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Since the emergence of scalp cooling therapy (SCT) for the prevention of chemotherapy-induced alopecia (CIA), support groups on social media platforms for interested patients have surfaced. Though there are over 20,000 active members across SCT Facebook groups, little is known about how members use this platform. A 23-question survey was posted in five scalp cooling Facebook groups, reaching 219 women. Results indicated that these Facebook groups play clear roles in providing the following: (1) a supportive community for patients, (2) instructions for SCT use, (3) advice regarding insurance coverage and reimbursement, and (4) recommendations for over-the-counter products for hair loss. Despite reported interest in hair loss products, only 5% of patients sought medical treatment from dermatologists. Due to group-specific access restrictions, private Facebook groups provide patients with a protected platform to learn more about SCT from both those with personal experience and SCT company specialists. Providers may consider recommending these online groups to interested patients during the scalp cooling counseling process. As patients with CIA express a growing interest in over-the-counter hair, eyebrow, and eyelash products, it is important for dermatologists to be aware of where their patients obtain recommendations, and further, if these recommendations have clinical evidence of efficacy.
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Alopecia , Cuero Cabelludo , Medios de Comunicación Sociales , Humanos , Alopecia/prevención & control , Alopecia/terapia , Femenino , Encuestas y Cuestionarios , Adulto , Persona de Mediana Edad , Grupos de Autoayuda , Antineoplásicos/efectos adversos , Antineoplásicos/administración & dosificación , Crioterapia/métodos , Anciano , Hipotermia Inducida/métodosRESUMEN
Inflammatory alopecia is an increasingly reported side effect of targeted cancer therapies. Here we report one case of inflammatory alopecia secondary to mitogen-activated protein kinase kinase (MEK) inhibitor agent Trametinib in a woman with ovarian cancer. Biopsies of the scalp were consistent with early scarring alopecia compatible with drug-induced alopecia. Significant improvement in hair loss occurred after treatment with intralesional Kenalog (ILK) injections and oral isotretinoin. Though acute alopecia has been described in patients using MEK inhibitors, this is the first reported case of inflammatory alopecia. J Drugs Dermatol. 2024;23(4):7802. doi:10.36849/JDD.7802e  .
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Alopecia , Neoplasias Ováricas , Humanos , Femenino , Alopecia/inducido químicamente , Alopecia/diagnóstico , Alopecia/tratamiento farmacológico , Triamcinolona Acetonida , Inhibidores de Proteínas Quinasas/efectos adversos , Neoplasias Ováricas/tratamiento farmacológico , Quinasas de Proteína Quinasa Activadas por Mitógenos/efectos adversos , Proteínas Quinasas Activadas por MitógenosRESUMEN
Though it is widely acknowledged that cancer treatments cause hair loss on the scalp, there are limited data on how they affect eyebrow and eyelash hairs. Patients with eyebrow and eyelash loss, or madarosis, seek various treatment options ranging from camouflage techniques with makeup, permanent tattoos, and prescription medications. Though not yet studied in patients with cancer-induced madarosis, techniques such as scalp cooling, cryotherapy, and topical vasoconstrictors are promising preventative options. More robust research is needed to improve both the quality and quantity of available treatment and preventative options. There is a clear need for dermatologists to play a role in supportive oncodermatology for patients who experience eyebrow and eyelash loss secondary to chemotherapy, endocrine therapies, and radiation therapy. J Drugs Dermatol. 2024;23(5):327-331. doi:10.36849/JDD.8003.
