The role of telomerase in hair growth and relevant disorders: A review.

BACKGROUND: Hair diseases may present with hair loss, hirsutism, hair melanin abnormalities and other manifestations. Hair follicles are known as mini-organs that undergo periodic remodeling, and their constant regeneration in vivo reflects interesting anti-aging functions. Telomerase prevents cellular senescence by maintaining telomere length, but its excessive proliferation in cancer cells may also induce cancer. However, the effects of telomerase in hair growth have rarely been reported. METHODS: In this study, we reviewed the role of telomerase in hair growth and the effects of hair disorders through literature search and analysis. RESULTS: There is growing evidence that telomerase plays an important role in maintaining hair follicle function and proliferation. Changes in telomerase levels in hair follicles have also been found in a variety of hair disorders. CONCLUSION: Telomerase plays a positive role in hair growth and is expected to become a new target for the treatment of alopecia or other hair diseases in the future.

[Review of the post-COVID-19 syndrome associated to acute telogen effluvium]. / Revisión del síndrome post-COVID-19 asociado a efluvio telógeno agudo.

Coronavirus disease 2019 (COVID-19) has impacted our society in numerous ways. So far (November 2022) around 640 million SARS-CoV-2 infections have been confirmed worldwide. It is known that this disease has a main affection at the cardiopulmonary level, however, it affects almost all the organs and systems of the body, including the skin. Post-COVID-19 syndrome occurs in some patients, leaving significant sequelae that impact their quality of life. Among the most common sequelae are: cough, dyspnea, chronic fatigue, hyposmia and dysosmia. In addition to these, other sequelae not related to respiratory syndrome have been reported, such as hair loss, which has been observed in around 20% of post-COVID-19 patients, this could be attributable to acute telogen effluvium (TE). To date, no study has been conducted to determine the relationship of ET in those who have had COVID-19. Acute ET is defined as diffuse, non-scarring hair loss, usually self-limited, lasting for about 6 months. Within its etiology, severe systemic febrile illness, pregnancy, restrictive diets, severe stress and various drugs have been described. It seriously affects the quality of life of patients and is often associated with loss of confidence and low self-esteem.

La enfermedad por coronavirus 2019 (COVID-19) ha impactado a nuestra sociedad en numerosos aspectos. Hasta el momento (noviembre 2022) se han confirmado alrededor de 640 millones de infecciones por SARS-CoV-2 en el mundo. Se sabe que esta enfermedad tiene afección principal a nivel cardiopulmonar, sin embargo, afecta casi todos los órganos y sistemas del cuerpo, entre ellos, la piel. El síndrome post-COVID-19 se presenta en algunos pacientes dejando secuelas significativas que impactan su calidad de vida. Entre las secuelas más comunes se encuentran: tos, disnea, fatiga crónica, hiposmia y disosmia. Además de estas se han presentado otras secuelas no relacionadas con el síndrome respiratorio, como la caída de pelo, que se ha observado en alrededor del 20% de los pacientes post-COVID-19, esto podría ser atribuible al efluvio telógeno (ET) agudo. Hasta la fecha, no se ha realizado ningún estudio para determinar la relación del ET en quienes han tenido COVID-19. El ET agudo se define como una pérdida de pelo difusa, no cicatrizal, generalmente autolimitada, con una duración de alrededor de 6 meses. Dentro de su etiología, se han descrito la enfermedad febril severa sistémica, el embarazo, las dietas restrictivas, el estrés severo y diversos fármacos. Afecta gravemente la calidad de vida de los pacientes y, a menudo, se asocia con pérdida de confianza y baja autoestima.

Molecular Basis of Hereditary Hair Diseases.

The hair follicle is an appendage of the skin that undergoes hair cycles throughout life. Recently, numerous genes expressed in the hair follicles have been identified, and variants in some of these genes are now known to underlie hereditary hair diseases in humans. Hereditary hair diseases are classified into non-syndromic and syndromic forms. In the Japanese population, the non-syndromic form of autosomal recessive woolly hair, which is caused by founder pathogenic variants in the lipase H (LIPH) gene, is the most prevalent hereditary hair disease. In addition, other types of hereditary hair diseases are known in Japan, such as Marie-Unna hereditary hypotrichosis, hypohidrotic ectodermal dysplasia, and tricho-rhino-phalangeal syndrome. To ensure correct diagnoses and appropriate patient care, dermatologists must understand the characteristics of each hair disorder. Elucidation of the molecular basis of hereditary hair diseases can directly tell us which genes are crucial for morphogenesis and development of hair follicles in humans. Therefore, continuation of "wet laboratory" research for these diseases remains important. To date, several syndromic forms of hereditary hair diseases have been approved as designated intractable diseases in Japan. As part of our efforts in the Project for Research on Intractable Diseases through the Ministry of Health, Labour, and Welfare of Japan, we anticipate that more hereditary hair diseases be recognized as designated intractable diseases in the future, which will be to the benefit of the affected individuals.

