Justicia procumbens prevents hair loss in androgenic alopecia mice.

The plant Justicia procumbens is traditionally used in Asia to treat fever, cough, and pain. Previous studies have reported its anticancer and anti-asthmatic properties. However, its potential for preventing androgenic alopecia (AGA) has not yet been reported. AGA is a widespread hair loss condition primarily caused by male hormones. In this study, we examined the hair loss-preventing effects of an aqueous extract of J. procumbens (JPAE) using human hair follicle dermal papilla cell (HFDPC) and a mouse model of testosterone-induced AGA. JPAE treatment increased HFDPC proliferation by activating the Wnt/ß-catenin signaling pathway. Additionally, JPAE increased the expression of Wnt targets, such as cyclin D1 and VEGF, by promoting the translocation of ß-catenin to the nucleus. Administration of JPAE reduced hair loss, increased hair thickness, and enhanced hair shine in an AGA mouse model. Furthermore, it increased the expression of p-GSK-3ß and ß-catenin in the dorsal skin of the mice. These findings imply that JPAE promotes the proliferation of HFDPC and prevents hair loss in an AGA mouse model. JPAE can therefore be used as a functional food and natural treatment option for AGA to prevent hair loss.

The effect of a helmet type, home-use low-level light therapy device for chemotherapy-induced alopecia: study protocol for a randomized controlled trial.

BACKGROUND: Alopecia is one of the most common adverse effects of chemotherapy. It reduces the patient's self-esteem and quality of life and the effect of therapy. Scalp cooling is the only verified current method for prevention but success is not guaranteed, particularly after receiving anthracycline-based combinations. Low-level light therapy has been clinically proven to inhibit the progress of androgenic alopecia. A previous study using human subjects shows limited benefits for low-level light therapy for patients who suffer chemotherapy-induced alopecia but an increase in the number of probes and the optimization of light sources may improve the efficacy. This study determines the efficacy of low-level light therapy for the prevention of chemotherapy-induced hair loss for patients with breast cancer using a randomized controlled trial. METHODS: One hundred six eligible breast cancer patients were randomly distributed into a low-level light therapy group and a control group, after receiving chemotherapy. Subjects in the low-level light therapy group received 12 courses of intervention within 4 weeks. Subjects in the control group received no intervention but were closely monitored. The primary outcome is measured as the difference in the hair count in a target area between the baseline and at the end of week 4, as measured using a phototrichogram (Sentra scalp analyzer). The secondary outcomes include the change in hair count at the end of week 1, week 2, and week 3 and hair width at the end of week 1, week 2, week 3, and week 4, as measured using a phototrichogram, and the change in distress, the quality of life, and self-esteem due to chemotherapy-induced alopecia, at the end of week 4, as measured using a questionnaire. DISCUSSION: This study improves cancer patients' quality of life and provides clinical evidence. TRIAL REGISTRATION: Registered at ClinicalTrials.gov- NCT05397457 on 1 June 2022.

Electric hand warmer versus observation to avoid discomfort during scalp cooling for chemotherapy-induced alopecia prevention: a randomized study.

Chemotherapy-induced alopecia (CIA) is a challenge in the management of cancer patients. Scalp cooling (SC) leads to reduction in CIA, however it is associated with significant adverse events, leading to 3-13% discontinuation rates. This pilot study evaluated the role of Electric Hand Warmers (EHW) on thermal (TC), sensorial (SCo) and general comfort (GC) in patients with breast cancer (BC) undergoing chemotherapy and SC to reduce CIA. Patients were randomly assigned to EHW use or observation. TC, SCo and GC were evaluated after each chemotherapy infusion. Favorable outcomes in both TC and SCo defined a positive result on GC. We analysed the impact of age, alopecia, chemotherapy regimen and EHW use in the different comfort scales using a Logistic Regression (LR) model. Forty women with early breast cancer were randomly assigned to EHW (n = 20) or observation (n = 20) during neo(adjuvant) chemotherapy. Median age was 53 years. In the EHW arm, favorable thermal response was reported by 79% versus 50% in the control arm (odds ratio [OR] 3.79, p < 0.001). SCo was satisfactory in 82% in the EHW arm versus 74% in the control arm (OR 1.62, p = 0.1). Overall, 73% in the EHW arm had favorable GC versus 44% in the control arm (OR 3.4, p < 0.001). Age, alopecia, and chemotherapy regimen did not impact on comfort measures. Conclusion: Our study suggests that the use of an EHW has a consistent favorable impact on TC and GC of BC patients under SC technology to prevent CIA.

