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Hair loss or taste loss?

Jnanendrappa N, Arora S, Yerebairapura Math S

Oral Dis, 2019 10;25(7):1831.
PMID: 31206951 DOI: 10.1111/odi.13146
Matched MeSH terms: Alopecia*
Fulltext Cicatricial alopecia - a case study

Kwa SK, Das Gupta E

Aust Fam Physician, 2015 Jul;44(7):476-8.
PMID: 26590492
Matched MeSH terms: Alopecia*
Alopecia secondary to repaired occipital encephalocele - role of tissue expander in hair restoration

Ishak A, Mat Saad AZ, Azman WS, Halim AS

Med J Malaysia, 2018 06;73(3):172-174.
PMID: 29962502 MyJurnal

Partial scalp alopecia is a common problem that can lead to severe social and psychological problems. Tissue expansion, although an old concept, provides a surgical alternative to manage areas of alopecia. We describe a case of alopecia secondary to repaired occipital encephalocele that was successfully treated using tissue expansion technique.

Matched MeSH terms: Alopecia/etiology*; Alopecia/surgery
Fulltext Sarcocystis nesbitti related autoimmune diffuse alopecia

Ch’ng CC, Wong SM, Tan CT

Neurology Asia, 2016;21(3):261-264.
MyJurnal

Background & Objective: Symptomatic sarcocystosis has been said to be rare until recent years, when there were reports of outbreaks of febrile myositis for travellers returning from the Malaysian island resorts. In 2012, an outbreak of Sarcocystis nesbitti infection involving 92 college students and staff occurred after returning from Pangkor Island, Malaysia. A few months after recovering from the febrile illness, some patients complained of hair loss. This study aimed to determine the prevalence, clinical features and outcome of this disorder.
Methods: All patients who became sick in the outbreak were asked whether they had the hair loss. For those who had, they were interviewed with standard questionnaires, examined and investigated. Patients were followed-up via an online survey 2 years later.
Results: Out of 89 patients who were ill, 19 patients (21.4%) complained of alopecia. The mean peak onset was 4 months after the initial illness. Eleven patients (57.9%) reported the hair fall of more than 100 per day. The other symptoms were itch 10 (52.6%), scaling 10 (52.6%), erythema 4 (21.1%), none had scarring. Eleven patients (57.8%) had positive antinuclear factor with high titre (speckled or nucleolar pattern). Two years after the event, 10 had complete or near complete spontaneous recovery, 1 had partial response and 1 had no improvement.
Conclusions: A delayed transient diffuse alopecia is seen in close to half of patients with Sarcocystis nesbittiinfection. This high frequency of positive ANF suggested an immune-mediated mechanism.

Study site: Dermatology Clinic, Universiti Malaya Medical Centre (UMMC)

Matched MeSH terms: Alopecia*
Polyps! Polyps! And More Polyps! - The First Case of Cronkhite-Canada Syndrome in Malaysia

Abdul Rani R, Hussin FR, Hamzaini AH, Isa MR, Raja Ali RA

Med J Malaysia, 2016 02;71(1):37-8.
PMID: 27130745

Cronkhite-Canada Syndrome (CCS) is a syndrome characterised by a constellation of signs including but not limited to onychodystrophy of the finger and toe nails, skin hyperpigmentation and alopecia. Endoscopic features showed hamartomatous polyps involving all segments of the gastrointestinal tract with the characteristic exception of being oesophageal sparring. These polyps show confirmation by the presence of eosinophils and mast cells at the lamina propria upon histological studies.

Matched MeSH terms: Alopecia
Thyroid function, autoantibodies, and HLA tissue typing in children with alopecia areata

Nanda A, Alsaleh QA, Al-Hasawi F, Al-Muzairai I

Pediatr Dermatol, 2002 11 20;19(6):486-91.
PMID: 12437547

A total of 80 Kuwaiti children with alopecia areata (AA), without clinical evidence of thyroid disease, were screened for the presence of thyroid abnormalities, and 50 unrelated children with AA were tissue typed for human leukocyte antigen (HLA) class I and class II antigens. Thyroid abnormalities were detected in 14 children (17.5%). Among these, 11 children (14%) had thyroid autoantibodies. These observations highlight the significance of screening for thyroid abnormalities in children with chronic, recurrent, and/or extensive disease. The Kuwaiti children with AA were observed to have a significant association with HLA B21 (OR 18.850, 95% CI 4.404-80.677), B40 (OR 6.767, 95% CI 1.818-25.181), and HLA B12 (OR 4.833, 95% CI 1.198-19.505) antigens. These findings differed from those reported elsewhere.

