The objective of this open label study is to determine the effectiveness of Serenoa repens in treating male androgenetic alopecia (AGA), by comparing its results with finasteride. For this purpose, we enrolled 100 male patients with clinically diagnosed mild to moderate AGA. One group received Serenoa repens 320 mg every day for 24 months, while the other received finasteride 1 mg every day for the same period. In order to assess the efficacy of the treatments, a score index based on the comparison of the global photos taken at the beginning (TO) and at the end (T24) of the treatment, was used. The results showed that only 38% of patients treated with Serenoa repens had an increase in hair growth, while 68% of those treated with finasteride noted an improvement. Moreover finasteride was more effective for more than half of the patients (33 of 50, i.e, 66%), with level II and III alopecia. We can summarize our results by observing that Serenoa repens could lead to an improvement of androgenetic alopecia, while finasteride confirmed its efficacy. We also clinically observed, that finasteride acts in both the front area and the vertex, while Serenoa repens prevalently in the vertex. Obviously other studies will be necessary to clarify the mechanisms that cause the different responses of these two treatments.Androgenetic alopecia (AGA) is a common form of scalp hair loss that affects up to 80% of elderly males (mostly over 60 years old). The onset ofAGA is extremely variable and the physical aspect is characterized by progressive miniaturization of scalp hair follicles (1, 2). Even though this condition is not considered a serious pathology, it is well known that loss of hair leads to stressful events for patients, often with considerable psychosocial consequences. Genetic factors and androgens playa major role in the pathogenesis of the disease. Polymorphism of the androgen receptor genes was first identified in association with androgenetic alopecia. These facts lead to different kinds of AGA patterns that often occur in members of the same families.Anamnesis and clinical examination can lead to the correct diagnosis of AGA, as well as a dermoscopy that can evidence the beginning of the miniaturization of the scalp hair follicles. The presence of more than 20% vellus-like hair in the androgen dependent areas can also lead to diagnosis of initial AGA (3-6).Minoxidil and finasteride are commonly used in treating AGA, both of which have FDA approval; dutasteride, a type I and II 5-alpha-reductase inhibitor, should also be considered and is currently in Phase
In literature many different therapies are proposed to treat Monilethrix, but a definitive therapy still doe not exist. We decided to treat four patients affected by Monilethrix, with topical minoxidil 2%, 1 ml night and day for 1 year. Minoxidil led to a an increase of normal hair shaft without any side effects in all the patients. Therefore topical minoxidil 2% could be considered a good therapy to treat Monilethrix.
Systemic non-Hodgkin lymphomas are often accompanied by cutaneous manifestations, which are not always looked out for. Nevertheless, these alterations can be very important because their presence is lied to the clinical behaviour of the underlying malignancy, with an early recognition being fundamental. The aim of this study was to make order in this topic and propose a preliminary classification of the cutaneous manifestations associated with non-Hodgkin lymphomas. We performed a retrospective chart review of 62 haematological patients affected by non-Hodgkin systemic lymphomas with dermatological manifestations, who were evaluated from January 2007 to December 2011, and combined these results with a systematic review of Pub medical literature from 1937 to 2011 on this topic. A preliminary classification of these manifestations has been proposed, dividing them in specific and non-specific ones, along with a description of the clinical features and those cases observed in our department. A preliminary approach has been proposed for the study of these manifestations that could be helpful in understanding the biological behaviour and aid early recognition of a flare up in systemic non-Hodgkin lymphomas.
Frontal fibrosing alopecia (FFA) and lichen planopilaris (LPP) are classified as scarring alopecia. Most authors consider FFA as a clinical variant of LPP on the basis of their similar histological findings; other authors think these pathologies are two different entities. We studied 48 cases of FFA and 86 cases of LPP. Clinical diagnosis was histologically confirmed and all patients underwent videodermoscopy. Moreover, histological study, identifying the main targets of these diseases, results helpful to confirm the diagnosis. FFA selectively affects vellus-Iike hair in the frontoparietal region and is characterized by a mild skin atrophy and a total loss of follicular openings. In LPP an involvement of total preterminal, terminal and veilus-like follicles, partial or total loss of follicular openings, diffuse hair thinning and twisting, perifollicular erythematous or violaceous papules and mild/severe spinous follicular hyperkeratosis with scalp sclerosis are the features observed. Videodermoscopy improves diagnostic capability, appearing to be helpful to underline FFA and LPP features, confirmed by histologic studies which identify and show different intensity of inflammatory process. Therefore, the two diseases could be considered two different entities on the basis ofthe different clinical features and the different targets, that can be related to a different pathogenetic mechanism.Lichen planopilaris is an uncommon inflammatory hair loss disease, characterized by autoreactive lymphocytic destruction of hair follicle and progressive scarring alopecia of the scalp. Clinical signs are commonly perifollicular erythema, scaling, and groups of keratotic follicular papules.Frontal fibrosing alopecia is a rather uncommon form of cicatricial alopecia originally described by Kossard in 1994, that usually occurs in fecund, postmenopausal and older women and men (1-4). The progressive recession of the frontal and parietal hairline is the most constant and characteristic clinical manifestations with skin atrophy and follicular or perifollicular erythema. We would like to underline how videodermoscopy enables dermatologists to view the scalp or skin surface at a rapid and high resolution and leads to digital recording the viewed images, considered also useful for patient follow-up. MATER1ALS AND METHODSThis is a retrospective study. From 2003 until
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