scholarly journals Alopecia Universalis Associated with Hyperthyroidism Treated with Azathioprine and Hydroxychloroquine: A Case Report

2021 ◽  
Vol 59 (241) ◽  
pp. 935-937
Author(s):  
Vikash Paudel ◽  
Deepa Chudal ◽  
Manish Bhakta Pradhan ◽  
Rupa Thakur ◽  
Buddhi Raj Pandey
Keyword(s):  
Case Report ◽  
Hair Loss ◽  
Alopecia Areata ◽  
Treatment Modalities ◽  
Alopecia Universalis ◽  
Multiple Treatment ◽  
Gradual Onset ◽  
Fourth Decade

Alopecia universalis is an uncommon form of alopecia areata involving hair loss over the entire scalp and body. This condition is difficult to treat and sustain the growth of hair for longer duration. We report a case of alopecia universalis associated with severe hyperthyroidism. A lady in her fourth decade presented to us with gradual onset of alopecia universalis, who later found to have hyperthyroidism which was refractory to multiple treatment modalities. She was treated successfully with azathioprine and hydroxychloroquine. Alopecia universalis with less response to oral steroidtherapy was successfully managed with azathioprine with hydroxychloroquine.

scholarly journals Effective treatment of alopecia universalis with oral tofacitinib: A case report

2021 ◽  
Vol 12 (1) ◽  
pp. 33-36
Author(s):  
Lenah Shaikh ◽  
Amnah Almulhim ◽  
Manal Al Rabai ◽  
Yasir Shaikh
Keyword(s):  
Case Report ◽  
Autoimmune Disease ◽  
Effective Treatment ◽  
Hair Loss ◽  
Alopecia Areata ◽  
The Body ◽  
Entire Body ◽  
Alopecia Universalis ◽  
One Year ◽  
Persistent Response

Alopecia areata is a common autoimmune disease presenting itself with patches of hair loss on the scalp, eyebrows, eyelashes, or any part of the body. It may manifest itself as a single patch, involving the entire scalp (alopecia totalis), or affecting the entire body, thus the name alopecia universalis. Multiple lines of treatment may be employed, but no single most effective treatment exists, especially if the condition is generalized and, thus, becomes more difficult to treat. Herein, we report a case of alopecia universalis treated with oral tofacitinib with an excellent and persistent response one year after.

scholarly journals Comparative Study on the Efficacy of Diphenylcyclopropenone Alone and in Combination with Intralesional or Systemic Corticosteroids for the Treatment of Extensive or Refractory Alopecia Areata

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A I E Rasheed ◽  
M Y Soltan ◽  
N N Mohammed
Keyword(s):  
Hair Loss ◽  
Alopecia Areata ◽  
Combined Therapy ◽  
Age At Onset ◽  
Previous History ◽  
Autoimmune Disorder ◽  
University Hospital ◽  
Treatment Modalities ◽  
Clinical Feature ◽  
Significant Difference

Abstract Background Alopecia areata (AA) is an autoimmune disorder characterized by transient, non-scarring hair loss with preservation of the hair follicle. It affects nearly 2% of the general population at some point during their lifetime. Extent of the disease can vary widely from localized hair loss in well-defined patches to diffuse or total hair loss, which can affect all hair-bearing sites. Patchy alopecia areata affecting the scalp is the most common type. Objectives The aim of this study is to evaluate the efficacy and safety of topical diphenylcyclopropenone alone and in combination with intralesional steroids or systemic steroids for the treatment of extensive and/or refractory cases of alopecia areata. Patients and Methods The study included 21 patients suffering from alopecia areata during January 2018 till November 2018. They were recruited from the Outpatient Clinic of Dermatology, Ain Shams University Hospital and El-houd EL-marsoud Hospital. All patients gave written consent to participate in this work after explanation of the technique, expectations, possible side effects and alternative treatments. The study was approved by Research Ethical committee of Ain Shams University. Results We found that about three quarters of AA patients were males and majority were young adults aged 15 to 50 years. The duration of the disease was more than one year and mean age of first onset was 15 years. About half of the patients was of refractory type. All patients recalled previous history of AA and 90% treated by combined therapy. Scalp was affected in all patients and eyebrow in half of them while nails were affected in 10%. Mean SALT score at time of presentation was 59%. Dermoscopic examination revealed that majority of the patients (95%) had yellow dots; two third had black dots and vellous hair; while exclamation and short thin hairs were found in approximately one third of the patients. The study found that there is statistically significant difference between mean SALT scores among the three treatment modality groups at start of treatment course specifically between group II (40.6 (±20.9)) and group III (82.5 (±21.7)) (p = 0.04). Conclusion DPCP is an effective and safe treatment of extensive and refractory AA especially with intralesional steroid. Older age at onset of the disease is good indicator for a better prognosis. No statistical significant difference between treatment modalities regarding response stratified by other demographic and clinical feature of AA patients.

