alopecia
Topical estrogen accelerates hair regrowth in mice after chemotherapy-induced alopecia by favoring the dystrophic catagen response pathway to damage.

Ohnemus U, Unalan M, Handjiski B, Paus R.

Department of Dermatology, University Hospital Hamburg-Eppendorf, University of Hamburg, Hamburg, Germany.

Estrogen receptor ligands are important modulators of skin physiology and are involved in the control of normal hair follicle cycling. Here, we have studied the effects of topically applied 17-beta-estradiol on pathologic hair follicle cycling as seen during chemotherapy-induced alopecia, one of the major unresolved problems of clinical oncology. For this study we employed a well-established murine model that mimics chemotherapy-induced alopecia in humans. For precisely quantifying the area of hair loss and hair regrowth in this model in vivo, we developed a simple planimetric assay (dotmatrix planimetry). We show that topical 17-beta-estradiol significantly alters the cycling response of murine follicles to cyclophosphamide, whereas the estrogen antagonist ICI 182.780 exerted no such effects. Initially, topical 17-beta-estradiol enhanced chemotherapy-induced alopecia significantly by forcing the follicles into the dystrophic catagen response pathway to hair follicle damage, whereas follicles treated by ICI 182.780 or vehicle shifted into the dystrophic anagen response pathway. Consequently, the regrowth of normally pigmented hair shafts after chemotherapy-induced alopecia was significantly accelerated in the 17-beta-estradiol treated group. Our data encourage one to explore topical estrogens as a potential stimulant for hair re-growth after chemotherapy-induced alopecia.

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alopecia
Interferon-gamma in alopecia areata.

Arca E, Musabak U, Akar A, Erbil AH, Tastan HB.

Department of Dermatology, Gulhane Military Medical Faculty, School of Medicine Etlik, 06018 Ankara, Turkey. earca gata.edu.tr

Alopecia areata is a common type of hair loss. In clinical practice most patients will present with reversible patchy hair loss whereas others may develop complete baldness. Although the etiopathogenesis of alopecia areata is poorly understood, evidence is accumulating that it can be regarded as a T-cell mediated tissue-restricted autoimmune disease of the hair follicle, especially expressing the T-helper-type 1 cytokines interleukin-1beta, interleukin-2, and interferon-gamma. The aim of the study was to compare the serum levels of interferon-gamma in patients with alopecia areata and the control group and also to investigate the difference between the localized form of the disease with the extensive forms like alopecia totalis (AT) and alopecia universalis (AU). Forty patients with alopecia areata and 20 healthy controls were enrolled in the study. Nineteen patients had localized AA (LAA) and twenty-one patients had AT, AU or AT/AU. The serum levels of interferon-y were measured using enzyme immunoassay techniques. The mean serum IFN-gamma level in AA patients (n = 40) was 14.25 +/- 8.76 pg/mL (mean +/- SD), whereas that of LAA (n = 19) or extensive (AT, AU or AT/AU) (n = 21) was 13.45 +/- 6.75 pg/mL or 14.98 +/- 10.37 pg/mL, respectively. The mean serum IFN-gamma level in controls was 9.95 +/- 2.6 pg/mL. Serum levels of IFN-gamma in patients with AA were significantly higher than those in controls (p < 0.05). Significant difference was observed in serum levels of IFN-y between patients with LAA and control group (p < 0.05). Serum levels of IFN-gamma in patients with AT, AU or AT/AU were significantly higher than those in controls (p < 0.05). There was no significant difference in levels of IFN-gamma between patients with LAA and extensive group (p > 0. 05). We conclude that the elevated serum levels of IFN-gamma may reflect the inflammatory symptoms in AA, especially in the extensive form and that control of IFN-gamma production may be important to management of this disease. And also the measurement of serum IFN-gamma in patients with AA may be useful in discriminating those likely to progress to AU from the remaining LAA, or as a prognostic indicator. Copyright John Libbey Eurotext 2003.

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alopecia
Topical 5-fluorouracil is ineffective in the treatment of extensive alopecia areata.

Kaplan AL, Olsen EA.

Duke University Medical Center, Durham, North Carolina, USA.

