Saurabh Swaroop Gupta; Aneet Mahendra; Sanjeev Gupta; Rohit Singla
Abstract
Background and Aim: Alopecia areata (AA) is a chronic, autoimmune disease that causes non-scarring hair loss. Recently, serum vitamin D has been implicated in the etiopathogenesis of AA due to its immunoregulatory effects. Its deficiency can cause a loss of selftolerance and predispose individuals to ...
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Background and Aim: Alopecia areata (AA) is a chronic, autoimmune disease that causes non-scarring hair loss. Recently, serum vitamin D has been implicated in the etiopathogenesis of AA due to its immunoregulatory effects. Its deficiency can cause a loss of selftolerance and predispose individuals to autoimmune diseases. This study compared the serum vitamin D levels between AA cases and controls. We aimed to compare the serum levels of vitamin D between AA patients and age and sex-matched healthy controls and to elucidate any correlation between AA and vitamin D serum levels in terms of disease pattern, severity, and extent.Methods: A case group comprising 25 AA patients and a second group of 25 healthy controls of 10 years of age or older were involved in the study. A detailed history was taken, along with a complete clinical examination. Serum vitamin D levels were measured and compared between the groups.Results: The mean level of vitamin D in cases (17.15 ± 5.01 ng/ ml) was significantly lower as compared to controls (34.58 ± 20.83 ng/ml) (P < 0.001). The duration, pattern, and severity of AA had no significant relationship with patients’ serum vitamin D levels.Conclusion: We demonstrated a statistically significant variation in serum vitamin D between controls and cases, with lower values in patients. Our findings indicate a possible cause-and-effect relationship between low serum vitamin D and AA, which needs further exploration.
Saman Mohammadi; Maryam Khalili; Mahin Aflatoonian; Rezvan Amiri; Zahra Sharif; Saeedeh Farajzadeh; Azadeh Mohebbi
Abstract
Background: Atopic dermatitis is a chronic relapsing inflammatoryskin disease that has possible associations with other diseases suchas allergic conditions, autoimmune skin diseases, and systemicdiseases. We evaluated the prevalence of alopecia areata andthyroid autoimmunity in children with atopic dermatitis.Methods: ...
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Background: Atopic dermatitis is a chronic relapsing inflammatoryskin disease that has possible associations with other diseases suchas allergic conditions, autoimmune skin diseases, and systemicdiseases. We evaluated the prevalence of alopecia areata andthyroid autoimmunity in children with atopic dermatitis.Methods: This was a cross-sectional study on 124 children(62 children with atopic dermatitis and 62 healthy children).Demographic features of the participants and duration of diseasein children with atopic dermatitis were recorded. Antithyroidperoxidase and thyroid stimulating hormone were evaluated inboth groups. Odds ratio (OR) and 95% confidence interval (CI)were calculated to estimate relative risk. The chi-squared testand analysis of variance test (ANOVA) were used to evaluatethe association of thyroid autoimmunity with the demographicand clinical features of patients.Results: Thyroid autoimmunity was only detected in atopicdermatitis children and not in the control group, and the differencewas statistically significant [OR = 4.32, 95% CI = 2.15–10.81,P = 0.04). Furthermore, overt thyroid disease was significantlymore common in the atopic dermatitis group compared withthe control group (OR = 4.46, 95% CI = 1.15–17.24, P = 0.03). Apersonal history of alopecia areata was also significantly morecommon in the atopic dermatitis group (OR = 4.46, CI = 1.17–15.29,P = 0.030). In addition, there was no significant difference betweenthyroid autoimmunity and overt thyroid disease in the patients’severity of atopic dermatitis and demographic features (P > 0.05).Conclusion: Patients with atopic dermatitis had a significantlyhigher percentage of thyroid autoimmunity, overt thyroid disease,and alopecia areata than the control group.
Bita Kiafar; Vahideh Sabeti; Farhad Faridhoseini; Lida Jarahi; Samaneh Salamian
Abstract
Background: Alopecia areata is one of the most common causesof hair loss. In this study, the personality traits and stress levelsof patients with alopecia areata were assessed and comparedwith a control group based on the NEO Five-Factor Inventory(FFI) and Perceived Stress Scale (PSS) questionnaires.Methods: ...
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Background: Alopecia areata is one of the most common causesof hair loss. In this study, the personality traits and stress levelsof patients with alopecia areata were assessed and comparedwith a control group based on the NEO Five-Factor Inventory(FFI) and Perceived Stress Scale (PSS) questionnaires.Methods: This cross-sectional study was performed on 120patients with alopecia areata and 120 healthy individuals as acontrol group from 2015 to 2017 in Mashhad, Iran. The controlgroup was selected from the families of patients who did not havecurrent involvement and no history of alopecia areata, matchedby gender, mean age, and level of education. A dermatologistevaluated the severity score of alopecia in participants. TheNEO FFI and PSS questionnaires were used to assess patients’personality aspects. SPSS v. 20 was used to analyze the data.Results: The results of the NEO FFI questionnaire showed thatstatistically, the mean score of neuroticism in alopecia areatapatients was significantly higher than in the control group(P = 0.023), but the extraversion and flexibility scores weresignificantly higher in the control group than in alopecia areatapatients (P = 0.026 & 0.049, respectively). The PSS questionnaireresults showed that the mean stress score of alopecia areatapatients was similar to the control group (P = 0.12).Conclusion: Our results suggest that compared with healthyindividuals, patients with alopecia areata have higher neuroticismscores and lower extraversion and flexibility scores on the NEOFFI.
