Background: Androgenetic alopecia (AGA) is a hair loss disorder that frequently affects the male population. Conventional treatment modalities are limited to minoxidil, 5α reductase inhibitors, and hair transplantation procedures. The efficacy of low-level laser therapy (LLLT), also known as photobiomodulation, in the treatment of AGA has been reported, yet little is known about the outcomes of combining photobiomodulation with other conventional therapies. Objective: To evaluate hair growth improvement in males with AGA, during the administration of minoxidil with and without photobiomodulation, using a half-head model. Study Design/Materials and Methods: Twenty-one men with AGA agreed to undergo 12 minutes of low-level laser irradiation (using a modified Capellux ® ), followed by topical minoxidil application (1 ml of 5% solution), to the affected scalp two times per day for 6 months. The photobiomodulation devices were modified such that the left half emitted light, and the right half did not. Efficacy was assessed by blinded analyses of clinical photos and automated phototrichograms (Trichoscan ® ) taken before treatment and after 3 and 6 months of therapy. Results: None of the study participants experienced any adverse events. All patients showed improvements in hair coverage on both sides of the scalp at 3 and 6 months. On the side with combined treatments, the number of total hairs was significantly increased after 3 (P < 0.001) and 6 months (P = 0.001). A similar increase was also observed on the minoxidil-only side, at both 3 (P < 0.001) and 6 months (P < 0.001). No statistically significant differences were detected between sides (P > 0.05). Conclusion: Additional improvement was not observed with the association of photobiomodulation to topical minoxidil in male AGA. Differences from previous studies that might have influenced our result include noncollimated light source, higher dosimetry, and a cohort with darker skin phototype and more severe alopecia. Lasers Surg. Med.

Microbial adherence to epithelial cell surfaces has been implicated as the first step in the initiation of several infectious diseases. The ability of antibiotics to affect the properties of bacterial adherence to cell surfaces may be a criterion in selecting antibiotics for therapy. This study was performed in order to investigate the activity of amoxicillin, chloramphenicol, and clarithromycin in modifying the adhering activity of Bordetella pertussis to human epithelial cells. The actions of antibiotics, alone or combined with aprotinin, were compared with that of trypsin, aprotmin and trypsin + aprotinin, to investigate the chemical nature of the ligand where antibiotics could act. The adhering activity was evaluated on human epithelial cells, collected from the oral mucosa, challenged with B. pertussis A2963 previously incubated in the presence of the tested substances for 1 h at 37° C in a shaker incubator. After staining, the percentage of mucosal cells with more than 50 adhering bacteria was evaluated. Under the described experimental conditions, trypsin significantly reduced the adherence of B. pertussis. Aprotinin had no effect but was able to counteract the inhibitory action of trypsin. Both clarithromycin and chloramphenicol markedly reduced adhering activity and their actions were not counteracted by aprotinin. Amoxicillin was without effect. It was hypothesized that chloramphenicol and clarithromycin, exerting their antimicrobial action by inhibiting bacterial protein synthesis, affected bacterial adhesion through an unknown mechanism without proteolytic effect.

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RESUMO: Contexto: A psoríase pustulosa palmoplantar (PPPP) é uma das apresentações clínicas da psoríase, muitas vezes de difícil tratamento, podendo-se utilizar diversos medicamentos tópicos e sistêmicos. O uso dos anti-TNFα no tratamento das formas pustulosas de psoríase é controverso, visto que a resposta clínica é variável, além desta classe de medicação biológica poder desencadear psoríase pustulosa. Descrição do Caso: Doente feminina, 60 anos, branca, com diagnóstico de PPPP há 12 anos e artrite psoriásica há seis anos. Antecedentes pessoais relevantes: hipertensão arterial sistêmica, hipertrigliceridemia e obesidade. Apresentou refratariedade tanto aos tratamentos tópicos instituídos (corticóides e emolientes) quanto aos sistêmicos (metotrexate, dapsona, colchinina e acitretina), tendo evoluído com excelente resposta terapêutica com etanercepte (administrado semanalmente, por via subcutânea, na dose de 50 mg). Discussão: Os anti-TNFα são eficazes no tratamento da psoríase em placas moderada a grave. Mas, o tratamento da PPPP com anti-TNFα não é classicamente preconizado. Segundo a literatura a resposta terapêutica com este tipo de medicamento é variável na PPPP. Além disso, os anti-TNFα podem desencadear quadro de pustulose palmoplantar. No entanto, há relatos de sucesso terapêutico com anti-TNFα em casos refratários de PPPP. Em função das comorbidades da paciente e após terem sido esgotadas as possibilidades terapêuticas clássicas, optamos pelo uso do etanercepte, que se mostrou eficaz. A doente iniciou tratamento em abril de 2008 e mantém o uso do etanercepte até a presente data, estando em remissão da doença. Conclusão: Destacamos a possibilidade do uso de anti-TNFα em paciente com PPPP refratária ao tratamento convencional. No nosso caso, o etanercepte mostrou-se eficaz e seguro, não tendo a doente apresentado nenhum efeito adverso grave.