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2.
Cochrane Database Syst Rev ; 7: CD008766, 2022 07 12.
Article in English | MEDLINE | ID: covidwho-1958662

ABSTRACT

BACKGROUND: Ovarian cancer is the seventh most frequent cancer diagnosis worldwide, and the eighth leading cause of cancer mortality. Epithelial ovarian cancer is the most common kind, accounting for 90% of cases. First-line therapy for women with epithelial ovarian cancer consists of a combination of cytoreductive surgery and platinum and taxane-based chemotherapy. However, more than 50% of women with epithelial ovarian cancer will experience a relapse and require further chemotherapy and at some point develop resistance to platinum-based drugs. Currently, guidance on the use of most chemotherapy drugs, including taxanes, is unclear for women whose epithelial ovarian cancer has recurred. Paclitaxel, topotecan, pegylated liposomal doxorubicin hydrochloride, trabectedin and gemcitabine are all licensed for use in the UK at the discretion of clinicians, following discussion with the women as to potential adverse effects. Taxanes can be given in once-weekly regimens (at a lower dose) or three-weekly regimens (at a higher dose), which may have differences in the severity of side effects and effectiveness. As relapsed disease suggests incurable disease, it is all the more important to consider side effects and the impact of treatment schedules, as well as quality of life, and not only the life-prolonging effects of treatment. OBJECTIVES: To assess the efficacy and toxicity of different taxane monotherapy regimens for women with recurrent epithelial ovarian, tubal or primary peritoneal cancer. SEARCH METHODS: We searched CENTRAL, MEDLINE and Embase, up to 22 March 2022. Other related databases and trial registries were searched as well as grey literature and no additional studies were identified. A total of 1500 records were identified. SELECTION CRITERIA: We included randomised controlled trials of taxane monotherapy for adult women diagnosed with recurrent epithelial ovarian, tubal or primary peritoneal cancer, previously treated with platinum-based chemotherapy. We included trials comparing two or more taxane monotherapy regimens. Participants could be experiencing their first recurrence of disease or any line of recurrence. DATA COLLECTION AND ANALYSIS: Two review authors screened, independently assessed studies, and extracted data from the included studies. The clinical outcomes we examined were overall survival, response rate, progression-free survival, neurotoxicity, neutropenia, alopecia, and quality of life. We performed statistical analyses using fixed-effect and random-effects models following standard Cochrane methodology. We rated the certainty of evidence according to the GRADE approach. MAIN RESULTS: Our literature search yielded 1500 records of 1466 studies; no additional studies were identified by searching grey literature or handsearching. We uploaded the search results into Covidence. After the exclusion of 92 duplicates, we screened titles and abstracts of 1374 records. Of these, we identified 24 studies for full-text screening. We included four parallel-group randomised controlled trials (RCTs). All trials were multicentred and conducted in a hospital setting. The studies included 981 eligible participants with recurrent epithelial ovarian cancer, tubal or primary peritoneal cancer with a median age ranging between 56 to 62 years of age. All participants had a WHO (World Health Organization) performance status of between 0 to 2. The proportion of participants with serous histology ranged between 56% to 85%. Participants included women who had platinum-sensitive (71%) and platinum-resistant (29%) relapse. Some participants were taxane pre-treated (5.6%), whilst the majority were taxane-naive (94.4%). No studies were classified as having a high risk of bias for any of the domains in the Cochrane risk of bias tool. We found that there may be little or no difference in overall survival (OS) between weekly paclitaxel and three-weekly paclitaxel, but the evidence is very uncertain (risk ratio (RR) of 0.94, 95% confidence interval (CI) 0.66 to 1.33, two studies, 263 participants, very low-certainty evidence). Similarly, there may be little or no difference in response rate (RR of 1.07, 95% CI 0.78 to 1.48, two studies, 263 participants, very low-certainty evidence) and progression-free survival (PFS) (RR of 0.83, 95% CI 0.46 to 1.52, two studies, 263 participants, very low-certainty evidence) between weekly and three-weekly paclitaxel, but the evidence is very uncertain. We found differences in the chemotherapy-associated adverse events between the weekly and three-weekly paclitaxel regimens. The weekly paclitaxel regimen may result in a reduction in neutropenia (RR 0.51, 95% 0.27 to 0.95, two studies, 260 participants, low-certainty evidence) and alopecia (RR 0.58, 95% CI 0.46 to 0.73, one study, 205 participants, low-certainty evidence). There may be little or no difference in neurotoxicity, but the evidence was very low-certainty and we cannot exclude an effect (RR 0.53, 95% CI 0.19 to 1.45, two studies, 260 participants). When examining the effect of paclitaxel dosage in the three-weekly regimen, the 250 mg/m2 paclitaxel regimen probably causes more neurotoxicity compared to the 175 mg/m2 regimen (RR 0.41, 95% CI 0.21 to 0.80, one study, 330 participants, moderate-certainty evidence). Quality-of-life data were not extractable from any of the included studies. AUTHORS' CONCLUSIONS: Fewer people may experience neutropenia when given weekly rather than three-weekly paclitaxel (low-certainty evidence), although it may make little or no difference to the risk of developing neurotoxicity (very low-certainty evidence). This is based on the participants receiving lower doses of drug more often. However, our confidence in this result is low and the true effect may be substantially different from the estimate of the effect. Weekly paclitaxel probably reduces the risk of alopecia, although the rates in both arms were high (46% versus 79%) (low-certainty evidence). A change to weekly from three-weekly chemotherapy could be considered to reduce the likelihood of toxicity, as it may have little or no negative impact on response rate (very low-certainty evidence), PFS (very low-certainty evidence) or OS (very low-certainty evidence). Three-weekly paclitaxel, given at a dose of 175 mg/m2 compared to a higher dose,probably reduces the risk of neurotoxicity.We are moderately confident in this result; the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. A change to 175 mg/m2 paclitaxel (from a higher dose), if a three-weekly regimen is used, probably has little or no negative impact on PFS or OS (very low-certainty evidence).