Nadia Abdalhafid Elsherif; Salwa Abdalsalm El-Dibany; Azza SH Greiw
Abstract
Background: Alopecia areata (AA) is non-scarring hair loss. Its etiopathology is not fully known, most evidence considered AA an immunologically mediated disease. To compare serum levels of total immunoglobulin E (IgE) between AA patients and healthy subjects, and to assess whether AA is associated with ...
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Background: Alopecia areata (AA) is non-scarring hair loss. Its etiopathology is not fully known, most evidence considered AA an immunologically mediated disease. To compare serum levels of total immunoglobulin E (IgE) between AA patients and healthy subjects, and to assess whether AA is associated with atopy.
Methods: 50 AA patients and 50 healthy subjects were included in this study. Presence of atopy was elicited by detailed family and/ or personal history of atopy. Clinically patients were divided into 2 groups: patients with single patch of AA (alopecia unilocularis, AU), or with multiple patches (alopecia multilocularis, AM). Serum levels of IgE were measured in both groups.
Results: Serum levels of total IgE were significantly higher in patients than in controls (178 ± 154 ku/l vs. 118 ± 57 ku/l; P < 0.05). Evidence of atopy was present in 48% of AA patients compare to 18% of control subjects (P < 0.05). Patients with disease duration more than one year had significantly higher serum IgE levels (P < 0.05), and patients with AM had significantly higher serum IgE levels than patients with AU (267 ± 189 ku/l vs. 102 ± 32.3 ku/l; P < 0.05). Mean value of serum IgE did not vary significantly with patient’s age at onset, gender, history of atopy or family history of AA. Atopy was significantly associated with AM.
Conclusion: Total serum IgE is elevated in AA patients with significant association with severe and chronic disease irrespective of the presence of atopy. Atopic diseases were more frequent in AA patients with severe clinical presentation.
Robabe Abedini; Saeed Shakiba; Narges Ghandi; Farnaz Yazdaniamjad; Nazgol-Sadat Haddadi; Maryam Nasimi
Abstract
Background: Alopecia areata (AA) is an autoimmune disease involving the inflammation of hair follicles. In many autoimmune diseases, inadequate levels of vitamin D have been reported. We aimed to determine the association between vitamin D levels and AA.
Methods: In this case-control study, 50 AA patients ...
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Background: Alopecia areata (AA) is an autoimmune disease involving the inflammation of hair follicles. In many autoimmune diseases, inadequate levels of vitamin D have been reported. We aimed to determine the association between vitamin D levels and AA.
Methods: In this case-control study, 50 AA patients and 50 controls were assessed regarding serum levels of 25-hydroxy vitamin D [25-(OH)-D3]. The levels of 25-(OH)-D3 were classified as deficient ( < 20 ng/ml), insufficient (20 to 30 ng/ml), and sufficient ( > 30 ng/dl). The severity of the disease was scored according to the Severity of Alopecia Tool (SALT).
Results: The serum level of 25-(OH)-D3 was significantly lower in AA cases compared with the control group. Patients with the totalis or universalis pattern of hair loss had lower levels of 25-(OH)-D3 relative to patients with the patchy or ophiasis type of AA. Moreover, severe cases showed significantly lower levels of vitamin D relative to mild and moderate cases. We found a significant inverse association between 25-(OH)-D3 level and age. We found no association between serum levels of 25-(OH)-D3 and gender, disease duration, disease recurrence, nail involvement, or positive family history of AA.
Conclusion: AA patients had lower serum levels of vitamin D, though this did not contribute to the severity or duration of disease or pattern of hair loss. More studies are required to evaluate the role of vitamin D supplementation in the pathophysiology of AA.
Azadeh Rakhshan; Afshin Moradi; Hedieh Peiroolia
Abstract
Background: Androgenic hair loss (AGA) and alopecia areata (AA) are common conditions which sometimes are histologically difficult to differentiate. This study was conducted to detect differentiating features of these two disorders with IHC analysis of T-cell subsets in the inflammatory ...