Matched MeSH terms: Alopecia Areata/complications; Alopecia Areata/genetics*; Alopecia Areata/immunology*
Fulltext Effects of tocotrienol supplementation on hair growth in human volunteers

Beoy LA, Woei WJ, Hay YK

Trop Life Sci Res, 2010 Dec;21(2):91-9.
PMID: 24575202 MyJurnal

Studies have shown an association between oxidative stress and alopecia. Patients with alopecia generally exhibit lower levels of antioxidants in their scalp area as well as a higher lipid peroxidation index. Tocotrienols belong to the vitamin E family and are known to be potent antioxidants. Hence, a study was conducted to investigate the effect of tocotrienol supplementation on hair growth in volunteers suffering from hair loss. Twenty one volunteers were randomly assigned to orally receive 100 mg of mixed tocotrienols daily while 17 volunteers were assigned to receive placebo capsule orally. The volunteers were monitored for the number of hairs in a pre-determined scalp area as well as the weight of 20 strands of 1 cm length hair clippings at 0 (before supplementation), 4 and 8 months. The number of hairs of the volunteers in the tocotrienol supplementation group increased significantly as compared to the placebo group, with the former recording a 34.5% increase at the end of the 8-month supplementation as compared to a 0.1% decrease for the latter. Nevertheless, the cumulative weight of 20 strands of hair clippings did not differ much from the baseline for both supplementation groups at the end of the study period. In conclusion, this trial demonstrated that supplementation with tocotrienol capsules increases hair number in volunteers suffering from hair loss as compared to the placebo group. This observed effect was most likely to be due to the antioxidant activity of tocotrienols that helped to reduce lipid peroxidation and oxidative stress in the scalp, which are reported to be associated with alopecia.

Matched MeSH terms: Alopecia
Fulltext Scales on the scalp

Adawiyah J, Leelavathi M

Malays Fam Physician, 2013;8(1):48-49.
PMID: 25606270 MyJurnal

A five-year-old boy presented with a six-week history of scales, flaking and crusting of the scalp. He had mild pruritus but no pain. He did not have a history of atopy and there were no pets at home. Examination of the scalp showed thick, yellowish dry crusts on the vertex and parietal areas and the hair was adhered to the scalp in clumps. There was non-scarring alopecia and mild erythema. There was no cervical or occipital lymphadenopathy. The patient’s nails and skin in other parts of the body were normal.

Matched MeSH terms: Alopecia
Cisplatin and vinorelbine in the treatment of locally advanced and metastatic non-small cell lung cancer

Wong CMM, Lim KH, Liam CK

JUMMEC, 2001;6:20-23.

From August 1999 to January 2001, twelve chemotherapy naive patients with locally advanced and metastatic non-small cell lung cancer (NSCLC) in our hospital received vinorelbine and cisplatin. Ten patients had stage IV disease while two had stage HI disease. Patients' performance status (PS) were as follows: four had PS 1, six had PS 2, and one each PS 3 and 4. A total of 46 cycles were given as scheduled. Only major haematological toxicities were noted; one patient each with Grade 3 anaemia, Grade 3 and Grade 4 leucopenia, two had Grade 3 neutropenia and 5 had Grade 4 neutropenia without associated mortality. Three patients had Grade 3 alopecia and one had Grade 3 phlebitis. After three cycles, three patients demonstrated partial response and two had stable disease. For the four patients who completed 6 cycles, two demonstrated stable disease and two partial response. Symptom improvement was reported in all but one patient. Performance status was better in four, stable in six but declined in two patients. In conclusion, in patients with locally advanced and metastatic NSCLC, vinorelbine/cisplatin is a well-tolerated and active regimen, offering symptom palliation and improved performance status in a significant proportion of patients. KEYWORDS; Vinorelbine, lung cancer, chemotherapy.