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Alopecia , Cejas , Pestañas , Humanos , Alopecia/etiología , Alopecia/terapia , Alopecia/diagnóstico , Neoplasias/terapia , Neoplasias/complicaciones , Antineoplásicos/efectos adversos , Antineoplásicos/administración & dosificación , Crioterapia/métodosRESUMEN
For patients with cancer, alopecia is a common side effect that negatively impacts personal identity, body image, self-esteem, quality of life, and medical decision-making. Scalp cooling is a technique used to prevent alopecia in patients undergoing chemotherapy in which patients wear a cooled cap during chemotherapy infusions, causing localized vasoconstriction of blood vessels on the scalp. Because of the recent emergence of scalp cooling, there is a need to explore further the reasons why patients pursue this treatment. A retrospective chart review of women with breast cancer treated at The Ohio State University was conducted to investigate how factors such as patient age, race, ethnicity, insurance status, stage of cancer, and chemotherapy regimen influenced patients' decisions to incorporate scalp cooling into their treatment plan as compared to those who did not. Findings revealed that patient age, race, insurance status, and chemotherapy regimen were predictors of a patient's likelihood to undergo scalp cooling. Patients diagnosed at younger age and those with private insurance were more likely to utilize scalp cooling. In comparison to White patients, non-White patients were less likely to choose scalp cooling. Furthermore, patients placed on the chemotherapy regimen of AC or AC-T were less likely to pursue scalp cooling than patients on PTCH or TC regimens. These findings provide background for the development of educational resources for both patients interested in this therapy and healthcare providers discussing this treatment option in dermatology and oncology settings.
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Antineoplásicos , Neoplasias de la Mama , Hipotermia Inducida , Humanos , Femenino , Neoplasias de la Mama/tratamiento farmacológico , Estudios Retrospectivos , Cuero Cabelludo , Hipotermia Inducida/métodos , Calidad de Vida , Alopecia/inducido químicamente , Alopecia/prevención & control , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Antineoplásicos/efectos adversosRESUMEN
For patients diagnosed with breast cancer, alopecia can be a distressing side effect of treatment. Major surgeries, cytotoxic chemotherapy, and endocrine therapy may result in several different types of alopecia. This article reviews the underlying mechanisms, etiology, prevention strategies, and treatment options for chemotherapy-induced alopecia, telogen effluvium, and endocrine-induced alopecia. Here, we aim to provide breast oncologists with a review of the types of hair loss related to cancer therapy and current preventative and treatment options to facilitate informative patient counseling.
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Alopecia Areata , Neoplasias de la Mama , Humanos , Femenino , Neoplasias de la Mama/tratamiento farmacológico , Alopecia/inducido químicamente , Alopecia Areata/etiologíaRESUMEN
PURPOSE: Dermatologic adverse events commonly result in the interruption of oncologic treatment, and targeted therapies are the most frequently interrupted class of anticancer agents. Alopecia is a common cutaneous adverse event reported with CK4/6i therapy. Though the clinical characteristics and therapeutic response of EIA have been well documented, few studies have characterized alopecia in patients treated with CDK4/6i. METHODS: This study analyzed a retrospective cohort of 28 breast cancer patients diagnosed with endocrine-induced alopecia (EIA) or CDKiA. Comparative analysis of the clinical characteristics of alopecia and therapeutic response to minoxidil was conducted. Therapeutic response to minoxidil (LDOM or topical [5%] solution or foam) was assessed by both Dean Scale and qualitative clinical improvement by comparison of pretreatment and posttreatment clinical images by single-blinded, board-certified academic dermatologists (ST and BD). RESULTS: CDKiA was clinically similar to androgenetic alopecia and specific vertex involvement was more common in patients treated with CDK4/6i + ET than endocrine monotherapy (n = 7 [70.0%] vs n = 4 [36.4%]; p = 0.04), respectively. After 4-6 months of minoxidil, there was a moderate to significant qualitative alopecia improvement in 80% of CDKiA patients versus 94.4% of EIA patients. Additionally, superior improvement of mean Dean Score grade was observed in EIA (with change from pre- to posttreatment - 0.44; p = 0.0002). CONCLUSION: Compared to endocrine monotherapy, patients on combination CDK4/6i + ET had greater extent of vertex involvement and were more recalcitrant to minoxidil. The preferential vertex involvement observed in CDKiA suggests that combination therapy with minoxidil and topical antiandrogens with poor systemic absorption should be studied in this setting.