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Background: Androgenic hair loss (AGA) and alopecia areata (AA) are common conditions which sometimes are histologically difficult to differentiate. This study was conducted to detect differentiating features of these two disorders with IHC analysis of T-cell subsets in the inflammatory infiltrates of alopecia areata and androgenetic alopecia. Methods: This cross-sectional study was conducted at Shohadae-Tajrish Hospital in 2018. Twenty-eight cases of alopecia areata and 32 androgenic hair loss cases were evaluated. H&E and IHC staining for CD3, CD4, and CD8+ T-lymphocytes were performed. Lymphocytic densities were graded in a quintet grading system. The inflammation density in various areas of skin tissue was evaluated. Statistical analysis was performed using SPSS version 21. Results: Peribulbar lymphocytic infiltration was seen in 88.5% of AA patients and 12.5% of AGA patients (P = 0.000). Presence of melanin, pigmented casts, and lymphocytes in follicular stelawere in favor of AA diagnosis. CD3, CD4, and CD8+ T-cells in follicular stela, peri-bulbar, and subcutaneous regions were higher and denser in AA patients, while CD3 and CD4+ T-cells aroundsebaceous ducts were in favor of AGA diagnosis. Conclusion: Peribulbar lymphocytic infiltration is among the most important differentiating features of AA and AGA. Infiltration of T-cells in various regions of skin tissue has high diagnosticvalue. Histologic and immunohistochemical evaluation of skin tissues according to these factors can differentiate these two entities with high precision.
Saniee Sara; Zare Armaghan Ghareaghaji; Radmehr Afsaneh
Abstract
Background: Alopecia areata (AA) is a common localized nonscarring hair loss. Vitamin D and such trace elements as zinc have significant immunomodulatory roles and are reduced in many autoimmune diseases. We aim to evaluate the zinc and vitamin D levels in AA patients belonging to an Iranian population.
Methods: ...
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Background: Alopecia areata (AA) is a common localized nonscarring hair loss. Vitamin D and such trace elements as zinc have significant immunomodulatory roles and are reduced in many autoimmune diseases. We aim to evaluate the zinc and vitamin D levels in AA patients belonging to an Iranian population.
Methods: We randomly recruited 77 patients with AA, and 112 age- and sex-matched normal subjects. Serum zinc and vitamin D levels were measured and compared between groups. Patients were considered vitamin D deficient or insufficient if 25-OH vitamin D levels were <10 and 10 to 30 ng/ml, respectively.
Results: Disease duration was 6.73±1.05 months. Compared to the control group, AA patients had significantly lower zinc (87.78±20.61 vs. 92.76±28.00, p=0.008) and vitamin D levels (20.23±11.11 vs. 25.63±15.90, p=0.01) and higher vitamin D deficiency (19.5% vs. 10.7%, p=0.03). There were significant correlations between AA duration and zinc levels (r=0.483, p<0.001); no recognizable relationship, on the other hand, was observed with vitamin Dlevels (r=0.022, p=0.84).Conclusion: There were significantly lower levels of zinc and vitamin D in AA patients, compared to normal subjects. Zinc level is inversely correlated with disease duration, and both zinc and vitamin D play crucial roles in AA pathogenesis and are possible supplements in AA treatment.
Nasiri Soheila; Iranmanesh Behzad; Gheisari Mehdi; Abdollahimajd Fahimeh; Nobari Niloufar
Abstract
Background: Alopecia Areata (AA) is an autoimmune disease affecting hair follicles. Although many details are well specified in the pathogenesis of the disease, there exist certain aspects which require more investigations. Given the fact that the increase in Th-1 immunity is the essential part of the ...
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Background: Alopecia Areata (AA) is an autoimmune disease affecting hair follicles. Although many details are well specified in the pathogenesis of the disease, there exist certain aspects which require more investigations. Given the fact that the increase in Th-1 immunity is the essential part of the pathogenesis, the incrimination of osteopontin, as a Th-1 cytokine, is considered appropriate in the pathogenesis of the disease. The aim of the present research was to evaluate the role of osteopontin in alopecia areata and its correlation with disease pattern and severity.
Methods: This case-control study consisted of 45 patients with alopecia areata and 45 health individuals. The level of osteopontin was measured through blood sampling and ELISA method.
Results: The mean plasma level of osteopontin was significantly lower in patients with alopecia areata than controls (P<0.05)
Conclusions: The plasma level of osteopontin in patients with alopecia areata is lower than healthy controls. Moreover, there is no significant relationship between the plasma level of osteopontin and disease severity. The clinical manifestations of alopecia areata might be a sign of the altered protective effects of osteopontin. Needless to say, more investigation is required to clarify the correlation between alopecia areata and osteopontin.
