An atypical case of a 14-year-old Filipino female with non-classical congenital adrenal hyperplasia presenting with alopecia universalis

Introduction@#Non-classical congenital adrenal hyperplasia (CAH) represents a group of inherited, autosomal recessive disor- ders that typically presents with androgenetic alopecia, but may present with alopecia universalis on rare occasions.@*Case report@#We report a case of a 14-year-old Filipino female with non-classical congenital adrenal hyperplasia presenting with alopecia universalis, treated with a combination of Tretinoin and Minoxidil solution, low dose prednisone and an oral supplement containing zinc gluconate, nicotinamide, superoxide dismutase, vitamin E and selenium, with noted gradual hair regrowth and improvement in Dermatology Life Quality Index (DLQI).@*Conclusion@#Alopecia universalis in a patient diagnosed with non-classical congenital adrenal hyperplasia is a rare and atypical manifestation, with no case reports available to describe its occurrence. Due to its rarity, there is no standard treatment for pa- tients with this condition. However, the combination of tretinoin and minoxidil solution, low dose prednisone and an oral supple- ment containing zinc gluconate, nicotinamide, superoxide dismutase, vitamin E and selenium shows promising results.

Efficacy of Oral Tofacitinib in Patients with Alopecia Areata: Tofacitinib Was Ineffective for Recalcitrant Alopecia Totalis of a Long Duration / 대한피부과학회지

No abstract available.

Alopecia areata universal / Alopecia areata universalis

Introducción: la alopecia areata es una condición común de pérdida de cabello no cicatricial, inducida por un proceso inflamatorio de origen multifactorial. Cualquier área pilosa puede estar afectada, el cuero cabelludo se afecta en un 90 por ciento de los casos, seguida de la zona de la barba, las cejas, las pestañas y la región púbica. La enfermedad puede progresar al punto en que se pierde todo el pelo del cuero cabelludo (alopecia areata total) o incluso de todo el cuerpo (alopecia areata universal). La etiología exacta se desconoce. Se reconoce la autoinmunidad como el proceso patogénico más importante, siento otros factores el genético y el ambiental. Caso clínico: se presenta el caso de una paciente de 45 años de edad, con pérdida progresiva y total del pelo corporal, a la cual se administraron múltiples tratamientos sin lograr mejoría. Conclusiones: aunque la alopecia areata es una de las enfermedades autoinmunes más comunes, la fisiopatología de esta forma crónica y recidivante de pérdida de pelo no está completamente comprendida y las terapias disponibles son decepcionantes(AU)

Introduction: Alopecia areata is a common condition of noncicatricial hair loss, induced by an inflammatory process of multifactorial origin. Any hairy area may be affected, the scalp is affected in 90 percent of cases, followed by the area of the beard, eyebrows, eyelashes and the pubic region. The disease can progress to the point where all the hair on the scalp (total alopecia areata) or even the entire body (alopecia areata universal) is lost. The exact etiology is unknown. Autoimmunity is recognized as the most important pathogenic process, while other factors are genetic and environmental. Clinical case: The case of a 45-year-old patient with progressive and total loss of body hair was presented, to whom multiple treatments were administered without achieving any improvement. Conclusions: Although alopecia areata is one of the most common autoimmune diseases, the pathophysiology of this chronic and recurrent form of hair loss is not completely understood and the therapies available are disappointing(AU)

A study of clinical profile of Alopecia areata in a tertiary care hospital in Western Odisha

Background: Acute disseminated encephalomyelitis is an acute demyelinating disorder of the central nervous system and is characterised by multifocal white matter involvement. Diffuse neurological signs with multifocal lesions in brain and spinal cord characterise the disease. It do not invade central nervous system. Aim: To evaluate role of MRI in acute disseminated encephalomyelitis. Materials and methods: A prospective study of 10 cases which was conducted in the pediatric department in Dhiraj hospital. MRI brain was done on 1.5 Tesla MRI machine. Results: ADEM can be distinguished from acute viral encephalitis because the disease is not the result of primary tissue invasion by an infectious organism. It was thought to be immune-mediated and is characterized neuropathologically by perivenular inflammation and demyelination. Conclusion: ADEM is more common in female and more associated with previous infection as compared to previous vaccination. Neurological deficit is mostly associated with it. CSF showed raised protein in almost cases. It showed hyperintense lesion on T2W and FLAIR sequences. Periventricular area of brain is commonly associated.

