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1.
J Drugs Dermatol ; 21(11): 1166-1169, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36342732

RESUMO

Androgenetic alopecia (AGA) in men and women is the most common cause of hair loss. Affected individuals may experience psychological distress and social withdrawal. Current treatment options for AGA, such as minoxidil and finasteride, vary in efficacy and have side effects. Platelet-rich plasma (PRP) and photobiomodulation are among treatment options that have gained popularity in recent years. While less is known about the effectiveness of fractional lasers for combating hair loss, research suggests that by creating microscopic thermal injury zones, fractional lasers may cause an increase in hair growth from a wound healing process. In this study, we evaluated the efficacy and safety of PRP and 1550 nm fractional erbium-glass laser as monotherapy or combination treatment for AGA in 60 patients. All patients experienced improvement in AGA, but patients treated with the combination therapy had greater improvement in hair density. Overall, PRP and 1550 nm in combination or alone are good treatment choices for AGA, with no side effects. J Drugs Dermatol. 2022;21(11):1166-1169. doi:10.36849/JDD.6750.


Assuntos
Lasers de Estado Sólido , Plasma Rico em Plaquetas , Masculino , Humanos , Feminino , Alopecia/diagnóstico , Alopecia/terapia , Alopecia/induzido quimicamente , Minoxidil , Finasterida/uso terapêutico , Lasers de Estado Sólido/efeitos adversos , Resultado do Tratamento
2.
Curr Opin Endocrinol Diabetes Obes ; 29(6): 535-540, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36226726

RESUMO

PURPOSE OF REVIEW: To explore the recent updates in the diagnosis, management, and clinical implications of androgenic alopecia among patients diagnosed with polycystic ovarian syndrome (PCOS). RECENT FINDINGS: PCOS diagnosis continues to be the most common cause of infertility among reproductively aged women, serving as the most common endocrinopathy among this population. Female pattern hair loss (FPHL) has been seen to be associated and more common among patients with PCOS, however, there are limited studies examining the impact of FPHL among PCOS patients. Although hyperandrogenism is associated with FPHL, the pathophysiology continues to be unclear as FPHL can be present with normal biochemical androgen markers. Treatment can be complex, as common treatments to promote hair growth can exacerbate undesired hirsutism, which can be overcome by cosmetic treatments. New second-line treatment options such as low level laser therapy and platelet rich plasma have been emerging, with limited data supporting efficacy. SUMMARY: PCOS is a complex endocrinological disorder that has significant gynecologic, cutaneous, and metabolic implications that require multidisciplinary collaboration and care. Reproductive goals should be thoroughly discussed prior to starting any treatment, as PCOS is the most common cause of infertility among reproductively-aged women.


Assuntos
Hiperandrogenismo , Infertilidade , Síndrome do Ovário Policístico , Feminino , Humanos , Idoso , Hirsutismo/etiologia , Hirsutismo/terapia , Hirsutismo/epidemiologia , Síndrome do Ovário Policístico/complicações , Síndrome do Ovário Policístico/diagnóstico , Síndrome do Ovário Policístico/terapia , Androgênios/uso terapêutico , Hiperandrogenismo/complicações , Alopecia/diagnóstico , Alopecia/etiologia , Alopecia/terapia
3.
J Drugs Dermatol ; 21(9): 943-952, 2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-36074501

