Alopecia areata: autoimmunity--the evidence is compelling, Hair transplanting: An important but often forgotten treatment for female pattern hair loss.

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J Investig Dermatol Symp Proc. 2003 Oct;8(2):164-7.

Alopecia areata: autoimmunity--the evidence is compelling.

There is strong evidence indicating that alopecia areata is a tissue-specific, autoimmune disease. Hair loss is associated with a perifollicular lymphocytic infiltrate made up primarily of CD4+ cells, along with a CD8+ intrafollicular infiltrate. Evidence of immune activation includes expression of HLA-DR; HLA-A,B,C; and ICAM-1 on the follicular epithelium. It is likely that the follicular expression of HLA-DR and ICAM-1 is induced by interferon-gamma produced by T cells. Antibodies to follicular epithelium are often present, but their significance is not known. Lesional scalp from alopecia areata patients grafted onto nude mice regrows hair coincident with a loss of infiltrating lymphocytes from the graft. Hair loss can be transferred to human scalp explants on SCID mice by injection of lesional T cells. It is necessary to activate the T cells by culture with follicular autoantigens. Melanocyte-associated antigens are also capable of activating T cells to induce hair loss, suggesting that they are capable of functioning as autoantigens for alopecia areata. Parallel evidence in rodent models of spontaneous alopecia areata also strongly supports a role for T cells in the pathogenesis of this condition.

J Am Acad Dermatol. 2003 Nov;49(5):853-60.

Hair transplanting: An important but often forgotten treatment for female pattern hair loss.

Unger WP, Unger RH.

The techniques used in the early days of hair transplanting were not suitable for the treatment of a majority of women with pattern hair loss. For at least the last 10 years, changes in those techniques have resulted in a reversal of that situation. Today, many women with female pattern hair loss are suitable candidates for transplanting, however, this is not widely appreciated. This article provides potential explanations for this and demonstrates examples of the current methods. Hair transplanting should be considered as a potential treatment option for most women with pattern hair loss.

Am J Clin Dermatol. 2003;4(11):757-70.

Optimal management of hair loss (alopecia) in children.

Hair loss in children encompasses a wide range of conditions that can be congenital or acquired. A congenital hair abnormality may be an isolated finding in an otherwise healthy child or may exist as a feature of a clinical syndrome. A thorough understanding of basic hair biology and normal hair development enables accurate assessment of the child with hair loss. Knowledge of the normal range and variation observed in children's hair additionally enhances this assessment. Social and cultural factors also influence these norms.The psychological and cosmetic importance of hair is immense in our society. The clinical presentation of pediatric hair disorders ranges from subtle to disfiguring. Management of hair disorders requires a holistic approach to the child and family. Young children usually lack self-awareness and it may be the parent who, projecting their own concerns onto the child, most acutely feels any associated anxiety. In addition, parents of a child with an inherited hair condition often feel guilt, and siblings can develop unsupported fears that they may be affected. Hair loss for the older child can lead to low self-esteem, depression and humiliation.Congenital and hereditary hypotrichosis and hair shaft abnormalities often have no effective treatment. There is a variety of treatment options for alopecia areata and telogen effluvium, but no single treatment is 100% effective. Tinea capitis is an infective condition of the hair that responds readily to the appropriate medical therapy. If no effective treatment for the hair loss exists, cosmetic camouflage with wigs is the best option.

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Gene delivery to the hair follicle, Genetic linkage studies in alopecia areata.

Alopecia areata: autoimmunity--the evidence is compelling, Hair transplanting: An important but often forgotten treatment for female pattern hair loss.

Hair loss includes excessive shedding of hair (effluvium) and the alopecias

Hair loss induced by dopamine agonist: case report and review of the literature.

Atrichia with papular lesions resulting from a novel homozygous missense mutation in the hairless gene.