Subject(s)
Neutropenia , Ovarian Neoplasms , Adult , Alopecia/drug therapy , Bridged-Ring Compounds , Carcinoma, Ovarian Epithelial/drug therapy , Female , Humans , Middle Aged , Neoplasm Recurrence, Local/drug therapy , Ovarian Neoplasms/drug therapy , Paclitaxel/adverse effects , Taxoids/adverse effects
3.
J Drugs Dermatol ; 21(7): 724-727, 2022 Jul 01.
Article in English | MEDLINE | ID: covidwho-1935022

ABSTRACT

The Novel Coronavirus disease (COVID-19) is caused by severe acute respiratory syndrome coronavirus two and primarily affects the epithelium of the airways. Multiple cutaneous manifestations of COVID-19 have been reported in the literature. Case reports citing many different types of exanthems and enanthems have been reported to correspond with the initial presentation and diagnosis of COVID-19. Some researchers have even described cutaneous symptoms linked to COVID-19 as an important presenting sign of the infection with COVID-19 in otherwise asymptomatic or minimally symptomatic patients. Hair loss has emerged as a frequently noted side effect of infection with COVID-19 and has been observed in many patients who have recovered from a documented COVID-19 illness. Given the prevalence of the onset of hair loss in patients who have overcome COVID-19, we designed this retrospective study in order to evaluate the prevalence of hair loss, along with histological findings if hair loss was present and response to treatment in 100 patients who presented to our outpatient dermatology clinic for various dermatological conditions and reported a history of having recovered from COVID-19. J Drugs Dermatol. 2022;21(7):724-727. doi:10.36849/JDD.6661.


