Effects of Early Cell Damage from Repetitive Intermittent Fever Exposure in Alopecia Progression and Evaluation of New Candidate Drugs: Ibuprofen, Menthol, and Cetirizine

BACKGROUND: Alopecia areata (AA) is a very disturbing and expensive disorder in which the exact etiology is not known and it is yet to be treated completely well. Most alopecia patients exhibit some inflammation in the hair follicles regardless of the causes. The clinical symptoms of alopecia present very diversely while the prime symptom is local intermittent fever which are related to inflamed cells. METHODS: This study aimed to evaluate how repetitive intermittent fever can damage the normal human dermal fibroblast (NHDF) cells and investigated the cytotoxic and proliferative effects after application of new candidate drugs (ibuprofen, menthol, cetirizine) for alopecia in comparison to minoxidil. RESULTS: This study demonstrated that ibuprofen, menthol, or/and cetirizine can prevent or slow down the damage of NHDF cells from intermittent fever in early alopecia. Aggressive preventative intervention with those drugs before complete destruction of hair follicle by excessive repetitive fever, is a very important step for alopecia therapy and these drugs are recommended as candidate drugs for alopecia in the future. CONCLUSION: Aggressive preventative intervention with drugs before complete destruction of hair follicles (NHDF cells) by excessive repetitive fever is a very important step for alopecia therapy or progression.

Retrospective Clinical Analysis of Treatment for Primary Warm Autoimmune Hemolytic Anemia

BACKGROUND: Primary warm autoimmune hemolytic anemia (AIHA) is a relatively rare hematologic disorder resulting from autoantibody production against red blood cells. There has been very few studies about primary warm AIHA in South Korea because of its low incidence. We retrospectively analyzed the treatment outcome of primary warm AIHA. METHOD: We reviewed retrospectively the medical records of 9 primary warm AIHA patients from December 2002 to January 2015. We analyzed the causes and clinical characteristics of primary warm AIHA patients. We retrospectively analyzed the clinical data in electronic medical records for 9 Korean patients with AIHA patients who were diagnosed during the period from December 2002 to January 2015 at the Regional University Hospital in Korea. The study protocol was approved by the Institutional Review Board (IRB #2015-08-007, Chosun University Hospital IRB). RESULTS: The mean age was 52 years (range 27~78), the mean hemoglobin level was 5.0 g/dL (range 2.5~6.4 g/dL). All patients received steroids at therapeutic dosages (corticosteroid 1 mg/Kg) as first line treatment. Eight of them showed complete response (5/8, 62.5%) and partial response (3/8, 37.5%), one patient required second-line treatment with rituximab. Two patients who responded first line treatment were relapsed at 86 weeks and 24 weeks after response, respectively. Only one patient of them was retreated with corticosteroid because of anemic symptoms. CONCLUSION: This study indicates that oral corticosteroid is an effective therapy for primary warm AIHA.