2例急性休止期脱发的临床表现

报告2例门诊急性休止期脱发患者。病例1:患者女,因恙虫病治疗4个月后脱发3个月;病例2:患者女,近期精神压力大,脱发1个月。2例患者脱发均弥漫,起病急,全头拉发试验阳性,皮肤镜下仅见较多新生毳毛,营养支持治疗后毛发恢复良好。诊断为急性休止期脱发并行鉴别诊断及文献复习。     

拉皮除皱术后急性休止期脱发一例

患者,女,拉皮除皱术后脱发2个月.顶部及颞部弥漫性脱发,起病急,进展快,全头皮轻拉试验阳性,皮肤镜下见大量休止期发.诊断为急性休止期脱发.予米诺地尔联合哈西奈德喷涂,复合维生素片、维D2磷酸氢钙片口服.毛发恢复良好.     

休止期脱发研究进展

休止期脱发是一种常见的弥漫性非瘢痕性脱发,指由于毛囊生长周期受到干扰而使休止期杵状发脱落增多的现象。影响毛囊生长周期致休止期脱发的因素包括内因或外因,其机制涉及生理性或病理性。文中结合文献复习,综述了休止期脱发的分类、病因及相关机制、与其他类型的弥漫性非瘢痕脱发的鉴别要点以及研究进展。     

慢性休止期秃发

较为详细地描述了一种较为常见的慢性休止期秃发,其中包括其病因、类型、临床特征、组织学改变、诊断与鉴别诊断以及治疗方法。并着重强调了慢性休止期脱发与弥漫性妇女雄激素源性秃发在临床和病理上的不同。治疗上以加强心理治疗并使患者了解本病不容忽视。     

慢性休止期秃发

较为详细地描述了一种较为常见的慢性休止期秃发，其中包括其病因，类型，临床特征，组织学改变，诊断与鉴别诊断以及治疗方法，并着重强调了慢性休止期脱发与弥漫性妇女雄激素源性秃发在临床和病理上的不同。治疗上以加强心理治疗并使患者了解本病不容忽视。     

50例女性型脱发的临床研究

目的：研究女性型脱发的临床、实验室结果及皮肤镜表现的特点。方法：对比分析50例女性型脱发患者及20例慢性休止期脱发患者的临床及实验室资料和皮肤镜表现,同时采集20例年龄相同、无脱发表现健康女性的头皮皮肤镜表现作为对照。结果：与慢性休止期脱发相比,女性型脱发患者中具有雄激素性脱发家族史者较常见,且其发病年龄较早。≤25岁女性型脱发患者的雄激素性脱发家族史阳性率最高、雌激素水平及E2/T值相对最低;25～40岁女性型脱发患者的血清铁蛋白水平最低;〉40岁女性型脱发患者严重脱发的发生率最高。女性型脱发患者的皮肤镜表现特点如头皮色素沉着、局部无毛征、棕色毛周征、白色毛周征和白点征与健康对照组相比有显著统计学差异。结论：遗传因素和低雌激素水平可能参与早发型女性型脱发的发病;低血清铁蛋白可能是中青年人发病的诱因之一;性激素水平的改变可能是中老年女性患者出现严重女性型脱发的原因之一。毛周征、头皮色素沉着、局部无毛征和白点征是女性型脱发的常见皮肤镜表现特点,其中白色毛周征不仅是严重脱发的表现,还可能是治疗预后不好的指标之一。     

铁缺乏是非绝经期妇女过度脱发的一种危险因素北大核心

脱发是女性的常见病,发病率随年龄而变化。雄激素性秃发在绝经后妇女中的发病率为37％,但在非绝经期妇女仅为10％-13％。在非绝经期妇女中还可以见到慢性休止期脱发,后者在美国、英国和日本妇女中的发病率达30％左右。尽管弥漫性雄激素性秃发和慢性静止期脱发是皮肤科的常见病,但在临床上,女性脱发的原因仍然不清楚,而且存在争议。有学者提出,铁缺乏可能是女性脱发的一种潜在原因,而且有研究显示,铁缺乏与慢性弥漫性脱发有关。迄今,铁蛋白水平和脱发之间的直接关系尚未研究。部分证据表明,血清铁蛋白水平降低与女性脱发或斑秃相关。欧莱雅研究院Deloche等为了进一步研究体内铁储备和脱发之间的关系,进行大样本脱发评估和血清铁蛋白检测。     

皮肤镜在脱发疾病中的应用

皮肤镜是一种无创性的诊断工具,便于携带和使用,能观察到微细的、肉眼不可见的形态学结构。它在脱发疾病诊断、鉴别诊断及疗效判断中意义重大,应用于斑秃与其他非瘢痕性脱发的鉴别诊断、瘢痕性和非瘢痕性脱发的鉴别、急性弥漫性脱发如弥漫性斑秃和急性休止期脱发的鉴别诊断、原发性瘢痕性脱发中病种确定等。常见脱发疾病的皮肤镜征象与组织病理改变有一定的关联,了解其内在联系,能够在一定程度上减少组织病理活检的概率。该文对常见脱发疾病的皮肤镜征象、皮肤镜在毛发疾病的诊断、鉴别诊断及疗效评判等方面作一综述。     