Matched MeSH terms: Alopecia
Efficacy and safety of diphenylcyclopropenone among Chinese patients with steroid resistant and extensive alopecia areata

Luk NM, Chiu LS, Lee KC, Chau CT, Lee VW, Chang M, et al.

J Eur Acad Dermatol Venereol, 2013 Mar;27(3):e400-5.
PMID: 23057682 DOI: 10.1111/jdv.12009

BACKGROUND: Topical immunotherapy has recently been found useful in the treatment of chronic and extensive Alopecia Areata (AA).
OBJECTIVE: To evaluate the efficacy and safety of diphenylcyclopropenone (DPCP) use among Chinese patients with steroid resistant and extensive AA in our institute.
METHODS: The medical records of 31 Chinese patients treated with DPCP were analysed retrospectively. The efficacy, adverse effects, and relapse rate of DPCP treatment were reviewed.
RESULTS: Thirty-one (16 male, 15 female) Chinese patients with extensive, steroid resistant Alopecia Areata and a mean age of 28.9 years (SE 10.4) were treated. The mean age of onset was 17.8 years (SE 8.8) with an average disease duration of 11.2 years (SE 7.7). Ten patients had a history of atopy and 4 had a history of thyroid disease. Nail changes were found in 14 patients and a family history of AA was found in 2 patients. Thirteen patients (41.9%) had experienced total hair loss. Two patients abandoned the treatment due to severe side effects. Of the remaining 29 patients, 4 (13.8%), 7 (24.1%), 5 (17.2%), and 13 (44.8%) achieved >90% complete response, >50-90% partial response, >10-50% minimal response, and <10% no response hair regrowth, respectively. Adverse effects included pruritus, erythema, vesiculation, scaling, cervical lymphadenopathy, dyspigmentation and urticarial reactions. Relapse occurred (>25% hair loss) in 69.23% of patients after 18 months of follow up.
CONCLUSIONS: DPCP is an effective and tolerable treatment for Chinese patients with extensive, steroid resistant AA.

Matched MeSH terms: Alopecia Areata/drug therapy*
Fulltext Non-ionizing radiation exposure causing ill-health and alopecia areata

Isa AR, Noor M

Med J Malaysia, 1991 Sep;46(3):235-8.
PMID: 1839918

Three cases of occupational exposure to radio-frequency and microwave radiation were seen at the out-patient clinic, Hospital Universiti Sains Malaysia. They presented with run-down symptoms of neck strain associated with throbbing headache, irritability, loss of appetite, fatigue, memory difficulties, and numbness of extremities. They also presented with alopecia areata which is felt to be causally linked to the radiation exposure.

Study site: Outpatient clinic Hospital Universiti Sains Malaysia (HUSM)

Matched MeSH terms: Alopecia Areata/etiology*
Hidrotic ectodermal dysplasia: study of a large Chinese pedigree

Rajagopalan K, Tay CH

Arch Dermatol, 1977 Apr;113(4):481-5.
PMID: 139851

Hidrotic ectodermaldysplasia was found, to our knowledge, for the first time in a Chinese family in Malaysia, and it affected 15 members in five generations. The disease, which is transmitted as a non-sex-linked autosomal dominant trait, presumably originated from southern China. All 15 members had the typical nail, hair, and skin lesions, and we observed three different types of nail defects. Scalp alopeica was more extensive in the female members while keratoderma of the palms and soles was more notable in the male members. The nail and skin lesions also became severer with age. Except for the infectious eczematoid dermatitis present in the propositus, none had other skin or systemic disorders. All were relatively healthy and had normal life expectancies;

Matched MeSH terms: Alopecia/genetics
Infantile vitiligo and alopecia in immunodysregulation polyendocrinopathy enteropathy X-linked syndrome

Lee WQ, Leong KF

Pediatr Dermatol, 2023;40(5):886-889.
PMID: 36727435 DOI: 10.1111/pde.15266

Immune dysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) is characterized by failure to thrive, severe chronic diarrhea, neonatal type 1 diabetes or thyroiditis, and eczematous dermatitis. We report a patient with infantile onset IPEX syndrome who developed vitiligo, alopecia, and chronic diarrhea. Awaiting stem cell transplant, he had multiple episodes of sepsis and succumbed at the age of 10 months. The constellation of symptoms is important to prompt clinicians to suspect this rare syndrome as early hematopoietic stem cell transplantation is the only cure for IPEX patients.