Improving Quality of Life During Chemotherapy: Cannabinoids, Cryotherapy, and Scalp Cooling.

There have been significant advances in the treatment of cancer in the past decade. However, patients continue to suffer from significant side effects of antineoplastic agents that greatly affect their quality of life (QOL), including chemotherapy-induced nausea and vomiting (CINV), chemotherapy-induced peripheral neuropathy (CIPN), and chemotherapy-induced alopecia (CIA). This review aims to provide an updated overview of emerging strategies for the management and prevention of these immediate and long-lasting side effects. The use of integrative medicine including cannabis continues to evolve in the realm of CINV and cancer-related anorexia. Although no pharmaceutical agent has been approved for the prevention of CIPN, cryotherapy, compression therapy and, more recently, cryocompression therapy have shown benefit in small trials, but there are concerns with tolerability especially related to cryotherapy. More data are necessary to determine an effective and tolerable option to prevent CIPN in large, randomized studies. Scalp cooling (SC), which has a similar mechanism to cryotherapy and compression therapy for CIPN prevention, has proven to be an effective and tolerable approach in randomized studies and has significantly limited CIA, an entity that definitively affects the QOL of patients living with cancer. Taken together, cannabis, cryotherapy, compression and cryocompression therapy, and SC all strive to improve the QOL of patients living with cancer by minimizing the side effects of chemotherapeutic agents.

Clinical Pathobiology of Radiotherapy-Induced Alopecia: A Guide toward More Effective Prevention and Hair Follicle Repair.

Because hair follicles (HFs) are highly sensitive to ionizing radiation, radiotherapy-induced alopecia (RIA) is a core adverse effect of oncological radiotherapy. Yet, effective RIA-preventive therapy is unavailable because the underlying pathobiology remains underinvestigated. Aiming to revitalize interest in pathomechanism-tailored RIA management, we describe the clinical RIA spectrum (transient, persistent, progressive alopecia) and our current understanding of RIA pathobiology as an excellent model for studying principles of human organ and stem cell repair, regeneration, and loss. We explain that HFs respond to radiotherapy through two distinct pathways (dystrophic anagen or catagen) and why this makes RIA management so challenging. We discuss the responses of different HF cell populations and extrafollicular cells to radiation, their roles in HF repair and regeneration, and how they might contribute to HF miniaturization or even loss in persistent RIA. Finally, we highlight the potential of targeting p53-, Wnt-, mTOR-, prostaglandin E2-, FGF7-, peroxisome proliferator-activated receptor-γ-, and melatonin-associated pathways in future RIA management.

Prevention and Treatment of Chemotherapy-Induced Alopecia: What Is Available and What Is Coming?

Millions of new cancer patients receive chemotherapy each year. In addition to killing cancer cells, chemotherapy is likely to damage rapidly proliferating healthy cells, including the hair follicle keratinocytes. Chemotherapy causes substantial thinning or loss of hair, termed chemotherapy-induced alopecia (CIA), in approximately 65% of patients. CIA is often ranked as one of the most distressing adverse effects of chemotherapy, but interventional options have been limited. To date, only scalp cooling has been cleared by the US Food and Drug Administration (FDA) to prevent CIA. However, several factors, including the high costs not always covered by insurance, preclude its broader use. Here we review the current options for CIA prevention and treatment and discuss new approaches being tested. CIA interventions include scalp cooling systems (both non-portable and portable) and topical agents to prevent hair loss, versus topical and oral minoxidil, photobiomodulation therapy (PBMT), and platelet-rich plasma (PRP) injections, among others, to stimulate hair regrowth after hair loss. Evidence-based studies are needed to develop and validate methods to prevent hair loss and/or accelerate hair regrowth in cancer patients receiving chemotherapy, which could significantly improve cancer patients' quality of life and may help improve compliance and consequently the outcome of cancer treatment.

Minimal added value of wetting hair before scalp cooling to prevent chemotherapy-induced alopecia in cancer patients - results from the Dutch Scalp Cooling Registry.