Rafiei Rana; Eftekhari Hojat; Granmayeh Siamak; Shafaei Sareh
Volume 19, Issue 3 , 2016, , Pages 97-100
Abstract
Mycosis fungoides (MF), the most common type of cutaneous T-cell lymphoma, is histologically characterized by atypical T lymphocytes with cerebriform nuclei that infiltrate the epidermis. Alope
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Mycosis fungoides (MF), the most common type of cutaneous T-cell lymphoma, is histologically characterized by atypical T lymphocytes with cerebriform nuclei that infiltrate the epidermis. Alope
Radmanesh Mohammad; Azar-Beig Mohsen
Volume 16, Issue 2 , 2013, , Pages 49-52
Abstract
Background: The cold-induced inflammation of cryotherapy mayalter the immunologic processes and structural components ofthe hair follicles responsible for AA. The aim of this study was tostudy the efficacy of cryotherapy in alopecia areata, and totalis.Method: Forty-four patients with recalcitrant scalp ...
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Background: The cold-induced inflammation of cryotherapy mayalter the immunologic processes and structural components ofthe hair follicles responsible for AA. The aim of this study was tostudy the efficacy of cryotherapy in alopecia areata, and totalis.Method: Forty-four patients with recalcitrant scalp alopeciaareata or totalis were treated with cryotherapy. The cryo-systemchosen was a closed contact CO2 system with metallic probes.The patients were evaluated for 4-8 weeks for hair growth.Satisfactory hair growth after 8 weeks was an indication forperforming cryotherapy for the remaining untreated areas.Result: Varying degrees of hair growth were detected in 52.50%of the patients four weeks and in 65.90 % eight weeks aftertreatment. About 38.64% of the patients showed more than 50%hair regrowth 8 weeks after therapy.Conclusion: Cryotherapy is effective for about two-thirds of thepatients with alopecia areata, many of whom are unresponsiveto conventional therapies.
Zahra Fazel; Mahnaz Banihashemi; Mohammad-Javad Yazdanpanah; Hadis Yousefzadeh
Volume 15, Issue 4 , 2012, , Pages 127-130
Abstract
Background: Various kinds of sensitizers are administrated foralopecia areata treatment. The aim of this study was to evaluatetreatment response to Dinitrochlorobenzene (DNCB) in alopeciaareata patients.Method: In this study, 117 patients were treated with DNCBunder a specific checklist. All patients ...
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Background: Various kinds of sensitizers are administrated foralopecia areata treatment. The aim of this study was to evaluatetreatment response to Dinitrochlorobenzene (DNCB) in alopeciaareata patients.Method: In this study, 117 patients were treated with DNCBunder a specific checklist. All patients were sensitized with a 2%DNCB and then treated with ascending DNCB concentrations(0.001%-2%). Response to treatment was categorized as none,mild, moderate and marked improvement.Result: Thirty three (27.5%) patients showed no response, 49(40.8%) had relapse 6 months after improvement, 29 (24.2%)had no relapse 6 months after the treatment and 6 patientswere excluded because they did not return for follow-up visits.Response to treatment in patients without eyelash and eyebrowinvolvement increased significantly (P=0.01). We did not observeany side effects except for localized dermatitis seen in 5% of thepatients.Conclusion: With respect to the suitable response to DNCBapplication and its availability, the authors suggest that DNCBbe reconsidered in alopecia areata. However, attention must bepaid to its mutagenicity..
Mahsa Ghajarzadeh; Maryam Ghiasi; Shahrbanoo Kheirkhah
Volume 14, Issue 4 , 2011, , Pages 140-143
Abstract
Background: Alopecia Areata (AA) is a skin disease which affects 0.2 % of general population. Unlike its little physical impairment, Alopecia areata causes a lot of cosmetic problems but most clinicians do not pay attention to mood disorders and the impaired quality of life as the consequences of disease. ...
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Background: Alopecia Areata (AA) is a skin disease which affects 0.2 % of general population. Unlike its little physical impairment, Alopecia areata causes a lot of cosmetic problems but most clinicians do not pay attention to mood disorders and the impaired quality of life as the consequences of disease. Objectives: To evaluate depression and quality of life in Iranian patients with Alopecia areata . Methods: From January 2009 until January 2010 one hundred alopecia areata patients who were randomly selected (through simple random selection) from the outpatient clinic of Razi Hospital were asked to answer valid and reliable instruments such as Beck Depression Inventory (BDI), SF-36 and DLQI (Dermatology Life Quality Index) questionnaires. Results: The mean scores of BDI, SF-36and DLQI of the patients were 14.4±9.7, 68.04 ±15.1 and 6.4±5.5, respectively. The BDI score was significantly different between male and female participants (F=18.1 ±11.2 vs. M=12.7±8.5, p=0.01) but SF -36 and DLQI scores did not significantly differ between the two gender groups. Duration of the disease, BDI and age had no significant correlation with DLQI scores. Patients with extensive beard involvement had the highest BDI score and the lowest SF-36 score. Conclusion: mood disorders should be considered in Alopecia areata patients to address the risk of markedly impaired quality of life
Wani Aejaz Ali; Jan Nighat
Volume 14, Issue 3 , 2011, , Pages 92-94
Abstract
Background: Alopecia Areate (AA) is a recurrent non-scarring patchy hair loss of autoimmune origin in a genetically susceptible individual although environmental factors may be contributory. The aim of this study is to evaluate serum iron and ferritin levels in patients with AA. Methods: Fifty patients ...