RESUMO

INTRODUCTION: Platelet-rich plasma (PRP) is a commonly used therapeutic option for androgenetic alopecia (AGA). Evidence syntheses for the impact of PRP on AGA has been handicapped by non-standardized protocols for its administration. We quantitatively synthesized the evidence base to determine the relative efficacy of PRP regimens with different frequencies of administration. We defined frequency as a vector of the (i) number of sessions and (ii) time interval between the sessions. METHODS: We systematically reviewed the peer-reviewed literature to obtain relevant data; we then conducted a multivariable meta-regression and network meta-analyses (NMAs). RESULTS: Twenty-five trials met our eligibility criteria; 10 unique PRP regimens were ultimately identified for use in our analyses. Our NMAs produced surface under the cumulative ranking curve (SUCRA) values that corroborated the findings of our multivariable meta-regression. The frequency of PRP sessions, chemical activation, number of centrifugations, the age and sex of the patient, and the design of PRP administration (ie, whole-head vs split-scalp) are correlated with the efficacy of PRP insofar as the mean change in total hair density at 6 months from baseline. CONCLUSIONS: For the most part, regimens’ SUCRA rankings and relative effects support that the efficacy of PRP administration increases when: (i) the number of sessions increases and (ii) the time interval between sessions decreases; we found that chemically-activated PRP (vs inactivated), double centrifugation (vs single), younger (vs older) age of treated patients, female (vs male) sex, and whole-head (vs split-scalp) administration is associated with improved PRP efficacy. Our approach rules out much confounding as the analysis of our outcome was exclusive to monotherapy at a singular timepoint. Our results may reconcile discrepant findings among previous studies and may be helpful in updating clinical practice guidelines. J Drugs Dermatol. 2022;21(9):943-952. doi:10.36849/JDD.6948.


Assuntos
Alopecia , Plasma Rico em Plaquetas , Alopecia/terapia , Feminino , Cabelo , Humanos , Masculino , Metanálise em Rede , Couro Cabeludo , Resultado do Tratamento
6.
Int J Mol Sci ; 23(16)2022 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-36012383

RESUMO

The diffusion of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) inducing coronavirus disease 2019 (COVID-19) has increased the incidence of several dermatological disorders, including hair loss (HL). This article aims to review the literature regarding the incidence of HL and telogen effluvium (TE) in COVID-19 patients and critically appraise the available evidence regarding the role of regenerative strategies like Platelet-Rich Plasma (PRP) and Human Follicle Stem Cells (HFSCs). A literature review regarding the correlation of HL and TE in COVID-19 patients analyzing the biomolecular pathway involved and the role of regenerative strategies was performed using PubMed, MEDLINE, Embase, PreMEDLINE, Scopus, and the Cochrane databases. Observational studies revealed an escalated incidence of pattern HL and TE in COVID-19 patients. Psychological stress, systemic inflammation, and oxidative stress are potential culprits. Proinflammatory cytokines and stress hormones negatively affect the normal metabolism of proteoglycans. Reduced anagenic expression of proteoglycans is a potential mediating mechanism that connects HL to COVID-19. Currently, only one study has been published on PRP against HL in COVID-19 patients. Further controlled trials are required to confirm PRP and HFSCs efficacy in COVID-19 patients.


Assuntos
Alopecia em Áreas , Alopecia , COVID-19 , Células-Tronco Mesenquimais , Plasma Rico em Plaquetas , Alopecia/terapia , Alopecia/virologia , Alopecia em Áreas/terapia , Alopecia em Áreas/virologia , COVID-19/complicações , COVID-19/terapia , Humanos , Proteoglicanas , SARS-CoV-2
9.
Int J Mol Sci ; 23(13)2022 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-35806129

RESUMO

In a clinical study of autologous cell-based therapy using dermal sheath cup (DSC) cells, the treatment of hair loss showed improvements. However, the outcomes were variable. Here, correlations between marker gene expression in DSC cells and treatment outcomes were assessed to predict therapeutic efficacy. Overall, 32 DSC cell lines were used to evaluate correlations between marker gene expression and treatment outcomes. Correlations between vascular pericyte and preadipocyte marker expression and treatment outcomes were inconsistent. As smooth muscle cell markers, MYOCD correlated negatively with treatment outcomes and SRF consistently demonstrated an inverse correlation. Additionally, CALD1 correlated negatively and ACTA2 correlated inversely with treatment outcomes. DSC cell lines were divided into good and moderate/poor responders to further investigate the correlations. SRF and CALD1 were lower in a good responder compared with a moderate responder. Next, DSC cells were differentiated toward dermal papilla cells. Dermal papilla markers SOX2 and LEF1 before differentiation had moderate positive and inverse correlations with the treatment outcome, respectively. SOX2 after differentiation more consistently demonstrated a positive correlation. Significant downregulation of smooth muscle-related genes was also observed after differentiation. These findings revealed putative markers for preclinical evaluation of DSC cells to improve hair loss.


