Autoantibodies involved in primary and secondary adrenal insufficiency following treatment with immune checkpoint inhibitors.

Primary and secondary adrenal insufficiency (AI) are commonly known immune-related adverse events following treatment with immune checkpoint inhibitors (ICIs), and are clinically relevant due to their morbidity and potential mortality. For this reason, upfront identification of patients susceptible for ICI-induced AI could be a step in improving patient's safety. Multiple studies have focused on the identification of novel biomarkers for ICI-induced AI, including autoantibodies, which may be involved in ICI-induced AI as a result of the T-cell-mediated activation of autoreactive B cells. This review highlights the currently described autoantibodies that may be involved in either primary [e.g. anti-21-hydroxylase, anti-17α-hydroxylase, anti-P450scc, anti-aromatic L-amino acid decarboxylase (AADC), anti-interferon (IFN)α and anti-IFNΩ] or secondary AI [e.g. anti-guanine nucleotide-binding protein G(olf) subunit alpha (GNAL), anti-integral membrane protein 2B (ITM2B), anti-zinc finger CCHC-type containing 8 (ZCCHC8), anti-pro-opiomelanocortin (POMC), anti-TPIT (corticotroph-specific transcription factor), anti-pituitary-specific transcriptional factor-1 (PIT-1) and others], and discusses the current evidence concerning their role as biomarker for ICI-induced AI. Standardized autoantibody measurements in patients (to be) treated with ICIs would be a clinically accessible and patient-friendly screening method to identify the patients at risk, and could change the management of ICI-induced AI.

New aspects in hair transplantation for females.

BACKGROUND: In the overall spectrum of plastic surgery, hair transplantation for females still plays a marginal role. Previously applied standard methods (standard grafts) could not produce aesthetically satisfying results, so that many female patients who could have benefitted from an operation were discouraged from doing so. It was not until the method of using minigrafts exclusively to cover large areas of androgenetic alopecia in men was developed that acceptable treatment possibilities were also made available to women. OBJECTIVE: The main applications of hair transplantation for females are: androgenetic alopecia, hereditary changes in the hairline, traumatic alopecia, and cosmetic indications. METHODS: Since 1986 all female patients were exclusively treated with mini- and micrografts in one to two or three sessions. RESULTS: Performing hair transplantation calls for a high degree of sensitivity on the part of the surgeon with respect to the woman and her expectations. CONCLUSION: With the mini- and micrograft technique new aspects in hair transplantation for females can be offered.

Partial retransplantation. A new approach in hair transplantation.

BACKGROUND: In hair transplantation, the availability of a limited number of grafts for a conventional transplantation can pose a serious problem. The result can be a so-called "bunch" or "brush" appearance in the recipient area. OBJECTIVE: We therefore developed a new method that allows this effect to be minimized. METHOD: This method is based on the use of a punch (1.6-1.7 mm in diameter) that allows small grafts to be extracted from already established standard grafts. We then transplant the resulting minigrafts in between the established standard grafts, which have now decreased in size. RESULTS: The immediate reduction in the size of the standard grafts and the simultaneous generation of minigrafts produce the desired result: the "minigraft exclusively" look. CONCLUSION: Thus, patients with previously poor results in standard hair transplantation can now benefit from the modern method of mini- and micrograft transplantation.

Recent advances in hair transplantation.

Mini- and micrografts produce esthetic results in the treatment of alopecia androgenetica which cannot be achieved using conventional methods. It is for this reason that they should be used exclusively. Their fineness furthermore opens up new vistas in plastic reconstructive surgery, making treatments possible which were previously inconceivable.

The use of minigrafts in hair transplantation surgery.

With the conventional hair transplantation method of Okuda-Orentreich, the tuft effect and the creation of an abrupt hairline have been major problems. In the method presented here, minigrafts are exclusively distributed and transplanted over the entire surface. Through the use of this technique a more aesthetic pattern of hair growth is achieved than was possible before, even after only one treatment.

[Treatment of male baldness exclusively with mini-grafts]. / Die Behandlung der männlichen Glatze ausschliesslich mit Mini-Grafts.

With regard to the treatment of alopecia, the so-called bunch effect and the creation of an abrupt hair line are a major problem of the conventional method of hair transplantation. Employing a recently developed technique, autologous miniature grafts bearing 3-4 or 5-6 hair follicles are implanted into randomly distributed recipient punch holes. By means of this technique, we are able to achieve aesthetically acceptable hair growth even after a single operating session.