Development of the alopecia areata scale for clinical use: Results of an academic–industry collaborative effort

King, Brett; Mesinkovska, Natasha Atanaskova; Craiglow, Brittany G.; Kindred, Chesahna; Ko, Justin; McMichael, Amy J.; Shapiro, Jerry; Goh, Carolyn; Mirmirani, Paradi; Tosti, Antonella; Hordinsky, Maria; Huang, Kathie P.; Castelo‐Soccio, Leslie; Bergfeld, Wilma F.; Paller, Amy S.; Mackay‐Wiggan, Julian; Glashofer, Marc; Aguh, Crystal; Piliang, Melissa; Yazdan, Pedram; Sicco, Kristen Lo; Cassella, James V.; Koenigsberg, Justine; Ahluwalia, Gurpreet S.; Ghorayeb, Eric; Fakharzadeh, Steven; Napatalung, Lynne; Gandhi, Kavita; DeLozier, Amy M.; Nunes, Fabio P.; Senna, Maryanne M.

doi:10.1016/j.jaad.2021.08.043

Cited by 40 publications

(38 citation statements)

References 17 publications

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“…The Brazilian AA consensus proposes evaluating severity with the following scale: mild AA: 20% or less scalp hair loss; moderate AA 21–49% scalp hair loss; and severe AA 50–100% scalp hair loss [ 52 ]. A mild or moderate severity rating increases to the next level if any of the following are present: negative impact on psychosocial functioning, noticeable involvement of eyebrows or eyelashes, inadequate response after 6 months of treatment, diffuse (multifocal) positive hair pull test consistent with rapidly progressive AA [ 52 ]. Implementing this severity scale could provide substantial benefits for treatment decisions and disease monitoring.…”

Section: Resultsmentioning

confidence: 99%

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Alopecia Areata in Latin America: Where are We and Where are We Going?

Velásquez‐Lopera

Mantilla

Jansen³

et al. 2022

Dermatol Ther (Heidelb)

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Alopecia areata (AA) represents an underrecognized burden in Latin America (LA), severely impacting quality of life (QoL). This impact is exacerbated by limited access to specialized dermatologic care and therapies for AA within and among nations. Many of the unmet needs for AA globally also exist in LA. The region has geographic, ethnic, cultural, and economic conditions. With new AA medicines targeting immunologic pathways on the horizon, LA must prepare regarding regulatory issues, reimbursement, awareness, and education to give adequate and timely treatment for patients with AA. To address these issues, the Americas Health Foundation convened a panel of six dermatologists from Argentina, Brazil, Colombia, and Mexico who are experts in AA and its comorbidities for a 3-day virtual meeting to discuss AA diagnosis and treatment in LA and create a manuscript offering recommendations to address discussed barriers. This publication examines unmet AA needs in LA, treatment, and innovative therapies and recommends improving AA care. Access constraints to conventional and novel medicines hinder appropriate treatments for patients. Therapy initiation delays can affect QoL, mental health, and disease progression. People with AA face stigmas, discrimination, and misconceptions owing to a lack of disease awareness. With promising new treatments for AA on the horizon, all stakeholders must coordinate efforts to enhance LA’s AA management landscape and improve patient outcomes.

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Section: Resultsmentioning

confidence: 99%

“…Since reviews have failed to identify a therapy supported by robust evidence, treatments are based on expert opinion or consensus [ 2 ]. This might soon change, given several ongoing clinical trials evaluating different therapies, including biologics and small molecules [ 52 , 54 – 57 ].…”

Section: Resultsmentioning

confidence: 99%

Alopecia Areata in Latin America: Where are We and Where are We Going?

Velásquez‐Lopera

Mantilla

Jansen³

et al. 2022

Dermatol Ther (Heidelb)

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“…Specifically, there is increasing awareness that a classical, autoantigen-and CD8+ T cell-dependent autoimmune variant of AA (AAA) and a possibly autoantigenindependent non-autoimmune variant (NAIAA) may have to be distinguished from each other (Gilhar et al, 2019a;Bertolini et al, 2020;Paus et al, 2020). This is in line with the long-standing, but often under-appreciated clinical recognition that AA shows a wide spectrum of phenotypes and sub-forms Ikeda et al, 1965;Meah et al, 2021;King et al, 2022).…”

Section: Introductionmentioning

confidence: 91%

Involvement of ILC1-like innate lymphocytes in human autoimmunity, lessons from alopecia areata

Britva

Keren

Bertolini

et al. 2022

Preprint

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Here, we have explored the involvement of innate lymphoid cells-type 1 (ILC1) in the pathogenesis of alopecia areata (AA), because we found them to be significantly increased around lesional and non-lesional HFs of AA patients. To further explore these unexpected findings, we first co-cultured autologous circulating ILC1-like cells (ILC1lc) with healthy, but stressed, organ-cultured human scalp hair follicles (HFs). ILClc induced all hallmarks of AA ex vivo: they significantly promoted premature, apoptosis-driven HF regression (catagen), HF cytotoxicity/dystrophy and most important for AA pathogenesis, collapse of the HFs physiological immune privilege. NKG2D-blocking or IFNγ-neutralizing antibodies antagonized this. In vivo, intradermal injection of autologous activated, NKG2D+/IFNγ-secreting ILC1lc into healthy human scalp skin xenotransplanted onto SCID/beige mice sufficed to rapidly induce characteristic AA lesions. This provides the first evidence that ILC1lc suffice to induce AA in previously healthy human HFs ex vivo and in vivo, and further questions the conventional wisdom that AA is always an autoantigen-dependent, CD8+ T cell-driven autoimmune disease.

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“…The patient had a Severity of Alopecia Tool (SALT) score of 100, 11 or severe alopecia per the new alopecia severity assessment. 12 She noted that she had previously received treatment for her AA over a decade earlier with topical steroids, intralesional triamcinolone acetonide, methotrexate, and diphenylcyclopropenone with no benefit but had not been on any treatment in recent years. The patient was on no medications.…”

Section: Case Reportmentioning

confidence: 99%

Hydroxychloroquine for granuloma annulare: A case report on secondary hair growth in alopecia universalis

Osman

Traboulsi

2023

SAGE Open Medical Case Reports

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Alopecia areata is an autoimmune disease resulting in non-scarring hair loss. Alopecia areata can progress to become alopecia totalis (loss of hair from the entire scalp) or alopecia universalis (loss of hair form the entire body), with the progression estimated to range from 7% to 30%. There are no universally proven therapies that both induce and sustain remission, and furthermore, the course of alopecia areata tends to be unpredictable, with ~80% of patients achieving spontaneous remission within 1 year. We herein present the case of a 61-year-old female who presented with a 20-year history of alopecia universalis, and biopsy confirmed widespread granuloma annulare. Hydroxychloroquine was initiated to treat her granuloma annulare, with subsequent significant hair regrowth on her scalp, eyebrows, eyelashes, and arms. A review of the literature is presented showing that hydroxychloroquine has variable success in treatment of alopecia areata, alopecia totalis, and alopecia universalis.

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Development of the alopecia areata scale for clinical use: Results of an academic–industry collaborative effort

Cited by 40 publications

References 17 publications

Alopecia Areata in Latin America: Where are We and Where are We Going?

Alopecia Areata in Latin America: Where are We and Where are We Going?

Involvement of ILC1-like innate lymphocytes in human autoimmunity, lessons from alopecia areata

Hydroxychloroquine for granuloma annulare: A case report on secondary hair growth in alopecia universalis

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