Factors Associated with Severity of Alopecia Areata

BACKGROUND: Alopecia areata is the most common cause of localized, nonscarring alopecia. Unfortunately, there are few data regarding clinical features and epidemiology of alopecia areata in Korean patients, and its clinical course and treatment response rates are unpredictable. OBJECTIVE: This study strived to investigate the differences in clinical profiles according to disease severity and to determine risk factors for severe alopecia areata. METHODS: A total of 1,137 patients from 2006 to 2015 were analyzed retrospectively. Patients were subdivided into two groups: mild-to-moderate and severe alopecia areata. The groups were compared on the basis of age of onset, duration, sex, family history, comorbid disorders including autoimmune diseases, nail changes, and laboratory test results. RESULTS: Eight hundred eighty-three patients were in the mild-to-moderate alopecia areata group and 254 patients were in the severe group. Average onset age was 30.77±17.66 years and 30.60±16.75 years in the mild-to-moderate and severe groups, respectively. Disease duration was statistically longer in the severe group. Male sex, nail changes, and thyroid diseases were more common in the severe group. Hypertension, diabetes mellitus, dyslipidemia, atopic dermatitis, and family history did not differ between groups. Of the serologic values, only alkaline phosphatase was considerably differing between groups. Male sex, presence of nail changes, and disease duration greater than one year were identified as significant risk factors for severe alopecia areata. CONCLUSION: This is the largest case analysis in Korean patients with alopecia areata. Clinical profiles stratified by disease severity warrant further study.

Alopecia.

To understand the causes of hair loss and to treat it by preventing the causative factors and with the help of homoeopathic remedies.

Common variable immunodeficiency and Type 1 Diabetes Mellitus in a 19-year-old Filipino male with Alopecia Universalis / Journal of the ASEAN Federation of Endocrine Societies

@#A 19-year-old Filipino male presents with recurrent respiratory tract symptoms every 4 to 5 months since childhood and sudden onset of diabetes type 1 with ketoacidosis. He had patchy hair loss which started at 7 years old, and was diagnosed with alopecia universalis. Thyroid antibodies and 21-hydroxylase antibody were normal. Common Variable Immunodeficiency with Polyglandular Autoimmune Syndrome IV was considered. The patient is on monthly intravenousimmunoglobulin therapy and basal bolus insulin regimen.

Clinical Characteristics and Prognostic Factors in Early-Onset Alopecia Totalis and Alopecia Universalis

Alopecia totalis (AT) and alopecia universalis (AU), severe forms of alopecia areata (AA), show distinguishable clinical characteristics from those of patch AA. In this study, we investigated the clinical characteristics of AT/AU according to the onset age. Based on the onset age around adolescence ( or = 13 yr), 108 patients were classified in an early-onset group and the other 179 patients in a late-onset group. We found that more patients in the early-onset group had a family history of AA, nail dystrophy, and history of atopic dermatitis than those in the late-onset group. These clinical differences were more prominent in patients with AU than in those with AT. In addition, significantly more patients with concomitant medical disorders, especially allergic diseases were found in the early-onset group (45.8%) than in the late-onset group (31.2%). All treatment modalities failed to show any association with the present hair condition of patients. In the early-onset group, patients with AU or a family history of AA showed worse prognosis, whereas this trend was not observed in the late-onset group. Systemic evaluations might be needed in early-onset patients due to the higher incidence of comorbid diseases. It is suggested that patients with AU or family history of AA make worse progress in the early-onset group than in the late-onset group.

