Grundlagen der hormonalen Kontrazeption

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毛发生长的评价方法

如何对毛发生长情况进行评价一直是毛囊生物学研究者和皮肤科医生关注的焦点,特别是随着非那雄胺和米诺地尔治疗雄激素性秃发的广泛应用,已经越来越迫切需要准确而客观地评价毛发生长.毛发生长的主要生理性参数包括:毛发的密度、直径、毛发的线性生长速度和毛发循环的比例等,其中,休止期胜长期毛囊的比例是反映毛发循环比例的重要参数.目前,评价毛发生长的方法包括创伤性、半创伤性和非创伤性三大类,在应用过程中各有其适应范围和优缺点.     

桥粒成分的改变引起毛发异常

桥粒是角质形成细胞间连接的主要结构，它们组成了上皮主要的细胞间黏附机制，使细胞可以经受外界的机械性损伤。桥粒的主要成分包括：斑菲素蛋白-1、斑菲素蛋白-2、桥粒斑蛋白、桥粒斑珠蛋白、桥粒芯糖蛋白1、桥粒芯糖蛋白4、Comeodesmosin。任何一种桥粒成分的改变都会引起毛发外观的异常，这为异常的毛发表型提供了重要资料，也为毛发疾病的病因治疗提供了一条新的思路。     

何慧英治疗小儿斑秃经验探析

正斑秃最早见于《外科正宗》,称"油风",为一种突然发生的局限性斑片状脱发。该病可发生于任何年龄,小儿患者多发生于学龄期,且发展迅速、缠绵难愈,影响发育和心理健康。现一般认为斑秃是自身免疫性疾病,与精神因素、遗传因素和微量元素缺乏等有关。西医常外用激素或内服免疫抑制剂等治疗。何慧英老师认为小儿斑秃多与脾胃不调或受惊有关,现将何老师治疗该病经验介绍如下。1谨从病机辨证论治古人对斑秃的病机早有洞察。《诸病源候论》:     

Dermoscopic Approach to a Small Round to Oval Hairless Patch on the Scalp

Background

Various kinds of alopecia can show small round or oval hairless patch. Dermoscopy could be a simple, useful tool for making a correct diagnosis.

Objective

The aim of this study is to investigate clinical usefulness of dermoscopy for diseases with small round or oval hairless patch on the scalp.

Methods

Dermoscopic examination was performed for 148 patients with small round or oval hairless patch using DermLite® II pro. The type and its patient number of alopecia investigated in the study were as below: alopecia areata (n=81), trichotillomania (n=24), tinea captis (n=13), traction alopecia (n=12), lichen planopilaris (n=8), discoid lupus erythematosus (n=7), congenital triangular alopecia (n=2) and pseudopelade of Brocq (n=1). The significance of dermoscopic findings for each disease were evaluated.

Results

Characteristic dermoscopic findings of alopecia areata were tapering hairs and yellow dots. Those of trichotillomania and traction alopecia were broken hairs. Dermoscopic findings of tinea capitis included bent hairs, perifollicular white macules and greasy scales. Discoid lupus erythematosus and lichen planopilaris were characterized by dermoscopic findings of lack of follicular ostia. Furthermore, keratin plugs were frequently seen in discoid lupus erythematosus whereas perifollicular hyperkeratosis and erythema were frequently seen in lichen planopilaris.

Conclusion

Dermoscopic examination for small round or oval hairless patch showed characteristic findings for each disease. Based on these results, we propose dermoscopic algorithm for small round or oval hairless patch on the scalp.     

Preferential Recognition of Hydroxyl Radical-Modified Superoxide Dismutase by Circulating Autoantibodies in Patients with Alopecia Areata

Background

Alopecia areata (AA) is a common form of localized, non-scarring hair loss. The cause of AA is unknown but reports suggest an autoimmune etiology, where oxygen free radicals play an important role.

Objective

The aim of this study was to investigate the role of a hydroxyl radicals (·OH)-modified antioxidant enzyme, superoxide dismutase (SOD), in AA autoimmunity.

Methods

SOD was modified by ·OH radicals. Binding characteristics of autoantibodies in AA patients (n=26) against ·OH-modified SOD (·OH-SOD) were evaluated by immunoassays and the results were compared with those of healthy, age-matched controls (n=30). The effects of ·OH radicals on immunoglobulin G (IgG) isolated from AA patients were studied.

Results

Highly specific binding to ·OH-SOD was observed in 32% of the samples of patient sera, whereas normal human sera showed negligible binding with either antigen. Competitive inhibition immunoassays reiterated the results from direct binding. Protein-A-purified IgG from AA patients (AA-IgG) also showed strong binding to ·OH-SOD as compared to IgG from normal human controls (p<0.001). In addition, AA-IgG from patients with alopecia universalis recognized ·OH-SOD to a greater extent than did AA-IgG from patients with the patchy, persistent type of alopecia. Furthermore, sera from AA patients had lower levels of SOD activity as compared to control sera.

Conclusion

This is the first report showing an association between ·OH-modified SOD and AA. These novel results demonstrate that ·OH radical-mediated changes in SOD present unique neo-epitopes that might contribute to antigen-driven antibody induction in AA.     

先天性三角形脱发10例临床分析

【摘要】 目的 观察先天性三角形脱发的临床特点。方法 收集厦门市儿童医院2020年8月至2021年6月诊治的10例先天性三角形脱发患儿的临床资料,分析其临床及皮肤镜特征。结果 10例患儿均为男性,年龄2个月至6岁4个月。6例患儿出生时或者出生后1月内发现脱发,4例为4个月至6岁。脱发情况：5例位于左侧额颞部,3例位于右侧额颞部,2例位于头顶部。患儿脱发区均可见毳毛样毛发,拉发试验均阴性,其中1例毳毛样毛发区散在正常毛发。皮肤镜检查：脱发区边界较清,可见大量毳毛样毛发,周围为正常毛发,未见黄点征、黑点征及感叹号状发。7例曾因脱发就诊于皮肤科,其中5例被诊断为斑秃,2例被诊断为皮脂腺痣。结论 先天性三角形脱发常见于儿童,好发部位为左侧额颞部。脱发区正常毛发被细的毳毛样毛发代替是该病的特点,皮肤镜有助于诊断和鉴别诊断。