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Introduction: There are few reports involving scalp microneedling in MPHL patients, and in most of them, physical stimulus is associated with other therapeutic agents. The aim of this study was to evaluate the efficacy and risks of isolated scalp microneedling in MPHL patients. Methods: Thirty patients were included in this randomized single-blinded study and submitted to 4 monthly scalp microneedling sessions. Two different microneedling devices were used: roller (n = 15) and tattoo cartridge (n = 15). Scalp coverage and hair density changes were measured 4 and 16 weeks after the last session. Adverse events were observed throughout the study, and scalp biopsies were performed before and after to investigate scarring changes. Results: Four of 12 participants in the roller group and 2 of 14 participants in the tattoo cartridge group showed an improvement in clinical pictures at the first follow-up visit. Only half of these patients sustained an improvement until the last follow-up visit. No benefit in hair density was observed in either group. No reports of adverse events were made. Neocollagenesis and elastolysis were noted in scalp biopsies. Discussion/Conclusion: Isolated scalp microneedling did not show improvement in scalp coverage or hair density of MPHL participants in this study.
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BACKGROUND: Androgenetic alopecia (AGA) is a hair loss disorder that frequently affects the male population. Conventional treatment modalities are limited to minoxidil, 5α reductase inhibitors, and hair transplantation procedures. The efficacy of low-level laser therapy (LLLT), also known as photobiomodulation, in the treatment of AGA has been reported, yet little is known about the outcomes of combining photobiomodulation with other conventional therapies. OBJECTIVE: To evaluate hair growth improvement in males with AGA, during the administration of minoxidil with and without photobiomodulation, using a half-head model. STUDY DESIGN/MATERIALS AND METHODS: Twenty-one men with AGA agreed to undergo 12 minutes of low-level laser irradiation (using a modified Capellux®), followed by topical minoxidil application (1 ml of 5% solution), to the affected scalp two times per day for 6 months. The photobiomodulation devices were modified such that the left half emitted light, and the right half did not. Efficacy was assessed by blinded analyses of clinical photos and automated phototrichograms (Trichoscan®) taken before treatment and after 3 and 6 months of therapy. RESULTS: None of the study participants experienced any adverse events. All patients showed improvements in hair coverage on both sides of the scalp at 3 and 6 months. On the side with combined treatments, the number of total hairs was significantly increased after 3 (P < 0.001) and 6 months (P = 0.001). A similar increase was also observed on the minoxidil-only side, at both 3 (P < 0.001) and 6 months (P < 0.001). No statistically significant differences were detected between sides (P > 0.05). CONCLUSION: Additional improvement was not observed with the association of photobiomodulation to topical minoxidil in male AGA. Differences from previous studies that might have influenced our result include non-collimated light source, higher dosimetry, and a cohort with darker skin phototype and more severe alopecia. Lasers Surg. Med. 2021. © 2021 Wiley Periodicals LLC.
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Alopecia , Minoxidil , Alopecia/terapia , Método Doble Ciego , Cabello , Humanos , Masculino , Minoxidil/uso terapéutico , Cuero Cabelludo , Resultado del TratamientoRESUMEN
Abstract Chemotherapy-induced alopecia causes an important impact on cancer patients and its risk of persistence is currently a considerable issue in cancer survivors. Of the various interventions proposed for the prevention of chemotherapy-induced alopecia, scalp cooling has emerged as an effective and safe strategy. This paper aims to provide an overview on scalp cooling and chemotherapy-induced alopecia prevention.
