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1.
Prague Med Rep ; 122(2): 73-79, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34137683

RESUMO

The hypothesis that the most common female endocrine disease, the polycystic ovarian syndrome (PCOS), has a male equivalent, has recently become more widely accepted. The male form of PCOS is marked by alterations in the secretion of gonadotropins, increased insulin resistance, and changes of the levels of several steroid hormones, with clinical manifestations including premature androgenic alopecia (AGA). Because these symptoms are not always found in men with genetic predispositions, knowledge of the male equivalent of PCOS needs to be supplemented by measurements of adrenal 11-oxygenated C19 steroids, particularly 11-keto-, and 11ß-hydroxy-derivatives of testosterone and dihydrotestosterone, by focusing on the newly-realized role of skin as an endocrine organ, and by confirming any age-related factors in glucose metabolism disorders in such predisposed men.


Assuntos
Resistência à Insulina , Síndrome do Ovário Policístico , Alopecia/etiologia , Androgênios , Feminino , Humanos , Masculino , Testosterona
3.
Infez Med ; 29(1): 37-45, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33664171

RESUMO

The aim of this study was to determine the relationship between COVID-19 severity and androgenic alopecia in patients hospitalized in the Surgery Service of Honorio Delgado Espinoza Hospital in Arequipa, Peru. A cross-sectional study was performed in male patients with a diagnosis of COVID-19. Alopecia, clinical characteristics, treatment, and evolution were collected. In all, 98 patients were included; median age was 55 years old (range 18-89), 32.7% with comorbidities, and 45.9% with androgenic alopecia. The severity of COVID-19 infection was moderate to severe in 13.2% of patients without alopecia, and in 88.9% of patients with alopecia (p>0.001). In the logistic regression model analysis, patients with alopecia had a higher risk of presenting moderate to severe symptoms due to SARS-CoV-2 infection (OR: 80.2; 95% CI 16.2-397.7). In conclusion, the severity of infection was statistically significant in patients over 60 years old and those with alopecia.


Assuntos
Alopecia/etiologia , COVID-19/complicações , SARS-CoV-2 , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Alopecia/terapia , COVID-19/epidemiologia , COVID-19/mortalidade , COVID-19/terapia , Comorbidade , Estudos Transversais , Hospitalização/estatística & dados numéricos , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Peru/epidemiologia , Índice de Gravidade de Doença , Distribuição por Sexo , Fatores Socioeconômicos , Adulto Jovem
4.
Obes Surg ; 31(6): 2649-2659, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33675022

RESUMO

BACKGROUND: Hair loss is a common complication after metabolic and bariatric surgery (MBS). There is a lack of published systematic review in the scientific literature on this topic. The aim of this study was to perform a systematic review and meta-analysis on hair loss after MBS in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. METHODS: PubMed, CINAHL, EMBASE, Web of Science, SCOPUS, and four Chinese databases were searched. Data were pooled using Review Manager 5.3 and Stata 12.0, and subgroups were performed if necessary and feasible. RESULTS: A total of 18 studies (n = 2538) were included. The pooled results showed that the incidence of hair loss after MBS was 57% (95% CI 42-71%). It decreased with longer follow-up times. Hair loss was significantly more common in younger (mean difference (MD), - 2.45; 95% CI, - 4.26 to - 0.64; p = 0.008) women (OR, 3.87; 95% CI, 0.59 to 17.59; p = 0.08). Serum zinc (standardized mean difference (SMD), - 1.13; 95% CI, - 2.27 to 0.01, p = 0.05), folic acid (SMD = - 0.88, 95% CI - 1.29 to - 0.46, p < 0.0001), and ferritin levels (SMD, - 0.22; 95% CI, - 0.38 to - 0.05; p = 0.01), but not serum iron and vitamin B12, were associated with hair loss following MBS. CONCLUSIONS: Hair loss is common after MBS especially in younger women, and those with low serum levels of zinc, folic acid, and ferritin. Prospective studies on larger cohorts are needed.