scholarly journals Improvement of atopic dermatitis and alopecia universalis with dupilumab: a case report

2021 ◽  
Author(s):  
Lama Alotaibi ◽  
Abdulrahman Alfawzan ◽  
Raghad Alharthi ◽  
Afaf Al sheikh
Keyword(s):  
Atopic Dermatitis ◽  
Case Report ◽  
Alopecia Areata ◽  
Alopecia Universalis ◽  
Receptor Alpha ◽  
Alpha Antagonist

Dupilumab is an interleukin (IL)-4 receptor alpha antagonist that showed significant improvement of atopic dermatitis (AD). Many reports have shown significant resolution of alopecia areata, alopecia universalis, and alopecia totalis after dupilumab treatment for AD. We present one of the few reported cases that showed improvement of underlying alopecia universalis treated with dupilumab.

scholarly journals Effective management of indralupta (alopecia areata) with jalaukavacharan - a case report

2018 ◽  
Vol 6 (5th) ◽  
Author(s):  
Likhita Sureshrao Dhage ◽  
Pournima Daware
Keyword(s):  
Case Report ◽  
Hair Loss ◽  
Alopecia Areata ◽  
Hair Follicles ◽  
Effective Management

 Panchkarma is said to be best treatment for disease curing by its root. According to Acharyas it is said that untreatable diseases can be treated with Raktamokshan . Raktamokshan is fifth karma among Panchkarma. Indralupta came under kshudra rogas.  Indralupta (alopecia areata) is the disease where hair loss in patient in the form of patches  over scalp is seen. Considering etiopathogenesis of Indralupta Vyadhi, Raktamokshan is said to be best treatment. In this case report, patient with Indralupta over scalp is treated with Jalaukavacharan. It not only work on localized hair loss but also promote hair follicles to grow new hairs.

scholarly journals Efficacy of plum blossom acupuncture on alopecia areata – A case report

2021 ◽  
pp. 395-397
Author(s):  
Sujithra Sreekumari Thanudhas
Keyword(s):  
Case Report ◽  
Hair Loss ◽  
Alopecia Areata ◽  
Pharmacological Treatment ◽  
Hair Growth ◽  
Genetic Factors ◽  
The Past ◽  
Autoimmune Condition

Alopecia areata (AA) is a complex autoimmune condition that causes non-scarring hair loss and may present at any age. It typically presents with sharply demarcated round patches of hair loss. AA presents heterogeneously and is influenced by both environmental and genetic factors. There is no effective pharmacological treatment currently available for this disorder so far. We had an opportunity to treat a patient with AA using acupuncture. The patient was a 23-year-old male who presented to us with a complaint of sudden hair loss in patches in two demarcated round areas in a diameter of 2–3 cm on the back of the head for the past year. He was diagnosed as AA by AA progression index. After a long treatment course of about 3 months with acupuncture, this patient showed significant hair growth.

Childhood Alopecia Areata: An Overview of Treatment and Recent Patents

2020 ◽  
Vol 14 ◽  
Author(s):  
Kam L. Hon ◽  
David C.K. Luk ◽  
Alexander K.C. Leung ◽  
Chantel Ng ◽  
Steven K.F. Loo
Keyword(s):  
Hair Loss ◽  
Alopecia Areata ◽  
Coal Tar ◽  
Psychological Impact ◽  
Hair Follicles ◽  
The Body ◽  
Whole Body ◽  
Treatment Modalities ◽  
Topical Treatments ◽  
Clinical Queries