Assuntos
Alopecia , Folículo Piloso , Alopecia/genética , Alopecia/metabolismo , Alopecia/terapia , Biomarcadores/metabolismo , Células Cultivadas , Feminino , Folículo Piloso/metabolismo , Humanos , Masculino , Miócitos de Músculo Liso/metabolismo , Pele/metabolismo , Resultado do Tratamento
10.
Dermatol Ther ; 35(10): e15720, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35851518

RESUMO

Telogen effluvium is one of the most common forms of diffuse, non-scarring hair loss for which patients present for clinical evaluation. It is usually a reactive and reversible disorder. Identifying and correcting the underlying cause is the most important component in management, yet there is always a need for therapeutic options. This study aims to evaluate the efficacy of single session botulinum toxin A injection versus multiple sessions of multivitamins mesotherapy in the treatment of telogen effluvium. A randomized clinical trial was conducted in the Dermatology, Venereology, and Andrology Department, Faculty of Medicine, Zagazig University Hospitals. Twenty-four patients with telogen effluvium were randomly divided into two groups each group included 12 patients. Group I received a single session of Botulinum toxin A injection and group II received multiple sessions of multivitamins mesotherapy injection. Both botulinum toxin A and multivitamins mesotherapy are effective in the treatment of telogen effluvium, which was reflected on the improvement of hair parameters as terminal hair and multiple follicular units. Both treatment modalities had minimal and well-tolerated side effects. Although both therapies have equivalent success rates, single session of botulinum toxin A is a better choice than multiple mesotherapy sessions.


Assuntos
Alopecia em Áreas , Toxinas Botulínicas Tipo A , Alopecia/diagnóstico , Alopecia/etiologia , Alopecia/terapia , Toxinas Botulínicas Tipo A/efeitos adversos , Cabelo , Humanos
11.
Cancer Rep (Hoboken) ; 5(10): e1671, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35861475

RESUMO

BACKGROUND: Intractable nasopharyngeal hemorrhage is a severe complication with high mortality rate in patients with radiation therapy (RT) for nasopharyngeal carcinoma (NPC) that requires emergency treatment. Quite a few of them combine with tumor recurrence. Treatment planning for these patients is extremely difficult for oncologists, and effective treatments are lacking. CASE: A 42-year-old man had a history of recurrent NPC that was treated with 2 cycles of chemoradiotherapies from 2017 to 2019. Five months after the second round of chemoradiotherapy, an episode of massive nasal bleeding occurred. As positron emission tomography (PET) scan revealed tumor recurrence in the left wall of nasopharynx, superselective embolization and subsequent intra-arterial infusion (IA, 4 times of cisplatin 60 mg + fluorouracil 1.0 g) were performed to stop bleeding and achieve tumor control. To date, the disease-free survival time has been over 1 year. No tumor recurrence or rebleeding is found except for alopecia on the left side. CONCLUSIONS: Interventional radiology is important and effective in the treatment of recurrent NPC for both massive nasal bleeding and tumor control. However, the unique complication of unilateral alopecia should not be ignored.


Assuntos
Cisplatino , Neoplasias Nasofaríngeas , Adulto , Alopecia/diagnóstico , Alopecia/etiologia , Alopecia/terapia , Protocolos de Quimioterapia Combinada Antineoplásica , Epistaxe/tratamento farmacológico , Fluoruracila/efeitos adversos , Humanos , Masculino , Carcinoma Nasofaríngeo/terapia , Neoplasias Nasofaríngeas/terapia
13.
FP Essent ; 517: 17-21, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35679468

RESUMO

The goals of management in patients with nonscarring and scarring alopecias are stabilization of hair loss and improvement in hair density. Management often is a lengthy process that requires months to years. Patients may present with more than one cause of alopecia, so management may need to address more than one process. Goals for alopecia management are diagnosis-specific. Physicians should set patient expectations early about the potential for hair regrowth with treatment. Patients should be counseled about hair care practices, personal care products, vitamins, and use of hairstyling devices. Management options such as topical and oral drugs and intralesional injections should be considered based on the diagnosis and the level of evidence supporting their use. Hair transplantation may be an option for select patients. There are more evidence-based guidelines for initial management of nonscarring alopecias than for scarring alopecias. Because of the relative rarity of scarring alopecias, there is a lack of large data sets on which to base guidelines.