Assuntos
Cirurgia Bariátrica , Obesidade Mórbida , Alopecia/epidemiologia , Alopecia/etiologia , Cirurgia Bariátrica/efeitos adversos , Feminino , Humanos , Obesidade Mórbida/cirurgia , Estudos Prospectivos , Vitamina B 12
7.
Plast Reconstr Surg ; 147(1S-2): 33S-37S, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-33347072

RESUMO

SUMMARY: The genetic basis of youthfulness is poorly understood. The aging of skin depends on both intrinsic factors and extrinsic factors. Intrinsic factors include personal genetics, and extrinsic factors include environmental exposure to solar radiation and pollution. We recently reported the critical role of the mitochondria in skin aging phenotypes: wrinkle formation, hair graying, hair loss, and uneven skin pigmentation. This article focuses on molecular mechanisms, specifically mitochondrial mechanisms underlying skin aging. This contribution describes the development of an mitochondrial DNA depleter-repleter mouse model and its usefulness in developing strategies and identifying potential agents that can either prevent, slow, or mitigate skin aging, lentigines, and hair loss. The ongoing research efforts include the transplantation of young mitochondria to rejuvenate aging skin and hair to provide youthfulness in humans.


Assuntos
Alopecia/terapia , DNA Mitocondrial/genética , Lentigo/terapia , Mitocôndrias/transplante , Envelhecimento da Pele/genética , Alopecia/etiologia , Animais , Antígenos de Neoplasias/genética , Antígenos de Neoplasias/metabolismo , Técnicas Cosméticas , Fibroblastos/citologia , Fibroblastos/metabolismo , Humanos , Lentigo/etiologia , Melaninas/metabolismo , Melanossomas/metabolismo , Proteínas de Membrana Transportadoras/genética , Proteínas de Membrana Transportadoras/metabolismo , Camundongos , Mitocôndrias/genética , Modelos Animais , Polimorfismo de Nucleotídeo Único , Rejuvenescimento , Pele/citologia , Pele/metabolismo , Pele/efeitos da radiação , Envelhecimento da Pele/efeitos da radiação , Pigmentação da Pele/genética , Pigmentação da Pele/efeitos da radiação , Raios Ultravioleta/efeitos adversos
9.
Ned Tijdschr Geneeskd ; 1642020 10 14.
Artigo em Holandês | MEDLINE | ID: mdl-33331723

RESUMO

A circular zone of hair loss was noted in a two-weeks old male baby, born prematurely. A painful and hyperemic caput succedaneum was diagnosed postpartum. The finding was diagnosed as halo scalp ring, caused by hypoxic-ischaemic tissue damage at the edge of the caput succedaneum, resulting in temporary hair loss.


Assuntos
Alopecia/etiologia , Traumatismos do Nascimento/complicações , Traumatismos Craniocerebrais/complicações , Recém-Nascido Prematuro , Humanos , Recém-Nascido , Masculino , Couro Cabeludo/patologia
10.
Zhonghua Shao Shang Za Zhi ; 36(9): 865-869, 2020 Sep 20.
Artigo em Chinês | MEDLINE | ID: mdl-32972073

RESUMO

Objective: To investigate the design of specialized protective cap for patients with alopecia after autologous hair transplantation and its application value in nursing care after autologous hair transplantation. Methods: The author designed a kind of specialized protective cap for patients with alopecia after autologous hair transplantation with elastic gauze, fiber, silica gel, and other materials. It was divided into two parts, the front piece was mainly used to protect the hair receiving site, and the back piece was mainly used for pressure hemostasis at the hair donor site. From February 2017 to January 2019, 81 patients with alopecia and had autologous hair transplantation in the First Affiliated Hospital of Air Force Military Medical University, who met the inclusion criteria, were enrolled in this prospective controlled study. According to the tail number of admission number of each patient, 43 patients with odd numbers were recruited in protective cap group (38 males and 5 females, aged 23 to 52 years) and 38 patients with even numbers were recruited in convention group (34 males and 4 females, aged 22 to 55 years). After hair transplantation surgery, patients in the two groups received routine postoperative education. Patients in the conventional group were treated with conventional dressing after surgery. On this basis, patients in protective cap group wore the specialized protective caps for at least 1 week continuously except for necessary dressing change, wound clean, and dressing remove. The follow-ups was performed by responsible doctors and nurses at clinic. The postoperative hemorrhage at the hair donor site on post surgery day (PSD) 3 and swelling of scalp at the surgical site on PSD 7, the folliculitis at the hair receiving site and survival condition of transplanted hair follicle at the receiving site, and satisfaction score within 3 months after surgery were observed and recorded. Data were statistically analyzed with two independent sample t test, chi-square test, and Fisher's exact probability test. Results: (1) On PSD 3, one patient in protective cap group had hemorrhage at the hair donor site, which was significantly less than 8 patients in convention group (P<0.05). (2) On PSD 7, 4 patients in protective cap group had swelling of scalp at the surgical site, which was significantly less than 11 patients in convention group (χ(2)=5.160, P<0.05). (3) Within 3 months after surgery, 0 patient in protective cap group had folliculitis at the hair receiving site, which was less than 3 patients in convention group. (4) In 3 months after surgery, the survival number of hair follicle in each 100 transplanted hair follicles at the hair receiving site of patients in protective cap group was 94.9±2.8, which was significantly more than 91.1±4.7 in convention group (t=4.354, P<0.01). (5) The patients' satisfaction score in protective cap group was (14.2±2.6) points, which was significantly higher than (12.1±3.0) points in convention group (t=3.338, P<0.01). Conclusions: After autologous hair transplantation, the specialized protective cap can reduce postoperative hemorrhage at the hair donor site, swelling of scalp at the surgical site, as well as improve the survival rate of transplanted hair follicles at the hair receiving site and score of patient satisfaction.


