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1.
JAMA Dermatol ; 156(9): 963-972, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32756880

RESUMO

Importance: Persistent radiation-induced alopecia (pRIA) and its management have not been systematically described. Objective: To characterize pRIA in patients with primary central nervous system (CNS) tumors or head and neck sarcoma. Design, Setting, and Participants: A retrospective cohort study of patients from January 1, 2011, to January 30, 2019, was conducted at 2 large tertiary care hospitals and comprehensive cancer centers. Seventy-one children and adults diagnosed with primary CNS tumors or head and neck sarcomas were evaluated for pRIA. Main Outcomes and Measures: The clinical and trichoscopic features, scalp radiation dose-response relationship, and response to topical minoxidil were assessed using standardized clinical photographs of the scalp, trichoscopic images, and radiotherapy treatment plans. Results: Of the 71 patients included (median [range] age, 27 [4-75] years; 51 female [72%]), 64 (90%) had a CNS tumor and 7 (10%) had head and neck sarcoma. Alopecia severity was grade 1 in 40 of 70 patients (56%), with localized (29 of 54 [54%]), diffuse (13 of 54 [24%]), or mixed (12 of 54 [22%]) patterns. The median (range) estimated scalp radiation dose was 39.6 (15.1-50.0) Gy; higher dose (odds ratio [OR], 1.15; 95% CI, 1.04-1.28) and proton irradiation (OR, 5.7; 95% CI, 1.05-30.8) were associated with greater alopecia severity (P < .001), and the dose at which 50% of patients were estimated to have severe (grade 2) alopecia was 36.1 Gy (95% CI, 33.7-39.6 Gy). Predominant trichoscopic features included white patches (16 of 28 [57%]); in 15 patients, hair-shaft caliber negatively correlated with scalp dose (correlation coefficient, -0.624; P = .01). The association between hair density and scalp radiation dose was not statistically significant (-0.381; P = .16). Twenty-eight of 34 patients (82%) responded to topical minoxidil, 5% (median follow-up, 61 [interquartile range, 21-105] weeks); 4 of 25 (16%) topical minoxidil recipients with clinical images improved in severity grade. Two patients responded to hair transplantation and 1 patient responded to plastic surgical reconstruction. Conclusions and Relevance: Persistent radiation-induced alopecia among patients with primary CNS tumors or head and neck sarcomas represents a dose-dependent phenomenon that has distinctive clinical and trichoscopic features. The findings of this study suggest that topical minoxidil and procedural interventions may have benefit in the treatment of pRIA.


Assuntos
Alopecia/diagnóstico , Irradiação Craniana/efeitos adversos , Minoxidil/administração & dosagem , Lesões por Radiação/diagnóstico , Couro Cabeludo/cirurgia , Administração Tópica , Adolescente , Adulto , Idoso , Alopecia/etiologia , Alopecia/terapia , Neoplasias do Sistema Nervoso Central/radioterapia , Criança , Pré-Escolar , Relação Dose-Resposta à Radiação , Feminino , Cabelo/efeitos da radiação , Cabelo/transplante , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Masculino , Pessoa de Meia-Idade , Lesões por Radiação/etiologia , Lesões por Radiação/terapia , Estudos Retrospectivos , Couro Cabeludo/efeitos da radiação , Índice de Gravidade de Doença , Resultado do Tratamento , Adulto Jovem
2.
Dermatol Online J ; 26(4)2020 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-32621692

RESUMO

Hidradenitis suppurativa is a chronic, painful disease that significantly reduces quality of life. Laser hair reduction is one modality that can be used in combination with other treatments to ameliorate the condition. We argue that insurance should provide coverage for this necessary service.


Assuntos
Remoção de Cabelo/economia , Hidradenite Supurativa/economia , Cobertura do Seguro , Seguro Saúde , Terapia com Luz de Baixa Intensidade/economia , Cabelo/efeitos da radiação , Remoção de Cabelo/métodos , Hidradenite Supurativa/terapia , Humanos , Estados Unidos
3.
Radiat Prot Dosimetry ; 186(2-3): 202-205, 2019 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-31702764

RESUMO

The unique feature of nuclear accidents with neutron exposure is the induced radioactivity in body tissues. For dosimetry purposes, the most important stable isotopes occurring in human body, which can be activated by neutrons, are 23 Na and 32 S. The respective activation reactions are as follows:23Na(n,γ)24Na and32S(n,p)32P. While sodium occurs in human blood, sulfur is present in human hair. In order to verify the practical feasibility of this dosimetry technique in conditions of our laboratory, samples of human blood and hair were irradiated in a channel of a training reactor VR-1.24Na activity was measured by gamma-ray spectrometry.32P activity in hair was measured by means of a proportional counter. Based on neutron-spectrum calculation, relationships between neutron dose and induced activity were derived for both blood and hair.


Assuntos
Sangue/efeitos da radiação , Cabelo/efeitos da radiação , Nêutrons , Radioisótopos de Fósforo/análise , Radiometria/métodos , Sódio/análise , Enxofre/análise , República Tcheca , Raios gama , Humanos , Doses de Radiação , Liberação Nociva de Radioativos , Radioatividade , Radioisótopos de Sódio
4.
J Cosmet Laser Ther ; 20(4): 252-257, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29227728

RESUMO

Alopecia is a common disease affecting more than half of the world total number of people. Alopecia exists in different types, but one of the most common of these types is the Androgenic Alopecia which has affected approximately 51% of the total number of males ranging between the age bracket of 40 years and 75 years. This type of alopecia is more common in females who are above the age of 65 years and above. Despite this widespread effect, much has not been done regarding identifying the possible drugs for treating this disease. At present, there exist only two possible medications that have been scientifically approved to cure this disease, include finasteride and minoxidil. Also, another possible form of treatment has been the case of hair transplantation. Despite the new possible treatment options available for treatment of different types of hair loss, there is a need for the invention for more efficient management and treatment options that are less costly, environmentally friendly, and most importantly human consumption friendly. Due to the recent evaluation that low-level laser therapy stimulated hair growth. This systematic review and meta-analysis was to determine whether the use of low-level laser therapy is an effective therapy for treatment of the Androgenic alopecia and also to some degree we reviewed the level of the patient's satisfaction. Some earlier studies had shown that the use of low-level laser therapy stimulated the hair growth when mice were treated with chemotherapy which was induced by the alopecia and also the other type of alopecia called alopecia areata. The researchers hypothesized that the primary mechanism of treating Androgenic alopecia to be the stimulation of the epidermal stem cells which are in the hair follicle making them bulge and shift the follicles into the anagen phase.


Assuntos
Alopecia/radioterapia , Cabelo/crescimento & desenvolvimento , Cabelo/efeitos da radiação , Terapia com Luz de Baixa Intensidade , Cabelo/patologia , Humanos , Terapia com Luz de Baixa Intensidade/efeitos adversos , Terapia com Luz de Baixa Intensidade/economia , Satisfação do Paciente
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