RESUMO
Introduction: Fractional lasers and microneedling devices are increasingly used with topical drugs to treat various conditions, including alopecia, as they grant access to dermal structures such as hair follicles and cutaneous vasculature. Objective: To perform a comprehensive review on transcutaneous drug delivery for the management of alopecia. Methods: PubMed, Embase, and Ovid Medline databases were searched using terms including: alopecia, microneedling, lasers, androgenetic alopecia (AGA), alopecia areata (AA), drug delivery. Articles were examined for inclusion criteria: diagnosis of alopecia regardless of type, use of fractional laser or microneedling devices, and subsequent administration of topical medication. Results: 8 studies, 6 prospective clinical trials and 2 case series, examining either AA or AGA were identified. For AA, five studies examined microneedling together with topical triamcinolone in three of these, while two studies used photodynamic therapy. Regarding AGA, two studies used topical minoxidil plus microneedling, and one examined topical finasteride with fractional erbium glass laser. Improvement was seen in 6 of the 8 studies. Discussion: Transcutaneous drug delivery via fractional laser and microneedling is a promising modality with preliminary evidence for increased hair regrowth over topical therapy alone. Further studies are needed to elucidate treatment parameters and appropriate device selection for drug delivery.
Assuntos
Alopecia/tratamento farmacológico , Fármacos Dermatológicos/uso terapêutico , Medicina Baseada em Evidências , Administração Oral , Administração Tópica , Alopecia/fisiopatologia , Alopecia em Áreas/tratamento farmacológico , Feminino , Humanos , Terapia a Laser , Masculino , Dermatopatias/tratamento farmacológicoAssuntos
Dermatite/diagnóstico , Dermatite/patologia , Adulto , Diagnóstico Diferencial , Quadril , Humanos , Masculino , TroncoAssuntos
Cardiomiopatia Restritiva/diagnóstico , Endocárdio/patologia , Parada Cardíaca/etiologia , Ventrículos do Coração/patologia , Miocárdio/patologia , Adulto , Biópsia , Cardiomiopatia Restritiva/etiologia , Cardiomiopatia Restritiva/patologia , Angiografia Coronária , Diagnóstico Diferencial , Ecocardiografia , Humanos , Imageamento por Ressonância Magnética , MasculinoAssuntos
Eosinófilos/patologia , Injeções Subcutâneas/efeitos adversos , Paniculite/etiologia , Peptídeos/administração & dosagem , Peçonhas/administração & dosagem , Diabetes Mellitus Tipo 2/tratamento farmacológico , Exenatida , Humanos , Masculino , Pessoa de Meia-Idade , Paniculite/patologia , Peptídeos/uso terapêutico , Peçonhas/uso terapêuticoRESUMO
Parasympathetic nerves from the pterygopalatine ganglia may participate in development of cluster headaches, in vascular responses to hypertension and in modulation of damage due to stroke. Stimulation of the nerves elicits cerebral vasodilatation, but it is not known if the nerves tonically influence cerebrovascular tone. We hypothesized that parasympathetics provide a tonic vasodilator influence and tested that hypothesis by measuring cerebral blood flow in anesthetized rats before and after removal of a pterygopalatine ganglion. Ganglion removal led to reduced cerebral blood flow without changing blood pressure. Thus, parasympathetic nerves provide tonic vasodilatory input to cerebral blood vessels.