Matched MeSH terms: Alopecia/genetics
Association of HLA class II antigens with clinical manifestations in malays with systemic lupus erythematosus

Yahya NK, Afzal N, Daud KM

International Medical Journal (Tokyo), 2009;16(1):3-7.

Objectives: To evaluate the frequency of HLA Class II antigens in Malays with SLE in order to determine their role in disease susceptibility and association with clinical manifestations.
Design: Cross-sectional study
Methods: Fifty-four SLE patients from Malay ethnic attending Physician Clinic at Hospital Universiti Sains Malaysia were enrolled into the study. Demographic and clinical findings were obtained from medical records. HLA typing of class II antigens were carried out using MicroSSP Class II generic (DRB/ DQB) from One Lambda Inc. Controls were from ethnically matched healthy individuals.
Results: A univariate analysis confirmed the association between HLA-DR15 with SLE compared to healthy control group; and was maintained using multiple logistic regression model (P corr = 0.002, adjusted OR = 5.513). There was a weak decrease of HLA-DR4 which was not significant after corrections for multiple comparisons made. DR7 was found to be significantly increased in patients with malar rash. There was positive association of DR15 with arthritis in patients compare to those without.
Conclusion: Our data support the role of HLA Class II genes in conferring SLE susceptibility.
Study site: Physician Clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia

Matched MeSH terms: Alopecia
Fulltext In Vitro Performance of Dutasteride-Nanostructured Lipid Carriers Coated with Lauric Acid-Chitosan Oligomer for Dermal Delivery

Noor NM, Abdul-Aziz A, Sheikh K, Somavarapu S, Taylor KMG

Pharmaceutics, 2020 Oct 20;12(10).
PMID: 33092119 DOI: 10.3390/pharmaceutics12100994

Dutasteride, licensed as an oral medicine for the treatment of benign prostatic hypoplasia, has been investigated as a treatment for androgenic alopecia. In this study, the potential for dustasteride to be delivered topically in order to reduce systemic exposure, irritation of the skin, and also cytotoxicity was explored. Chitosan oligomer (CSO) was successfully synthesised with lauric acid as a coating for a dutasteride-loaded nanostructured lipid carriers (DST-NLCs) system. DST-NLCs were prepared using a combination of melt-dispersion and ultrasonication. These negatively charged NLCs (-18.0 mV) had a mean particle size of ~184 nm, which was not significantly increased (p > 0.05) when coated with lauric acid-chitosan oligomer (CSO-LA), whilst the surface charge changed to positive (+24.8 mV). The entrapment efficiency of DST-NLCs was 97%, and coated and uncoated preparations were physically stable for up to 180 days at 4-8 °C. The drug release was slower from DST-NLCs coated with CSO-LA than from uncoated NLCs, with no detectable drug permeation through full-thickness pig ear skin from either preparation. Considering the cytotoxicity, the IC50 values for the DST-NLCs, coated and uncoated with CSO-LA were greater than for dutasteride alone (p < 0.05). DST-NLCs and empty NLCs coated with CSO-LA at 25 µM increased the cell proliferation compared to the control, and no skin irritation was observed when the DST-NLC formulations were tested using EpiDerm™. The cell and skin uptake studies of coated and uncoated NLCs incorporating the fluorescent marker Coumarin-6 showed the time-dependent uptake of Coumarin-6. Overall, the findings suggest that DST-NLCs coated with CSO-LA represent a promising formulation strategy for dutasteride delivery for the treatment of androgenic alopecia, with a reduced cytotoxicity compared to that of the drug alone and lower irritancy than an ethanolic solution of dutasteride.