Subject(s)
COVID-19 , Alopecia/diagnosis , Alopecia/epidemiology , Alopecia/etiology , COVID-19/complications , COVID-19/epidemiology , Humans , Prevalence , Retrospective Studies , SARS-CoV-2
4.
J Med Life ; 15(5): 631-634, 2022 May.
Article in English | MEDLINE | ID: covidwho-1934916

ABSTRACT

COVID-19 is a concerning global pandemic. Common manifestations are fever and respiratory symptoms. In addition, recent studies reported dermatological manifestations as extrapulmonary signs. One of these is telogen effluvium which is related to post COVID-19 comorbidities. The aim of this study was to assess the prevalence of telogen effluvium among COVID-19 patients. This observational cross-sectional study included 198 patients who were admitted for COVID-19. The PCR test was performed to detect positive cases. After discharge, all patients were interviewed about hair loss. Of these patients, 79 were male (39.9%), and 119 were female (60.1%). The age ranged from 18 to 85 years old. 48 patients showed hair loss. Telogen effluvium (TE) is one of the consequences of the COVID-19 pandemic. COVID-19 leads to more medications and stress situations, which trigger TE.


Subject(s)
Alopecia Areata , COVID-19 , Adolescent , Adult , Aged , Aged, 80 and over , Alopecia/epidemiology , COVID-19/complications , COVID-19/epidemiology , Female , Humans , Male , Middle Aged , Pandemics , Prevalence , Severity of Illness Index , Young Adult
6.
JNMA J Nepal Med Assoc ; 60(249): 473-477, 2022 May 05.
Article in English | MEDLINE | ID: covidwho-1863659

ABSTRACT

Cronkhite-Canada Syndrome is a rare disease characterised by diffuse gastrointestinal polyposis, abdominal pain, diarrhoea, cutaneous and mucosal hyperpigmentation, alopecia, and onychodystrophy. Here we report a case of a 40-year-old female with Cronkhite-Canada Syndrome, who presented with the complaints of diffuse abdominal pain, blood mixed stools, and diarrhoea associated with tenesmus. She had nausea and reduced appetite and lost 10 kgs in 3 months. She had hair fall (alopecia), atrophic changes of nails (onychodystrophy), and hyperpigmentation of the skin in fingers, tongues, and lips. Histopathological biopsy of the gastric and colonic biopsy revealed polypoid edematous mucosa and the colonic biopsies showed scattered dilated glands with inflammatory exudate and mucin. She got Entamoeba histolytica and COVID-19. She received respective antibiotics and protein diets that helped relieve the symptoms. After 4 weeks of steroids, her symptoms improved drastically. Corticosteroids, treating co-infection along with nutritional counselling can be helpful to relieve the symptoms. Keywords: alopecia; case reports; cronkhite-canada syndrome; hyperpigmentation.


Subject(s)
COVID-19 , Hyperpigmentation , Intestinal Polyposis , Abdominal Pain/etiology , Adult , Alopecia/etiology , Diarrhea/etiology , Female , Humans , Hyperpigmentation/complications , Hyperpigmentation/etiology , Intestinal Polyposis/complications , Intestinal Polyposis/diagnosis , Intestinal Polyposis/pathology
7.
Dermatol Ther ; 35(6): e15433, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1735906

ABSTRACT

The prevalence of hair loss has increased during COVID-19. In this study, we review the current literature on incidence and characteristics of various types of COVID-19-related and COVID-19-vaccine- related hair loss including telogen effluvium, alopecia areata, friction alopecia and anagen effluvium. Regarding most of them, the more severe the infection, the more profound and prolonged the course of alopecia. However, the most important issue is reassuring the patients of the non-serious nature of this complication, since psychological support is the most important factor in the earlier resolution of the condition.