Background: Alopecia Areata (AA) is a systemic autoimmune condition which usually starts in childhood. Objective: This article aims to review genetics, therapy, prognosis and recent patents for AA. Methods: We used clinical queries and keywords of “alopecia areata” AND “childhood” as search engine. Patents were searched using the key term “alopecia areata” in Patents.google.com and freepatentsonline.com. Results: Due to an immune mediated damage of the hair follicles, hair is lost from the scalp and other areas of the body temporarily or even permanently. Children with AA are generally healthy. Evidence of genetic association and increased predisposition for AA was found by studying families with affected members. Pathophysiologically, T- lymphocytes attack hair follicles and cause inflammation and destruction of the hair follicles and hair loss. In mild cases, there would be well demarcated round patchy scalp hair loss. The pathognomonic “exclamation mark hairs” may be seen at lesion periphery. In more severe cases, the hair loss may affect the whole scalp and even the whole body. The clinical course is also variable which may range from transient episodes of recurrent patchy hair loss to an indolent gradually deteriorating severe hair loss. The treatment of AA depends on factors including patients’ age, extent of the hair loss, duration of disease, psychological impact, availability and side effect profile of the treatments. For localized patchy alopecia, topical application of corticosteroids and/or intralesional corticosteroids are the treatment of choice. Other topical treatments include minoxidil, anthralin, coal tar and immunotherapy. In severe resistant cases, systemic immunosuppressants may be considered. Although herbal medicine, acupuncture, complementary and alternative medicine may be tried on children in some Asian communities, the evidence to support these practices are lacking. To date, only few recent patents exist in topical treatments including Il-31, laser and herbal medications. Clinical efficacy is pending for these treatment modalities. Conclusions: None of the established therapeutic options are curative. However, newer treatment modalities including excimer laser, interleukin-31 antibodies and biologics are evolving so that there may be significant advances in treatment in the near future. AA can be psychosocially devastating. It is important to assess the quality of life, degree of anxiety, social phobia and mood of the patients and their families. Psychological support is imperative for those who are adversely affected psychosocially.

scholarly journals A Case Report of Catatonia and Neuroleptic Malignant Syndrome With Multiple Treatment Modalities

Medicine ◽  
2015 ◽  
Vol 94 (43) ◽  
pp. e1752 ◽  
Author(s):  
Yu-Jie Chiou ◽  
Yu Lee ◽  
Chin-Chuen Lin ◽  
Tiao-Lai Huang
Keyword(s):  
Case Report ◽  
Neuroleptic Malignant Syndrome ◽  
Treatment Modalities ◽  
Multiple Treatment

scholarly journals EP06 Successful treatment of alopecia universalis with rituximab therapy

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Anuoluwapo R Oke ◽  
Steven Young-Min
Keyword(s):  
B Cell ◽  
Mhc Class I ◽  
Hair Loss ◽  
Alopecia Areata ◽  
Hair Follicles ◽  
Class I ◽  
Whole Body ◽  
Type I ◽  
Alopecia Universalis ◽  
First Report

Abstract Background Alopecia universalis (AU) is a severe subtype of alopecia areata (AA), in which there is non-scarring hair loss affecting the whole body. The pathogenesis involves, increased MHC class I expression in hair follicles, loss of hair follicle immune privilege and autoimmune-mediated damage to pigmented hair. There is no cure for alopecia areata, and though mild cases may have a good chance of either spontaneous or treatment-induced recovery, the prognosis of complete hair loss is poor with less than 10% recovery. Treatment remains a challenge with no reliably effective therapy and in the absence of well-evaluated trials, isolated case reports can influence practice. Here, we present the first report of AU being successfully treated with rituximab with remarkably sustained improvement at 6 years follow up. This case is also the first report of AU developing in adult dermatomyositis (DM) and we speculate upon the implications for the aetiopathogenesis of both conditions. Methods A 55-year-old lady, presented with proximal limb weakness, lethargy, a non-itchy rash, pleurisy and breathlessness. The serum creatinine kinase (3369 u/L) and anti-Jo-1 antibodies were elevated consistent with antisynthetase syndrome and a diagnosis of dermatomyositis was made. There was an initial response to corticosteroids and cyclophosphamide. She then relapsed and was treated with IV rituximab. Seventeen months after her initial presentation, she developed widespread hair loss sparing only white hairs (making Telogen Effluvium unlikely), combined with a concurrent relapse of her dermatomyositis. A diagnosis of alopecia universalis (AU) was made. A further course of IV rituximab therapy administered at this stage led to an excellent response in both her dermatomyositis and AU. At three months review, both the AU and the dermatomyositis had entered remission and this has been sustained 6 years on. Results Please refer to the conclusion section. Conclusion Disease activity in dermatomyositis has been linked with the expression of type I Interferon IFN and this may induce MHC class I expression that is identified on muscle biopsy. It may be that similar type I IFN action on hair follicles may have triggered the development of AU in our case. Whilst this is the first report of AU occurring with adult dermatomyositis, there has been a report of AU occurring in juvenile dermatomyositis. There are also other reports of other combinations of autoimmune conditions occurring with both DM & AU. This case also demonstrates that rituximab, an anti-CD 20 B cell therapy, maybe a useful treatment option in alopecia areata and universalis. This has not been reported elsewhere. Despite postulation that AU is a mainly T cell-driven disease, this case demonstrates that B cells may play a role, in much the same way that we now recognise the importance of B cell involvement in RA. Disclosures A.R. Oke None. S. Young-Min None.

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