Assuntos
Alopecia , Cicatriz , Alopecia/diagnóstico , Alopecia/etiologia , Alopecia/terapia , Cicatriz/etiologia , Cicatriz/terapia , Cabelo , Humanos
15.
Skinmed ; 20(2): 97-104, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35532761

RESUMO

Autologous serum is a component taken from patient's blood after centrifugation to be used for the same patient. Lately, growth factors (GF) found in platelet-rich plasma (PRP) has been widely used as an alternative therapeutic modality in various medical fields. The benefits of using autologous serum effectively include reduced risk of hypersensitivity or allergic reactions as well as the reduced risk of transmission of infectious diseases; however, in practice, the availability of products with GF is still limited. This study aimed to review the latest evidences of using autologous serum therapy in dermatology. We searched and screened the study papers of past 5 years (2015 - 2020) through Pubmed Medline for the following topic: "Risks and benefits of autologous serum in the field of dermatology." The initial search obtained 333 papers, of which only 14 met the inclusion criteria: these included five papers on dermatology, seven on ophthalmology, and one paper each on plastic surgery and orthopedics. PRP serum contains GF, vitamins, hormones, and other components. GF contained in PRP is an effective therapeutic modality to be used in dermatology for wound healing, skin rejuvenation, acne scar, and androgenic alopecia. (SKINmed. 2022;20:97-104).


Assuntos
Dermatologia , Plasma Rico em Plaquetas , Alopecia/terapia , Cicatriz/terapia , Humanos , Rejuvenescimento
16.
J Cosmet Dermatol ; 21(8): 3226-3231, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35441799

RESUMO

BACKGROUND: Alopecia is a common chief complaint and is challenging to treat. As such, regenerative treatments to promote hair growth are an emerging area of research. Exosomes, which are extracellular vesicles involved in cell communication, homeostasis, differentiation, and organogenesis, have been shown to play a central role in hair morphogenesis and regeneration with potential for use as alopecia treatment. AIMS: This review summarizes and assesses the body of literature surrounding exosomes as regenerative therapeutics for alopecia and identifies areas for improvement in future research. METHODS: A review was conducted using a comprehensive list of keywords including "exosome," "alopecia," and "hair loss" on PubMed, EMBASE, and Google Scholar databases published from inception to February 2022. Reference lists of identified articles were included. 47 studies were included. Clinical trial databases were searched using the term "exosome"; however, no trials relevant to hair growth were identified. RESULTS: Our updated and comprehensive review details the history of exosome use in medicine, postulated underlying mechanisms in treating hair loss, and current clinical studies. Preclinical studies demonstrate clear benefits of exosome therapeutics in regenerative medicine and for hair loss treatment. Clinical trials demonstrate safety of exosome use in medicine, but data showing efficacy and safety of exosome therapy for alopecia are lacking. We identified several gaps in knowledge required for effective clinical translation including safety, exosome source, and optimal treatment delivery mechanism and dosage. CONCLUSION: Exosomes are on the horizon as an exciting therapeutic for the treatment of alopecia. Further studies and clinical trials are required.


