Eyebrow loss, eyelash loss, and dermatochalasis.

The eyebrows, eyelashes, and eyelids are important protective structures for the eye and are also of considerable cosmetic value. The dermatologist should understand the available cosmetic and surgical techniques for helping patients with eyebrow loss, eyelash loss, and dermatochalasis.     

Lasers,lights, and compounds for hair loss in aesthetics

Hair loss is a common complaint that is often stressful for patients and a challenge for practitioners to treat. Fortunately, innovations in the field have contributed to growing evidence for several promising topical, oral, and light and energy-based therapies. We have reviewed the current literature about the efficacy of these treatments, including topical agents (finasteride, latanoprost, spironolactone, caffeine, and metformin), oral minoxidil, nutraceuticals, platelet-rich plasma, low-level laser therapy, fractional lasers, and laser-assisted drug delivery. In addition, several debates related to these treatments have been discussed, including post-finasteride syndrome, effects of biotin supplementation on laboratory testing, standardization of platelet-rich plasma and low-level laser therapy, and combination treatment to enhance hair transplantation.     

Congenital hair loss disorders: rare, but not too rare

The mammalian hair follicle (HF) is an active skin appendage which operates hair cycles throughout life. Recent advances in molecular genetics have led to the identification of many genes expressed in the HF. Furthermore, mutations in some of these genes have been shown to underlie congenital hair loss disorders in humans. Patients with congenital hair loss disorders can show various hair shaft anomalies, such as woolly hair and monilethrix. In the Japanese populations, most patients with congenital woolly hair/hypotrichosis possess common founder mutations in the lipase H (LIPH) gene. Identification of the causative genes for hair loss disorders directly demonstrates crucial roles of these genes in HF morphogenesis, development and/or hair growth in humans.     

经皮水分丢失与健康人性别、年龄、解剖部位的关系

通过经皮水分丢失（TEWL）来评价皮肤的屏障功能，并研究经皮水分丢失与性别，年龄，解剖部位的关系，参加本次实验的为健康志愿者共104名，其中女性53名，男性51名，分为5个不同年龄组，用与计算机相连的蒸发测定仪Darmalab TEWL探头测量。结果发现不同年龄组男女性别之间TEWL值均无显著性差异（P＞0．05），新生儿组TEWL值明显高于其他各年龄组（P＜0．05），老年组TEWL值低于其他年龄组。在8个不同部位测量中，经统计得到TEWL值顺序为：手掌＞额部＞颊部＝手背＞小腿＝背部＞前臂＝胸部。说明TEWL与性别无明显相关性，而与年龄相关，以新生儿最高，老年人最低，在身体各部位的测量中，四肢末端和暴露部位经皮水分丢失较高。     

Acquired ichthyosis, alopecia and loss of hair pigment associated with leiomyosarcoma

Acquired ichthyosis is an important clinical finding; internal malignancy, systemic disease and medication are recognised associations. We present a 70-year-old lady with acquired ichthyosis and leiomyosarcoma, one of the less frequently associated malignancies. An additional unusual finding was generalised thinning and loss of pigment affecting her hair. Scalp biopsy showed histological evidence of ichthyosis. Following resection of the tumour the ichthyosis resolved and there was regrowth of darker hair.     

Transonychial water loss: relation to sex, age and nail-plate thickness

The transonychial water loss (TOWL) was measured in 21 healthy volunteers with an evaporimeter, to establish the usefulness of this technique and study the influence of sex, age and nail-plate thickness. The median TOWL was 19.4 g/m2 h-1 and it decreased with increasing age (R = 0.51, P less than 0.018). The median transepidermal water loss (TEWLHAND) from the back of the hand was 16.0 g/m2 h-1 and from the dorsal side of the underarm (TEWLARM) it was 5.6 g/m2 h-1. The TEWLARM was significantly less than from any of the two other points studied (P less than 0.01), while there was no significant difference between the values obtained on the hand and the nail. TEWLARM had a median value of 6.4 g/m2 h-1 in men and 4.3 g/m2 h-1 in women (P less than 0.05) in this study. No significant correlation between nail-plate thickness, as measured by ultrasound 20 MHz A-scan, and TOWL was found. Measurements of TOWL are of interest and should be age-related. Further studies are needed to determine TOWL in various forms of nail pathology.     