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Neoplasias de la Mama , Minoxidil , Humanos , Femenino , Minoxidil/uso terapéutico , Minoxidil/efectos adversos , Estudios Retrospectivos , Neoplasias de la Mama/tratamiento farmacológico , Alopecia/inducido químicamente , Alopecia/tratamiento farmacológico , Administración Cutánea , Resultado del Tratamiento , Quinasa 4 Dependiente de la CiclinaRESUMEN
Little is known about the regional extent and variability of nitrate from atmospheric deposition that is transported to streams without biological processing in forests. We measured water chemistry and isotopic tracers (δ18O and δ15N) of nitrate sources across the Northern Forest Region of the U.S. and Canada and reanalyzed data from other studies to determine when, where, and how unprocessed atmospheric nitrate was transported in catchments. These inputs were more widespread and numerous than commonly recognized, but with high spatial and temporal variability. Only 6 of 32 streams had high fractions (>20%) of unprocessed atmospheric nitrate during baseflow. Seventeen had high fractions during stormflow or snowmelt, which corresponded to large fractions in near-surface soil waters or groundwaters, but not deep groundwater. The remaining 10 streams occasionally had some (<20%) unprocessed atmospheric nitrate during stormflow or baseflow. Large, sporadic events may continue to be cryptic due to atmospheric deposition variation among storms and a near complete lack of monitoring for these events. A general lack of observance may bias perceptions of occurrence; sustained monitoring of chronic nitrogen pollution effects on forests with nitrate source apportionments may offer insights needed to advance the science as well as assess regulatory and management schemes.
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Bosques , Nitratos , Canadá , Monitoreo del Ambiente , Nitrógeno , RíosRESUMEN
Background and Aims: In plants, extensive intra-specific variation exists in the allocation of resources between vegetative growth and reproduction, reflecting different functional strategies. A simple method for the classification of intra-specific variation in these strategies would enable characterization of evolutionary and ecological processes. Methods: C-S-R theory can be applied to classify functional strategies (competitive C; stress tolerant, S; ruderal, R) in different plant species. Using a diverse set of arabidopsis ( Arabidopsis thaliana ) accessions grown under common conditions, it was tested whether a simple approach designed for allocating C-S-R strategies at the species level can also be used to analyse intra-specific variation. Key Results: Substantial intra-specific variation between arabidopsis accessions was found along the S-R axis. There was a positive correlation of temperature at the geographical origin with the dimension of S and a negative correlation with the dimension of R. Flowering time in a natural annual cycle and leaf dry matter content were identified as the main determinants of this adaptation, with plants originating from warmer climates having a higher leaf dry matter content and flowering earlier in a common garden. Conclusions: It was shown that functional strategies reflect adaptation to climate, with consequences for important traits such as fecundity and total plant dry weight. The approach could be used in genome-wide association studies to determine the genetic basis of functional strategies in wild species or crops.
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Aclimatación/genética , Arabidopsis/genética , Arabidopsis/fisiología , Clima , Proteínas de Arabidopsis/genética , Variación GenéticaRESUMEN
Emissions of nitrogen oxides (NOx) in the United States (U.S.) from large stationary sources, such as electric generating units, have decreased since 1995, driving decreases in nitrogen deposition. However, increasing NOx emissions from emerging industries, such as unconventional natural gas (UNG) extraction, could offset stationary source emission reductions in shale gas producing regions of the U.S. The Marcellus Shale in the northeastern U.S. has seen dramatic increases in the number of wells and associated natural gas production during the past 10 years. In this study, we examine the potential impacts of shale gas development on regional NOx emission inventories and dry deposition fluxes to Clean Air Status and Trends (CASTNET) sites in Pennsylvania and New York. Our results demonstrate that the current distribution of CASTNET sites is ineffective for monitoring the influence of Marcellus well NOx emissions on regional nitrogen deposition. Despite the fact that existing CASTNET sites are not influenced by UNG extraction activity, NOx emissions densities from shale gas extraction are substantial and are estimated to reach up to 21 kg NOx ha-1 year-1 in some regions. If these emissions deposit locally, UNG extraction activity could contribute to critical nitrogen load exceedances in areas of high well density.
