A Retrospective Study on Alopecia Areata in Children: Clinical Characteristics and Treatment Choices

2021 ◽  
pp. 1-6
Author(s):  
Christina Stefanaki ◽  
George Kontochristopoulos ◽  
Eleni Hatzidimitraki ◽  
Aravella Stergiopoulou ◽  
Alexandra Katsarou ◽  
...  
Keyword(s):  
Alopecia Areata ◽  
Clinical Characteristics ◽  
Age Of Onset ◽  
Topical Steroids ◽  
Pediatric Dermatology ◽  
Dermatology Department ◽  
Treatment Choices ◽  
Hair Regrowth ◽  
Oral Steroids ◽  
Disease Location

<b><i>Background:</i></b> Although children are affected frequently with alopecia areata (AA), data are limited on clinical characteristics and treatment choices. <b><i>Materials and Methods:</i></b> We retrospectively reviewed the records of the pediatric dermatology department over a 12-year period to identify children with AA. Clinical data were collected. <b><i>Results:</i></b> Three hundred and sixty-four children with AA were identified, aged 1–12 years, 214 males and 150 females. The mean age of onset was 6.6 years (±3.3). The disease presented with patches on the scalp in the majority (90.7%), whereas only 6 children had alopecia totalis or universalis. The most commonly prescribed treatment was topical steroids (69.1%), followed by the combination of topical steroids and minoxidil 2% (14.3%). Oral steroids were prescribed in only 16 children. Follow-up at 3 months was available for only 70 children and the majority (84.3%) had some hair regrowth. Hair regrowth was unrelated to the number of plaques (<i>p</i> = 0.257), disease location (<i>p</i> = 0.302), and atopy (<i>p</i> = 0.999). Hair regrowth only correlated with the type of treatment (<i>p</i> = 0.003) with potent topical and intralesional steroids giving the best results. <b><i>Conclusion:</i></b> AA usually presents with a mild form in children, and potent topical steroids are the mainstay of treatment.

A glance on dystonias, how to recognize and handle them

2019 ◽  
pp. 22-29
Author(s):  
F. N. Mercan ◽  
E. Bayram ◽  
M. C. Akbostanci
Keyword(s):  
Differential Diagnosis ◽  
Movement Disorder ◽  
Age Of Onset ◽  
Clinical Manifestations ◽  
Body Part ◽  
Classification Model ◽  
Treatment Choices ◽  
Muscle Groups

Dystonia refers to an involuntary, repetitive, sustained, painful and twisting movements of the affected body part. This movement disorder was first described in 1911 by Hermain Oppenheim, and many studies have been conducted to understand the mechanism, the diagnosis and the treatment of dystonia ever since. However, there are still many unexplained aspects of this phenomenon. Dystonia is diagnosed by clinical manifestations, and various classifications are recommended for the diagnosis and the treatment. Anatomic classification, which is based on the muscle groups involved, is the most helpful classification model to plan the course of the treatment. Dystonias can also be classified based on the age of onset and the cause. These dystonic syndromes can be present without an identified etiology or they can be clinical manifestations of a neurodegenerative or neurometabolic disease. In this review we summarized the differential diagnosis, definition, classifications, possible mechanisms and treatment choices of dystonia.

scholarly journals AB0442 CLINICAL FEATURES OF POLYMYOSITIS AND DERMATOMYOSITIS PATIENTS WITH SEVERE DYSPHAGIA

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1249.1-1249
Author(s):  
Y. Hayashi ◽  
K. Izumi ◽  
S. Hama ◽  
M. Higashida-Konishi ◽  
M. Ushikubo ◽  
...  
Keyword(s):  
Interstitial Pneumonia ◽  
Clinical Features ◽  
Clinical Characteristics ◽  
Age Of Onset ◽  
Inflammatory Diseases ◽  
Medical Center ◽  
Hospital Organization ◽  
Initial Examination ◽  
Severe Dysphagia ◽  
Frequent Complication

