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

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.

Author(s):  
Ives Alexandre Yutani Koseki ◽  
Débora Sarzi Sartori ◽  
Isabelle Maffei Guarenti ◽  
Fábio Yutani Koseki ◽  
Amanda Dagostim Gietner ◽  
...  

Drug reactions with eosinophilia and systemic symptoms (DRESS) are rare and potentially fatal adverse hypersensitivity reaction to some drugs, especially anticonvulsants. The syndrome affects not only the skin but also other organs, especially the liver. The incidence can vary from 1 to 5 cases per 10.000 patients exposed to anticonvulsants.The recognition of the syndrome is of fundamental importance since the mortality rate is between 10 and 40%. Once the diagnosis is established, the triggering drug must be identified and discontinued. Corticosteroids are usually associated with therapy. Autoimmune sequelae have been reported, including vitiligo and rarely alopecia. Alopecia universalis is a variant of alopecia areata, characterized by hair loss throughout the body. We report a case of DRESS, associated with two autoimmune dermatological diseases: alopecia universalis and vitiligo.


2021 ◽  
Vol 59 (241) ◽  
pp. 935-937
Author(s):  
Vikash Paudel ◽  
Deepa Chudal ◽  
Manish Bhakta Pradhan ◽  
Rupa Thakur ◽  
Buddhi Raj Pandey

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.


2021 ◽  
pp. 1-5
Author(s):  
Chloe J. Walker ◽  
Kelly E. Flanagan ◽  
James T. Pathoulas ◽  
Isabel Pupo Wiss ◽  
Maryanne M. Senna

<b><i>Introduction:</i></b> Tocilizumab (TCZ), a recombinant humanized antihuman monoclonal antibody targeting interleukin-6 (IL-6) signaling, is often utilized in the management of autoimmune disease. Few reports have demonstrated hair growth changes in patients on TCZ. <b><i>Case Presentation:</i></b> Herein, we review the literature and report a 21-year-old woman with progressive alopecia areata (AA) presenting with AA improvement while on TCZ for concomitant posterior uveitis. <b><i>Discussion:</i></b> Our case demonstrates the potential ability of TCZ to disrupt IL-6 signaling involved in AA, leading to hair loss and regrowth.


BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S115-S115
Author(s):  
Ciara Clarke ◽  
Clodagh Rushe ◽  
Fintan Byrne

ObjectiveWe report a case of a 58-year-old gentleman who was hospitalised intermittently for one year due to treatment resistant schizophrenia. Prior to hospitalisation he had been prescribed standard antipsychotics for decades without full resolution of positive psychotic symptoms. During his final admission lasting six months he was guarded, suspicious, irritable, constantly paced the corridor and displayed thought block and paranoid persecutory delusions. He would not enter the assessment room or allow any blood or ECG monitoring, however, he was compliant with oral medication. He was successfully treated with high dose olanzapine (40mg/day) and was discharged to the community. The aim of this study is to bring awareness and add to the body of evidence for the use of high-dose olanzapine in patients with treatment resistant schizophrenia in whom a trial of clozapine is not possible.Case reportThe patient gave written consent for this case report to be written and presented. An extensive literature review was performed and key papers were identified. Discussion focuses on the key areas in the literature.DiscussionThis case demonstrates that high-dose olanzapine can be used effectively as an alternative to clozapine in treatment resistant schizophrenia.ConclusionThis case highlights the need for further evaluation of high-dose olanzapine as an alternative to clozapine in patients with treatment-resistant schizophrenia.


2021 ◽  
Author(s):  
Lama Alotaibi ◽  
Abdulrahman Alfawzan ◽  
Raghad Alharthi ◽  
Afaf Al sheikh

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.


2020 ◽  
Vol 16 ◽  
Author(s):  
Rebecca Afford ◽  
Alexander K. C. Leung ◽  
Joseph M. Lam

Background: Alopecia areata (AA) is a non-scarring hair loss disorder of autoimmune etiology. Objective: To familiarize physicians with the clinical presentation, diagnosis, evaluation, and management of pediatric alopecia areata. Methods: The search term "Alopecia areata" was entered into a Pubmed search. A narrow scope was applied to the categories of "epidemiology", "clinical diagnosis", "investigations", "comorbidities", and "treatment". Meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews were included. Only papers published in the English language were included. A descriptive, narrative synthesis was provided of the retrieved articles. Results: AA is an autoimmune disease of unknown etiology. It is the third most common dermatologic presentation in children with a lifetime risk of 1-2%. Diagnosing AA can be made on the basis of the history and clinical findings. Patients will often present with patchy, non-scarring hair loss generally affecting the scalp. History may reveal a personal or family medical history of autoimmune or atopic disease or a recent stressful event. Tricoscopic examination will classically show “exclamation point hairs” and “yellow dots”. Nonspecific nail changes may be present. Other clinical variants include alopecia totalis, alopecia universalis, ophiasis, sisaipho, and Canitis subita. There are multiple treatment options for AA including conservative treatment, and topical, oral, and injectable medications. Conclusion: AA is an autoimmune disease with a heterogenous presentation and unpredictable clinical course. Although there is no cure for AA, there are many current treatment options available to help manage this disfiguring disease.


