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Saudi Med J 2002 Dec;23(12):1489-91

Striae distensae - like lesions. A cause of scarring alopecia among children.


OBJECTIVE: Although alopecia areata is a common problem among children, many misdiagnoses for this condition can happen. The aim of this study was to demonstrate the striae distensae as lesions that cause scarring alopecia with a great resemblance to alopecia areata. METHODS: A total of 36 children with provisional diagnosis of alopecia areata of the scalp were assessed clinically in the Department of Dermatology and Venereology, Baghdad Teaching Hospital, Baghdad, Iraq, between June 1998 to June 2001. Their age ranged from 3 12 years and the mean + standard deviation (SD) was 7.30 + 2.59 years with equal sex ratio. RESULTS: All patients provided for this study had a history of patchy hair loss of few months duration. Their parents denied any history of obvious trauma and many modalities of treatment had been tried without benefit. The clinical examination revealed single or multiple (1-6) (mean + SD 2.41 + 1.22) complete linear hair loss patches resembling atrophic scar that was similar to striae distensae. The histopathological examination showed atrophy of the epidermis, full replacement of the dermis by collagen bundles, and complete loss of appendages. CONCLUSION: This is a new entity, which seems to be common among children and often confused with untreated cases of alopecia areata. This condition should be added to the differential diagnosis of patchy hair loss in children and the parents should be reassured of the cause of hair loss and no treatment therapy needed.


Dermatol Surg 2002 Aug;28(8):720-8

Follicular unit extraction: minimally invasive surgery for hair transplantation.


BACKGROUND: Follicular Unit Transplantation (FUT) is performed using large numbers of naturally occuring individual follicular units obtained by single-strip harvesting and stereo-microscopic dissection. Donor wound scarring from strip excision, although an infrequent complication, still concerns enough patients that an alternative solution is warranted. OBJECTIVE: The purpose of this paper is to introduce Follicular Unit Extraction (The FOX Procedure), in which individual follicular units are removed directly from the donor region through very small punch excisions, and to describe a test (The FOX Test) that determines which patients are candidates for this procedure. This paper explores the nuances, limitations, and practical aspects of Follicular Unit Extraction (FUE). METHODS: FUE was performed using 1-mm punches to separate follicular units from the surrounding tissue down to the level of the mid dermis. This was followed by extraction of the follicular units with forceps. The FOX test was developed to determine which patients would be good candidates for the procedure. The test was performed on 200 patients. Representative patients who were FOX-positive and FOX-negative were studied histologically. RESULTS: The FOX Test can determine which patients are suitable candidates for FUE. Approximately 25% of the patients biopsied were ideal candidates for FUE and 35% of the patients biopsied were good candidates for extraction. CONCLUSION: FUE is a minimally invasive approach to hair transplantation that obviates the need for a linear donor incision. This technique can serve as an important alternative to traditional hair transplantation in certain patients.


Br J Dermatol 2002 Apr;146(4):601-8

The hairless gene in androgenetic alopecia: results of a systematic mutation screening and a family-based association approach.


BACKGROUND: Genetic disposition and androgen dependence are important characteristics of the common patterned loss of scalp hair known as androgenetic alopecia (AGA). The genetic factors contributing to AGA are currently unknown. The human hairless gene (HR) has recently been cloned and mutations have been reported in families with autosomal recessive universal congenital alopecia and papular atrichia. The main feature of these disorders is persistent complete absence of hair at or shortly after birth. This suggests that HR is essential and specific for the development of hair. OBJECTIVES: To test the hypothesis that HR may be involved in AGA. METHODS: We systematically screened HR for genetic variability by means of single-strand conformation analysis (SSCA) in 46 unrelated men with AGA. To test for an involvement of HR in the development of AGA, seven common variants were genotyped in 61 families with 93 affected offspring. The results were analysed with the transmission/disequilibrium test (TDT). RESULTS: SSCA showed 15 single nucleotide substitutions: eight missense mutations, four silent mutations and three mutations in exon-flanking intronic sequences. TDT results showed a marginally significant association between AGA and variants 3379-29G/T (P = 0.024) and 2611-68C/T (P = 0.047). These results, however, did not remain significant after applying the conservative Bonferroni correction for multiple testing. CONCLUSIONS: Our results do not provide evidence for a strong involvement of HR in the development of AGA, although a minor role cannot be fully excluded.


J Am Acad Dermatol 2002 Apr;46(4):541-4

Sulfasalazine for alopecia areata.


Sulfasalazine is used as a therapy for various autoimmune conditions, including psoriasis; its effectiveness is presumed to be the result of its immunomodulatory effects. We have treated patients with severe alopecia areata with sulfasalazine as part of our dermatology practice and have noticed cosmetically acceptable regrowth in 23% of patients in whom a response could be determined. In view of its good safety profile, sulfasalazine may be considered for systemic treatment of severe alopecia areata.


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Related Web resources:


  • What is hair?
  • Curly Hair
  • Biology of hair growth and development.
  • The phenomenon of hair loss.
  • Methods and treatments for hair loss and baldness.
  • Drugs and hair transplantation surgery for hair loss and baldness.
  • Hair loss linked to other health problems.
  • Baldness by choice and fashion.
  • Alopecia info.
  • Alopecia treatment info.
  • Alopecia treatment info.
  • Hair care info.
  • Hair loss and alopecia research articles: abstracts and source links.



    DHEA has been suggested to provide numerous potential benefits. DHEA (or dehydroepiandrosterone) is converted into androgens (male hormones) or estrogens (female hormones) in the cells.





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