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Contaminantes Atmosféricos , Nitrógeno , Monitoreo del Ambiente , Gas Natural , New York , Pennsylvania , Estados UnidosRESUMEN
How should managers choose among conservation options when resources are scarce and there is uncertainty regarding the effectiveness of actions? Well-developed tools exist for prioritizing areas for one-time and binary actions (e.g., protect vs. not protect), but methods for prioritizing incremental or ongoing actions (such as habitat creation and maintenance) remain uncommon. We devised an approach that combines metapopulation viability and cost-effectiveness analyses to select among alternative conservation actions while accounting for uncertainty. In our study, cost-effectiveness is the ratio between the benefit of an action and its economic cost, where benefit is the change in metapopulation viability. We applied the approach to the case of the endangered growling grass frog (Litoria raniformis), which is threatened by urban development. We extended a Bayesian model to predict metapopulation viability under 9 urbanization and management scenarios and incorporated the full probability distribution of possible outcomes for each scenario into the cost-effectiveness analysis. This allowed us to discern between cost-effective alternatives that were robust to uncertainty and those with a relatively high risk of failure. We found a relatively high risk of extinction following urbanization if the only action was reservation of core habitat; habitat creation actions performed better than enhancement actions; and cost-effectiveness ranking changed depending on the consideration of uncertainty. Our results suggest that creation and maintenance of wetlands dedicated to L. raniformis is the only cost-effective action likely to result in a sufficiently low risk of extinction. To our knowledge we are the first study to use Bayesian metapopulation viability analysis to explicitly incorporate parametric and demographic uncertainty into a cost-effective evaluation of conservation actions. The approach offers guidance to decision makers aiming to achieve cost-effective conservation under uncertainty.
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Anuros/fisiología , Conservación de los Recursos Naturales/métodos , Especies en Peligro de Extinción , Animales , Teorema de Bayes , Conservación de los Recursos Naturales/economía , Análisis Costo-Beneficio , Toma de Decisiones , Ecosistema , Dinámica Poblacional , Incertidumbre , VictoriaRESUMEN
PURPOSE: For patients who seek to camouflage cancer-related hair loss, cranial prostheses such as wigs and hair pieces exist. We sought to determine the availability of yaki-textured, type IV curls, and afro wigs at boutiques in Comprehensive Cancer Centers (CCCs). METHODS: The 56 CCCs in the United States were surveyed to see whether they had an affiliated wig boutique for patients experiencing hair loss. Boutique workers were then asked a series of seven questions regarding cranial prostheses options for patients seeking yaki-textured, type IV curls, and afro wigs. The availability of wigs was compared with US Census data on population size and density of Black residents. RESULTS: Of the 56 CCCs, 27 (46%) institutions had active affiliated hair boutiques. We were able to reach 19 (70%) of the 27 boutiques, of which 53% (n = 10) offered yaki-textured wigs, 37% (n = 7) offered type IV curls or afro wigs, and 47% (n = 9) offered neither. Two additional boutiques offered in-store catalogs for Black patients who were interested in naturally appearing wigs. Although two institutions offered a wig bank that was free to all patients, neither had yaki-textured or afro wigs in stock. There was no significant relationship between population size or density of Black residents and availability of these wigs. CONCLUSION: Many Black patients undergoing cancer treatment interested in cranial prosthesis do not have consistent access to wigs with textures comparable with type IV hair at CCCs. With increased inventory of racially inclusive wigs, partnerships with third-party vendors, and support for the previous authorization process, we can better support Black patients experiencing cancer-related hair loss.
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Treatments for breast cancer can have an array of adverse effects, including hair loss, scarring, and irritated skin. These physical outcomes can, in turn, lead to body image concerns, anxiety, and depression. Fortunately, there is growing evidence that certain cosmetic therapies can improve patient self-image. Here we review various cosmetic treatment options including hair camouflage, eyebrow and eyelash camouflage, treatments for hirsutism, nipple and areola tattooing, post-mastectomy scar tattooing, treatments for dry skin/xerosis, removal of post-radiation telangiectasias, and lightening of post-radiation hyperpigmentation. For each patient concern, we report potential procedures, clinical evidence of impact on quality of life, special considerations, and safety concerns. This article aims to equip dermatologists with resources so that they may effectively counsel breast cancer survivors who express treatment-related cosmetic concerns.