Subject(s)
Alopecia Areata , COVID-19 , Vaccines , Alopecia/complications , Alopecia Areata/epidemiology , COVID-19/prevention & control , Humans , SARS-CoV-2
8.
Cutis ; 109(1): 40-42, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1699674

ABSTRACT

Alopecia has been one of the more common concerns reported at teledermatology (TD) visits during the COVID-19 pandemic. In light of the growing use of TD, a team of experts were consulted to develop workflows for virtual hair and scalp examinations, with particular consideration for skin of color patients.


Subject(s)
COVID-19 , Telemedicine , Alopecia/diagnosis , Humans , Pandemics , SARS-CoV-2 , Skin Pigmentation
9.
Am J Dermatopathol ; 44(7): 539-541, 2022 07 01.
Article in English | MEDLINE | ID: covidwho-1691774

Subject(s)
COVID-19 , Alopecia , Humans
11.
Dermatol Online J ; 27(10)2021 Oct 15.
Article in English | MEDLINE | ID: covidwho-1643786

ABSTRACT

The prevalence of telogen effluvium (TE) has increased during COVID-19. In this study we describe the clinical characteristics of patients with COVID-19-related TE and review the current literature on COVID-19-associated TE. We conducted a retrospective chart review of 66 patients, all of which had COVID-19 infection (confirmed by PCR or antibodies) and had either non-scarring hair loss or TE in Elmhurst, Queens. Our data suggest that this form of TE is similar to other forms of TE, after which many patients experience regrowth within several months.


Subject(s)
Alopecia/etiology , COVID-19/complications , Alopecia/blood , Alopecia/epidemiology , COVID-19/blood , COVID-19/epidemiology , Cohort Studies , Comorbidity , Female , Humans , Male , Middle Aged , New York City/epidemiology , Retrospective Studies , Time Factors , Vitamin D/analogs & derivatives , Vitamin D/blood
12.
J Cosmet Dermatol ; 21(4): 1339-1346, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1625816

ABSTRACT

Emerging literature evidence shows that the manifestations of the coronavirus disease 2019 (COVID-19), which is the disease caused by SARS-CoV-2, encompass alterations of the pulmonary, cardiovascular, gastrointestinal, and neurological system. Moreover, hematologic and dermatologic manifestations have been documented. The aim of this review is to summarize the dermatologic manifestations of COVID-19 involving the hair and nails in a narrative way. A total of 1136 patients have been reported to have de novo hair loss following COVID-19. Notably, 958 patients experienced telogen effluvium (TE) (female/male ratio = 3,86:1), two female patients experienced anagen effluvium, and 176 people had alopecia areata (female/male ratio of 19:3). Ten patients were reported to have ungual changes following the infection with the novel coronavirus: The individuals affected were 6 women and 4 men. COVID-19 can be associated with hair and ungual manifestations. This review summarizes the evidence regarding the hair and ungual manifestations of COVID-19, which could be harnessed to better understand the clinical implications and pathophysiology of this disease that has been burdening society globally since December 2019.


Subject(s)
Alopecia Areata , COVID-19 , Alopecia/complications , Alopecia Areata/epidemiology , Alopecia Areata/etiology , COVID-19/complications , Female , Hair , Humans , Male , Nails , SARS-CoV-2
14.
J Cosmet Dermatol ; 21(3): 874-879, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1583491