PURPOSE: Preventing chemotherapy-induced alopecia (CIA) is related to the degree of temperature reduction during scalp cooling. Wetting hair before scalp cooling reduces the scalp skin temperature. This observational study investigated the effects of wetting hair before scalp cooling on preventing CIA and on tolerance in cancer patients. METHODS: This Dutch multi-center cohort study comprised 1825 patients receiving ≥1 cycle of docetaxel (D), 5-fluorouracil-epirubicin-cyclophosphamide (FEC), 5-fluorouracil-epirubicin-cyclophosphamide-docetaxel (FECD), paclitaxel (P), or paclitaxel-carboplatin (PC). Patients underwent scalp cooling with wet or dry hair. Primary and secondary outcomes were the effects of wetting hair on head cover use and tolerance, respectively. RESULTS: None of the associations between wetting hair and head cover use in patients on D, FEC, P, or PC was significant; however, results all tended to be in favor of wetting hair. For FECD, univariate (p=0.005; OR=1.6; CI=1.1-2.1) and multivariable associations (p=0.007; OR=1.8; CI=1.2-2.6) were significant. Scalp cooling discontinuation due to intolerance differed significantly between groups that wetted hair or not (3% and 1% respectively; p=0.034). CONCLUSION: In a large patient group with mainly a European hair type and a high hair mass, no convincing evidence was found whether wetting hair prior to scalp cooling contributes to better prevention of CIA. Since it is argued that a higher reduction in scalp skin temperature by wetting hair contributes positively to scalp cooling efficacy, only a randomized controlled trial can provide an ultimate conclusion at the highest level of evidence. Until that time, healthcare professionals have to take into account that wetting hair may introduce lower compliance to the scalp cooling procedure.

[Efficacy and Safety of Scalp Cooling Device RV21-01 for Suppression of Chemotherapy-Induced Alopecia in Breast Cancer Patients].

We evaluated the efficacy and safety of the RV21-01 scalp cooling device in controlling hair loss during chemotherapy in this study. Thirty-nine breast cancer patients who underwent anthracycline- and/or taxane-based chemotherapy were assigned to the scalp cooling group(27 patients)and the hair loss observation group(12 patients). The alopecia rate using the NCI alopecia toxicity criteria and the quantitative alopecia toxicity grade was 51.9%(14/27 patients)and 100%(12/12 patients)in the scalp cooling and hair loss observation groups, respectively. Regarding safety, all subjects in both the scalp cooling and hair loss observation groups experienced adverse events; only 1 subject in each group experienced a severe adverse event due to chemotherapy and majority of the subjects in both groups experienced minor adverse events. RV21-01 scalp cooling therapy was demonstrated to be effective in reducing hair loss in patients undergoing standard chemotherapy for breast cancer. In addition, the adverse events associated with the scalp cooling therapy were minor and mild, and hence, deemed acceptable.

Reducing Surgical Risks for Hair Replacement Surgery.

Hair loss is a common problem among men and women. Hair replacement surgery (HRS) has become increasingly popular as technological advancements have been made producing remarkably natural results when performed by a skilled surgeon. Although complications from HRS are low compared with other esthetic surgeries, they can still occur even with the best-trained and qualified surgeon or staff. The process of hair restoration can be a long road for some patients and active patient participation and education is key for successful results. In this article, we seek to discuss the surgical risks of HRS and discuss methods to prevent them in your practice.

[Scalp cooling for the prevention of chemotherapy-induced alopecia: systematic review and meta-analysis.] / Enfriamiento del cuero cabelludo para la prevención de la alopecia secundaria a quimioterapia: revisión sistemática y metanálisis.

OBJECTIVE: Alopecia is one of the most common adverse effects of chemotherapy, having a significant impact on the quality of life of patients who suffer from it. Among the interventions available for its prevention, scalp cooling (SC) is the most widely used. The aim of this study was to assess the efficacy and safety of the use of SC systems during chemotherapy sessions for the prevention or the reduction of the extent of chemotherapy-induced alopecia. METHODS: A systematic review of the literature published up to November 2021 was carried out. Randomized clinical trials were selected. The main outcome measure was alopecia (hair loss>50%) during and after chemotherapy treatment. When possible, a quantitative synthesis of the results was performed through meta-analysis using the Stata v.15.0 software. The risk ratio (RR) of the variable alopecia, was estimated using a random effects model following the Mantel-Haenszel method. Statistical heterogeneity of the results was evaluated graphically and through the test of heterogeneity χ2 and the Higgins I2 statistic. Sensitivity analyses and subgroup analyses were performed. RESULTS: 13 studies were included, with a total of 832 participants (97.7% women). In most studies, the main chemotherapy treatment applied was anthracyclines or the combination of anthracyclines and taxanes. The results obtained indicate that SC prevents alopecia (loss>50%) by 43% compared to the control group (RR=0.57; 95% CI=0.46 to 0.69; k=9; n=494; I2=63.8%). No statistically significant difference was found between the efficacy of automated and non-automated cooling systems (P=0.967). No serious short- or medium-term adverse events related to SC were recorded. CONCLUSIONS: The results suggest that scalp cooling contributes to the prevention of chemotherapy-induced alopecia.

