Efficacy and safety of superficial cryotherapy for alopecia areata: A retrospective,comprehensive review of 353 cases over 22 years

Alopecia areata (AA) affects anagen hair follicles, resulting in non‐scarring hair loss. Since introduced by Huang et al., superficial cryotherapy has been accepted as a considerable primary therapeutic modality for AA. The aim of this study was to objectively clarify the therapeutic efficacy and safety of superficial hypothermic cryotherapy for treatment of AA. Medical records of 353 patients from 1993 to 2014 were retrospectively analyzed. According to the response to the superficial cryotherapy, patients were categorized into four groups: “marked”, “partial”, “poor” and “no recovery”. The marked and partial recovery groups were considered as responders. The proportions of the responders among patient subgroups which were defined by various patients, disease, and treatment factors were compared. Of the patients, 60.9% were classified as responders after 3 months of superficial hypothermic cryotherapy. The proportion of the responders were higher when the treatment interval was 2 weeks or less and in the incipient disease stage, with statistical significance. No severe side‐effects other than mild pain and pruritus were reported. In conclusion, superficial cryotherapy is an effective and safe therapeutic modality for AA. Especially when the treatment interval is 2 weeks or less and in the first occurrence of the disease, the therapeutic outcome is superior.     

Minoxidil topical treatment may be more efficient if applied on damp scalp in comparison with dry scalp

There is yet no consensus among prescribers whether minoxidil (MXD) formulations should be applied on wet/damp or dry scalp and no clear FDA guidelines on the matter. We hypothesized that the use of MXD on damp scalp may lead to higher drug penetration. First, because the drug diffusion and consequent deposition into the hair follicle may be favored when follicle cast is humid. Second, because humidity may also prevent drug crystallization and, therefore, maintain a higher thermodynamic activity for longer periods, which leads to increased penetration. Following in vitro experiments on rat and porcine skin we confirmed the hypothesis, which could markedly improve treatment effectiveness.     

梅毒性脱发4例

报告4例以脱发为主诉症状的二期梅毒,脱发表现为虫蚀状,弥漫性小片状,脱发区毛囊周围充血发红,梅毒血清学试验及梅毒螺旋体检查阳性,对4例患者采用苄呈青霉素治疗后毛发再生,未留瘢痕.     

The genetic epidemiology of alopecia areata in China

BACKGROUND: Alopecia areata (AA) is hypothesized to be an organ-specific autoimmune disease with genetic predisposition and an environmental trigger. There are few clinical data in Asians. OBJECTIVES: To describe the genetic epidemiological features of AA patients in China and to determine the possible genetic model for AA. METHODS: Data for 1032 patients with AA were obtained by questionnaire in the Institute of Dermatology of Anhui Medical University in China from 2001 to 2003. Complex segregation analysis and heritability analysis were performed using Falconer's method, EPI INFO 6.0 and SAGE-REGTL programs. RESULTS: In total, 1032 AA patients (male/female ratio 1.1 : 1) were enrolled, representing 0.94% of the total number of cases seen in our outpatient clinic during that time. The mean +/- SD age of onset was 28.98 +/- 13.43 years. The difference between the mean age of onset in males and females was not significant. Most patients (82.6%) experienced their first episode of AA within the first four decades of life. A positive family history of AA was obtained in 87 patients (8.4%). The prevalence of AA in first-, second- and third-degree relatives of the proband with AA was 1.6%, 0.19% and 0.03%, respectively. These figures were higher than those in controls. A greater severity and longer duration of AA were seen in the early onset group than in the late-onset group. The early onset group also had more affected first- and second-degree relatives. The heritability of AA in first-, second- and third-degree relatives was 47.16%, 42.53% and 22.29%, respectively. Based on the REGTL results, the best model was a polygenic additive model for AA. CONCLUSIONS: The effect of genetic factors is strong in AA, but environmental factors such as infection and psychological stress may still play an important role. Our findings on the genetics of AA are consistent with a polygenic additive mode of inheritance.