ABSTRACT

OBJECTIVE: To establish the association of androgenetic alopecia (AGA) and the severity of coronavirus disease 2019 (COVID-19). DESIGN: Observational study. METHODOLOGY: A total of 300 hospitalized patients of COVID-19 were included. Scoring of AGA was done, and severity of COVID-19 was measured as better and worse hospital outcomes. Correlation between severity of AGA and severity of COVID-19 was noted. RESULTS: Out of 300 patients, 220 (73.33%) were male and 80 (26.67%) were female. In males, mild-to-moderate Hamilton-Norwood scale (HNS<3) and severe alopecia (HNS3-7) were noted among 43(20%) and 177(80.55%) patients, respectively. In females, 43(54%) had no AGA while 37(46%) had AGA. In 37 females with AGA, mild-to-moderate (Ludwig scale <2) and severe alopecia (Ludwig scale 2-3) were seen in 9(24.32%) and 28(75.68%) patients, respectively. We report a significant increase in frequency (95%) and severity of AGA and worse outcomes in males (p-value 0.000, chi-square: 18.90) compared with females (46%) (p-value 0.273, chi-square: 7.544), with notable adverse COVID-19 disease outcomes in the younger age group of men and also in few women of younger age group suffering from AGA without any comorbidities. CONCLUSION: Our study shows a significant increase in frequency and severity of AGA and worse outcomes in men compared with women. There was a significant association between AGA severity and hospital disease outcome in men compared with women. Younger age group patients with severe AGA particularly men also faced adverse outcomes while having no known comorbidities, supporting the hypothesis that anti-androgen drugs might be valuable in patients of COVID-19.


Subject(s)
COVID-19 , Alopecia/epidemiology , Comorbidity , Female , Humans , Male , SARS-CoV-2
15.
J Cosmet Dermatol ; 21(2): 590-594, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1583490

ABSTRACT

BACKGROUND: Hair-related manifestations such as alopecia areata or telogen effluvium were reported during COVID-19 disease. Accelerated hair loss with androgenetic alopecia (AGA) pattern or management has not been discussed before. AIMS: This study aimed to examine the accelerated AGA pattern hair loss and management with PRP treatment. MATERIALS AND METHODS: This study was designed prospectively and nine patients included to study confirmed PCR test for COVID-19 infection. Patients underwent platelet-rich plasma (PRP) injections for 4 sessions. Results were accessed with the hair pull test (HPT) and self-administered hair growth questionnaire (HGQ). RESULTS: Nine patients were admitted with complaints of hair loss after an average of 220 ± 24.2 (min: 182 max: 264) day after recovery of COVID-19. Mean age of the patients was 33.8 ±8.4 years old (min: 26, max: 52). Six (66.7%) patients were male, and three (33.3%) of them were female. HPT score decreased to 6.0 ± 1.6 after the first PRP application (p = 0.007, CI 95%:2.7-5.2) and decreased to 1.2 ± 0.8 after the last PRP session (p = 0.008, CI 95%: 6.4-11.1). Five (55.5%) of the patients described the treatment as "very effective" after treatment with HGQ. CONCLUSIONS: Accelerated hair loss associated with COVID-19 continues in long term and PRP treatment provides a satisfactory solution.


Subject(s)
Alopecia Areata , COVID-19 , Platelet-Rich Plasma , Adult , Alopecia/therapy , Female , Humans , Male , SARS-CoV-2 , Treatment Outcome
17.
J Cosmet Dermatol ; 21(2): 420-425, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1570865

ABSTRACT

BACKGROUND: During the coronavirus disease 2019 (COVID-19) outbreak, multiple studies showed higher rates of severe infection in adults and specifically in male patients, which may be related to differences in androgen receptor (AR) expression. Androgenetic alopecia (AGA) is one of the AR expression manifestations. AIM: To explore AGA severity as a possible risk factor for COVID-19 severity in hospitalized patients. METHODS: A total of 164 subjects (116 men and 48 females) with confirmed COVID-19 in need of hospitalization were included in this study. An experienced dermatologist examined the correlation of clinical signs of COVID-19 severity with AGA types. For evaluation of the association between categorical variables and comparison of the mean age in three groups of COVID-19 patients, the Fisher's exact test and the analysis of variance were used. RESULTS: Our cross-sectional study included 116 male patients (70.7%) with a median age of 65.5 (age range: 22-97) years. Among them, 13.8% required intubation, 15.5% needed intensive care unit (ICU) care, and 70.7% required inward hospitalization. The Hamilton-Norwood Scale (HNS) was as follows: HNS I 14.7%, HNS II 12.1%, HNS III 20.7%, HNS IV 19.8%, HNS IV 29.8%, HNS V 17.2%, HNS VI 13.8%, and HNS VII 1.7%. Also, 29.3% of the patients were female, possessing a median age of 72 (age range: 23-98) years. In this group, 8.3% required intubation, 6.3% required ICU care, and 85.4% needed inpatient ward admission care. The Ludwig Scale (LS) was as follows: LS I 52.1%, LS II 35.4%, and LS III 12.5%. CONCLUSION: The severity of AGA type did not correlate with the severity of COVID-19 among hospitalized patients. Our results were in contrast with other research that suggested AGA severity as a marker of unfavorable outcomes of COVID-19.