Matched MeSH terms: Alopecia
Fulltext Shrinking lung syndrome – a rare cause of recurrent dyspnoea in SLE

Baharuddin H, Mohd Zim MA, Rosman A, Mohd Zain M

Journal of Clinical and Health Sciences, 2017;2(1):35-38.

Here we present a 24-year-old lady with systemic lupus erythematosus (SLE) whom we diagnosed with shrinking lung syndrome (SLS), a rare manifestation of SLE. The initial SLE manifestation was alopecia, thrombocytopenia, serositis and vasculitis. Anti-nuclear antibody (ANA), anti-double stranded DNA (dsDNA) antibody, anti-ribonucleic (RNP) and anti-Ro antibody were positive. A year after diagnosis, she started to develop intermittent dyspnea and was hospitalised on three occasions. Lung examinations revealed reduced breath sounds at both bases and dullness at the right base. Multiple chest radiographs showed bilateral raised hemi-diaphragms. Other investigations including CT pulmonary angiogram, high resolution CT of the thorax, ventilation-perfusion scan and echocardiogram were not significant. On the third hospital admission, we noticed bilateral small lung volumes in the previous high resolution CT scan. Inspiratory and expiratory chest radiographs were performed and showed minimal change in lung volumes and a diagnosis of shrinking lung syndrome (SLS) was made. Her SLE remained active with lupus nephritis despite multiple immunosuppression and she passed away two years later due to sepsis with multi-organ failure.

Matched MeSH terms: Alopecia
Fulltext Foot problem and Foot care practices among diabetic patients in a primary care clinic, Kuala Lumpur

Nurjasmine Aida Jamani, Noor Azimah Muhammad, Aida Jaffar, Saharuddin Ahmad, Noorlaili Tohit

International Journal of Allied Health Sciences, 2018;2(3):435-444.
MyJurnal

Foot problems are very common in diabetic patients but may go unnoticed by the patients and
undiagnosed by the healthcare providers leading to substantial morbidity and amputations. The aims of this study were to assess patient’s foot care practices, awareness on their foot condition as well as to determine the prevalence of diabetic foot problem and its associated factors. Methods: This was a cross sectional study conducted among diabetic patients in a primary care clinic in Kuala Lumpur. Patients with diabetes, aged more than 18 years were selected using systematic random sampling technique. Patients were requested to answer a set of self-administered pre-tested questionnaire that obtain information on their socio-demographic profiles, diabetic clinical data, awareness on their feet condition and foot care practice. A trained clinician examined patients’ feet using a standard foot examination protocol. Results: A total of 166 patients with diabetes participated in this study. Nearly half of the patients (70, 42.2%) had diabetic foot problem but only 31 (18.7%) of them were aware of their foot condition. The three common problem were trophic changes of the skin (92.8%), followed with hair loss (71.1%) and callosity (65.7%). The independent associated factors for foot problem were increasing age (AOR=1.05, 95% CI 1.015-1.095; p

Matched MeSH terms: Alopecia
Fulltext Cat's curse: a case of misdiagnosed kerion

Mazlim M, Muthupalaniappen L

Malays Fam Physician, 2012;7(2-3):35-8.
PMID: 25606254 MyJurnal

Kerion is an inflammatory type of tinea capitis which can be mistaken for bacterial infection or folliculitis as both conditions display similar clinical features. It occurs most frequently in prepubescent children and rarely in adults. We report a 26-year-old woman who presented with multiple tender inflammed nodules on her scalp. Her condition was misdiagnosed as bacterial abscess and treated with multiple courses of antibiotics without improvement. Later, her condition was re-diagnosed as kerion based on clinical appearance, history of contact with infected animal and Wood's lamp examination. symptoms and lesions resolved completely with systemic antifungal treatment leaving residual scarring alopecia. The delay in the diagnosis and treatment of this patient resulted in permanent scarring alopecia.

Matched MeSH terms: Alopecia
Fulltext The efficacy and tolerability of scalp cooling in preventing chemotherapy-induced alopecia in patients with breast cancer receiving anthracycline and taxane-based chemotherapy in an Asian setting

Saad M, Chong FLT, Bustam AZ, Ho GF, Malik RA, Ishak WZW, et al.