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Neoplasias de la Mama , Calidad de Vida , Humanos , Neoplasias de la Mama/terapia , Neoplasias de la Mama/cirugía , Neoplasias de la Mama/radioterapia , Femenino , Técnicas Cosméticas/efectos adversos , Mastectomía/efectos adversos , Imagen Corporal/psicología , Cicatriz/etiología , Cicatriz/psicología , Cicatriz/terapia , Supervivientes de Cáncer/psicología , Tatuaje/efectos adversosRESUMEN
BACKGROUND AND OBJECTIVE: Breast cancer is the leading cause of cancer among women, with over 2.3 million women being diagnosed in 2022. In addition to the emotional and physical toll that comes with a new cancer diagnosis, treatments such as chemotherapies, endocrine therapies, and radiation therapies may cause undesirable side effects. Side effects from cancer treatments can be detrimental to the quality of life of patients and their support systems. This narrative review consolidates current research on the impacts of alopecia on breast cancer survivors and provides a comprehensive overview of the various preventative options and treatments available. METHODS: Current literature on alopecia and breast cancer was searched using PubMed and Google Scholar. The search strategy utilized a combination of keywords related to breast cancer, alopecia, body image, and alopecia prevention and treatment. Retrievable and English articles from January 2000 to April 2024 were included in the review. KEY CONTENT AND FINDINGS: Women with breast cancer cited alopecia, or hair loss, as the third-most undesirable side effect from chemotherapy, only trailing behind nausea and vomiting. Other studies have further supported this notion, expressing that alopecia negatively impacts patients' body image, social functioning, and sense of self. Further research has indicated that alopecia could hinder individuals from accessing essential cancer therapies. Breast cancer patients use a variety of coping strategies for cancer treatment-induced alopecia, including preventive measures, treatments to accelerate hair regrowth, camouflaging tools, and psychosocial supports. CONCLUSIONS: Alopecia, as a result of cancer treatment, has many significant and distressing effects on breast cancer patients. Customized interventions may help breast cancer patients feel more comfortable about themselves, after experiencing chemotherapy-induced alopecia. These findings indicate the need for further research on preventative options and treatments for cancer treatment-induced alopecia.
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Key Clinical Message: Post-radiation angiosarcoma of the breast is a rare complication associated with a poor prognosis. This case reports the first loss of function mutation in TSC1 in breast radiation-induced angiosarcoma and illustrates the utility of evaluating these markers to identify potential therapeutic targets. Abstract: Post-radiation angiosarcoma of the breast is rare and associated with a poor prognosis. This case presents the first loss of function mutation in TSC1 in breast radiation-induced angiosarcoma. Evaluation of these markers can aid in identifying potential therapeutic targets.
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The peripheral somatosensory system overproduces neurons early in development followed by a period of cell death during final target innervation. The decision to survive or die in somatosensory neurons of the dorsal root ganglion (DRG) is mediated by target-derived neurotrophic factors and their cognate receptors. Subsets of peripheral somatosensory neurons can be crudely defined by the neurotrophic receptors that they express: peptidergic nociceptors (TrkA+), nonpeptidergic nociceptors (Ret+), mechanoreceptors (Ret+ or TrkB+), and proprioceptors (TrkC+). A direct comparison of early developmental timing between these subsets has not been performed. Here we characterized the accumulation and death of TrkA, B, C, and Ret+ neurons in the DRG as a function of developmental time. We find that TrkB, TrkC, and Ret-expressing neurons in the DRG complete developmental cell death prior to TrkA-expressing neurons. Given the broadly defined roles of the neurotrophin receptor p75NTR in augmenting neurotrophic signaling in sensory neurons, we investigated its role in supporting the survival of these distinct subpopulations. We find that TrkA+, TrkB+, and TrkC+ sensory neuron subpopulations require p75NTR for survival, but proliferating progenitors do not. These data demonstrate how diverging sensory neurons undergo successive waves of cell death and how p75NTR represses the magnitude, but not developmental window of this culling. © 2018 Wiley Periodicals, Inc. Develop Neurobiol 78: 701-717, 2018.