Establishing and prioritizing research questions for the prevention, diagnosis and treatment of hair loss (excluding alopecia areata): the Hair Loss Priority Setting Partnership.

BACKGROUND: Hair and scalp problems are common. Unfortunately, many uncertainties exist around the most effective management and treatment strategies for these disorders. OBJECTIVES: To identify uncertainties in hair-loss management, prevention, diagnosis and treatment that are important to both people with hair loss and healthcare professionals. METHODS: A Hair Loss Priority Setting Partnership was established between patients, their carers and relatives, and healthcare professionals to identify the most important uncertainties in hair loss. The methodology of the James Lind Alliance was followed to ensure a balanced, inclusive and transparent process. RESULTS: In total, 2747 treatment uncertainties were submitted by 912 participants; following exclusions 884 uncertainties relating to hair loss (excluding alopecia areata) were analysed. Questions were combined into 'indicative uncertainties' following a structured format. A series of ranking exercises further reduced this list to a top 25 that was taken to a final prioritization workshop where the top 10 priorities were agreed. CONCLUSIONS: We present the top 10 research priorities for hair loss (excluding alopecia areata) to guide researchers and funding bodies to support studies important to both patients and clinicians.

Establishing and prioritizing research questions for the treatment of alopecia areata: the Alopecia Areata Priority Setting Partnership.

BACKGROUND: Alopecia areata (AA) is a common hair loss disorder that results in patchy to complete hair loss. Many uncertainties exist around the most effective treatments for this condition. OBJECTIVES: To identify uncertainties in AA management and treatment that are important to both service users (people with hair loss, carers and relatives) and healthcare professionals. METHODS: An AA priority setting partnership was established between patients, their carers and relatives, and healthcare professionals to identify the most important uncertainties in AA. The methodology of the James Lind Alliance was followed to ensure a balanced, inclusive and transparent process. RESULTS: In total, 2747 treatment uncertainties were submitted by 912 participants, of which 1012 uncertainties relating to AA (and variants) were analysed. Questions were combined into 'indicative uncertainties' following a structured format. A series of ranking exercises further reduced this list to a top 25 that were taken to a final prioritization workshop where the top 10 priorities were agreed. CONCLUSIONS: We present the top 10 research priorities for AA to guide researchers and funding bodies to support studies important to both patients and clinicians.

A 14-year paraneoplastic rash: urticarial vasculitis and dermal binding bullous pemphigoid secondary to chronic lymphocytic leukaemia.

A 72-year-old woman with a 14-year history of urticarial vasculitis (UV) and a 13-year history of bullous pemphigoid (BP) presented with associated progressive chronic lymphocytic leukaemia (CLL). Both skin conditions responded poorly to treatment, until chemotherapy for CLL was commenced. The skin features showed a clear paraneoplastic course, resolving with chemotherapy and recurring when the CLL relapsed and the lymphocyte count rose above 5 × 10(9)/L. No case of UV secondary to CLL, and very few cases of BP related to CLL have been reported, and no paraneoplastic rash of any type lasting 14 years has been reported previously.

Addition of Mn to Ge quantum dot surfaces--interaction with the Ge QD {105} facet and the Ge(001) wetting layer.

The interaction of Mn with Ge quantum dots (QD), which are bounded by {105} facets, and the strained Ge wetting layer (WL), terminated by a (001) surface, is investigated with scanning tunneling microscopy (STM). These surfaces constitute the growth surfaces in the growth of Mn-doped QDs. Mn is deposited on the Ge QD and WL surface in sub-monolayer concentrations, and subsequently annealed up to a temperature of 400 ° C. The changes in bonding and surface topography are measured with STM during the annealing process. Mn forms flat islands on the Ge{105} facet, whose shape and position are guided by the rebonded step reconstruction of the facet. Voltage-dependent STM images reflect the Mn-island interaction with the empty and filled states of the Ge{105} reconstruction. Scanning tunneling spectra (STS) of the Ge{105} facet and as-deposited Mn-islands show a bandgap of 0.8 eV, and the Mn-island spectra are characterized by an additional empty state at about 1.4 eV. A statistical analysis of Mn-island shape and position on the QD yields a slight preference for edge positions, whereas the QD strain field does not impact Mn-island position. However, the formation of ultra-small Mn-clusters dominates on the Ge(001) WL, which is in contrast to Mn interaction with unstrained Ge(001) surfaces. Annealing to T < 160 °C leaves the Mn-clusters on the WL unchanged, while the Mn-islands on the Ge{105} facet undergo first a ripening process, followed by a volume gain which can be attributed to the onset of intermixing with Ge. This development is supported by the statistical analysis of island volume, size and size distribution. Increasing the annealing temperature to 220° and finally 375 ° C leads to a rapid increase in the Mn-surface diffusion, as evidenced by the formation of larger, nanometer size clusters, which are identified as germanide Mn5Ge3 from a mass balance analysis. This reaction is accompanied by the disappearance of the original Mn-surface structures and de-wetting of Mn is complete. This study unravels the details of Mn-Ge interactions, and demonstrates the role of surface diffusion as a determinant in the growth of Mn-doped Ge materials. Surface doping of Ge-nanostructures at lower temperatures could provide a pathway to control magnetism in the Mn-Ge system.