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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.
Rev Med Chir Soc Med Nat Iasi 2001 Jul-Sep;105(3):533-5
Endocrinological disorders in association with alopecia areata-a 27 patients study
Alopecia areata is a dermatological disease, characterized by the loss of hair, which affect men, women and children and can evaluate alone or in association with a variety of other disorders. Between these endocrinological diseases, especial thyroid disorders, have a high incidence. Twenty-seven patients with alopecia areata (12 women and 15 men) aged between 3 and 46 years were endocrinologically investigated. Eighteen of them (66.6%) had endocrinological disorders. Thyroid diseases were present in 10 cases (37%): 4 cases with endemic goiter, 2 cases with nodular goiter and 4 cases with hypothyroidism (1 case with autoimmune thyroiditis, 1 case with nodular goiter, 1 case with cystic goiter and 1 case with hypothyroidism post thyroidectomy for thyroidal lymphoma). Twelve cases (44.4%) were found with tetania. The incidence of thyroid diseases in alopecia areata is higher then in general population (2%), as well as the incidence of tetania. These evidences suggest that it is necessary to make a screening of endocrinological disorders in patients with alopecia areata.
J Dermatol 2002 Apr;29(4):197-201
Ultrastructural study of acquired pili torti-like hair defects accompanying pseudopelade.
Acquired structural hair defects are caused by various physical and chemical manipulations. Plucked hairs and hair follicle biopsy specimens of pili torti-like hairs that arose from pseudopelade scalp were studied. In scanning electron microscopy, the hair shafts had a segmental pili torti-like appearance, accompanied by oblique or longitudinal grooves and ridges. In light microscopy, the hair follicles showed an asymmetric hair bulb and inner root sheath, and a shortened keratogenous zone within sclerosing fibrous connective tissue. In transmission electron microscopy, the numbers and thickness of the hair cuticle cells were different on the opposite sides of the hair shaft. The hair cuticle was irregularly shaped and formed asymmetric waves. The tonofilaments in the hair cortex ran almost parallel to the hair axis. From these findings, it was clear that the grooves and ridges were produced by the deformed hair cuticle and cortex, whose shapes were modulated by the asymmetric inner root sheath. This asymmetry most likely resulted from a dysfunctional dermal papilla, which was affected by fibrosis. The pili torti-like appearance appeared to be caused by the grooves and ridges that ran obliquely on the hair shaft surface.
J Invest Dermatol 2002 Feb;118(2):216-25
Molecular mechanisms regulating hair follicle development.
Clinical conditions causing hair loss, such as androgenetic alopecia, alopecia areata, and scarring alopecia, can be psychologically devastating to individuals and are the target of a multimillion dollar pharmaceutical industry. The importance of the hair follicle in skin biology, however, does not rest solely with its ability to produce hair. Hair follicles are self-renewing and contain reservoirs of multipotent stem cells that are capable of regenerating the epidermis and are thought to be utilized in wound healing. Hair follicles are also the sites of origin of many neoplasias, including some basal cell carcinomas and pilomatricoma. These diseases result from inappropriate activation of signaling pathways that regulate hair follicle morphogenesis. Identification of the signaling molecules and pathways operating in developing and postnatal, cycling, hair follicles is therefore vital to our understanding of pathogenic states in the skin and may ultimately permit the development of novel therapies for skin tumors as well as for hair loss disease. The purpose of this review is to summarize recent progress in our understanding of the molecular mechanisms regulating hair follicle formation, and to discuss ways in which this information may eventually be utilized in the clinic.
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