2021 ◽  
pp. 106689692110498
Author(s):  
Harumi Nakamura ◽  
Yuki Koyanagi ◽  
Masanori Kitamura ◽  
Yoji Kukita

Rhabdomyosarcoma (RMS) is a soft tissue tumor with striated muscle cell differentiation. It mostly occurs in children. While it can affect any part of the body, it commonly involves the urogenital organs, head and neck including the parameninges and orbit, and limbs. We describe an adult case of primary epithelioid RMS of the liver. A 71-year-old man presented with a 5.6 cm liver mass. Tumor histology revealed diffuse proliferation of small epithelioid cells and focal spindle cells. The tumor cells were immunohistochemically positive for myogenin (positive ratio 30%), desmin, Myo D1, and CD56. The tumor weakly expressed MDM2 and did not express CDK4. This suggested that dedifferentiated liposarcoma with a rhabdomyosarcomatous component was unlikely. There was no fusion gene of PAX3-FKHR or PAX7- FKHR to indicate alveolar RMS by RT-PCR. Subsequently, RNA Pan-Cancer Targeted sequencing was performed for 1385 genes revealed a single base substitution (c.742C>T) in TP53 that changes an amino acid (p.Arg248Trp). No fusion gene was found. No other primary RMS lesions were detected aside from the liver lesion. The tumor was diagnosed as a primary epithelioid RMS of the liver. His RMS already metastasized to the lymph nodes of the entire body. The patient declined further therapy and died one year later. This was the first case report of a primary epithelioid RMS of the liver.


2002 ◽  
Vol 26 (3) ◽  
pp. 311-313 ◽  
Author(s):  
Marcelo Gonçalves ◽  
Daniel Pinto Oliveira ◽  
Edmar Oliveira Oya ◽  
Andréa Gonçalves

A report of Garre's osteomyelitis of the mandible associated with a fistula is presented. Elimination of pulpal periapical infection through endodontic therapy was shown to be an effective treatment. The total bone healing was observed one year later.


Author(s):  
Likhita Sureshrao Dhage ◽  
Pournima Daware

 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.


2021 ◽  
Vol 32 (3) ◽  
pp. 150
Author(s):  
Nuri Fitriasari ◽  
Tenny Setiani Dewi ◽  
Etis Duhita Rahayuningtyas

Pendahuluan: Lidah dalam filosofi medis dipercaya sebagai barometer kesehatan rongga mulut maupun tubuh secara keseluruhan. Permukaan mukosa lidah kadang memperlihatkan gambaran yang berbeda dari kondisi normal sehingga disebut variasi normal. Geographic tongue dan fissured tongue merupakan suatu variasi normal yang asimptomatik namun dapat menjadi simptomatik ketika dipengaruhi suatu kebiasaan baru yang bersifat mengiritasi seperti setiap hari mengkonsumsi makanan yang memiliki rasa pedas yang ekstrim. Tujuan laporan kasus ini memaparkan tentang kelainan pada variasi normal lidah yang dipicu oleh kebiasaan baru konsumsi makanan tersebut pada seorang pasien remaja. Pasien juga kemudian diketahui dalam kondisi anemia. Laporan kasus: Seorang wanita berusia 18 tahun berobat ke Poliklinik Ilmu Penyakit Mulut RSUP.Dr Hasan Sadikin dengan diagnosis geographic tongue disertai fissured tongue. Pasien mengeluhkan sakit pada lidah dan terasa mati rasa serta nyeri seperti tertusuk-tusuk, terutama jika terkena makanan pedas, sejak satu tahun yang lalu. Terdapat riwayat mengonsumsi makanan yang pedas dan panas hampir setiap hari. Hasil pemeriksaan penunjang hematologi menunjukkan pasien dalam kondisi anemia. Penatalaksanan yang dilakukan meliputi instruksi menjaga kesehatan rongga mulut, pemberian preparat Fe, B12, dan asam folat, serta obat kumur. Pasien menunjukkan perbaikan dalam  pengobatan selama 3 minggu. Simpulan: Kondisi variasi normal pada lidah yang semula asimtomatik dapat menjadi simtomatik akibat iritasi makanan panas dan pedas, pada pasien dengan kondisi anemia.Kata kunci: Geographic tongue, fissured tongue, variasi normal lidah, makanan pedas dan panas, anemia. ABSTRACTIntroduction: In medical philosophy, the tongue is believed to be a barometer of the oral cavity’s health and the body as a whole. The mucosal tongue surface often shows a different feature from normal conditions, thus called normal variation. Geographic tongue and fissured tongue are normal variations that are asymptomatic but can become symptomatic when influenced by new irritating habits such as daily food consumption with an extremely spicy taste. This case report was aimed to describe abnormalities in normal tongue variation triggered by the new habit of consuming such foods in a teenage patient. The patient was also found to be anaemic. Case report: An 18-year-old woman went to the Oral Medicine Polyclinics of Dr Hasan Sadikin Hospital with a geographic tongue diagnosis accompanied by the fissured tongue. The patient complained of a sore tongue and felt numbness and soreness like being prickly, especially when exposed to spicy food, since one year prior. There was a history of spicy and hot foods consumption almost every day. The results of the haematology examination showed that the patient was in an anaemic condition. The treatment included instructions for maintaining oral health, administration of Fe, B12, folic acid preparations, and mouthwash usage. The patient showed improvement after treatment for three weeks. Conclusion: The condition of normal tongue variation, which initially asymptomatic, can become symptomatic due to irritation of hot and spicy food in anaemic patients.Keywords: Geographic tongue, fissured tongue, normal tongue variations, hot and spicy food, anaemia.


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