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Background: Alopecia Areate (AA) is a recurrent non-scarring patchy hair loss of autoimmune origin in a genetically susceptible individual although environmental factors may be contributory. The aim of this study is to evaluate serum iron and ferritin levels in patients with AA. Methods: Fifty patients of AA and 50 age and sex matched control subjects without any hair loss were studied. Results: No significant difference was found in mean hemoglobin, ferritin, and iron levels in two groups. Serum iron ferritin and hemoglobin levels did not show any significant variations with respect to the extent or duration of the disease, family history, history of atopy, and nail involvement. Conclusion: In our study, the levels of serum iron and ferritin showed no significant changes in AA patients and seems not to play a role in the etiology of AA.
Maryam Akhyani; Hasan Seirafi; Zahra Hallaji; Pardis Kiani; Sara Sabouri rad; Hosein Ahrar Mohammad
Volume 14, Issue 1 , 2011, , Pages 6-11
Abstract
Background: Alopecia Areata (AA) is a recurrent non-scarring type of hair loss that can affect any hair-bearing area. Prognosis of AA is unpredictable and most patients experience more than one episode of hair loss. The purpose of this study was to investigate the relationship between the severity of ...
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Background: Alopecia Areata (AA) is a recurrent non-scarring type of hair loss that can affect any hair-bearing area. Prognosis of AA is unpredictable and most patients experience more than one episode of hair loss. The purpose of this study was to investigate the relationship between the severity of AA with respect to age of onset, nail involvement, family history, number of recurrences and duration of the disease. Methods: A total of 239 consecutive patients with AA who were visited in our dermatology clinic from June 2009 to November 2009 were included in this study. The extent of scalp involvement, age of onset, nail involvement, family history, number of recurrences and duration of AA were recorded. Results: Two hundred and thirty nine (239) patients with AA including 141 males and 98 females entered our analysis (male: female ratio = 1.43:1). The age of the patients at the onset of the disease had a wide range from 1 to 60 years (mean ± SD = 21.51 ± 5.4). Two hundred and twelve patients (88.7%) had their first episode of AA before the age of 40 years. Duration of the AA varied from 1 month to 31 years. Ninety six (40.2%) patients experienced only one episode and 25 patients (10.5%) had more than 4 episode of alopecia. Nail changes was reported in 34 patients (14.2%). Forty five patients (18.8%) had a positive family history of alopecia areata. A personal history of atopy and autoimmune diseases was seen in 23 (9.6%) and 27 (11.3%) patients, respectively. The relationship between extensive AA and age of onset, duration, nail changes and positive family history was confirmed (p 0.05). Conclusion: AA occurred at a comparatively younger age. There was a correlation between extensive alopecia areata and age of onset, duration, nail changes, and positive family history as prognostic factors. There were no relationships between the severity of AA and sex, history of atopy and autoimmune diseases.
Pouran Layegh; Hamid Reza Arshadi; Sara Shahriari; Fakhrolzaman Pezeshkpour; Yalda Nahidi
Volume 13, Issue 4 , 2010, , Pages 106-111
Abstract
Background: Due to their chronic nature, influences on the body image, hopelessness toward complete recovery and frequent recurrences, dermatological diseases seem to be one of the important predisposing factors in depression and suicidal ideation. Thus, the present study aimed at evaluating the degree ...
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Background: Due to their chronic nature, influences on the body image, hopelessness toward complete recovery and frequent recurrences, dermatological diseases seem to be one of the important predisposing factors in depression and suicidal ideation. Thus, the present study aimed at evaluating the degree of depression and suicidal ideation in patients with psoriasis, acne, alopecia areata and vitiligo.Methods: The study was carried out on 300 patients with psoriasis, acne, alopecia and vitiligo who were referred to the dermatology clinic of Ghaem Hospital in Mashad. Beck depression questionnaire was used to collect the data which was then statistically analyzed with ANOVA and T-test, using SPSS software.Results: In this study, 35.7% (107) of the subjects were female and 64.3% (193) were male with a mean age of 26.55±10.81 years. The prevalence rate of clinical depression was found to be 47.4% in patients with acne; 69.4% in those with psoriasis; 70.1% in those suffering from vitiligo; 50% in diffuse alopecia areata; 60% in universalis alopecia areata; 100% in ophiasis alopecia areata and 68.3% in patients with localized alopecia areata. As for suicidal ideation, there was no sign in 88.3% (265); however, 6.3% (19) of the patients reported to have thought of suicide but they had no desire for the attempt while 4% (12) of them had some desire for suicide and 1.3% (4) were seriously determined to commit suicide if only they would find themselves in an appropriate situation.Conclusion: As shown by the findings of the study, there was a close relationship between dermatological diseases and psychological factors; thus, it is important to immediately diagnose concurrent psychological effects, especially those of depression and suicidal ideation. We found that there was a significant relationship between the prevalence rate of dermatological conditions and psychological effects; i.e. depression (P=0.008) and suicidal ideation (P=0.001). We also found out that the rate of suicide attempt was highest among the patients with universalis alopecia, diffuse alopecia areata and vitiligo, respectively.