Assuntos
Alopecia , Transplante de Pele , Adulto , Alopecia/etiologia , Alopecia/prevenção & controle , Alopecia/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Couro Cabeludo/cirurgia , Transplante Autólogo , Adulto Jovem
11.
Clin Dermatol ; 38(4): 477-483, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32972606

RESUMO

Biotinidase deficiency is a rare hereditary metabolic disease. Only a few cases have been reported in China, almost all of which have been in the pediatric population. We report a case of a girl with characteristic skin and hair findings with a negative family history, although her grandparents were consanguineous. The metabolites in the proband's blood and urine increased prominently, and the percentage of biotinase was 1.168%, much lower than normal. Genotyping identified two heterozygous mutations, which were C.1457T>A (p.L486Q) and C.1491dupT (p.L498Ffs*13) in the BTD gene. The diagnosis of biotinidase deficiency was established. No relevant reports about the missense mutation at the mutation site C.1457T>A (p.L486Q) of the BTD gene have been retrieved. Biotin replacement therapy was administered in the dose of 20 mg/d. The dermatitis subsided after 1 month, and the hair color was almost normal after 3 months. This reminds dermatologists to include biotinidase deficiency in their clinical differential when faced with children's intractable dermatitis, yellow hair, and alopecia.


Assuntos
Alopecia/etiologia , Biotina/administração & dosagem , Biotina/metabolismo , Deficiência de Biotinidase/complicações , Deficiência de Biotinidase/diagnóstico , Deficiência de Biotinidase/genética , Biotinidase/genética , Eczema/etiologia , Cor de Cabelo , Deficiência de Biotinidase/tratamento farmacológico , Criança , Feminino , Heterozigoto , Humanos , Mutação , Resultado do Tratamento
12.
Medicine (Baltimore) ; 99(17): e19842, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32332635

RESUMO

INTRODUCTION: Seborrheic alopecia (SA) has clinical manifestations, duration of disease, and priorities. In the current situation where there are many and complicated clinical treatments, Western medicine treatment can delay and control the development of the disease and promote hair regeneration. However, some patients may aggravate symptoms after taking the drug, and the condition is easy to repeat after stopping the drug. Acupuncture is an important method for non-surgical treatment of SA, and it has various methods, low side effects, high safety, and simple and economical. Therefore, we will use a clinical randomized controlled study to explore the effect of acupuncture on SA, and provide a new idea and reference for the treatment of this disease. METHODS/DESIGN: We will select 60 patients diagnosed with SA. They will be randomly divided into intervention group and control groups. The control group will be given conventional treatment measures. The intervention group will receive acupuncture. Efficacy will be evaluated by comparing the skin lesion score and dermatological quality of life index before and after treatment. DISCUSSION: This trial may provide evidence regarding the clinical effectiveness, safety, and cost-effectiveness of acupuncture for patients with SA. TRIAL REGISTRATION NUMBER: CTR2000030430.