Background:Polymyositis (PM) and dermatomyositis (DM) are autoimmune inflammatory diseases characterized by proximal myositis. Dysphagia has been reported to develop in 35 to 62% of PM/DM patients and known as poor prognosis factor.Objectives:The purpose of this study is to determine the clinical characteristics of PM/DM patients who present with deglutition disorder.Methods:Consecutive patients with PM/DM who visited National Hospital Organization Tokyo Medical Center between April 2010 and January 2021 are included in this study. We compared clinical features between the patients with and without dysphagia. The diagnosis of dysphagia was based on videofluorography swallow study, and dysphagia requiring gastrostomy was defined as severe dysphagia. The clinical characteristics compared in this study were following: age of onset, levels of serum creatine kinase (CK) and lactate dehydrogenase(LDH), sense of dysphagia, manual muscle test (MMT) score, and complication of malignancy or interstitial pneumonia.Results:A total of 73 patients with PM/DM were identified. Among them, 12 patients were diagnosed with dysphagia, and 5 patients developed severe dysphagia. Patients with dysphagia had the following characteristics compared to patients without dysphagia: higher levels of serum LDH (833.7 ± 500.1 U/L vs 471.9 ± 321.0 U/L, p = 0.0088), higher levels of serum CK at initial examination (6070.3 ± 7184.8 IU/L vs 1534.7 ± 2978.8 IU/L, p = 0.0086) and more frequent sense of dysphagia (90.9% vs 10.6%, p< 0.0001), lower MMT score(3.18 ± 1.07 vs 4.31 ± 0.75, p = 0.0017). In addition to those, patients with severe dysphagia presented older age of onset (mean age 69.4 ± 12.0 vs 51.7 ± 14.8, p = 0.014), more frequent complication of malignancy (80.0% vs 14.8%, p= 0.0048) and less frequent complication of interstitial pneumonia (0.0% vs 55.5%, p= 0.023).Conclusion:These results indicate that dysphagia develops frequently in PM/DM patients with higher levels of serum LDH or CK, sense of dysphagia and low MMT score. Among them, patients with elderly onset or malignancy are at risk for sever dysphagia, and should be treated carefully.Disclosure of Interests:None declared.

scholarly journals Toxoplasma gondii Infection and Clinical Characteristics of Patients With Schizophrenia: A Systematic Review and Meta-analysis

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Arjen L Sutterland ◽  
David A Mounir ◽  
Juul J Ribbens ◽  
Bouke Kuiper ◽  
Tom van Gool ◽  
...  
Keyword(s):  
Systematic Review ◽  
Toxoplasma Gondii ◽  
Publication Bias ◽  
Clinical Characteristics ◽  
Negative Symptoms ◽  
Age Of Onset ◽  
Meta Analysis ◽  
Random Effects Models ◽  
Duration Of Illness ◽  
Toxoplasma Gondii Infection

Abstract Schizophrenia is associated with an increased prevalence of IgG antibodies against Toxoplasma gondii (T. gondii seropositivity), whereby the infection seems to precede the disorder. However, it remains unclear whether a T. gondii infection affects clinical characteristics of schizophrenia. Therefore, a systematic review and meta-analysis was conducted following PRISMA guidelines examining the association between T. gondii seropositivity and severity of total, positive, or negative symptoms or age of onset in schizophrenia. PubMed, Embase, and PsycInfo were systematically searched up to June 23, 2019 (PROSPERO #CRD42018087766). Random-effects models were used for analysis. Furthermore, the influence of potential moderators was analyzed. Indications for publication bias were examined. From a total of 934 reports, 13 studies were included. No overall effect on severity of total, positive, or negative symptoms was found. However, in patients with a shorter duration of illness T. gondii seropositivity was associated with more severe positive symptoms (standardized mean difference [SMD] = 0.32; P &lt; .001). Similar but smaller effects were seen for total symptoms, while it was absent for negative symptoms. Additionally, a significantly higher age of onset was found in those with T. gondii seropositivity (1.8 y, P = .015), although this last finding was probably influenced by publication bias and study quality. Taken together, these findings indicate that T. gondii infection has a modest effect on the severity of positive and total symptoms in schizophrenia among those in the early stages of the disorder. This supports the hypothesis that T. gondii infection is causally related to schizophrenia, although more research remains necessary.

scholarly journals Multiple sclerosis in Kenya: Demographic and clinical characteristics of a registry cohort

2021 ◽  
Vol 7 (2) ◽  
pp. 205521732110227
Author(s):  
Imran Jamal ◽  
Jasmit Shah ◽  
Peter Mativo ◽  
Juzar Hooker ◽  
Mitchell Wallin ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Symptom Onset ◽  
Clinical Characteristics ◽  
Age Of Onset ◽  
Sub Saharan Africa ◽  
University Hospital ◽  
Tertiary Referral Hospital ◽  
Female Ratio ◽  
Sub Saharan ◽  
Neuro Imaging