Malekzad Farhad; Eshghi Gholamreza; Ebadi Atyeh; Younespour Shima
Volume 13, Issue 3 , 2010, , Pages 91-95
Abstract
Background: Alopecia areata is one of the most common human autoimmune disorders and its severe types are refractory to all conventional therapies. Corticosteroids have been used in severe alopecia areata since 1950s but there is concern over complications caused by high doses of corticosteroids. Methotrexate ...
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Background: Alopecia areata is one of the most common human autoimmune disorders and its severe types are refractory to all conventional therapies. Corticosteroids have been used in severe alopecia areata since 1950s but there is concern over complications caused by high doses of corticosteroids. Methotrexate has been used as an adjunctive therapy in some autoimmune disorders and has been proposed to be effective in the treatment of severe alopecia areata both as a monotherapy and in combination with corticosteroids. Methods: In this study, 120 patients of intractable alopecia areata totalis and universalis with a mean duration of 3.27 ±1.60 years were studied. We treated them with methotrexate in combination with intravenous and low dose of prednisolone for one year. Methotrexate 10 mg per week was administered in combination with three monthly methylprednisolone and oral prednisolone 15 mg per day for one year. Response to the treatment was evaluated clinically and by serial photographs. Results: Sixty four patients (57.7%) gained total hair regrowth after treatment with no significant difference between alopecia totalis and universalis. Almost half of the patients (44.75%) remained disease free until the end of the one-year follow-up. Relapse occurred in 34 patients (56.25%); of them 20% were focal relapses. Nine patients out of 120 patients (7.5%) experienced severe adverse effects of the therapy. Conclusion: Our study suggested that methotrexate could be used as a safe and well tolerated adjunctive therapy for severe alopecia areata although careful monitoring of adverse effect is necessary. Furthermore, controlled prospective clinical trials are warranted to answer many of the questions regarding methotrexate therapy for severe alopecia areata.
Maryam Akhiani; Hasan Seyrafi; Farshad Farnaghi; Parastoo Banan; Vahideh Lajvardi
Volume 11, Issue 3 , 2008, , Pages 103-107
Abstract
Background: Topical immunotherapy with diphencyprone (DPCP) for the treatment of severe alopecia areata has been used since 1983 and is felt to be the treatment of choice for chronic extensive alopecia areata. Highly variable results have been reported. The purposes of this study were to evaluate the ...
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Background: Topical immunotherapy with diphencyprone (DPCP) for the treatment of severe alopecia areata has been used since 1983 and is felt to be the treatment of choice for chronic extensive alopecia areata. Highly variable results have been reported. The purposes of this study were to evaluate the efficacy of DPCP in the treatment of chronic, extensive alopecia areata and to assess the long-term overall benefit of treatment.Methods: In a retrospective study, 54 patients with chronic extensive alopecia areata who had used DPCP for more than 1.5 years between 2001 and 2005 were studied. Patients' information and results of treatment after every session were collected from record files.Results: The response to treatment was excellent (76-100% terminal hair re-growth) in 40.7%, good (51-75% terminal hair re-growth) in 14.8%, moderate (26-50% terminal hair re-growth) in 14.8%, and mild (1-25% terminal hair re-growth) in 29.6% of patients. However, 33% of them had a relapse. The response to treatment was excellent and good in 62% of the patients with less than 10 years duration of alopecia areata, but in the group with the duration of more than 10 years, a good and/or excellent response was found in 25% of patients and 75% had a poor and/or moderate response (P=0.017). There was no relationship between response to treatment and sex, onset of disease, nail involvement, atopy, extent of hair loss, and family history of alopecia areata.Conclusion: Topical immunotherapy with DPCP has proved to be an effective treatment with prolonged therapeutic results in Iranian population. Duration of disease less than 10 years is a main predictor for a good response rate.
Akhyani Maryam; Jafari Alireza Keshtkar; Seyrafi Hassan; Ghaninedjad Hayedeh; RezaPazouki Hamid; Tousi Siavash; Robati Reza Mahmood; Davari Parastoo; Firooz Alireza
Volume 11, Issue 1 , 2008, , Pages 7-10
Abstract
Background: Latanoprost, a prostaglandin F 2a analogue, is an intraocular pressure lowering drug used in the treatment of glaucoma. Increase in eyelash number, length, pigmentation, curvature is reported after using topical Latanoprost in these patients. The aim of this study was to evaluate the effect ...