Assuntos
Terapia por Acupuntura , Alopecia/etiologia , Alopecia/terapia , Dermatite Seborreica/complicações , Terapia por Acupuntura/economia , Adolescente , Adulto , Análise Custo-Benefício , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Resultado do Tratamento , Adulto Jovem
13.
Ann Dermatol Venereol ; 147(2): 131-134, 2020 Feb.
Artigo em Francês | MEDLINE | ID: mdl-31973905

RESUMO

BACKGROUND: Severe combined immunodeficiency (SCID) is a the most severe form of primary immunodeficiency and is highly heterogeneous. We report an atypical form of SCID revealed by exfoliative erythroderma. PATIENTS AND METHODS: A 3-month-old boy, born to consanguineous parents, was admitted to the dermatology department with exfoliative erythroderma associated with eczematous patches and alopecia of the scalp, eyelashes, and eyebrows, but with no lymphadenopathy or hepatosplenomegaly. He displayed chronic diarrhea and recurrent infection since birth. A complete blood count showed marked leukocytosis with eosinophilia and lymphocytosis. These clinical and biological findings improved partly with topical steroids. The patient no longer had erythroderma and showed regrowth of hair, eyelashes and eyebrows. The subsequent CBC showed less marked eosinophilia with mild lymphopenia and no leukocytosis. Immunoglobulin levels were undetectable. Primary immunodeficiency was discussed. Immunological investigations concluded on a diagnosis of T-B-NK+ SCID. Mutation analysis revealed a homozygous c.1338C>G (pCys446Trp) mutation in the RAG2 gene. Hematopoietic stem cell transplantation is planned in the near future. CONCLUSION: This case illustrates atypical T-B-NK+ SCID revealed by severe exfoliative erythroderma in a 3-month-old boy with RAG2 gene mutation. Neonatal erythroderma must be considered a warning sign of primary immunodeficiency requiring immediate immunological phenotyping as well as genetic testing for a definitive diagnosis.


Assuntos
Dermatite Esfoliativa/etiologia , Imunodeficiência Combinada Severa/complicações , Alopecia/etiologia , Alopecia/patologia , Doença Crônica , Consanguinidade , Proteínas de Ligação a DNA/genética , Dermatite Esfoliativa/patologia , Diarreia/etiologia , Eczema/etiologia , Eczema/patologia , Transplante de Células-Tronco Hematopoéticas , Humanos , Lactente , Masculino , Proteínas Nucleares/genética , Fotografação , Imunodeficiência Combinada Severa/genética , Imunodeficiência Combinada Severa/terapia
17.
Lupus ; 29(1): 79-82, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31789124

RESUMO

Antimalarials are usually recommended for the first-line systemic treatment of cutaneous lupus erythematosus. Alopecia in patients with discoid lupus erythematosus (DLE) is sometimes a refractory condition in spite of topical therapies. We herein described a case of DLE on the scalp with a pathological change of a xanthomatous reaction, which was successfully treated with hydroxychloroquine (HCQ). A 34-year-old woman presented with hair loss to the parietal region. She had been diagnosed with systemic lupus erythematosus (SLE) four years previously. Treatment with 30 mg/day of prednisolone (PSL) had been initiated, and the dose was gradually reduced. At 10 mg/day of PSL, she had noticed her hair loss. Physical examination revealed some small erythematous lesions to the parietal region with accompanying hair loss. Pathological findings of the erythematous lesion on her head revealed thickening of the basement membrane zone, the interface dermatitis with vacuolar degeneration, and both superficial perivascular and perifollicular infiltration of inflammatory cells in the dermis. In addition, there was an infiltrate of xanthomatous cells detected in the papillary dermis, which were positive for CD68 and CD163. The patient started treatment with HCQ at a dose of 200 mg/day. The skin lesions completely resolved within five months after initiation of HCQ without increase in the dose of PSL. Xanthomatous reactions are rarely recognized in lupus erythematosus. The chronic epithelial injury in DLE could be implicated in triggering the secondary reactive process of a xanthomatous reaction. We believe that the reaction seen in our patient was a secondary change to pathological alteration due to SLE. However, as yet unrecognized factors may play a role in the development of a xanthomatous reaction in DLE.


