Alopecia areata

Alternative/Adjunctive treatment Psoriasis, seborrheic dermatitis, severe diaper rash, dishidrosis, nodular prurigo, chronic discoid lupus erythematosus, alopecia areata, lymphocytic infiltration of the skin, mycosis fungoides, and familial benign pemphigus of Hailey-Hailey. 

Numerous glucocorticosteroids for topical application are available. Essentially they all suppress the symptoms of inflammatory and hypersensitivity reactions and their mechanism of action is similar. Their indications include seborrhoeic and atopic dermatitis, phototoxic reactions, psoriasis, chronic discoid lupus, hypertrophic lichen planus and alopecia areata. However it has to be kept in mind that the use of corticosteroids for these conditions in most cases only gives symptomatic relieve and that the problem tends to recur on cessation of therapy. Traditionally topical corticosteroid formulations are grouped according to approximate relative efficacy. This efficacy is determined by both the potency of the agent and the concentration in which the corticosteroid is used. 

Anthralin (Anthra-Derm) is a potent reducing agent whose mechanism of action is unknown. It is approved for the treatment of psoriasis and also may be helpful in alopecia areata. The major toxicides are discoloration of skin, hair, and nails and irritant dermatitis. 

Unlabeled Uses Treatment of alopecia areata, aplastic anemia, atopic dermatitis, Behpet s disease, biliary cirrhosis, prevention of corneal transplant rejection... 

Alopecia areata (a single area on the scalp), diarrhea, nausea, headache, rash, abdominal pain, dyspepsia. 

Dermatology Topical steroids are useful in keloids, hypertrophic scars, other localised hypertrophic, infiltrated, inflammatory lesions of lichen planus, psoriatic plaques, granuloma annulare and lichen simplex chronicus discoid lupus erythematosus, necrobiosis lipoidica diabeticorum and alopecia areata. 

Of 15 patients suffering from alopecia areata and treated for a long time (up to one year), 9 patients showed completely regenerated hair, 4 patients had adequately regenerated hair (the hair was long but thin). The treatment was not effective (growth of fluffy hair) in only 2 patients. 

After treatment of 19 patients suffering from alopecia areata of tape form (of these 12 patients were treated for about 6 months, 3 patients for up to one year, and 3 patients for one and a half year) complete regeneration of hair was observed in 13 patients, considerable improvement in 5 patients and no visible results in 1 patient. 

In general, treatment of 107 patients suffering from alopecia of the above types with l-(chloromethyl)- and 1-ethoxysilatrane liniments led to complete regeneration of hair in 34.7% of the patients, partial regeneration of hair in 43%, growth of fluffy hair in 19.6% and no hair growth in 2.8% of patients. In other words, the treatment was effective in 77.7% of patients. The use of the liniments was most successful for treatment of patients suffering from alopecia areata where a positive effect was observed in 31 patients out of 34 (91.1%). 

Fig. 14. Treatment of alopecia with l-(chloromethyl)- and 1-ethoxysilatrane liniments a) Patient S. P., 17 years of age, suffering from subtotal alopecia for 10 years, after treatment with l-(chloromethyl)silatrane for 2 years b) Patient 1.1., 11 years of age, suffering from alopecia areata for 2 years, after treatment for 5 months c) Patient D.I., 9 years of age, suffering from total alopecia for 4 years, after treatment with 1-ethoxysilatrane for 1.5 years d) Patient I. V., 20 years of age, suffering from total alopecia for 3 years, after treatment for 6 months. The photograph is taken 11 months after the beginning of treatment...

Acute anaphylaxis occurred in an 18-year-old man after the third course of intradermal injections of triamcinolone suspension ( Kenalog 10 mg per treatment) for alopecia areata (446). Subsequent rechallenge with intradermal triamcinolone 1 ml resulted in the same anaphylactic reaction as before and his serum IgE concentration was increased. 

Meidan, V., and E. Touitou. 2001. Treatments for androgenetic alopecia and alopecia areata Current options and future prospects. Drugs 61 53. 

Dermatologic disorders Decreased inflammation Alopecia areata, dermatitis (various forms], keloids, lichens, mycosis fungoides, pemphigus, psoriasis... 

Key words Skin, alopecia areata, atopic dermatitis, chronic proliferative dermatitis, full thickness skin grafts, hair, xenograft. 

