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Med Hypotheses 2002 Nov;59(5):522-6
The hydraulic influence in androgen-related hair growth: implications in autoimmune disease.
Androgen-related changes in hair growth represent something of a mystery. Through the action of dihydrotestosterone (DHT), hair growth is increased in specific areas of the body. Elevated levels of DHT produce a general increase over the larger part of the body, often accompanied by hair loss in specific areas of the scalp. Because of this 'opposite' effect, a genetic difference in the hair follicles is proposed. This view is supported through the success of the 'plug graft' transplantation technique. However, this is unsatisfactory, because transplantation procedures that should work well according to this theory, ultimately fail. There is an alternative 'mechanism', that demonstrates its origins in the prime function of hair as an insulator. This simple mechanism makes sense of all the recognized effects of DHT in the dermal system, and throughout the body. In DHT-related hair growth it can be directly observed. The implication is that DHT achieves its effects through a primary physiological action that can be easily tested given the necessary expertise. Given existing knowledge, such a proven action of DHT would have serious implications for further understanding of female susceptibility to autoimmune disease.
Clin Exp Dermatol 2002 Jul;27(5):418-21
Cosmetics and hair loss.
Cosmetic hair care products are often implicated by the user or the clinician in cases of hair loss. Yet, these products are used ad lib, in a wide variety of home conditions and on a wide variety of hair types, by millions of consumers every day with no adverse effects. Based on this extensive data set, the absence of literature reports, and a detailed understanding of the mode of action of cosmetic hair care products, we can conclude that they do not cause hair loss. Clinicians investigating cases of hair loss must fully appreciate the hair cycle, the length of time a single fibre may be present on the head, and its biological and cosmetic history in order to understand the causes of hair loss and make the correct diagnosis. With a better understanding of the cosmetic practices used by everyday consumers, the clinician will be in a strong position to help patients re-grow their hair and guide them through a high quality hair care regime.
J Dermatol Sci 2002 Aug;29(2):85-90
Antioxidant enzymes and lipid peroxidation in the scalp of patients with alopecia areata.
Alopecia areata (AA) is an autoimmune inflammatory disease. However, little is known about the alterations in lipid peroxidation and antioxidant enzymes in the scalp of patients with AA. Therefore, the aim of this study was to investigate the status of oxidative stress in the scalp of patients with AA. We measured the levels of thiobarbituric acid reactive substances (TBARS) as lipid peroxidation status, superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) as antioxidant enzymes in the scalp of ten patients with AA and ten control subjects. The levels of TBARS in scalp of patients with AA (3654.1+/-621.2 nmol/g tissue) were significantly higher than those of controls (1210.2+/-188.8 nmol/g tissue) (P=0.002). The levels of SOD (134.8+/-23.8 U/g tissue) and GSH-Px (332.7+/-66.2 U/g tissue) in scalp of patients with AA were also significantly higher than those of controls (63.2+/-8.8 U/g tissue, 112.0+/-18.4 U/g tissue, respectively) (P=0.019, P=0.002, respectively). The mean levels of TBARS, SOD and GSH-Px in early phase of disease were increased 2-fold as compared with late phase of the disease. These results indicate that oxidative status is affected in AA. Lipid peroxidation and antioxidant enzymes may be involved in the pathogenesis of AA. Furthermore, we found high SOD and GSH-Px activities in the scalp of patient with AA. These high levels could not protect the patients against the reactive oxygen species, because lipid peroxidation could not be lowered in AA patients.
Ann Dermatol Venereol. 2003 Mar;130(3):326-30.
Intravenous pulse methylprednisolone therapy for severe alopecia areata: an open study of 66 patients
INTRODUCTION: Treatment of alopecia areata is a difficult challenge. Some European publications have shown encouraging results with high dose pulse corticosteroid therapy in extensive plurifocal alopecia areata. We undertook a prospective open study between January 2000 and December 2001 using repeated pulse each month, with the aim of identifying the effects of this repetition and underlining the best indications. PATIENTS AND METHODS: Sixty-six patients aged 9 to 60 years old presenting an extensive alopecia areata exceeding 30% of the scalp surface (n=47), alopecia totalis (n=8), alopecia universalis (n=8), ophiasic alopecia (n=3), for less than 12 months entered this study. The administered treatment was methylprednisolone 500 mg/d during 3 days or 5 mg/kg twice per day during 3 days in children. These pulses were repeated after 4 and 8 weeks, then a second series was carried out or not according to cases. The main evaluation criterion was the percentage of new terminal hair appearing on the bald areas, appreciated by clinical and photographic evaluation at 3 and 6 months. RESULTS: Ophiasic alopecia areata did not respond to treatment. A quarter of patients presenting universal alopecia had a good response (higher than 80 p. 100) followed by a relapse in half the cases. Half of the patients presenting alopecia totalis had a good response, which was maintained three times out of four. Multifocal alopecia areata seems the best indication since the patients under study presented a good response in 63.8 p. 100 of cases (78 p. 100 when it was a first episode and 90.5 p. 100 if the treatment had been started in less than 3 months before). The repetition of the pulses did not appear to increase the number of responders. CONCLUSION: This study provides the best indication of pulse methylprednisolone therapy: first recent episode of extensive plurifocal alopecia areata. These results are less convincing in long term history or other forms of alopecia areata.
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