Assuntos
Alopecia/tratamento farmacológico , Antirreumáticos/administração & dosagem , Hidroxicloroquina/administração & dosagem , Lúpus Eritematoso Cutâneo/tratamento farmacológico , Adulto , Alopecia/etiologia , Alopecia/patologia , Antígenos CD , Antígenos de Diferenciação Mielomonocítica , Feminino , Humanos , Lúpus Eritematoso Cutâneo/complicações , Receptores de Superfície Celular , Pele/patologia
18.
Am J Dermatopathol ; 42(3): 173-177, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31855586

RESUMO

BACKGROUND: Folliculitis decalvans (FD) and lichen planopilaris (LPP) are classified as neutrophilic and lymphocytic cicatricial alopecias according to the North American Hair Research Society. Recently, a clinical phenotype combining concomitant or sequential features for both was described as a FD LPP phenotypic spectrum (FDLPPPS). OBJECTIVES: To review the most common phenotypic presentation of FDLPPPS with a main focus on histopathology. METHODS: We reviewed retrospectively series of 7 patients with a similar phenotypic presentation with special focus on the histologic pattern. All patients presented with concomitant features for FD and LPP and recalcitrant course unresponsive to topical and systemic immunomodulatory/anti-inflammatory agents. RESULTS: The most common clinical phenotype was that of hairless patches on the vertex with lost follicular ostia and perifollicular scale and the following diagnostic findings: (1) polytrichia; (2) positive bacterial culture for Staphylococcus in over 50% of the samples isolated from pustules and hemorrhagic crusts; (3) "mixed" histologic features for primary cicatricial alopecia including multicompound follicular structures of average 2-5 follicles (follicular packs), atrophy of the follicular epithelium, lymphohistiocytic infiltrate with granulomas, and prominent plasma cells, but absence of neutrophilic infiltrate in all cases except scarce neutrophils in one; and (4) clinical improvement with adjuvant systemic antimicrobials. CONCLUSIONS: The FDLPPPS may be underreported and should be considered in all cases of LPP recalcitrant to treatment. Dermatologists and dermatopathologists should recognize this phenotypic spectrum to guide optimal clinical management consisting of immunomodulatory and anti-inflammatory agents along with systemic antimicrobials.


Assuntos
Alopecia/patologia , Foliculite/patologia , Líquen Plano/patologia , Adulto , Alopecia/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fenótipo , Estudos Retrospectivos
20.
Strahlenther Onkol ; 196(1): 48-57, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31418046

RESUMO

PURPOSE: Published results of quality of life (QoL) studies mostly concern whole brain radiotherapy for limited or multiple brain metastases. This prospective multicentre study was designed to compare the QoL of patients with limited (1-3) brain metastases treated with either whole brain (WBRT) or stereotactic radiotherapy (SRT). METHODS: From 01/2007-03/2011, 90 limited brain metastases patients who were previously untreated (n = 77) or had undergone primary surgery (n = 13) were recruited at 14 centres in Germany and Austria. QoL was measured with the EORTC-QLQ-C15-PAL and BN20 brain modules before the start of radiotherapy and after 3 months. RESULTS: Fifty-two patients (58%) received WBRT and 38 (42%) received SRT. At 3 months, 67 patients (74%) were still living, and 92.6% of the 3­month survivors completed the second set of questionnaires. Analysis of the QLQ-C15-PAL and BN20 scales revealed significant deterioration in patients treated with WBRT and SRT in physical function (p < 0.001 and p = 0.007), fatigue (p < 0.001 and p = 0.036), nausea (p = 0.003 and p = 0.002), appetite loss (p < 0.001 and p = 0.025), drowsiness (p < 0.001 and p = 0.011), hair loss (p = 0.019 and p = 0.023) and itchy skin (p = 0.030 and p = 0.018). Motor dysfunction (p < 0.001), communication deficits (p = 0.002) and leg weakness (p < 0.001) declined significantly only in patients treated with WBRT. Comparing the two radiotherapy techniques over time, the results showed significant differences in symptom scores for future uncertainty, fatigue and appetite loss. CONCLUSIONS: QoL data as an outcome of the paper should be considered in decision making on the irradiation technique in patients with small number of brain metastases. Larger studies are required to verify the results according to subgroups.


Assuntos
Neoplasias Encefálicas/radioterapia , Neoplasias Encefálicas/secundário , Irradiação Craniana/efeitos adversos , Qualidade de Vida/psicologia , Lesões por Radiação/etiologia , Radiocirurgia/efeitos adversos , Atividades Cotidianas/classificação , Alopecia/etiologia , Áustria , Neoplasias Encefálicas/psicologia , Transtornos da Comunicação/etiologia , Fadiga/etiologia , Transtornos da Alimentação e da Ingestão de Alimentos/etiologia , Seguimentos , Alemanha , Humanos , Debilidade Muscular/etiologia , Estudos Prospectivos
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