Association of microbiota with hair and scalp diseases / 中华皮肤科杂志

Skin microbiota is associated with various skin diseases. Scalp hair follicles penetrate deeply into the skin, and carry complex microbial communities distinct from those on the skin surface. Local imbalance of microbial communities may impair the skin barrier function, leading to a variety of hair and scalp diseases. This review discusses changes in microbial diversity and colonization by specific microorganisms in various hair diseases, including dandruff, folliculitis decalvans, etc., and provides new ideas for exploring the pathogenesis of and therapeutic strategies for various hair and scalp diseases.

Upadacitinib for the treatment of alopecia areata and severe atopic dermatitis in a paediatric patient: A case report.

This case report describes the first successful treatment of alopecia areata and atopic dermatitis with the Janus kinase 1 inhibitor upadacitinib in a paediatric patient. After minimal response to topical corticosteroids and spironolactone, improvements in hair growth on the scalp and body were noted after only 6 weeks of upadacitinib treatment.

Advances in nanotechnology-based hair care products applied to hair shaft and hair scalp disorders.

OBJECTIVE: Nanotechnology has been intensively applied to the development of novel cosmetic products for hair and scalp care during the last decades. Such a trend is corroborated by the fact that about 19% of the total nanocosmetics registered in the StatNano database are intended for hair and scalp care. Nanotechnology-enabled formulations based on nanoparticles, cyclodextrins, liposomes and nanoemulsions have emerged as novel approaches due to chemical stability and their controlled release. Regarding hair care formulations, nanocarriers can target the hair shaft, hair follicle and scalp. Therefore, they have been used to treat several hair disorders, including dandruff and other hair-damaging conditions. METHODS: This review addressed the most important nanocarriers applied to hair-related disorders improvement. Furthermore, the application for hair photoprotection and improvement of hair colour duration by nanotechnological formulations is also approached. Besides, we provided an overview of the current scenario of available nano-based commercial hair products and novel patented inventions. RESULTS: From the patent search, the Patent Cooperation Treaty was pointed as the most important depositing agency while the United States of America has been the most depositing country. On the contrary, according to the StatNano database, Brazil stands out in the hair care worldwide market, and it is also the main producer of hair cosmetics based on nanotechnology. CONCLUSION: As nano-based products offer several advantages over conventional cosmetics, it is expected that in future, there will be more research on nanocarriers applied to hair disorders, as well as commercial products and patent applications.

Au cours des dernières décennies, les nanotechnologies ont été intensivement appliquées au développement de nouveaux produits cosmétiques pour le soin des cheveux et du cuir chevelu. Cette tendance est corroborée par le fait qu'environ 19% du nombre total de nano-cosmétiques enregistrés dans la base de données StatNano sont destinés à la fois aux soins des cheveux et du cuir chevelu. Les formulations basées sur les nanoparticules, les cyclodextrines, les liposomes et les nano-émulsions sont devenues de nouvelles approches grâce à l'amélioration de la stabilité chimique des médicaments et des ingrédients actifs cosmétiques et à leur libération contrôlée. En ce qui concerne les formulations de soins capillaires, les nanocarriers peuvent cibler le follicule pileux, la tige des cheveux et du cuir chevelu. Par conséquent, ils ont été utilisés pour traiter plusieurs troubles capillaires, notamment les pellicules et d'autres affections capillaires. Dans cette revue, les nano-carriers les plus importants appliqués à l'amélioration des troubles liés aux cheveux ont été abordés. L'application pour la photoprotection des cheveux et l'amélioration de la durée de la couleur des cheveux par des formulations nanotechnologiques est également abordée. En outre, nous fournissons un aperçu du scénario actuel des produits capillaires commerciaux à base des nanotechnologies disponibles et des nouvelles inventions brevetées. D'après la recherche de brevets, le Traité de coopération en matière de brevets a été désigné comme l'agence de dépôt la plus importante, tandis que les États-Unis d'Amérique ont été le pays le plus déposant. Diversement, le Brésil se distingue sur le marché mondial des soins capillaires et il est aussi le principal producteur de cosmétiques capillaires basés sur les nanotechnologies. Par conséquent, comme les produits à base de nanotechnologies offrent plusieurs avantages par rapport aux cosmétiques conventionnels, on s'attend à ce que les recherches sur les nano-carriers appliqués aux troubles capillaires se multiplient à l'avenir, de même que les produits commerciaux et les demandes de brevets.

