Alopecia: Etiopathogenesis, Symptoms & Management

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dermatology".

Deadline for manuscript submissions: closed (25 July 2023) | Viewed by 18036

Special Issue Editors


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Guest Editor
Dermatology Unit, Hospital Universitario Virgen de las Nieves, IBS Granada, 18002 Granada, Spain
Interests: alopecia; barrier function; quality of life; alopecia areata; androgenetic alopecia
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Special Issue Information

Dear Colleagues,

Despite recent advances, there is still need for a more comprehensive understanding of the etiopathogenesis of scalp diseases. In addition to trichoscopy, new diagnostic tools are currently being developed to diagnose and differentiate between types of alopecia. Scalp diseases have a great impact on patients’ quality of life. Moreover, some comorbidities have been related to alopecia, including alexithymia, obsessive–compulsive disorder, and autoimmune and cardiovascular diseases. Fortunately, the availability of therapeutic options for different types of alopecia is increasing. This Special Issue will focus on new research discussing the etiopathogenesis of different types of alopecia, new signs and symptoms to differentiate between them, and new treatment options for improving disease severity and patients’ quality of life.

Dr. Trinidad Montero-Vilchez
Prof. Dr. Salvador Arias-Santiago
Guest Editors

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Keywords

  • alopecia
  • treatment
  • quality of life
  • alopecia areata
  • frontal fibrosing alopecia
  • androgenetic alopecia
  • etiopathogenesis

Published Papers (5 papers)

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Research

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8 pages, 784 KiB  
Article
Frontal Fibrosing Alopecia Quality of Life Index: A Validated Disease-Specific Questionnaire Involving Women
by María Librada Porriño-Bustamante, Trinidad Montero-Vílchez, María Antonia Fernández-Pugnaire and Salvador Arias-Santiago
J. Clin. Med. 2023, 12(3), 824; https://doi.org/10.3390/jcm12030824 - 20 Jan 2023
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Abstract
Quality of life (QoL) can be affected in patients with alopecia. The few studies that evaluate QoL in FFA use unspecific questionnaires. The aim of this report was to design and validate a specific questionnaire to assess the impairment of QoL in FFA [...] Read more.
Quality of life (QoL) can be affected in patients with alopecia. The few studies that evaluate QoL in FFA use unspecific questionnaires. The aim of this report was to design and validate a specific questionnaire to assess the impairment of QoL in FFA patients. A specific questionnaire, called the Frontal Fibrosing Alopecia Quality of Life Index (FFA-QLI), was designed and validated using the Dermatology Life Quality Index (DLQI). One-hundred and one women with FFA were included. Cronbach’s alpha value was 0.865, and the intraclass correlation coefficient between all the items in the questionnaire was 0.870. The FFA-QLI correlated positively with the DLQI (r = 0.729, p < 0.001). Patients with severe FFA showed a higher FFA-QLI (19.72) score compared to those with a mild disease (14.11) (p = 0.002), and the area under the curve for identifying severe disease was greater in the FFA-QLI than in the DLQI. The cut-off points were used to select patients with mild, moderate, and severe impairment in QoL. A score < 21 in the FFA-QLI corresponded to a low impact on QoL; values > 35 matched with greater QoL impairment; and values ranging from 21 to 35 corresponded to moderate QoL alteration. To conclude, a validated disease-specific questionnaire to assess QoL in FFA patients is here presented, with a greater power to discriminate severe cases of FFA than the DLQI. Full article
(This article belongs to the Special Issue Alopecia: Etiopathogenesis, Symptoms & Management)
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10 pages, 3104 KiB  
Article
Preliminary Investigation on Micro-Needling with Low-Level LED Therapy and Growth Factors in Hair Loss Related to COVID-19
by Pietro Gentile
J. Clin. Med. 2022, 11(19), 5760; https://doi.org/10.3390/jcm11195760 - 28 Sep 2022
Cited by 7 | Viewed by 2256
Abstract
The incidence of hair loss (HL) and telogen effluvium (TE) has increased due to the spread of the coronavirus disease (COVID-19) induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). New biotechnologies based on micro-needling (MND) with Low-Level LED Therapy (LLLT) and Growth [...] Read more.
The incidence of hair loss (HL) and telogen effluvium (TE) has increased due to the spread of the coronavirus disease (COVID-19) induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). New biotechnologies based on micro-needling (MND) with Low-Level LED Therapy (LLLT) and Growth Factors (GFs) used for hair re-growth (HR-G) in Androgenetic Alopecia (AGA) need to be standardized also in HL and TE related to COVID-19. This article aims to describe the preliminary clinical results obtained from an open-label case-series observational study. MND with LLLT and GFs was used in patients affected by HL and TE-related to COVID-19. In total, 10 patients (6 men were identified in stage I–III vertex according to the Norwood–Hamilton scale, and 4 women were identified in stage I–II according to the Ludwig scale) were enrolled and analyzed after screening (exclusion and inclusion criteria evaluation). HR-G assessment was analyzed through photography, physician’s and patient’s global assessment scale, and standardized phototrichograms during a short follow-up: T0—baseline; T1—20 weeks (wks). In the targeted area computerized trichograms showed encouraging results with a hair density increase of 11 ± 2 hairs/cm2 at T1 after 20 wks (20 wks vs. 0 wks) compared with baseline (58 ± 2 hairs/cm2 at T1 versus 47 ± 2 hairs/cm2 at baseline) with a not quite statistically significant difference in HR-G (p = 0.0690). The preliminary effectiveness of MND with LLLT and GFs use has been demonstrated in mild-to-moderate HL and TE related to COVID-19. Further controlled trials are required to confirm these preliminary results. Full article
(This article belongs to the Special Issue Alopecia: Etiopathogenesis, Symptoms & Management)
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Review