OBJETIVO: La alopecia es uno de los efectos adversos más comunes de la quimioterapia, con un impacto importante sobre la calidad de vida de los/las pacientes que la padecen. Entre las intervenciones disponibles para su prevención, el enfriamiento del cuero cabelludo (ECC) es la que cuenta con un uso más extendido. El objetivo de este estudio fue evaluar la eficacia y la seguridad del uso de sistemas de ECC durante las sesiones de quimioterapia para la prevención o reducción de la extensión de la alopecia secundaria a la quimioterapia. METODOS: Se llevó a cabo una revisión sistemática de la literatura publicada hasta noviembre de 2021. Se seleccionaron ensayos clínicos aleatorizados. La medida de resultado principal fue la alopecia (pérdida de cabello superior al 50%) durante y posteriormente al tratamiento de quimioterapia. Cuando fue posible, se realizó síntesis cuantitativa de los resultados mediante metanálisis con el programa Stata v.15.0. Se estimó el riesgo relativo (RR) de la variable alopecia, utilizando un modelo de efectos aleatorios siguiendo el método de Mantel-Haenszel. La heterogeneidad estadística de los resultados se evaluó gráficamente y mediante el test de la χ2 y el estadístico I2 de Higgins. Se realizaron análisis de sensibilidad y análisis de subgrupos. RESULTADOS: Se incluyeron 13 estudios con un total de 832 participantes (97,7% de mujeres). En la mayoría de los estudios, los agentes quimioterapéuticos principales aplicados fueron las antraciclinas o la combinación de antraciclinas y taxanos. Los resultados obtenidos indican que el ECC reduce la aparición de la alopecia un 43% frente al grupo control (RR=0,57; IC95%=0,46 a 0,69; k=9; n=494; I2=63,8%). No se encontró una diferencia estadísticamente significativa entre la eficacia de sistemas de enfriamiento automatizados y no automatizados (P=0,967). No se registraron eventos adversos graves a corto o medio plazo relacionados con el ECC. CONCLUSIONES: Los resultados sugieren que el ECC contribuye a prevenir la alopecia secundaria a la quimioterapia.

Prostaglandin E2 prevents radiotherapy-induced alopecia by attenuating transit amplifying cell apoptosis through promoting G1 arrest.

BACKGROUND: Growing hair follicles (HFs) harbor actively dividing transit amplifying cells (TACs), rendering them highly sensitive to radiotherapy (RT). Clinically, there is still a lack of treatment options for radiotherapy-induced alopecia (RIA). OBJECTIVE: Our present study aimed to investigated the effect and mechanism of local prostaglandin E2 (PGE2) treatment in RIA prevention. METHODS: We compared the response of growing HFs to radiation with and without local PGE2 pretreatment in a mouse model in vivo. The effect of PGE2 on the cell cycle was determined in cultured HF cells from fluorescent ubiquitination-based cell cycle indicator mice. We also compared the protective effects of PGE2 and a cyclin-dependent kinases 4/6 (CDK4/6) inhibitor against RIA. RESULTS: The local cutaneous PGE2 injection reduced RIA by enhancing HF self-repair. Mechanistically, PGE2 did not activate HF stem cells, but it preserved more TACs for regenerative attempts. Pretreatment of PGE2 lessened radiosensitivity of TACs by transiently arresting them in the G1 phase, thereby reducing TAC apoptosis and mitigating HF dystrophy. The preservation of more TACs accelerated HF self-repair and bypassed RT-induced premature termination of anagen. Promoting G1 arrest by systemic administration of palbociclib isethionate (PD0332991), a CDK4/6 inhibitor, offered a similar protective effect against RT. CONCLUSIONS: Locally administered PGE2 protects HF TACs from RT by transiently inducing G1 arrest, and the regeneration of HF structures lost from RT is accelerated to resume anagen growth, thus bypassing the long downtime of hair loss. PGE2 has the potential to be repurposed as a local preventive treatment for RIA.