Indian J Cancer, 2019 1 4;55(2):157-161.
PMID: 30604728 DOI: 10.4103/ijc.IJC_581_17

BACKGROUND: Scalp cooling has been shown in several studies to be an effective method in preventing chemotherapy-induced alopecia (CIA). Data on the use of scalp cooling in Asian countries are limited, and evidence for its use and efficacy among our patients are not available.
OBJECTIVE: The aim of this study was to assess the effectiveness and tolerability of scalp cooling among breast cancer patients in our study population.
METHODS: Consecutive breast cancer patients receiving FE75C, FE100C, FE100C-D, docetaxel75 or docetaxel, and cyclophosphamide (TC) at our treatment center were recruited and allocated to the treatment (scalp cooling, DigniCapTM system) or control group in this prospective nonrandomized controlled study. The assessment of alopecia was carried out using the World Health Organization grading system and clinical photographs.
RESULTS: Seventy patients were recruited, but only 25 completed the study and were evaluable for analysis. Five of 12 patients (42%) in the scalp cooling group managed to preserve hair. Two of three patients who received FE75C and TC regimens had minimal hair loss. All patients treated with FE100C had severe hair loss. Half of all patients who received scalp cooling throughout chemotherapy rated the treatment as reasonably well tolerated. The most common reason for discontinuing scalp cooling was intolerance to its side effects.
CONCLUSION: Scalp cooling is potentially effective in reducing CIA caused by docetaxel, TC, and FE75C chemotherapy regimen. However, it was not well tolerated by our study population. The dropout rate was high, and this needs to be taken into consideration when pursuing further trials in a similar setting.

Matched MeSH terms: Alopecia/therapy*
Fulltext Dental derived stem cell conditioned media for hair growth stimulation

Gunawardena TNA, Masoudian Z, Rahman MT, Ramasamy TS, Ramanathan A, Abu Kasim NH

PLoS One, 2019;14(5):e0216003.
PMID: 31042749 DOI: 10.1371/journal.pone.0216003

Alopecia is a clinical condition caused by excessive hair loss which may result in baldness, the causes of which still remain elusive. Conditioned media (CM) from stem cells shows promise in regenerative medicine. Our aim was to evaluate the potential CM of dental pulp stem cells obtained from human deciduous teeth (SHED-CM) to stimulate hair growth under in vitro and in vivo conditions. SHED and hair follicle stem cells (HFSCs) (n = 3) were cultured in media combinations; i) STK2, ii) DMEM-KO+10% FBS, iii) STK2+2% FBS and profiled for the presence of positive hair growth-regulatory paracrine factors; SDF-1, HGF, VEGF-A, PDGF-BB and negative hair growth-regulatory paracrine factors; IL-1α, IL-1β, TGF-β, bFGF, TNF-α, and BDNF. The potential of CM from both cell sources to stimulate hair growth was evaluated based on the paracrine profile and measured dynamics of hair growth under in vitro conditions. The administration of CM media to telogen-staged synchronized 7-week old C3H/HeN female mice was carried out to study the potential of the CM to stimulate hair growth in vivo. SHED and HFSCs cultured in STK2 based media showed a shorter population doubling time, higher viability and better maintenance of MSC characteristics in comparison to cells cultured in DMEM-KO media. STK2 based CM contained only two negative hair growth-regulatory factors; TNF-α, IL-1 while DMEM-KO CM contained all negative hair growth-regulatory factors. The in vitro study confirmed that treatment with STK2 based media CM from passage 3 SHED and HFSCs resulted in a significantly higher number of anagen-staged hair follicles (p<0.05) and a significantly lower number of telogen-staged hair follicles (p<0.05). Administration of SHED-CM to C3H/HeN mice resulted in a significantly faster stimulation of hair growth in comparison to HFSC-CM (p<0.05), while the duration taken for complete hair coverage was similar for both CM sources. Thus, SHED-CM carries the potential to stimulate hair growth which can be used as a treatment tool for alopecia.

Matched MeSH terms: Alopecia/therapy*

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