Alopecia Areata Alopecia areata is a relatively common autoimmune skin disease that affects humans, mice, rats, horses, dogs, cattle, and even a feather form in chickens (26). Although the disease occurs spontaneously, mice have a low frequency of disease. Full thickness skin grafts provided a reproducible and predictable model (53). This mouse has been used effectively to test drugs known to work on humans with alopecia areata by all methods discussed in this chapter (27). 

This work was supported by grants from the National Alopecia Areata Foundation (NAAF). 

Sundberg, J. P., McElwee, K. J. and King, L. E. (2004) Spontaneous and experimental skin-graft-transfer mouse models of alopecia areata, in Animal models of human inflammatory skin diseases (Chan, L. S., ed.). CRC Press, Boca Raton, pp. 429-449. 

Betz, R. C., Rforr, J., Flaquer, A., Redler, S., Hanneken, S., Eigelshoven, S., et al. (2007) Loss-of-fiinction mutations in the filaggrin gene and alopecia areata strong risk factor for a severe course of disease in patients... 

McElwee, K. J., Boggess, D., King, L. E. and Sundberg, J. P. (1998) Experimental induction of alopecia areata-like hair loss in C3H/HeJ mice using fullthickness skin grafts. J Invest Dermatol 111, 797-803. 

K. J. and Hoffmann, IT (2003) Alopecia areata treatment of today and tomorrow. 

R. A. and Matthews, B.W., Type II restriction endonucleases structural, functional, and evolutionary relationships, Curr. Opin. Chem. Biol. 3, 578-583, 1999 Akar, A., Orkunoglu, F.E., Ozata, M., Sengul, A., and Gur, A.R., Lack of association between vitamin D receptor Fokl polymorphism and alopecia areata, Eur. J. Dermatol. 14, 156-158, 2004 Guy, M., Lowe, L.C., Bretherton-Watt, D. et al., Vitamin D receptor gene polymorphisms and breast cancer risk, Clin. Cancer Res. 10, 5472-5481, 2004 Claassen, M., Nouwen, J., Fang, Y. et al., Staphylococcus aureus nasal carriage is not associated with known polymorphism in the Vitamin D receptor gene, FEMS Immunol. Med. Microbiol. 43,173-176, 2005 Bolu,... 

Alopecia areata or alopecia totalis has been noted in isolated cases (SEDA-21, 384). 

Diphencyprone is a potent sensitizing chemical used to induce a contact dermatitis of the scalp in the topical immunotherapy of alopecia areata. 

Alam M, Gross EA, Savin RC. Severe urticarial reaction to diphenylcyclopropenone therapy for alopecia areata. J Am Acad Dermatol 1999 40(1) 110-12. 

Moderate and reversible alopecia secondary to telogen effluvium is common (7-30%), and sometimes recedes despite continued treatment (305). Alopecia areata has very occasionally been described (306). 

Alopecia areata after 7 months of interferon alfa, slowly reversible on withdrawal, has also been reported in a 36-year-old woman (308). 

Agesta N, Zabala R, Diaz-Perez JL. Alopecia areata during interferon alpha-2b/ribavirin therapy. Dermatology 2002 205(3) 300-l. 

Kernland KH, Hunziker T. Alopecia areata induced by interferon alpha Dermatology 1999 198(4) 418-19. 

Minoxidil (2,4-diamino-6-piperidinopyrimidine-3-oxide) is a potent vasodilator effective in severe hypertension irrespective of the cause. Isolated case reports have been published of hair growth in areas of male pattern baldness in patients treated with oral minoxidil, therefore topical minoxidil has been used for the treatment of alopecia areata and alopecia androgenica, with some success. 

Photochemotherapy, which consists of oral (and sometimes topical) administration of psoralens (the furo-coumarins 5-methoxypsoralen, 8-methoxypsoralen, and trioxysalen) plus long-wave ultraviolet radiation, known as PUVA, is a well-established effective treatment for psoriasis, which has also been used for vitiligo (1), mycosis fungoides, alopecia areata, dyshidrotic eczema, atopic dermatitis, and certain other skin diseases. Guidelines for treatment have been recommended (2,3). 

Dinit rochlorobenzene T reatment of alopecia areata Yellow discoloration of grey hair enhancement of allergy to non-related allergens mutagen ) carcinogen ( ) (SEDA-4, 107) (SEDA-6, 149) (32) (SEDA-10, 131) (SEDA-109, 195)... 

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