Assuntos
Exossomos , Terapia com Luz de Baixa Intensidade , Alopecia/terapia , Cabelo , Humanos , Regeneração
17.
J Cosmet Dermatol ; 21(10): 4307-4312, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35380746

RESUMO

BACKGROUND: Androgenic alopecia is a common genetic disorder that characterized by progressive hair follicles and hair atrophy. Despite all available therapeutic techniques, there is low patient satisfaction rate. It seems finding new treatment options for androgenic alopecia is necessary. In the past decade, platelet-rich plasma (PRP), an autologous collection of concentrated platelets with hemostatic and tissue repairing effects, has received developing attention for androgenetic alopecia treatment as a valuable therapeutic technique. METHODS: In this study, 8 patients suffering from resistance androgenic alopecia were enrolled. The PRP and platelet gel were prepared, and a total volume of 10 cc of the combination of PRP and platelet gel were injected in the scalp androgen-related areas using 23-gauge syringe. The treatment was performed one month and 3 months after first injection (three times). The hair pull test was done before treatment. The outcome was evaluated 3, 6, and 9 months after treatment by hair pull test, dermoscopy, photography, and patient's satisfaction. RESULTS: A significant reduction in hair loss was observed before and after treatment. Hair count (density) increased from average number of 72 (hair/cm2 ) to 210 hair/cm2 ). Also, the hair diameter was significantly increased before and after treatment for all patients (p < 0.05). After the treatment, the pull test was significantly decreased in 8 patients (p < 0.05). CONCLUSION: This study supports the combination therapy of PRP and platelet gel for resistance androgenic alopecia treatment. This technique is an uncomplicated, feasible, and cost-effective treatment option for resistance androgenic alopecia, with high patient satisfaction.


Assuntos
Alopecia , Plaquetas , Plasma Rico em Plaquetas , Humanos , Alopecia/terapia , Cabelo , Couro Cabeludo , Resultado do Tratamento
18.
Hautarzt ; 73(5): 353-357, 2022 May.
Artigo em Alemão | MEDLINE | ID: mdl-35364687

RESUMO

BACKGROUND: Platelet rich plasma (PRP) injections have been reported to be an effective and low side effect treatment for androgenetic alopecia (AGA). However, robust data concerning this therapy are lacking. AIM: We address some potentially critical aspects of PRP treatment and give some reasons why study results may differ. MATERIALS AND METHODS: In the following review we give a brief overview of the current literature and compare the results of the various trials. RESULTS: In recent years, several clinical trials have been published that have revealed different but rather positive results, which offers hope to those affected by AGA and to physicians as well. However, the results were observed in methodologically weak trials and data from randomized controlled trials are lacking. Differences in trial designs have made it difficult to draw concrete conclusions about its clinical efficacy. Even in the studies where no hair-growth-promoting effect could be observed, the majority of subjects were at least satisfied with the result. The combination of several treatment approaches seems to lead to optimal improvement in hair growth. CONCLUSION: There are many factors that could have influenced the results of the different studies. The results were observed in methodologically weak studies, giving reason for caution when drawing conclusions. Nevertheless, the majority of the subjects were at least satisfied with the result. Given the current low level of evidence, PRP treatments need to be further investigated in larger studies.


Assuntos
Alopecia , Plasma Rico em Plaquetas , Alopecia/diagnóstico , Alopecia/terapia , Humanos , Resultado do Tratamento
20.
J Drugs Dermatol ; 21(3): 309-310, 2022 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-35254751

RESUMO

Platelet-rich plasma (PRP) is an autologous concentration of plasma from a patient’s blood containing platelets up to 7 times higher than normal plasma. Originally indicated to improve connective tissue regeneration in orthopedic surgery, PRP has also proven to be advantageous in the treatment of androgenic alopecia (AGA), alopecia areata (AA), and other forms of non-scarring alopecia.


Assuntos
Alopecia em Áreas , Lúpus Eritematoso Discoide , Plasma Rico em Plaquetas , Alopecia/etiologia , Alopecia/terapia , Alopecia em Áreas/etiologia , Alopecia em Áreas/terapia , Cicatriz/etiologia , Cicatriz/terapia , Humanos , Lúpus Eritematoso Discoide/complicações , Lúpus Eritematoso Discoide/diagnóstico , Lúpus Eritematoso Discoide/terapia , Transplante Autólogo
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