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Background: Latanoprost, a prostaglandin F 2a analogue, is an intraocular pressure lowering drug used in the treatment of glaucoma. Increase in eyelash number, length, pigmentation, curvature is reported after using topical Latanoprost in these patients. The aim of this study was to evaluate the effect of Latanoprost ophthalmic solution on eyelash regrowth in patients with alopecia areata.Methods: Fifteen patients with alopecia areata and bilateral eyelash involvement, who showed excellent response to diphencyprone therapy, entered the study to be treated with Latanoprost ophthalmic solution. In each patient, one eye was randomly treated with Latanoprost daily over 3 months. To assess the eyelash changes, patients were followed up monthly. Results: Ten patients completed the study. Two patients had significant eyelash regrowth of both eyes. One patient showed eyelash regrowth on upper eyelid of the eye treated with Latanoprost. Conclusion: In this study, Latanoprost was not effective in treatment of alopecia areata of eyelashes. It is advisable to evaluate the efficacy of higher concentration and/or more frequent application of the Latanoprost with an appropriate vehicle for the treatment of alopecia areata of eyelashes.
M Omidian; AR Salehi; M Ahmadi
Volume 9, Issue 1 , 2006, , Pages 64-65
V Feizi; H Mortazavi; B Barik Bin; M Yousefi; AR Ranjbar
Volume 8, Issue 3 , 2005, , Pages 195-200
Abstract
Background: Autoimmune mechanisms are involved in the etiology of Alopecia areata. It is also shown that Selenium has some effects on regulation of autoimmune mechanisms. Objective: To compare the plasma level of Selenium between those with and without Alopecia areata. Patients and Methods: In this case-control ...
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Background: Autoimmune mechanisms are involved in the etiology of Alopecia areata. It is also shown that Selenium has some effects on regulation of autoimmune mechanisms. Objective: To compare the plasma level of Selenium between those with and without Alopecia areata. Patients and Methods: In this case-control study, 29 patients with Alopecia areata referred to Razi hospital in Tehran, and 29 persons without this disease were selected consequently. Plasma level of Selenium was determined and compared between the groups. Results: The mean age of cases was 24.9±10.5 and of controls was 29.1±10.5 years. In both groups 15 (51.7%) patients were male and 14 (48.3%) of them were female. The mean plasma Selenium level in cases was significantly lower than what was observed in controls (62.1±13.3 g/l vs. 88.3±13.2 g/l, P<0.0005). Conclusion: This study indicated that mean plasma Selenium level in patients with Alopecia areata was lower than those without this disorder. It is recommended to evaluate the effects of adding Selenium to dietary regimen of patients with Alopecia areata.
M Emad; Sh Aghaei; P Jafari
Volume 8, Issue 3 , 2005, , Pages 211-217
Abstract
Background: Highly variable results of topical immunotherapy with Diphencyprone (DPC) in the treatment of Alopecia areata have been reported so far. Objective: The purpose of this study was to evaluate the efficacy and tolerability of DPC in the treatment of severe and chronic chronic Alopecia areata. ...
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Background: Highly variable results of topical immunotherapy with Diphencyprone (DPC) in the treatment of Alopecia areata have been reported so far. Objective: The purpose of this study was to evaluate the efficacy and tolerability of DPC in the treatment of severe and chronic chronic Alopecia areata. Patients and Methods: 28 patients (16 female and 12 male, 10-35 years old, mean age 25 years) with chronic and/or extensive Alopecia areata were enrolled in an open-label clinical trial. After sensitization with 2% DPC, progressively higher concentrations beginning at 0.001% were applied weekly for 6 months to one side of the scalp. The maximum concentration of DPC was 2%. Results: 27 of 28 patients completed therapy. The overall response rate was 81.5% (22 cases). Complete response (90%-100% terminal hair re-growth) was obtained in 22.2% (6 cases) and partial response (10%-90% terminal hair re-growth) in 59.3% (16 cases), and 18.5% (5 cases) showed no regrowth. In all patients an eczematous reaction consisting of erythema, itching, and scaling at the site of application was observed. Other observed side effects included occipital lymphadenopathy in 40.7% (11 cases), severe eczema/blister formation in 40.7% (11 cases), hyperpigmentation in 18.5% (5 cases). Notably, partial recurrence was observed in 66.7% (18 cases) of these patients after 6 to 12 months of follow up. Conclusion: Topical DPC treatment for Alopecia areata is an effective therapy with a relatively high relapse rate.
AR Keshtkar Jafari; M Akhyani; A Akhavan Malayeri; V Kheiri
Volume 7, Issue 1 , 2003, , Pages 33-37
Abstract
Background: Alopecia areata is a patchy hair loss that may occur in any hair bearing area on the body. There are many reports of ocular abnormalities such as lens and retinal changes in alopecia areata. Objective: To evaluate ocular alterations in alopecia areata with regard to the lens and retina. Patients ...
