International Journal of Trichology最新文献

Background: Androgenetic alopecia (AGA), although considered medically benign, has been found to be associated with increased cardiovascular risk, especially in patients with early onset (≤ 30 years). Metabolic syndrome (MetS) comprises a cluster of cardiovascular risk factors predicting morbidity. Very few studies focused on early development of MetS in younger males and the association with the severity of AGA, necessitating further research.

Objectives: To estimate the prevalence of MetS in men with early-onset AGA and to assess if there is a positive correlation between the severity of AGA and the development of MetS and its components.

Materials and methods: A cross-sectional study was undertaken in a tertiary care hospital from November 2020 to October 2022, on men in the age group of 18 - 40 years. 100 men with early-onset AGA (≤ 30 years) were included in the study. MetS was diagnosed as per the criteria by the International Diabetes Federation (IDF), and American Heart Association/ National Heart, Lung and Blood Institute (AHA/NHLBI). Chi-square test and student's t-test were used for statistical analysis.

Results: Metabolic syndrome was diagnosed in 63 (63%) of the patients. The prevalence of MetS (P = 0.006), elevated waist circumference (P = 0.006), elevated serum triglycerides (P = 0.011), and mean value of serum high-density lipoprotein (P = 0.05) was statistically significant in patients with severe AGA.

Conclusion: A high prevalence of metabolic syndrome was found in young males with early-onset AGA. Screening and lifestyle modifications should be enforced earlier to lessen cardiovascular morbidity and mortality in young male patients with AGA.

Anterolateral alopecia of the legs or peroneal alopecia is a benign entity presenting with symmetrical, non-scaring well-demarcated patches of hair loss on the anterior and lateral aspects of the legs. It is prevalent in men with a prevalence rate of 35%. The condition has rarely been encountered in literature due to its benign course. This report highlights the significance of dermoscopic examination in diagnosing anterolateral alopecia of the legs. It can be considered an alternative to histopathology in those who refuse a biopsy.

Syndromes, defined as clusters of consistent symptoms, are vital in understanding diseases and disorders. The interplay between hair and clinical syndromes is examined in brief here, emphasizing the need for a unified data resource to aid clinicians and postgraduate students. The syndromes are categorized into hypertrichosis, characterized by excessive hair growth, and hypotrichosis, defined by a lack of hair. For hypertrichosis, various syndromes such as Ambras, Cantú, and Rubinstein-Taybi syndrome are elucidated, highlighting their distinct clinical features and genetic underpinnings. Hypotrichosis syndromes include Bjornstad's, Netherton and Rothmund-Thomson syndromes. By categorizing and elucidating the array of hair-related syndromes, this comprehensive review aims to enhance clinical understanding and improve patient care in this domain.

Background: Telogen effluvium (TE) is self limiting diffuse hair loss occurring 3-4 months after a triggering event. There is scarcity of data on TE as possible sequelae of COVID-19.

Methods: We assessed 113 cases of TE occurring after SARS-CoV-2 infection as a retrospective study.

Results: Most of the patients belonged to the age group 18-30 years and were females (85.8%). Most of the patients (92%) had acute TE. The median duration of hair loss was 2 months. Trichodynia and pruritus were the common associated complaints. Hair pull test was positive in 54.9% patients. Trichoscopy showed short regrowing hairs in 61.2% patients and empty hair follicles in 77.9% patients. Ferritin, vitamin D and Vitamin B12 deficiency was seen in 27.4%, 38.1% and 20.4% patients respectively. TE was seen more commonly with symptomatic COVID infection (93% patients).

Conclusion: TE occurring after SARS-CoV-2 infection calls for assessment of micronutrient deficiency, as there appears to be an association between COVID-19 infection and nutritional deficiency. Although acute TE is the most common presentation, relapse in chronic TE might also occur as sequelae of COVID-19 infection.

Background: Female pattern hair loss (FPHL) is the most common hair loss disorder in women. Its origin is polygenic and multifactorial. Specific genetic factors predispose androgen receptors to be particularly sensitized so that they bind to circulating androgens, even with normal circulating levels.

Objectives: The aim of this work was to evaluate and compare the efficacy and safety of topical spironolactone versus topical minoxidil in the treatment of FPHL.

Methods: This prospective, simple randomized, comparative study was conducted on 80 female patients with FPHL. They were divided into two groups: Group (A): was subjected to topical spironolactone 1% gel application for 6 months, twice. Group (B): was subjected to topical minoxidil 5% gel application for 6 months, twice daily. The efficacy of treatment was assessed clinically by the Ludwig scale, Global Esthetic Improvement Scale, and trichoscopy.

Results: There was a statistically significant difference in improvement in both groups after treatment as regards: the Ludwig scale, Global Esthetic Improvement Scale, and Trichoscopy. In Group A: 10 patients had mild, 16 patients had moderate, two patients had excellent, and 12 had marked improvement. In Group B: 10 patients had mild, 14 patients had moderate, two patients had excellent, and 14 had marked improvement. Contact dermatitis, scalp irritation, and headache, which were more evident in Group B than in Group A.

Conclusions: Both topical spironolactone and topical minoxidil were cheap, safe, and effective lines for the treatment of FPHL with minimal and tolerable side effects.

Folliculitis decalvans (FD) poses a significant challenge due to treatment resistance and relapses. We report a case of FD refractory to various treatments for 15 years, where initiating adalimumab led to an excellent response. Male patient, 33 years, throughout the 15-year follow-up followed up due to a confirmed diagnosis of FD, underwent several cycles of antibiotics, besides the use of isotretinoin and dapsone, at different times, both without clinical improvement. Understanding that the diagnosis of FD falls within the spectrum of hidradenitis suppurativa (HS), we decided to started adalimumab with a dosage regimen specific to HS and we used the HS physician global assessment (HS-PGA) score to assess the improvement. After 13 weeks, the patient showed significant improvement going from a severe to mild rating by the HS-PGA score. Using a tumor necrosis factor-alpha (TNFα) blocker like adalimumab in treatment may be justified, since is an inflammatory cytokine commonly seen in neutrophilic dermatoses, including FD. The inappropriate cell-mediated immune response in FD leads to increased TNFα levels. However, further studies and broader monitoring of each case are necessary to better understand possible flare-ups during treatment and achieve lasting remission of the disease.

A 7-year-old female child presented with a linear depressed lesion involving the forehead and frontoparietal region of the scalp and was diagnosed as en coup de sabre. Following treatment with soap Psoralen combined with ultraviolet A (UVA) therapy and topical corticosteroid and calcipotriol combination, there was significant resolution of the induration, and in addition, there was partial regrowth of the hair. The resolution of the induration could be objectively documented using a durometer. We used shore durometers, which are simple, handheld measuring devices with a wider range of durometer scores that use specific, standardized techniques to measure the hardness. Durometers provide an accurate, scalable measurement with an ease of detecting change. Variation in the durometer readings corresponds to the change in disease activity.

Abametapir is a new metalloproteinase inhibitor that received Food and Drug Administration approval in July 2020 as a topical pediculocide. The uniqueness of this new drug is that it targets metalloproteinase needed for hatching the eggs as well as killing adults. Herein we discuss this new drug, its history of development, its modality of use and its adverse drug reactions. It is hoped it will make Dermatologists aware of this new development.