We report the results of a pilot study of topical 5% 5-fluorouracil (FU) cream for the treatment of alopecia areata, an immunologically modulated disorder of hair growth. Patients with extensive (>50% scalp surface area involvement) alopecia areata that was refractory to previous treatments applied 5-FU to one side of their scalp twice daily for 3 to 6 months. In all, 9 patients enrolled, and 8 completed the study. No patient experienced measurable hair growth on the treated side. Only mild irritation was observed in a subset of patients with application of 5-FU to the nonphotodamaged scalp skin. Based on these results, we cannot recommend the use of topical 5-FU for treatment of alopecia areata without further evidence of therapeutic benefit.

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alopecia
Lack of association between Vitamin D receptor FokI polymorphism and alopecia areata.

Akar A, Orkunoglu FE, Ozata M, Sengul A, Gur AR.

Department of Dermatology, Gulhane Military Medical Academy, School of Medicine, 06018 Ankara, Turkey. aakar gata.edu.tr

Vitamin D receptor (VDR) is expressed in the hair follicle and the lack of it leads to alopecia. In this study, we investigated whether there was a relationship between VDR FokI gene polymorphism and alopecia areata (AA). This is the first study investigating the relationship between VDR gene polymorphism and AA. Twenty-five patients with the extensive forms of AA (alopecia totalis; AT, alopecia universalis; AU and AT/AU) and 27 healthy control subjects were genotyped. Their genotypes were determined by a polymerase chain reaction (PCR) and restriction fragment length polymorphism analysis. The genotypes were classified as FF (absence of the FokI site) and ff (presence of the FokI site). Allele frequencies for F and f alleles were 76.0% and 24.0% in the alopecic group and 72.2% and 27.7% in the control group (p > 0.05). The frequencies for the FF, Ff and ff genotypes were 56.0%, 40.0% and 4.0% in the patient group, and 48.1%, 48.1% and 3.7% in the control group, respectively. No statistically significant differences were observed in the frequencies of the VDR FokI genotype between the patient and the control groups. However, to conclude that there is no relationship between VDR gene polymorphism and AA, the VDR FokI polymorphism should be further studied in other populations, larger groups, and the distribution of other VDR polymorphisms such as BsmI, Tru9I, ApaI, TaqI and polyA.

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alopecia
Scarring alopecia in discoid lupus erythematosus: a clinical, histopathologic and immunopathologic study.

Fabbri P, Amato L, Chiarini C, Moretti S, Massi D.

Second Dermatology Clinic, Department of Dermatological Sciences, University of Florence, Florence, Italy. fabbri unifit.it

Scarring alopecia is a very frequent feature of chronic discoid lupus erythematosus (DLE). So far in the literature, only clinic-pathologic features or histopathologic-immunopathologic traits of DLE scarring alopecia (DLESA) have been reported. We describe the most significant features of clinical morphology, histopathology, serum and tissue immunopathology of 36 DLESA patients (41.9% of all our scarring alopecia patients). Clinically, 33.3% presented a single lesion and 52.7% presented multiple lesions of scarring alopecia, while 13.8% exhibited a picture resembling Pseudopelade of Brocq, with the classic 'footprints in the snow' appearance. The most frequent morphologic features were sclero-atrophy (80.5%) and erythema (63.8%). The main histopathologic aspects appeared to be fibrosis (100%), follicular hyperkeratosis (91.4%), epidermal atrophy (88.5%), lymphocytic infiltrate (88.5%), thickened basement membrane (77.1%) and basal vacuolar degeneration (74.2%). Antinuclear antibodies were present in 42.8% of patients and antigastric mucosa, antithyroid and anticardiolipin antibodies in 17-21% of patients. A positive lupus band test was demonstrated in 81.8% of cases and perivascular deposit in 30.3% of patients. Histopathology alone allowed a correct diagnosis only in 68.5% of cases; in the other cases, the diagnosis was assessed also taking into account immunopathologic findings. Our study defines the clinic, histopathologic and immunopathologic features of DLESA patients and points out that a multiparametric approach is mandatory to assess the diagnosis of DLESA.

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alopecia
Helping patients cope with chronic alopecia areata.

Prickitt J, McMichael AJ, Gallagher L, Kalabokes V, Boeck C.

Ann Hill Communications, San Rafael, CA, USA.

Helping a patient cope with a frustrating and unpredictable disease like alopecia areata can be a difficult task for many dermatology nurses. Five dermatology nurses who practice in the United States and Canada say that one important resource that should not be overlooked during the course of treatment of alopecia areata is the patient support group. Another major resource is the referral of patients to the National Alopecia Areata Foundation, which coordinates the patient support groups.

Online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15307624&dopt=Abstract alopecia, hair loss