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Background: Alopecia areata is a patchy hair loss that may occur in any hair bearing area on the body. There are many reports of ocular abnormalities such as lens and retinal changes in alopecia areata. Objective: To evaluate ocular alterations in alopecia areata with regard to the lens and retina. Patients & Methods: Seventy three patients with alopecia areata including 34 males and 39 females, 69.6% partialis, 11% totalis and 19.2% universalis, were examined with slit lamp, fundoscopy and indirect ophthalmoscopy after full dilatation of pupils. Results: There was not any changes in patients’ lens and retina in this study. Conclusion: This study showed that lens and retinal changes are uncommon in alopecia areata.
S Shamsoddini; VR Sepehr
Volume 5, Issue 4 , 2002, , Pages 20-27
Abstract
Background: Alopecia areata has a wide range of different clinical presentations. It may present as localized or diffuse hair thinness without hair loss, a small patch of hair loss or may progress to alopecia totalis and universalis. Objectives: Determination of clinical patterns of alopecia areata in ...
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Background: Alopecia areata has a wide range of different clinical presentations. It may present as localized or diffuse hair thinness without hair loss, a small patch of hair loss or may progress to alopecia totalis and universalis. Objectives: Determination of clinical patterns of alopecia areata in Kerman province and to compare the results with other studies in other countries. Patients and Methods: 952 patients with alopecia areata out of 25186 new cases referred to skin clinics in Kerman from June 2000 till June 2002 were evaluated for age, sex, family history of alopecia areata, extent of hair loss and history of infectious diseases. Results: 3.78% of all new cases referred to skin clinics suffered from alopecia areata. The male to female ratio was 2.6 to 1 and the most frequent clinical presentation of alopecia was round to oval type. Hair loss was confined to the scalp in 252 cases (26.5%). 216 cases (22.7%) had body hair loss without scalp alopecia, and 484 patients (50.8%) developed a combination of scalp and body hair loss. The combination pattern was significantly more frequent in the first three decades of life. Conclusion: Alopecia areata has a relatively high prevalence in Kerman province. It involves both scalp and body in the majority of cases especially in the first three decades of life.
AR Firooz; M Rashighi Firoozabadi; B Ghazi Saidi; Y Dowlati
Volume 4, Issue 3 , 2001, , Pages 11-17
Abstract
Background: Alopecia areata (AA) is a common disease with an unknown etiology. It is a chronic disease with causes severe disfigurement. So it may significantly affect the patients’ quality of life (QOL). This study was designed to evaluate illness perception and QOL in patients with AA. Patients ...
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Background: Alopecia areata (AA) is a common disease with an unknown etiology. It is a chronic disease with causes severe disfigurement. So it may significantly affect the patients’ quality of life (QOL). This study was designed to evaluate illness perception and QOL in patients with AA. Patients and Methods: A questionnaire consisting of 28 questions about causes, course and the impact on QOL were given to patients with AA older than 12 years attending a private skin clinic in 1999 in Tehran. The questions were asked as closed questions and the patients answered them anonymously as “I agree”, “I do not know” and “I disagree”. Only questionnaires with more than 80% of questions answered were analyzed. The role of age, sex, duration, previous treatment, education, severity and family history of AA were assessed. Results: 80 patients (42 male and 38 female) with a mean age of 27.5±9.3 years and disease duration of 7.8±7.7 years entered the study. 60 of them had AA and 20 had alopecia totalis/universalis (AT/AU). 77% of patients believed on the role of stress as the cause of disease, more in older patients and shorter duration. 17% believed on the role of genetic background, more in patients with positive family history of AA or longer duration of disease. AA had a pronounced effect on QOL of 58% of patients, more in younger patients. 51% of patients considered their disease as severe, more in younger patients or severe disease. Only 58% of patients considered their treatments effective and 49% of them believed it will improve with praying. Conclusion: AA may considerably affect various aspects of patients’ lives. The knowledge of patients about the causes and course of this disease is very limited. Physicians should spend more time on the education of patients.
ZB Mousavi
Volume 3, Issue 1 , 1999, , Pages 31-34
Abstract
Background: EMLA cream is a eutectic mixture of Lidocaine and Prilocaine used to induce local anesthesia for dermatological procedures. Objective: This study was designed to evaluate the efficacy of EMLA cream in reducing the pain of intralesional injection of steroid in patients with alopecia areata. ...
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Background: EMLA cream is a eutectic mixture of Lidocaine and Prilocaine used to induce local anesthesia for dermatological procedures. Objective: This study was designed to evaluate the efficacy of EMLA cream in reducing the pain of intralesional injection of steroid in patients with alopecia areata. Patients and Methods: This study was carried out on 27 alopecia areata patients. The injections of corticosteroid were done in one of lesions after using EMLA cream (For 30, 45 or 60 minutes) and in other lesions without it in each patient. Results: 82% of patients experienced less pain in injections done after using EMLA cream. Conclusion: EMLA cream can reduce the pain of intralesional injections of corticosteroid in patches of alopecia areata.