Enfriamiento del cuero cabelludo para la prevención de la alopecia secundaria a quimioterapia: revisión sistemática y metanálisis / Scalp cooling for the prevention of chemotherapy-induced alopecia: systematic review and meta-analysis

Fundamentos: La alopecia es uno de los efectos adversos más comunes de la quimioterapia, con un impacto importante sobrela calidad de vida de los/las pacientes que la padecen. Entre las intervenciones disponibles para su prevención, el enfriamiento delcuero cabelludo (ECC) es la que cuenta con un uso más extendido. El objetivo de este estudio fue evaluar la eficacia y la seguridaddel uso de sistemas de ECC durante las sesiones de quimioterapia para la prevención o reducción de la extensión de la alopeciasecundaria a la quimioterapia. Métodos: Se llevó a cabo una revisión sistemática de la literatura publicada hasta noviembre de 2021. Se seleccionaron ensayosclínicos aleatorizados. La medida de resultado principal fue la alopecia (pérdida de cabello superior al 50%) durante y posteriormenteal tratamiento de quimioterapia. Cuando fue posible, se realizó síntesis cuantitativa de los resultados mediante metanálisis con elprograma Stata v.15.0. Se estimó el riesgo relativo (RR) de la variable alopecia, utilizando un modelo de efectos aleatorios siguiendoel método de Mantel-Haenszel. La heterogeneidad estadística de los resultados se evaluó gráficamente y mediante el test de la χ2 yel estadístico I2 de Higgins. Se realizaron análisis de sensibilidad y análisis de subgrupos. Resultados: Se incluyeron 13 estudios con un total de 832 participantes (97,7% de mujeres). En la mayoría de los estudios, losagentes quimioterapéuticos principales aplicados fueron las antraciclinas o la combinación de antraciclinas y taxanos. Los resultadosobtenidos indican que el ECC reduce la aparición de la alopecia un 43% frente al grupo control (RR=0,57; IC95%=0,46 a 0,69; k=9;n=494; I2=63,8%). No se encontró una diferencia estadísticamente significativa entre la eficacia de sistemas de enfriamiento auto-matizados y no automatizados (P=0,967). No se registraron eventos adversos graves a corto o medio plazo relacionados con el ECC...(AU)

Background: Alopecia is one of the most common adverse effects of chemotherapy, having a significant impact on the qualityof life of patients who suffer from it. Among the interventions available for its prevention, scalp cooling (SC) is the most widely used. The aim of this study was to assess the efficacy and safety of the use of SC systems during chemotherapy sessions for the preventionor the reduction of the extent of chemotherapy-induced alopecia.Methods: A systematic review of the literature published up to November 2021 was carried out. Randomized clinical trials were selected. The main outcome measure was alopecia (hair loss>50%) during and after chemotherapy treatment. When possible, a quantitative synthesisof the results was performed through meta-analysis using the Stata v.15.0 software. The risk ratio (RR) of the variable alopecia, was estimatedusing a random effects model following the Mantel-Haenszel method. Statistical heterogeneity of the results was evaluated graphically andthrough the test of heterogeneity χ2 and the Higgins I2 statistic. Sensitivity analyses and subgroup analyses were performed. Results: 13 studies were included, with a total of 832 participants (97.7% women). In most studies, the main chemotherapy treat-ment applied was anthracyclines or the combination of anthracyclines and taxanes. The results obtained indicate that SC preventsalopecia (loss>50%) by 43% compared to the control group (RR=0.57; 95% CI=0.46 to 0.69; k=9; n=494; I2=63.8%). No statisticallysignificant difference was found between the efficacy of automated and non-automated cooling systems (P=0.967). No serious short-or medium-term adverse events related to SC were recorded. Conclusions: The results suggest that scalp cooling contributes to the prevention of chemotherapy-induced alopecia.(AU)

Retrospective cohort study of scalp cooling in breast cancer patients.

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.

Ethical, legal, organizational and social issues related to the use of scalp cooling for the prevention of chemotherapy-induced alopecia: A systematic review.