Background Multiple Sclerosis (MS) is the leading cause of non-traumatic neurological disability in young adults. There is limited literature regarding the burden of MS in sub-Saharan Africa (SSA). Objective To describe the demographic and clinical characteristics of patients with MS (PwMS) presenting to a tertiary referral hospital in Nairobi. Methods We conducted a retrospective descriptive study for PwMS presenting to Aga Khan University Hospital, Nairobi from 2008–2018. Results 99 cases met the diagnostic criteria for MS with a male to female ratio of 1:4. Majority (68.7%) of PwMS were indigenous Africans with a mean age of onset of 30.7 years. Mean duration from symptom onset to first neuro-imaging was 5.04 years. Only 33% of patients had sensory symptoms at onset whereas 54.5% had vitamin D deficiency/insufficiency. Majority (79.5%) had relapsing remitting MS (RRMS) and 56.6% were initiated on disease modifying therapy (DMT). Only 21.2% of patients on DMT were non-compliant. Patients with RRMS were more likely to be initiated on DMT at our hospital (p < 0.001). Conclusion Clinical characteristics of these patients largely resemble those of other SSA cohorts and African American patients. There was a delay between symptom onset and neuroimaging. There were also issues with DMT compliance.

scholarly journals Dermatoses in the hospital and their impact on quality of life

2021 ◽  
Vol 12 (4) ◽  
pp. 462-463
Author(s):  
Kaoutar Sof ◽  
Soraya Aouali ◽  
Sara Bensalem
Keyword(s):  
Quality Of Life ◽  
Alopecia Areata ◽  
Drug Eruption ◽  
Skin Tumors ◽  
Severe Psoriasis ◽  
Dermatology Department ◽  
Verneuil’S Disease ◽  
The Mean ◽  
The Impact

Sir, Dermatological pathologies may be responsible for the creation of a real handicap, affecting the patient’s self-esteem and their professional and social life. The aim of this study was to assess the impact of diseases on the quality of life of patients hospitalized at the dermatology department. The following was a retrospective study that included patients over eighteen years of age, hospitalized at the dermatology department of Hospital Mohammed VI in Oujda from January 2018 through December 2019. The Arabic version of the validated DLQI was used for all patients [1]. A total of 294 patients were collected, with a mean age of 53.95 years and a male-to-female ratio of 0.85. The most frequent reasons for hospitalization were infectious dermo-hypodermitis (n = 51), autoimmune bullous dermatosis (n = 23), severe drug eruption (n = 20), genodermatosis (n = 17), melanocytic (n = 9) and non-melanocytic skin tumors (n = 17), severe psoriasis (n = 17), cutaneous lymphoma (n = 11), alopecia areata (n = 10), dermatomyositis (n = 8), and Verneuil’s disease (n = 5). The DLQI was impossible to calculate in eleven patients. The mean DLQI in all patients was 10.20, corresponding to a moderate effect on quality of life. The mean DLQI was as follows: Verneuil’s disease at 17.4, severe psoriasis at 16.6, dermatomyositis at 14.42, genodermatosis at 12.37, cutaneous lymphoma at 11.45, severe drug eruption at 11, alopecia areata at 10.5, AIBD at 9.67, skin tumors at 7.76, and infectious dermo-hypodermitis at 7.52. The DLQI was the first index measuring quality of life in dermatology and is still widely used today[2]. The number of publications concerning the impact of dermatological pathologies on quality of life has increased in recent years [3]. Our results showed that the DLQI was higher in patients with Verneuil’s disease, severe psoriasis, and dermatomyositis. These results agree with the data of the literature, many publications have shown that psoriasis seriously impaired the quality of life and was responsible of social anxiety in patients [4]. Verneuil’s disease is also responsible of a significant impairment on quality of life mainly due to the sexual disorders caused by this pathology [5]. Another study on dermatomyositis showed that there is a significant correlation between the severity of skin signs and the quality of life of patients [6]. Dermatological pathologies are distinguished from other pathologies by their displaying character, which is responsible for a significant impact on the patient’s quality of life. The management of dermatology patients requires psychological support in addition to conventional therapy. However, these pathologies are still not recognized as long-term illnesses in Morocco.