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23 pages, 7409 KiB  
Review
Alopecias: Practical Tips for the Management of Biopsies and Main Diagnostic Clues for General Pathologists and Dermatopathologists
by Fernando Pinedo-Moraleda, Belén Tristán-Martín and Giulia Greta Dradi
J. Clin. Med. 2023, 12(15), 5004; https://doi.org/10.3390/jcm12155004 - 29 Jul 2023
Cited by 1 | Viewed by 2823
Abstract
Accurately diagnosing specific variants of alopecia remains challenging for pathologists, potentially delaying appropriate therapeutic decisions by dermatologists. Issues such as limited knowledge on optimal biopsy types and processing methods add complexity. Understanding the normal histology of hair follicles and their changes throughout the [...] Read more.
Accurately diagnosing specific variants of alopecia remains challenging for pathologists, potentially delaying appropriate therapeutic decisions by dermatologists. Issues such as limited knowledge on optimal biopsy types and processing methods add complexity. Understanding the normal histology of hair follicles and their changes throughout the follicular cycle further complicates microscopic evaluation. This paper aims to summarize these characteristics and highlight essential diagnostic clues for pathologists to confidently suggest a diagnosis, therefore playing a key role in alopecia diagnosis. Ongoing education, collaboration with dermatologists, and staying up to date on advancements is crucial for the accurate diagnosis and effective management of different types of alopecia. Full article
(This article belongs to the Special Issue Alopecia: Etiopathogenesis, Symptoms & Management)
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18 pages, 1379 KiB  
Review
Study of the Thyroid Profile of Patients with Alopecia
by Adelina Popa, Mara Carsote, Dragos Cretoiu, Mihai Cristian Dumitrascu, Claudiu-Eduard Nistor and Florica Sandru
J. Clin. Med. 2023, 12(3), 1115; https://doi.org/10.3390/jcm12031115 - 31 Jan 2023
Cited by 7 | Viewed by 6209
Abstract
Thyroid hormones are required for the physiological growth and maintenance of hair follicles. We aim to study the thyroid profile of patients with alopecia. This is a narrative review. PubMed literature was searched from 2013 to 2022. We followed different types of alopecia: [...] Read more.
Thyroid hormones are required for the physiological growth and maintenance of hair follicles. We aim to study the thyroid profile of patients with alopecia. This is a narrative review. PubMed literature was searched from 2013 to 2022. We followed different types of alopecia: alopecia areata (AA), androgenic alopecia in males and females, telogen effluvium (TE), frontal fibrosing alopecia (FFA), lichen planopilaris, and alopecia neoplastica (AN). AA shares a common autoimmune background with autoimmune thyroid diseases, either sporadic or belonging to autoimmune polyglandular syndromes. Some data suggested that AA is more severe if thyroid anomalies are confirmed, including subclinical dysfunction or positive antithyroid antibodies with normal hormone values. However, routine thyroid screening for patients with AA, if the patients are asymptomatic from a thyroid point of view and they have negative personal and family history of autoimmunity, remains controversial. TE, apart from the autoimmune type, associates thyroid anomalies of a hormonal assay (between 5.7% and 17%). FFA, mostly a postmenopausal entity (however, not exclusive), associates a higher prevalence of thyroid conditions (up to 50%) than the general population. However, these might have an age-dependent pattern, thus the association may be incidental since there are a limited number of studies. Overall, alopecia remains a very challenging condition for patients and physicians; a multidisciplinary team is required to improve the outcome and quality of life. The common autoimmune background is suggestive of some types of alopecia and thyroid disorders, yet, the underlying mechanisms are still a matter of debate. AA, TE, FFA, LPP, and, potentially, female pattern hair loss have been found to be connected with thyroid entities, thus a state of awareness from a dual perspective, of trichology and endocrinology, is helpful. Full article
(This article belongs to the Special Issue Alopecia: Etiopathogenesis, Symptoms & Management)
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Other

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7 pages, 1509 KiB  
Case Report
Autologous Platelet-Rich Plasma (PRP) for Treating Androgenetic Alopecia: A Novel Treatment Protocol Standardized on 2 Cases
by Ana Maletic, Ivo Dumic-Cule, Petar Brlek, Rado Zic and Dragan Primorac
J. Clin. Med. 2022, 11(24), 7327; https://doi.org/10.3390/jcm11247327 - 9 Dec 2022
Cited by 1 | Viewed by 4378
Abstract
Platelet-rich plasma (PRP) treatment has emerged in recent years as a valuable, effective, and affordable treatment for androgenetic alopecia. Androgenetic alopecia is the most common type of alopecia, affecting both men and women, and is characterized by diminished hair follicles mainly pronounced in [...] Read more.
Platelet-rich plasma (PRP) treatment has emerged in recent years as a valuable, effective, and affordable treatment for androgenetic alopecia. Androgenetic alopecia is the most common type of alopecia, affecting both men and women, and is characterized by diminished hair follicles mainly pronounced in the frontal region and vertex. A considerable variety of PRP treatment regimens have been described so far, but there is no consensus on the standardization of PRP preparation or administration protocol. Our study was conducted on two patients to test the efficacy of a new PRP application protocol of only two treatments by using a combination of a PRP collecting device and a conventional kit. Efficacy of treatment was assessed after a 6-month follow-up by artificial intelligence (AI)-driven software on microscopic images of treated regions. An average number of hairs, cumulative hair thickness, and the number of follicular units increased in the vertex region of both patients by 30/59%, 35/53%, and 14/48%, respectively. The novel treatment regimen showed significant effectiveness in only six months. Full article
(This article belongs to the Special Issue Alopecia: Etiopathogenesis, Symptoms & Management)
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