Detection of a Novel Missense Mutations in Atrichia with Papular Lesions

BACKGROUND: Atrichia with papular lesions (APL) is a rare inherited disease characterized by early onset of total hair loss, followed by papular lesions over the extensor areas of the body. Recently, mutations in the human hairless (HR) gene have been implicated in its pathogenesis. The identification of mutations in the HR gene is important for differentiating between APL and alopecia universalis (AU). OBJECTIVE: We compared the HR genes of patients with presumed AU who showed minimal or no response to treatment with the HR genes of healthy controls. METHODS: The subjects were 11 patients with presumed AU who had not responded to treatments. Fifty healthy people were included as controls for molecular analysis. To screen for mutations, polymerase chain reaction was performed. RESULTS: DNA analysis identified a novel heterozygous G-to-A transition at nucleotide position 191 in exon 5. The mutation was not found in the controls, other AU patients, or any unaffected family members except for the patients' mother and maternal grandfather, who were heterozygous HR gene carriers. CONCLUSION: Our study identifies a novel missense mutation in exon 5 of the HR gene in a Korean APL patient previously diagnosed as AU.

A Case of Alopecia Universalis with Vogt-Koyanagi-Harada Syndrome / 대한피부과학회지

Vogt-Koyanagi-Harada (VKH) syndrome is an idiopathic autoimmune disease involving melanocytes. The characteristic features are uveitis, meningismus, tinnitus, alopecia, vitiligo and poliosis, dependent upon the site of melanocyte location. Among the skin manifestations, alopecia usually appears as discrete, alopecic patches around the head. We report a case of fifty-year-old woman who presented with typical features of VKH syndrome, plus alopecia universalis and nail dystrophy.

A Case of Juvenile Rheumatoid Arthritis Associated with Alopecia Universalis / 대한피부과학회지

We observed a 25-year-old male patient who had developed juvenile rheumatoid arthritis(RA) associated with alopecia areata at 14 years of age. When he received treatment for RA, his symptoms of RA and hair loss improved at approximately the same time. One year later, as the symptoms of RA aggravated, the hair loss had progressed eventually to alopecia universalis(AU). Thus we suggest that RA and AU may be associated with a common immunologic factor in etiology of the two diseases.

A Case of Alopecia Universalis in a Gravida / 대한피부과학회지

A 33-year-old woman began to have diffuse hair loss with the onset of pregnancy, and it rapidly developed into alopecia universalis within 2 months af a mid-trimester termination at 20 weeks of gestation. Two months after completion of the depilation, white terminal hair started to regrow and repigmentation began after another 2 months. The hair loss was aggravated immediately after the termination and the regrowing pattern coincided with that of alopecia areata.

A Case of Alopecia Universalis Associated with Autoimmune Poly Glandular Syndrome type II / 대한피부과학회지

Autoimmune polyglandular syndrome (APGS) is characterized by the association of two or more endocrine disorders that are mediated by autoimmune mechanism. We report herein a case of alopecia universalis associated with APGS manifesting autoimmune Addison's disease, insulin-dependent diabetes mellitus, Hashimoto's thyroiditis, primary gonadal failure, which met the criteria of APGS type II. Alopecia is less commonly associated PGA type II.

Systematized Epidermal Nevi Associated with Congenital Alopecia Universalis and Onychodystrophy

We report a case of a 25-year-old woman with systematized epidermal nevi associated with alopecia universalis and onychodystrophy. The histopathologic examinations by light and electron microscopies of the epidermis of the trunk and scalp lesions showed epidermal nevus with characteristic features of epidermolytic hyperkeratosis. This is a rare case of systematized epidermal nevi associated with congenital alopecia universalis and onychodystrophy. Though there is no apparent gross skin lesion on the hair bearing area, the development of epidermal nevi can affect the hair and nail units which are derived from the common epidermal germinative cells.