Stratum corneum cytokines,structural proteins,and transepidermal water loss: effect of hand hygiene

Background/aims: There are few reports on the cytokine response to high frequency hand hygiene among health care workers (HCWs) in an occupational setting. We have observed significant skin barrier compromise consistent with chronic irritant contact dermatitis in HCWs. We hypothesized that repetitive hand hygiene would activate the epidermal inflammatory cascade and lead to changes in structural proteins and cytokines. Methods: Keratin 6, keratin 1, 10, 11, involucrin, IL1α, TNFα, IL8, IL1RA, and IL10 were analyzed from the SC using bead‐based arrays. Knuckle and dorsum samples were evaluated for HCWs (n=23) before and after repetitive hand hygiene and compared with those of age‐matched non‐wet workers (n=23) without hand skin irritation. Erythema, dryness, and barrier integrity were measured. Results: Transepidermal water loss (TEWL) was higher for HCWs but unchanged with exposure. IL1α and TNFα were highest in control volar forearm. IL1α, TNFα, and IL8 were significantly lower in HCWs than controls despite higher erythema, dryness, and TEWL. Decreases in keratin 1, 10, 11, increases in keratin 6, and reduction in IL1α, TNFα, and IL8 were seen after hand hygiene. Conclusion: This preliminary study showed significantly lower SC biomarker levels in HCW compared with controls and regional differences between the hand and forearm. Exposure to repetitive hand hygiene results in substantial chronic skin irritation without time for barrier recovery between work periods. The impact on SC structural proteins and cytokines has many commonalities with chronic inflammation, although mechanistic questions remain.     

Hair density, hair diameter and the prevalence of female pattern hair loss

BACKGROUND: Female pattern hair loss is common but estimates of its prevalence have varied widely. The relationships between the clinical diagnosis of female pattern hair loss and objective measurements of hair density and hair diameter have not previously been evaluated. OBJECTIVES: To determine the prevalence of female pattern hair loss and to relate the clinical findings to hair density and hair diameter. METHODS: We examined 377 women, aged 18--99 years, who presented to a general dermatology clinic with complaints unrelated to hair growth (the unselected sample). A second group of 47 women referred with typical female pattern hair loss was included in analyses of the relationships between hair density, hair diameter and the clinical diagnosis. Hair density was measured using a photographic method. In each subject the major and minor axis diameters were measured in a random sample of 50 hairs. RESULTS: Six per cent of women aged under 50 years were diagnosed as having female pattern hair loss, increasing to 38% in subjects aged 70 years and over. The mean +/- SEM hair density was 293 +/- 61.3 hairs cm(-2) at age 35 years, falling to 211 +/- 55.1 hairs cm(-2) at age 70 years. Hair density showed a normal distribution in the unselected sample. Most women classified as having female pattern hair loss had hair densities within the lower half of the normal distribution. The perception of hair loss was determined mainly by low hair density (ANOVA P < 0.001), but there was overlap in hair density between women classified as having Ludwig I hair loss and the no hair loss group, which was partly accounted for by differences in mean hair diameter (ANOVA P < 0.001). Low hair density was associated with fewer hairs of all diameters. CONCLUSIONS: Hair density in women is distributed as a normal variable, indicating that it is determined as a multifactorial trait. Women with female pattern hair loss have a hair density which falls below the mean but lies within the spectrum of the normal distribution, although other factors, including hair diameter, may affect the subjective impression of hair loss. The hair diameter data suggest that low hair density is not due to progressive diminution in hair follicle size and that follicular miniaturization may occur within the space of a single hair cycle.