Effects of chemical straighteners on the hair shaft and scalp

Abstract Background The effects of chemical straighteners on the scalp and hair shaft are not fully known, although such substances are widely used. Hair straightening became popular in Brazil with the use of formaldehyde and its derivatives, despite the prohibition by the current legislation. Objective To identify changes in hair shaft and scalp caused by the use of chemical straighteners. Methods A search was performed using keywords in three databases from 03/16/2020 to 05/20/2020, with publications between the years 2000 to 2020. After applying the inclusion and exclusion criteria, 33 articles were selected for review. Results In some studies, hair relaxers were associated with eczema, desquamation, pain, burns, and inflammation in the scalp. Hair loss, damage to the shaft, alteration in the color of the hairs and in the composition of their amino acids were observed. Findings are variable across the studies. Study limitations The search was restricted to three databases, in two languages, different study designs were accepted. Conclusions Straightening techniques can have side effects, including scalp inflammation, damage to the shaft, and hair loss. Its long-term effects remain unknown and further studies are necessary.

Effects of chemical straighteners on the hair shaft and scalp.

BACKGROUND: The effects of chemical straighteners on the scalp and hair shaft are not fully known, although such substances are widely used. Hair straightening became popular in Brazil with the use of formaldehyde and its derivatives, despite the prohibition by the current legislation. OBJECTIVE: To identify changes in hair shaft and scalp caused by the use of chemical straighteners. METHODS: A search was performed using keywords in three databases from 03/16/2020 to 05/20/2020, with publications between the years 2000 to 2020. After applying the inclusion and exclusion criteria, 33 articles were selected for review. RESULTS: In some studies, hair relaxers were associated with eczema, desquamation, pain, burns, and inflammation in the scalp. Hair loss, damage to the shaft, alteration in the color of the hairs and in the composition of their amino acids were observed. Findings are variable across the studies. STUDY LIMITATIONS: The search was restricted to three databases, in two languages, different study designs were accepted. CONCLUSIONS: Straightening techniques can have side effects, including scalp inflammation, damage to the shaft, and hair loss. Its long-term effects remain unknown and further studies are necessary.

Ethnic Equity Implications in the Management of Pseudofolliculitis Barbae.

One major issue facing the health care system in the United States is the disparity in health care management of diseases that affect minority patient populations. Pseudofolliculitis barbae (PFB) is very common in Black men. It presents as skin-colored to erythematous, follicular or perifollicular papules and pustules predominantly on the neck and chin. The most definitive treatment for PFB is cessation of close shaving. However, many Black men are forced to comply with "clean-shaven" policies in the workforce. For those who are able to obtain medical waivers, there is significant time and costs associated with this, especially if they must wait to receive this waiver from a dermatologist. If primary care providers are able to identify the disease and spread awareness of its legitimacy, it may be easier for patients to receive the necessary waivers and may encourage employers to reflect on the ethnic equity of this practice. Our professional support can help reduce stigma and lead to improvements in the physical and psychological health of this historically mistreated population.

Microagulhamento do couro cabeludo como terapia complementar no tratamento da alopecia de padrão feminino / Scalp microneedling as a complementary therapy for female pattern hair loss

A alopecia de padrão feminino figura dentre as queixas mais frequentes no consultório dermatológico e afeta até 50% das mulheres no climatério e na pós-menopausa. Apesar da existência de múltiplas terapias hoje disponíveis, algumas pacientes mostram-se refratárias aos tratamentos convencionais, sendo necessária a associação de tratamentos de segunda linha para a obtenção de bons resultados estéticos. Este trabalho ilustra as vantagens do microagulhamento nesse cenário por meio do relato de uma paciente de 48 anos de idade que não apresentou boa resposta clínica à associação do minoxidil tópico e à finasterida oral.