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Humanos , Neoplasias de la Mama/tratamiento farmacológico , Hipotermia Inducida , Antineoplásicos/efectos adversos , Cuero Cabelludo , Protocolos de Quimioterapia Combinada Antineoplásica , Alopecia/inducido químicamente , Alopecia/prevención & controlRESUMEN
INTRODUCTION: Insufficient hair growth after hair transplant, as well as erythema and perifollicular scaling, may be diagnosed as lichen planopilaris and treated as such based on clinical and histopathological findings. The purpose of this study is to observe graft biopsies of patients after uncomplicated hair transplants and to discuss if histological findings are enough to diagnose lichen planopilaris. METHODS AND RESULTS: Eight patients diagnosed with androgenetic alopecia who were submitted to hair transplant were enrolled. In each of the participants, a scalp biopsy was performed in the receptor area and in the adjacent area. Biopsies were performed between 6 months and 1 year after surgery. Exams were analyzed by 3 pathologists. The t test was performed for paired observations, comparing the transplanted and the nontransplanted area for lymphocytic infiltrate and fibrosis. The significance level was considered as 5% (p < 0.05). Four of 8 participants had perifollicular lymphocytic infiltrate, from moderate to dense intensity in the recipient area. Fibrosis was seen in 6 patients. These findings were not seen in the control area. CONCLUSIONS: It is questioned whether lymphocytic infiltrate and fibrosis may be expected in patients who are submitted to normal hair transplants.
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Chemotherapy-induced alopecia causes an important impact on cancer patients and its risk of persistence is currently a considerable issue in cancer survivors. Of the various interventions proposed for the prevention of chemotherapy-induced alopecia, scalp cooling has emerged as an effective and safe strategy. This paper aims to provide an overview on scalp cooling and chemotherapy-induced alopecia prevention.
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Antineoplásicos , Neoplasias de la Mama , Hipotermia Inducida , Alopecia/inducido químicamente , Alopecia/prevención & control , Antineoplásicos/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica , Neoplasias de la Mama/tratamiento farmacológico , Humanos , Cuero CabelludoRESUMEN
BACKGROUND: Tinea capitis (TC) is a dermatophytosis of the scalp caused by the Trichophyton and Microsporum genera. The condition can be classified according to clinical symptoms or based on mycological presentations observed on direct examination. Treatment is best determined after isolation of the causative agent, with griseofulvin indicated for Microsporum and terbinafine for Trichophyton. MATERIALS AND METHODS: This was a prospective study correlating clinical and mycological classifications with agents isolated from culture of patients seen at a tertiary hospital in São Paulo (Brazil) between May 15, 2017, and January 11, 2019. RESULTS: A total of 23 patients were treated, comprising 19 (83%) with alopecic clinical aspect (14 [60%] trichophytic and five [23%] microsporic) and 4 (17%) with kerion celsi presentation. According to the parasite invasion at the hair shaft, 9 (40%) were endothrix and 14 (60%) were ectothrix cases. Trichophyton tonsurans was isolated from culture in 14 (60%) patients and Microsporum canis in 5 (40%) patients. A statistically significant association was found for mycological classification and agent isolated from culture (P = 0.003) with associations of the endothrix form with T. tonsurans and of ectothrix with M. canis. CONCLUSIONS: The mycological classification appears to be a valid method for suggesting the etiological agent of TC.
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We report the case of a 5-year-old girl born from consanguineous parents, presenting with alopecia universalis since the age of 8 months, without papules or cysts over the scalp or body. The goal of this paper is to emphasize the relevance of histopathology for the early diagnosis of atrichia with papular lesions in children with alopecia universalis, in settings where genetic testing may not be available.
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Alopecia/diagnóstico , Alopecia/etiología , Alopecia/patología , Dermoscopía , Femenino , Humanos , Masculino , Persona de Mediana Edad , PresiónRESUMEN
BACKGROUND: Frontal fibrosing alopecia (FFA) differs from lichen planopilaris (LPP) in many clinical aspects, but histology fails to distinguish between these entities. Direct immunofluorescence (DIF) is a diagnostic technique used for autoimmune diseases, including those affecting skin and hair. OBJECTIVE: To characterize DIF patterns in patients with FFA. METHOD: Data was collected retrospectively from FFA cases presenting to the Centre de Santé Sabouraud Hair Clinic in Paris from November 2013 to November 2014. RESULTS: Of 149 patients with FFA, 44 cases underwent DIF. Thirteen cases showed positive results with DIF. Patterns characteristic of LPP and lupus erythematosus were observed, with nearly half showing nonspecific staining. CONCLUSION: DIF patterns in patients with FFA were variable. This diagnostic technique should be used with caution in cases of cicatricial alopecia, particularly FFA.