Subject(s)
COVID-19 , Adult , Aged , Aged, 80 and over , Alopecia/epidemiology , Androgens , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , SARS-CoV-2 , Young Adult
18.
J Cosmet Dermatol ; 21(1): 16-23, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1557807

ABSTRACT

BACKGROUND: Telogen Effluvium (TE) in a post-Covid-19 patient causes excessive shedding of hair. No definite treatment is available till now. Past studies demonstrates that QR678Neo® has shown promising results in various types of Alopecia. AIM: In this study, we aim to establish efficacy of QR678 Neo® hair growth factor formulation administration in Covid-19-induced persistent TE for treatment of hair loss and for hair regrowth. MATERIAL & METHOD: Twenty adult patients (all females) presenting with persistent TE starting few weeks after recovery from Covid-19 infection, and continuing beyond 6 months were included for the study. A 1.5 mL solution of QR678 Neo® hair growth factor formulation was administered in the scalp per session. A total of 8 sessions (one session every 4 weeks) were done. The results were assessed at the baseline, after 4thsession, and 1 month after 8th session. RESULTS: Most of the patients showed significant reduction in hair fall; 89% patients showed excellent hair growth. Global photographic assessment score showed marked improvement, which maintained even post therapy. Videomicroscopic assessment showed increase in the hair count (mean =29.32) after 8th session, that further improved even post therapy. The subjective assessment scores for overall hair growth, appearance of hair, reduction in visibility of the scalp, and hair loss were 4, 4.5, 4.25, and 5, respectively. CONCLUSION: Management of Covid-19-induced persistent Telogen Effluvium has been unclear and futile so far. Intra-dermal administration of QR678 Neo® hair growth factor formulation in the scalp, reduces hair fall, improves hair regrowth, and increases the hair density.


Subject(s)
Alopecia Areata , COVID-19 , Adult , Alopecia/chemically induced , Alopecia/drug therapy , Female , Humans , Intercellular Signaling Peptides and Proteins , Prospective Studies , SARS-CoV-2 , Single-Blind Method
19.
J Postgrad Med ; 67(3): 174-176, 2021.
Article in English | MEDLINE | ID: covidwho-1485286

ABSTRACT

Scleredema adultorum of Buschke is a rare disorder of the connective tissue, involving the skin. Here, we present a 61-year-old male, who is a known case of compensated liver cirrhosis with a past history of being treated for autoimmune thyrotoxicosis, who presented with complaints of alopecia, skin tightening, dry skin, pruritus, and woody indurated plaques on the skin of the upper back, shoulder, and arms. Skin biopsy of the arm revealed the characteristic features of scleredema. He was extensively evaluated for known literature-cited causes of scleredema, and the work up revealed a negative result. He was also found to be hypothyroid on presentation. Hence, we present a case of scleredema occurring in a patient with hypothyroidism and chronic liver disease, which to our knowledge is being described for the first time in literature.


Subject(s)
Hypothyroidism/complications , Liver Cirrhosis/complications , Scleredema Adultorum/diagnosis , Alopecia/etiology , Betamethasone/therapeutic use , COVID-19/drug therapy , Fusidic Acid/therapeutic use , Glucocorticoids/therapeutic use , Humans , Male , Middle Aged , Pruritus/etiology , Thyrotoxicosis/complications
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