No abstract

Alopecia areata (AA) is a dermatologic disease whose onset is significantly associated to life events. Its course may often be characterized by high levels of anxiety and depression. These observations suggested a rationale for using an antidepressant in AA. Thirteen patients were enrolled in a double-blind, placebo-controlled study of efficacy of imipramine in alopecia. After six months clinically significant hair regrowth occurred in 5 of the 7 patients on imipramine, whereas no response was observed in the placebo group. An improvement in psychic symptomatology was present in both groups. Our preliminary results indicate the potential efficacy of imipramine in patients with AA, not acting directly through a reduction of anxiety or depression.

Stress-responsive neurohormonal systems are involved in major depression (MD) and panic disorder (PD). The immune system, which is closely connected with neuronal and hormonal systems, has been studied in MD: a systemic immune activation has been recently reported. To determine whether similar changes in the immune function are present also in PD, we studied leukocyte enumeration by flow cytometry in conjunction with monoclonal antibody staining, in 18 PD, 23 MD in drug-free conditions and 20 controls. We found a significantly higher percentage of HLADR+(p<0.001) and of CD19 cells (p<0.01) in PD and MD and a lower percentage of CD3 (p<0.05) in PD. Urinary free cortisol levels were higher in MD compared to PD. A pattern of lymphocyte subpopulation distribution compatible with an activation of the immune system was found in MD and PD. This activation was present also with high glucocorticoid levels, suggesting a possible defect of glucocorticoid receptors