二期梅毒脱发误诊1例

患者男,25岁。因不规则脱发2年,于2004年2月13日至中国医学科学院皮肤病研究所就诊。2年前患者无意中发现头皮散在不规则脱发,呈点状及片状,无自觉症状,在当地医院被诊断为斑秃,予斑秃丸每日3次,每次5g口服,2%米诺地尔(敏乐定)搽剂及地塞米松搽剂间断外用,效果不明显。追问病史     

5%米诺地尔联合口服抗雄药物治疗雄激素性秃发早期脱发现象的初步探讨

目的：探讨5%米诺地尔联合口服抗雄药物治疗雄激素性秃发（AGA）早期的脱发现象,观察16周内头发脱落数量及特征。方法：收集AGA患者治疗期间（1～16周）脱发量数据,探究脱发量的变化特点。结果：67例AGA患者使用药物后,第2～8周脱发量相对第1周（基线）均明显增加（P<0.05）;且分别与第1周和第2周比较,第3周均呈现出脱发量明显增加的情况（P<0.05）,由此将脱发量变化百分比>68.22%（第3周脱发量变化百分比的均值）的情况定义为“脱发明显”。据此将患者分为脱发明显组39例（58.21%）和非脱发明显组28例（41.79%）。脱发明显组中,患者脱发量明显增加发生于第3～5周,随后第12周降至基线水平。脱发明显组中脱发量的时间变化、严重程度在男女中差异均无统计学意义（P>0.05）,仅20.51%患者每周脱发量变化百分比中的最大数值（简称为最大百分比）较第1周>3倍。结论：“脱发明显”多发生于AGA患者用药后第3～5周,约于第12周降至第1周水平,持续时间短且男女间无明显差别。“脱发明显”是药物作用的一种表现,也预示着毛囊可能由休止期转入生长期的正...     

Chronic telogen effluvium is due to a reduction in the variance of anagen duration

Background/Objectives: Chronic telogen effluvium and diffuse cyclical hair loss in women are well‐described clinical entities characterized by chronic and fluctuating increases in hair shedding without loss of hair volume. We sought to investigate the follicular dynamics of chronic telogen effluvium and diffuse cyclical hair loss using a previously validated computer simulation known as the follicular automaton. Methods: Using our model, we were able to simulate reductions in both the mean and variance of anagen duration and thus investigate their consequences with respect to both hair volume and hair shedding. Results: We showed that reducing the mean anagen duration results in a loss of hair volume without prominent fluctuations in hair fall: findings that reproduced the key features in androgenetic alopecia. In contrast, a reduction in the variance of anagen duration generated follicular dynamics that accurately reproduced the known key features of chronic telogen effluvium and diffuse cyclical hair loss: acute exacerbations, periodicity and only minimal reductions in long‐term hair volume. Conclusions: We provide evidence that suggests chronic telogen effluvium may be secondary to a reduction in the variance of anagen and suggest this pathological state represents a new functional type of recurrent hair shedding.     

Acute telogen effluvium onset event is associated with the presence of female androgenetic alopecia: potential therapeutic implications

Acute telogen effluvium (ATE) is often associated with female androgenetic alopecia (FAA), but predictive factors of ATE–FAA association and clinical factors or therapies that may influence the progression of ATE to chronic telogen effluvium (CTE) have not been reported. We have identified predictive factors of ATE–FAA association and retrospectively evaluated the impact of therapies on the progression to CTE. Conclusions are as follows: (i) Triggering cause is a significant independent factor that predicts association of ATE with FAA. (ii) Triggering causes with higher risk of concurrent FAA are severe diet, iron deficiency, and thyroid dysfunction. (iii) Patients suffering ATE may benefit from different therapeutic approaches (depending on which is the triggering cause) to prevent or treat the association with FAA. (iv) Minoxidil use shows a trend to lower the percentage of progression to CTE. (v) Apart from treating the precipitating cause, the different additional oral treatments used have not shown any correlation with progression to CTE.     

Clinical study on the efficacy and tolerability of a topical regenerative treatment in patients with telogen effluvium and mild androgenetic alopecia

Hair loss may change the quality of life since modern society considers hair an essential element in beauty definition. The most common causes of hair loss are androgenetic alopecia (AGA) and telogen effluvium (TE). AGA requires a lifetime use of minoxidil or finasteride (and sometimes they lose efficacy over the years), whereas TE has no standardized therapy available. Our study focuses on a novel topical regenerative preparation that, by mimicking autologous PRP, can safely and efficiently improve hair loss in patients affected by TE and AGA.     

Hirsutism, postpartum telogen effluvium, and male pattern alopecia

This paper reviews the interrelating factors affecting hair growth. It presents current data on the development of alopecia and hirsutism in males and females and the newer approaches to treatment.