Profile of Indian patients with premature canities.

BACKGROUND: Premature canities is a common yet incompletely understood dermatological entity with scarce demographic and clinical data. AIM: Evaluation of the demographic and clinical profile of cases with premature canities and to look for systemic associations. METHODS: Fifty two self-reported cases of premature canities (onset before 20 years of age) and an equal number of healthy controls were recruited from the outpatient department of the Department of Dermatology, Guru Teg Bahadur Hospital Delhi, India from November 2011 to March 2013. A detailed history including onset, duration and pattern of involvement, a family history with pedigree charting and scalp examination were recorded on a predesigned proforma. A history of atopy was looked for in all study subjects and they were screened for thyroid disorder and diabetes. RESULTS: The mean age of cases and controls was comparable. The mean age of onset of graying was 11.6 ± 3.6 years. The mean duration at the time of presentation was 39.8 ± 37.2 months. The frontal region was the earliest affected area in 25 (48.1%) cases. Positive family history of premature canities was reported in 39 (75%) cases with an equal prevalence on paternal and maternal sides. More than half of the cases, 29 (55.8%) reported having a first degree relative affected by premature canities, 13 (25%) had a second degree and 20 (38.5%) had a third degree relative affected. Atopy was found to be strongly associated with premature canities with an odds ratio of 3.8. No association with thyroid abnormality or diabetes mellitus was seen. LIMITATION: The study suffered from the limitation of a small sample size. CONCLUSION: It was observed that the process of graying mostly starts in the frontal region. It was also found to be associated with a strong family history and atopic predisposition. Larger studies are recommended to arrive at a definite conclusion.

Premature graying of hair.

Premature graying is an important cause of low self-esteem, often interfering with socio-cultural adjustment. The onset and progression of graying or canities correlate very closely with chronological aging, and occur in varying degrees in all individuals eventually, regardless of gender or race. Premature canities may occur alone as an autosomal dominant condition or in association with various autoimmune or premature aging syndromes. It needs to be differentiated from various genetic hypomelanotic hair disorders. Reduction in melanogenically active melanocytes in the hair bulb of gray anagen hair follicles with resultant pigment loss is central to the pathogenesis of graying. Defective melanosomal transfers to cortical keratinocytes and melanin incontinence due to melanocyte degeneration are also believed to contribute to this. The white color of canities is an optical effect; the reflection of incident light masks the intrinsic pale yellow color of hair keratin. Full range of color from normal to white can be seen both along individual hair and from hair to hair, and admixture of pigmented and white hair is believed to give the appearance of gray. Graying of hair is usually progressive and permanent, but there are occasional reports of spontaneous repigmentation of gray hair. Studies evaluating the association of canities with osteopenia and cardiovascular disease have revealed mixed results. Despite the extensive molecular research being carried out to understand the pathogenesis of canities, there is paucity of effective evidence-based treatment options. Reports of repigmentation of previously white hair following certain inflammatory processes and use of drugs have suggested the possibility of cytokine-induced recruitment of outer sheath melanocytes to the hair bulb and rekindled the hope for finding an effective drug for treatment of premature canities. In the end, camouflage techniques using hair colorants are outlined.

The changes in hair growth pattern after autologous hair transplantation.

BACKGROUND: Recently donor dominance has been emphasized in autologous hair transplantation while the influence of the recipient site has been considered negligible. In fact, there have been few studies that show this. OBJECTIVE: This study was performed to examine the influence of the recipient site on transplanted hairs. A clinical study of 19 leprosy patients was performed. These patients had received single hair transplantation due to madarosis and were admitted to The Leprosy Mission, Jesus Hospital, Taegu, Korea, or had visited its outpatient clinic. METHODS: In this study, the rate of growth, thickness of shaft, and graying rate between the transplanted eyebrow hair in the recipient site and scalp hair near the donor site were compared to observe the changes in the growth pattern of the hairs after transplantation. RESULTS: For most of the patients, the growth rate and graying rate of transplanted hairs were lower than those of hairs in the donor site. CONCLUSION: It seems that the recipient site may have an influence on the transplanted hairs. Further studies are needed, including clinical, histopathologic, and molecular biological methods.