Female pattern hair loss (FPHL) is one of the most frequent complaints in dermatological practice. It affects up to 50% of climacteric and postmenopausal women. Despite multiple therapies available nowadays, some patients are refractory to conventional treatments, requiring the association of second-line therapies to obtain good aesthetic results. This paper aims to show the advantages of microneedling of the scalp for such cases by reporting the case of a 48-years-old patient who failed to the association of topical minoxidil and oral finasteride therapy

Uma revisão sistemática e metanálise sobre a associação entre alopecia androgenética e o risco de síndrome metabólica / A systematic review and meta-analysis on the association between androgenic alopecia and the risk of metabolic syndrome

Este estudo conduziu uma revisão sistemática de estudos sobre a relação entre alopecia androgênica e síndrome metabólica. Realizamos uma revisão abrangente de bancos de dados, incluindo PubMed, Web of Knowledge, Google Scholar, Scopus e Embase, e extraímos artigos relevantes publicados de 2010 a 2018. Os relatos de caso, artigos de revisão ou artigos sem textos completos foram excluídos. Nove estudos foram examinados para a etapa de metanálise. Os resultados mostraram uma relação significativa entre alopecia e síndrome metabólica (OR = 2,81; IC 95% = 2,16-3,66; I2 = 73%; P = 0,0003). Existe uma correlação significativa entre a alopecia androgênica e a síndrome metabólica.

This study conducted a systematic review of studies on the relationship between androgenic alopecia and metabolic syndrome. We performed a comprehensive review of databases including PubMed, Web of Knowledge, Google Scholar, Scopus, and Embase, and extracted relevant articles published from 2010 to 2018. The case reports, review articles, or studies lacking full-text articles were excluded. We examined nine studies for the meta-analysis step. The results showed a significant relationship between alopecia and metabolic syndrome (OR = 2.81; CI 95% = 2.16-3.66; I2 = 73%; P = 0.0003). There is a significant correlation between androgenic alopecia and metabolic syndrome

Update on trichoscopy: Integration of the terminology by systematic approach and a proposal of a diagnostic flowchart.

Trichoscopy represents a non-invasive diagnostic modality widely used in daily practice. Despite the common perception that this technique has been fairly established, some key issues remain to be addressed. Complexity and inconsistency in terminology in past literature are likely to confuse investigators when they are recording, reporting, and retrieving the findings. In addition, a diagnostic algorithm adopting sufficiently integrated and updated findings is not readily available. By adopting a systematic review approach, this review attempted to redefine major trichoscopic findings and integrate their synonyms individually into the most frequently used terms besides identifying and discussing terms which potentially cause confusion. The findings are categorized into five subgroups: hair shaft, follicular, perifollicular, scalp findings, and hair distribution pattern abnormalities. The calculation of sensitivities and positive predictive values of such redefined findings was conducted by reviewing the descriptions in the past literature on major hair diseases, including alopecia areata, androgenetic alopecia/female pattern hair loss, telogen effluvium, trichotillomania, lichen planopilaris, frontal fibrosing alopecia, central centrifugal cicatricial alopecia, discoid lupus erythematosus, folliculitis decalvans, tinea capitis, and dissecting cellulitis, to confirm the diagnostically meaningful findings for representative diseases. This attempt redefined, for instance, yellow dots, short vellus hairs, exclamation mark hairs, black dots, and broken hairs as the findings of diagnostic significance for alopecia areata and hair diameter diversity, peripilar sign, and focal atrichia for androgenetic alopecia/female pattern hair loss. An updated diagnostic flowchart is proposed with the instructions to maximize its usefulness. Current limitations and future perspectives of trichoscopy as well as other emerging non-invasive diagnostic modalities for hair diseases are also discussed.

Circle Hairs in a Patient with Multiple Myeloma.

Circle hair is a rare body-hair disorder of unknown etiology, typically characterized by perfectly or nearly perfectly coiled hair located below the cornified layer of the skin. Its main histopathological features are dilated hair-follicle infundibula and entrapped hair shafts. After its first description in 1963, there have only been a small number of reported cases, and its pathophysiology remains unclear. Herein, we report a case of an 80-year-old woman with skin lesions and abnormal hairs on both legs. We also propose a possible mechanism of her circle hairs: it may have occurred as an effect of her acquired ichthyosis secondary to her underlying multiple myeloma. There is no specific treatment for circle hairs, and reassurance that it is a harmless condition is sufficient. We prescribed a topical humectant and keratolytic agent to moisten the skin and lessen the hair entrapment, which resulted in clinical improvement. As the pathogenesis of the disease is unknown, further studies are warranted.

Ritlecitinib: an investigational drug for the treatment of moderate to severe alopecia areata.

