scalp were included in this study. In doubtful cases of noncicatricial alopecia, a single 4-mm punch biopsy was performed for transverse sectioning with hematoxylin and eosin stain. In all cases of cicatricial alopecia, two 4-mm punch biopsies were performed, one for transverse sectioning and the second for vertical sectioning and direct immunofluorescence (DIF). The final diagnosis was made on the basis of the trichopathologic findings.

Results: A total of 23 cases were included in our study with the majority (52.2%) being in the age group of 20-30 years. The mean age at diagnosis was 30.5 ± 11.38 years. On the basis of trichopathologic findings, a final diagnosis was made in 18 (78.3%) cases. However, 5 (21.7%) cases remained undiagnosed and were labeled as nonspecific. According to the final diagnosis based on the trichopathologic findings, maximum cases were of discoid lupus erythematosus (DLE) (26.1%), followed by lichen planopilaris (21.7%), pseudopelade of Brocq (13%), alopecia areata (8.7%), folliculitis decalvans (4.3%), and traction alopecia (4.3%). Trichopathologic examination revealed hyperkeratosis (60%), basal cell vacuolization (55%), epidermal atrophy (55%,) perifollicular lymphocytic infiltrate (30%), pigment incontinence (30%), perifollicular fibrosis (25%), and thickened basement membrane (25%). Only four cases showed deposits of immunoreactants in DIF and all four were finally diagnosed as DLE.

Conclusions: Trichopathology along with special stain is a useful tool in the diagnosis of patchy alopecia and must be carried out in cases where diagnosis is in doubt clinically, particularly in cases of cicatricial alopecia. DIF may have a supportive role in histopathologically inconclusive cases and should be carried out, particularly when DLE is suspected. Trichopathology in combination with DIF is an important tool in the diagnosis of the majority of cases of cicatricial as well as clinically doubtful cases of noncicatricial alopecia.

Background: The frequencies of the different types of alopecia in hair referral centres have so far been reported in a single multicentre study at multiple specialist hair clinics over a time period of one month.

Aim: Single center studies over a longer time-frame offer a more representative and homogeneous study population with regard to ethnic, demographic, and climatic factors, and seasonality of hair growth and shedding than multicenter studies over a short time frame.

Materials and methods: Retrospective study of patient data at a single centre over 10 years.

Results: A total of 15'211 patients (73% female, 27% male) were included, and we found the following frequencies: pattern hair loss (67%), alopecia areata (11%), the cicatricial alopecias (11%), and telogen effluvium (7%). Among the cicatricial alopecias, the most frequent diagnosis was frontal fibrosing alopecia (33% of cicatricial alopecias), followed in order of frequency by lichen planopilaris (19%), fibrosing alopecia in a pattern distribution (18%), folliculitis decalvans (8%), discoid lupus (5.5%), and dissecting cellulitis (2%). Some specific types of alopecia were observed more frequently in women, others in men, with a predominance of central centrifugal cicatricial alopecia and traction alopecia in women of African origin, and dissecting cellulitis of the scalp and acne keloidalis in men of African origin. The proportion of patients under the age of 10 years was 2.4%. Among the pediatric hair conditions were in order of frequency: alopecia areata (39%), prepubertal pattern hair loss (24%), telogen effluvium (6%), hereditary hypotrichosis (6%), congenital triangular alopecia (4%), short anagen hair (4%), loose anagen hair (3%), trichotillomania (2%), and tinea capitis (1.4%).

Conclusion: Knowledge of the main types of alopecia and of their epidemiological and clinical specifics are prerequisite for providing an understanding of the etiologies and appropriate patient care in a respective specialty clinic.

Human beings are the only primates without thick body hair. Evolution has played its part in reducing the thickness and density of body hair from our prime ancestors. To understand the causality of this, it is wise to explore three other characteristics which distinguish Homo sapiens from other primates; bipedalism, practical nakedness, and the family reproductive unit. The evolution of hairlessness, combined with the need for efficient eccrine sweat production for cooling, provided evolutionary pressure to protect the skin from ultraviolet damage by developing cutaneous pigmentation. There was a subsequent loss of pigmentation as humans journeyed to northern latitudes. The relationship between nakedness, bipedality, the establishment of family reproductive unit, and the appearance of melanin in the skin all constitute a fascinating challenge to understand. It is indeed intriguing that while nature prefers the Homo sapiens to be relatively naked and hairless, the Homo sapiens is so obsessively fascinated with the preservation of persistence of hair. These issues are indeed very relevant for all physicians who treat hair, such as dermatologists and hair transplant surgeons.

Background: Cosmetologists and hair stylists are often the first and most frequented professionals evaluating patients with alopecia. This makes them a strong ally for dermatologists. Our study aimed to assess the knowledge and practices of African-American cosmetologists regarding hair loss. The study focused on their confidence levels in identifying scarring alopecia conditions in clients, general knowledge of hair loss causes and risk factors, and the frequency of client referrals to dermatologists.

Methods: A survey was distributed among African-American cosmetologists, consisting of questions related to their confidence in recognizing scarring alopecia conditions, their knowledge of hair loss causes and risk factors, and their referral practices for clients experiencing hair loss. The survey was distributed electronically, and responses were collected anonymously. Descriptive statistics were used to analyze data.

Results: A total of 19 African-American cosmetologists participated in the survey. A majority of cosmetologist had never heard of lichen planopilaris (LPP) and central centrifugal cicatricial alopecia (CCCA) (78.9% and 57.9%, respectively) The majority of cosmetologists reported avoiding or limiting tight braids/locs (100%), tight ponytails/buns (100%), tight hair weaves (89.5%, n=17). 94.7% (n=18) referred clients to a dermatologist for hair loss in the past year.

Conclusion: The findings revealed varying levels of confidence among cosmetologists in identifying different types of scarring alopecia conditions. The results highlighted gaps in cosmetologists' knowledge of hair loss risk factors. The results suggest that there is a need for increased education and awareness among African-American cosmetologists regarding hair loss and scarring alopecia. Addressing these knowledge gaps and improving the confidence levels of cosmetologists in recognizing hair loss can have a positive impact on client care and well-being. Collaboration and communication between cosmetologists and dermatologists are crucial in providing comprehensive support for clients experiencing hair loss.