Spontaneous hair regrowth in eight patients with severe alopecia areata

2018 ◽  
Vol 59 (4) ◽  
pp. e318-e319
Author(s):  
Pablo Fernandez-Gonzalez ◽  
David Saceda-Corralo ◽  
Cristina Pindado-Ortega ◽  
Diego Buendia-Castaño ◽  
Montserrat Fernández-Guarino ◽  
...  
Keyword(s):  
Alopecia Areata ◽  
Hair Regrowth

IDIOPATHIC, RECURRENT CHOLESTASIS

PEDIATRICS ◽  
1970 ◽  
Vol 45 (5) ◽  
pp. 812-820
Author(s):  
Frederick B. Ruymann ◽  
Akio Takeuchi ◽  
H. Worth Boyce
Keyword(s):  
Age Of Onset ◽  
Serum Alkaline Phosphatase ◽  
Bile Canaliculi ◽  
Electron Microscopic ◽  
Portal Triad ◽  
Caucasian Girl ◽  
Younger Age ◽  
Oral Steroids ◽  
Liver Biopsies ◽  
Purpuric Rash

Idiopathic, recurrent cholestasis is characterized by episodes of obstructive jaundice often preceded by pruritus, steatorrhea, and purpuric rash. Between episodes of jaundice the liver histology is normal. We report a case of idiopathic, recurrent cholestasis occurring in a 14-year-old Caucasian girl who has experienced seven episodes of jaundice since 8 years of age. Serum alkaline phosphatase elevation preceded clinical jaundice. During remission the bromsulphalein excretion was normal. Response to oral steroids occurred when used after 4 weeks of jaundice. Cholestyramine resin and cyproheptadine relieved pruritus and in combination may have prevented progressive jaundice when administered early. Light microscopy during exacerbation showed centrilobular cholestasis with a slight mononuclear infiltration of the portal triad. The electron microscopic examinations demonstrate dilated bile canaliculi with altered microvilli. Serial liver biopsies over 6 years show no fibrosis or cytoplasmic alterations of hepatocytes. Of the 24 reported cases of idiopathic, recurrent cholestasis, two-thirds have been in males and had onset of jaundice under 20 years of age. This younger age of onset merits a greater awareness by the practicing pediatrician. After the diagnosis is established by clinical, biochemical, and morphologic studies, a benign course can be anticipated.

scholarly journals Prevalence and Clinical Characteristics of Alopecia Areata at a Tertiary Care Center in Saudi Arabia

2020 ◽  
Vol 2020 ◽  
pp. 1-4 ◽  
Author(s):  
Aysha A. Alshahrani ◽  
Rawan Al-Tuwaijri ◽  
Zainah A. Abuoliat ◽  
Mesnad Alyabsi ◽  
Mohammed I. AlJasser ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Saudi Arabia ◽  
Alopecia Areata ◽  
Clinical Characteristics ◽  
Disease Duration ◽  
Tertiary Care ◽  
Hair Follicles ◽  
Atopic Diseases ◽  
The Mean ◽  
Saudi Patients

Introduction. Alopecia areata (AA) is a common autoimmune disorder of hair follicles characterized by patches on nonscarring hair loss. Reports of prevalence and clinical characteristic of AA in Saudi Arabia are limited. The aim of our study is to describe the prevalence and clinical characteristics of Saudi patients with AA. Materials and Methods. A retrospective cross-sectional study was conducted at King Abdulaziz Medical City in Riyadh, Saudi Arabia. All patients diagnosed with AA between January 2016 and December 2017 were included. Data included patient demographics, type of AA, disease duration, family history of AA, and comorbid autoimmune diseases. Results. A total of 216 patients with AA were included. The overall prevalence of AA was approximately 2.3%. The mean disease duration at the time of presentation was 2 months while the mean age of onset was 25.61 years. The most common type of AA in both adult and pediatric groups was the patchy type involving the scalp. Comorbid diseases were found in 32.41% of patients. Common associated conditions included hypothyroidism, diabetes mellitus, and atopic diseases. Conclusion. The overall prevalence of AA among a population of Saudi patients is 2.3%. AA prevalence is higher in pediatrics than adults. Common comorbid conditions include hypothyroidism, diabetes mellitus, and atopic diseases.

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