INTRODUCTION: Scalp cooling (SC) aims to prevent chemotherapy-induced alopecia. The goal of this systematic review is to tackle ethical, legal, organizational and social issues related to SC. METHODS: A critical appraisal of the literature was carried out using a systematic review design. MEDLINE, Embase and Web of Science databases were searched up until 2 June 2021. Studies addressing these aspects in English or Spanish were considered. Representatives of both patient associations and professional scientific societies related to the topic participated in the design of the protocol and the review of the findings. RESULTS: A total of 17 studies were included. Articles were critically appraised using the MMAT and SANRA. Findings were organized into four categories: (1) ethical aspects focused on equal access, gender equity and doctor-patient communication supported by Patient Decision Aids (PtDAs); (2) patient perspective and acceptability; (3) professional perspective and acceptability; (4) organizational aspects focused on accessibility and feasibility. CONCLUSION: Cancer patients' expectations when using SC need to be adjusted to reduce the potential distress associated with hair loss. PtDAs could help patients clarify their values and preferences regarding SC. Equal access to technology should be guaranteed. PATIENT OR PUBLIC CONTRIBUTION: In this systematic review, the representatives of the patient associations (Ms. María Luz Amador Muñoz of the Spanish Association Against Cancer [AECC] and Ms. Catiana Martinez Cánovas of the Spanish Breast Cancer Federation [FECMA]) participated in the review of the study protocol, as well as in the results, discussion and conclusions, making their contributions. In the type of design of these studies (systematic reviews), it is not usual to have the direct participation of patients, but in this one, we have done so, as it is a systematic review that is part of a report of the Spanish Network of Health Technology Assessment Agencies (ETS).

Diagnóstico histopatológico diferencial de transplante capilar tardio com líquen plano pilar / Differential histopathological diagnosis of late hair transplantation with lichen planopilaris

Introdução: A alopecia androgenética é a alopecia não cicatricial mais comum em homens e mulheres e, por isso, uma das principais queixas dermatológicas da tricologia nos consultórios médicos e o líquen planopilar é uma doença inflamatória linfocítica que causa perda definitiva de cabelos e pode ser confundida com baixa pega ou perda de enxertos pós transplante capilar. Devido a escassez de dados na literatura sobre os achados clínicos, tricoscópicos e histopatológicos de uma evolução normal de transplante capilar após um ano de evolução desenvolvemos este estudo, para ajudar os profissionais de saúde a guiar suas biópsias para que o diagnóstico diferencial de líquen planopilar não seja feito erroneamente, já que o padrão inflamatório de um quadro normal pode ser semelhante ao dessa patologia. Objetivo: Observar biópsias de enxertos de pacientes com alopecia androgenética após mais de 1 ano de transplante capilar não complicado e discutir se os achados histológicos são ainda semelhantes ao líquen planopilar e podem, neste ponto, causar confusão diagnóstica. Metodologia: Foi realizado um estudo transversal em 9 pacientes com diagnóstico de alopecia androgenética submetidos a transplante capilar bem sucedido com pelo menos 12 meses de cirurgia. Resultados: Observou-se através da avaliação histopatológica da área de enxerto capilar de aspecto normal no local transplantado e da área com achados de alopecia androgenética adjacente, não submetida ao transplante capilar, uma tendência a ausência de inflamação e fibrose periístmica. Conclusão: Após um ano de transplanta capilar, o processo inflamatório causado pelo procedimento em si não pareceu se manter, diminuindo a chance de um diagnóstico diferencial de líquen planopilar. Entretanto, novos estudos com maior amostra são necessários para corroborar com esses dados. Palavras-chave: Alopecia androgenética. Transplante autólogo. Histopatologia. Líquen plano pilar.

Prospective Study Investigating the Efficacy and Safety of a Scalp Cooling Device for the Prevention of Alopecia in Women Undergoing (Neo)Adjuvant Chemotherapy for Breast Cancer.

The prevention of chemotherapy-induced alopecia still represents an urgent need for every day clinical practice. In this regard, this prospective single-center study included breast cancer (BC) patients who underwent a scalp cooling device (Dignicap®) during (neo)adjuvant chemotherapy with the aim to evaluate the efficacy and safety of this device in preventing alopecia. One hundred and seventy-eight patients (median age 43 years) were enrolled. The chemotherapy regimen included anthracycline and taxane-based chemotherapy (68.1%), docetaxel and cyclophosphamide (25.8%), anthracycline and taxane-based plus carboplatin (3.9%), and paclitaxel alone (2.2%). In 25.3% of cases, a dose dense schedule was used. Overall, the success rate was 68.0%: 100% in paclitaxel alone, 87.0% in docetaxel-cyclophosphamide, 59.5% in anthracycline and taxane, and 71.4% in the sequential regimen plus carboplatin group (anthracycline and taxane-based chemotherapy versus taxane-based chemotherapy, p ≤ 001. No difference in terms of hair preservation between dose-dense or standard schedule was found (p = 0.557). Early discontinuation of the scalp cooling was observed in 50 patients (28.1%). Although 138 patients (77.5%) experienced adverse events, 70.2% of patients were satisfied with this device. In conclusion, this large prospective study confirmed the helpful effect of the scalp cooling system in preventing alopecia in BC patients also undergoing sequential anthracyclines and taxane-based chemotherapy.