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Graham-Little-Piccardi-Lassueur syndrome is a rare lichenoid dermatosis. It is characterized by the triad of scarring alopecia of the scalp, alopecia of the axilla and or groin, and keratotic follicular papules of the body. The present paper reports on two cases affecting young women. Histopathological findings suggest the disorder represents a generalized form of lichen planus follicularis.
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Alopecia/patología , Hipotricosis/patología , Liquen Plano/patología , Adulto , Alopecia/complicaciones , Alopecia/fisiopatología , Biopsia con Aguja , Brasil , Femenino , Humanos , Hipotricosis/complicaciones , Hipotricosis/fisiopatología , Inmunohistoquímica , Liquen Plano/complicaciones , Liquen Plano/fisiopatología , Pronóstico , Enfermedades Raras , SíndromeRESUMEN
Acute traction alopecia is a diagnostic challenge when the external factor is not suspected or admitted. We report two female patients with non-scarring patchy alopecia resulting from traction of video-electroencephalogram electrodes in which the clinical diagnosis of alopecia areata was suspected. Associated diffuse hair disorders might be implicated in these cases. The correct diagnosis of traction alopecia is important in order to avoid unnecessary treatments.
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PURPOSE: To determine the relationship between pili annulati (PA) and acquired trichorrhexis nodosa (TN) seen in the same patient, considering the two main theories evoked by previous studies: greater stiffness of darker PA bands or associated cuticular damage. PROCEDURES: Light microscopy of hair shafts from different regions of the patient's scalp. RESULTS: TN was not superimposed to dark bands of PA. CONCLUSIONS: Greater stiffness of darker PA bands was excluded as the cause of hair breakage. Hair breakage in PA patients might be related to cuticular abnormalities, as previously reported. Because weathering of long thin chemically treated hairs is extremely common, coincidence cannot be completely ruled out in this case.
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Alopecia areata is a common autoimmune disorder that leads to nonscarring hair loss. Black dots, also called comedo-like cadaver hairs, can be found in almost 50% of alopecia areata patients and indicate disease activity. Trichostasis spinulosa is a follicular disorder resulting from the retention of numerous hairs surrounded by a keratinous sheath in dilated follicles. Trichostasis spinulosa is a relatively common but underdiagnosed disorder of hair follicles. Here, we describe a man with alopecia areata of the eyebrows, androgenetic alopecia and trichostasis spinulosa at the vertex and show how dermoscopy can be useful in distinguishing black dots from Trichostasis spinulosa lesions.
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Alopecia Areata/patología , Enfermedades del Cabello/patología , Queratosis/patología , Prurito/patología , Dermatosis del Cuero Cabelludo/patología , Biopsia , Dermoscopía , Diagnóstico Diferencial , Humanos , Masculino , Persona de Mediana Edad , Cuero Cabelludo/patologíaRESUMEN
Alopecia areata is a common autoimmune disorder that leads to nonscarring hair loss. Black dots, also called comedo-like cadaver hairs, can be found in almost 50% of alopecia areata patients and indicate disease activity. Trichostasis spinulosa is a follicular disorder resulting from the retention of numerous hairs surrounded by a keratinous sheath in dilated follicles. Trichostasis spinulosa is a relatively common but underdiagnosed disorder of hair follicles. Here, we describe a man with alopecia areata of the eyebrows, androgenetic alopecia and trichostasis spinulosa at the vertex and show how dermoscopy can be useful in distinguishing black dots from Trichostasis spinulosa lesions.
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Humanos , Masculino , Persona de Mediana Edad , Alopecia Areata/patología , Enfermedades del Cabello/patología , Queratosis/patología , Prurito/patología , Dermatosis del Cuero Cabelludo/patología , Biopsia , Dermoscopía , Diagnóstico Diferencial , Cuero Cabelludo/patologíaRESUMEN
Psoriasis is a relatively frequent inflammatory dermatosis. Scarring alopecia due to scalp psoriasis was first reported in 1972, but few reports have been written since then, showing that this is a very rare complication of a common disorder. We report a young Brazilian woman with longstanding scalp psoriasis, which progressed to scaring alopecia.