INTRODUCTION: Alopecia areata (AA) is an inflammatory and autoimmune form of hair loss, which can present with one patch of hair loss, but in more extreme cases can lead to total body hair loss. There are limited therapeutic options and no cure, but medication can sometimes induce sustained remission. Disease control cannot be guaranteed; even those who regrow all hair on treatment can experience relapse. There are no FDA approved systemic treatments; therefore, an unmet need for safe, and effective treatments exists. Few treatments have been evaluated by randomized controlled trials. Case reports and series indicate oral Janus Kinase (JAK) inhibitors as a potential therapy. Ritlecitinib is a novel oral JAK3-selective inhibitor being investigated as an AA treatment. AREAS COVERED: This article introduces ritlecitinib as treatment for AA and considers the mechanism of action, pharmacodynamics, pharmacokinetics, clinical efficacy, and safety [reporting data from a 24-week, phase 2a double-blinded placebo-controlled trial of ritlecitinib in patients with AA who have more than 50% scalp hair loss]. EXPERT OPINION: Ritlecitinib offers a novel mode of action, rapid onset, and the capacity for a superior safety profile over other JAK inhibitors. If approved, ritlecitinib will be widely prescribed by physicians overseeing the more severe AA patients for the foreseeable future. As JAK inhibitors regulate the hair growth cycle and have anti-inflammatory effects, the implementation of ritlecitinib in hair loss disorders other than AA, may prove beneficial.

Moniletrix of the scalp from almost normal aspect to total alopecia: variable intrafamilial expressiveness

Abstract Monilethrix is a rare defect of the hair shaft, with most cases showing an autosomal dominant pattern of inheritance and variable clinical expression. It is characterized by hypotrichosis secondary to hair fragility. The diagnosis is made through trichoscopy, detecting typical findings such as periodic narrowing at regular intervals, giving the hair the appearance of beads in a rosary. This article reports the case of six members of a family diagnosed with monilethrix with alopecia of varying degrees.

Case report of a solitary fibrofolliculoma on the alar rim.

Fibrofolliculoma is a benign tumor characterized by a smooth, dome-shaped papule of size 2-4 mm. Most fibrofolliculomas occur as multiple lesions, and very rarely, they are solitary. Herein, we report a case of solitary fibrofolliculoma found in the alar rim, without the typical characteristics of a fibrofolliculoma. A 42-year-old man visited the hospital with a protruding lesion that had occurred 1 year previously. A mass of size 5× 7 mm was observed on the left alar rim. The tumor was dome-shaped and palpable. The patient did not have any similar lesions elsewhere. No family member was known to have such a lesion. An incisional biopsy was performed before surgery, and pathological examination revealed hyperkeratosis and dyskeratosis; however, an accurate diagnosis was not made. Complete resection was planned for the mass on the alar rim. The resected mass was subjected to permanent biopsy, and the pathological examination results led to the diagnosis of fibrofolliculoma. Therefore, when diagnosing a dome-shaped mass in the alar rim, despite the suspicion of a very rare disease, it is necessary to suspect fibrofolliculoma and consider the process from diagnostic examination to treatment.

Familial Frontal Fibrosing Alopecia: Report of a case and systematic review of the literature.

Frontal fibrosing alopecia (FFA) is an emerging disease in Western countries. We present the cases of three sisters who were referred simultaneously to the Department of Dermatology, Hospital Universitario San Cecilio, Granada, Spain, in 2018. All patients suffered from at least partial frontotemporal hairline recession and eyebrow loss. Following trichoscopic examination, the three sisters were diagnosed with FFA. Only one of the sisters agreed to be treated; she was prescribed with topical clobetasol propionate solution and minoxidil and achieved disease control at the three-month follow-up. These patients represent a new case of familial FFA wherein three sisters as well as their mother were affected by FFA. A systematic review found a total of 24 cases of familial FFA, of which this report is the 25th. In the majority of families, only females were affected (88%) while in the remainder both males and females (8%) were affected; there was only one family where only males were affected (4%). The relationship between the affected individuals was predominately between sisters (56%) followed by mother and daughter (32%). The median age was 61 years old (range: 14-88 years) and the duration of the disease ranged between 3-360 months. Family groups of FFA are an infrequently described phenomenon with unknown prevalence.

An Approach to Hair Loss in Pediatric Primary Care.

Pediatric hair loss is a cause of concern for patients and families. Early diagnosis and treatment are crucial, as delays in care for certain diagnoses can cause permanent scarring alopecia. The evaluation of hair loss includes a thorough history, physical examination, and other potential tests. The causes of hair loss can be classified as either acquired versus congenital. Acquired causes of hair loss can be subdivided into scarring and nonscarring; however, some conditions may present as nonscarring and progress to scarring alopecia. Recommendations for the evaluation and treatment of pediatric hair loss for the primary care practitioner will be summarized.