A case of alopecia universalis without the involvement of scalp hairs

A case of alopecia universalis in a 45-year-old male was reported. The hair loss initiated on the eyebrows and progressed to the whole body, but the scalp hairs were well preserved. Histopathologic features of eyebrows were compatible findings with alopecia areata. This is a unique case of alopecia universalis without any involvement of scalp hairs.

A case of twenty-nail dystrophy associated with chronic thyroiditis and universalis / 대한피부과학회지

Twenty-nail dystrophy is a rare entity in which all 20 nail are uniformly and simultaneously affected with excess longitudinal ridging and loss of luster. This condition is thought to be idiopathic but, many cases are associated with alopecia areata, lichen planus, psoriasis, and ichthyosis. In such cases, it has been hypothesized that immunplogical disorders could play a role in pathogenesis. A 29-year-old male patient presented with dystrophic nail chatge on his all finger and toe nails for 3 years. On phisical examination, all nails were uniformly affected with longitudinal ridging and loss of luster and all body hairs were lost. Thyroid scan showed a finding of chronic thyroiditis. Herein we report a case of twenty-nail dystrophy associated with chronic thyroiditis and alopecia areata.

A clicical study for alopecia totalis and alopecia universalis / 대한피부과학회지

BACKGROUND: Alopecia totalis and alopecia universalis are uncomman and developed from 5-10% of the patients with alopecia areata. OBJECTIVE: The authors perfcirmed a study for clinical obervations and the effects of treatments of alopecia totalis and alopecia universalis in order that this study may cointribute to further studies and treatments of them. MEHTODS: The author performed a clinical study of 42 patients with alopecia totalis and alopecia universalis retrospectively in order to evaluate the clinical manifestation. and the effects of treatments from January 1984 to March 1992 at the department of Dermatology, College of Medicine, Chung Ang University. RESULTS: 1. The incidence of alopecia totalis and alopecia universalis was 6.7% (42/623) among the alopecia patients who were occtipied 1.4% (623/44,839) among the all new dermatologic out patients. 2. The age distributions at the onset of disease showed a peak incidenced an age of less than 15 years (52.4%, 22/42) and the average age was 19.7 years. 3. The laboratory fi ndings showed decreased total T cell count in 1 case(1/10), inversed T/T ratio in 6 cases(6/10), poisitive anti-thyroglobulin anti-body in 3 cases(3/11), and abnormal serum levels of testosterone, esradiol and progesterone in 5 cases(5/22), 2 cases(2/14) and 8 cases(8/13), respectively. 4. The effects in the group treated with topical immunotherapy with DPCP(2,3-diphenylcyclopropenone) or DI CB(2,4-dinitrochlorobenzene) revealed no significant difference from those in the group treated with an intralesional injection of triamcinolone acetonide. 5. The response rates to treatment were make ily higher in the patients with alopecia totalis than alopecia uriiversalis, in cases where the duration of disease was less than 5 years, and in the patients associated with psychologic stress. CONCLUSION: These results suggested that alopecia totalis and alopepia aniversalis frequently occur in children, and some of them we eassociated with cell mediated immunity defects, autoantibody and endocrine factors. The patients with alopecia totalis, with short duration if disease and associated with emotional stress showed better therapeutic responses.

Erythrokeratodermia Variabilis with Alopecia Universalis

We describe a 8-year-old girl with erythrokeratodermia varibilis (EKV). This diagnosis was supported by erythematous, configurate patches over the entire body. Their size, shape and location varyed with enviromental factors and emotional state. In addition, well defined brownish, hyperkeratotic plaques were scattered over the trunk and extremities. Also, this patient had alopecia universalis, which is not typical of EKV. Etretinate therapy resulted in an almost complete clinical clearing of the plaques; however, her alopecia universalis and erythematous lesions were not affected.