中国六城市斑秃患病率调查

目的 通过多地区人群调查获得我国斑秃患病率等基本数据.方法 采用整群抽样调查方法,统一设计调查表,在我国6个省各选一个城市进行社区人口斑秃流行病学调查.结果 共调查19 974人,收回有效问卷17 345份,应答率为86.84%.发现斑秃患者47例,总患病率为0.27%,标化患病率为0.24%.男性患病率为0.38%,女性患病率为0.18%,男性显著高于女性(X2=6.53,P<0.05).在47例斑秃患者中,脱发面积<1/3头皮面积者占70.21%,>1/3占29.79%,全秃占2.13%,普秃占2.13%;有阳性家族史者8.51%.太原地区斑秃患病率为0.45%,西昌为0.33%,廊坊为0.28%,焦作为0.22%,淄博为0.17%,海拉尔为0.19%,各地区患病率差异无统计学意义(P>0.05).结论 中国6城市斑秃患病率为0.27%.男性患病率显著高于女性.     

斑秃患者外周血Th17细胞的检测北大核心CSCD

目的 分析Th17细胞与斑秃病程、病情等的关系.方法 分别抽取斑秃组和健康对照组的外周血,流式细胞仪检测Th17细胞的比例,用SPSS16.0进行统计分析.结果 斑秃组60例外周血中Th17细胞占CD4＋T细胞的比例（1.33％±0.74％）显著高于30例健康对照组（0.91％±0.54％,P＜ 0.01）.初发斑秃患者Th17细胞比例显著高于复发患者（P＜0.05）,活动期高于非活动期（P＜0.05）,病程≤6个月者高于病程＞6个月者（P＜0.01）,而头皮脱发面积≤50％者与脱发面积＞50％及全秃和普秃者比较差异无统计学意义.结论 外周血Th17细胞的水平与斑秃活动性、疾病复发及病程有关.     

中国六省市白癜风流行病学调查

目的 通过多地区、大样本流行病学调查,获得中国白癜风患病情况的基本资料.方法 在我国6个省、自治区中各选择1个城市作为调查点,采取整群抽样方法.所有被调查者填写问卷和接受皮肤科医师检查.调查数据录入EpiData数据库,运用SPSS 13.0软件进行统计学分析.结果 共抽样调查19 974例,有效问卷17 345份,应答率86.84%.发现白癜风患者122例,总患病率0.70%,标化患病率为0.56%.其中男性患者75例,患病率为0.95%,标化患病率为O.69%,女性患者47例,患病率为0.50%,标化患病率为0.45%.男性患病率较女性高,差异具有统计学意义(P相似文献   

斑秃与精神心理因素关系的探讨

目的:对斑秃患者心理进行调查并作结果分析.方法:采用心理健康症状自评量表(SCL-90),对86例斑秃患者进行问卷调查分析.结果:SCL-90 测评结果显示:斑秃患者在人际关系、焦虑、抑郁和敌对性项的得分明显高于对照组,差异有统计学意义(P<0 05),女性斑秃患者在焦虑项的得分明显高于男性斑秃患者,差异有统计学意义(P<0 05),重型斑秃、全秃和普秃患者在人际关系、焦虑、抑郁的得分明显高于局限型斑秃对照组,差异有统计学意义(P<0 05).结论:斑秃患者存在人际关系、焦虑、抑郁等心理障碍,对斑秃患者进行心理干预治疗是有必要的,特别是重型斑秃、全秃和普秃患者.     

我国6省雄激素性秃发流行病学调查

目的:通过多地区人群调查获得我国雄激素性秃发(AGA)的患病率以及患病类型等数据.方法:采用整群抽样调查方法,在6个省各选择1个城市进行社区人群的流行病学调查.结果:共调查17 886人,收回有效问卷15 257份,应答率为85.3%.AGA总患病率12.8%,其中男性患病率21.3%,女性患病率6.0%显著低于男性(P<0.01).AGA的患病率随着年龄增长而增加.男性秃发混合型最常见,秃发程度Ⅳ级多见.女性秃发Ⅰ级最多见.各地区患病率存在明显差异(P<0.01).26.9%的AGA患者家族史阳性.结论:我国人群AGA总患病率12.8%,显著低于高加索人种,男性AGA患病率是女性的3.5倍.     

四川凉山地区黄褐斑患病率调查

目的探讨凉山地区黄褐斑发病规律及危险因素。方法采用整群抽样调查方式入户调查。结果共调查2756人,发现黄褐斑总患病率13.61%,标化患病率13.42%。男性患病率8.33%,女性患病率17.98%,女性明显高于男性(P0.01)。彝族黄褐斑患病率21.43%,汉族黄褐斑患病率9.76%,彝族显著高于汉族(P0.01)。彝族男性患病率14.18%,汉族5.40%,彝族男性患病率显著高于汉族男性(P0.01);彝族女性患病率为27.53%,汉族13.33%,彝族明显高于汉族(P0.01)。结论凉山地区黄褐斑发病率为13.61%,其中彝族显著高于汉族,女性高于男性。     

口服环孢菌素治疗斑秃:临床和免疫组化分析

环孢菌素(Cy)能抑制可能引起斑秃病理变化的辅助性T细胞的活性.故作者试用Cy治疗6例斑秃(5例男性,1例女性),其中3例普秃,1例全秃和2例为斑片状斑秃.脱发的平均持续时间为8年.Cy用量为6mg/kg/d,疗程12周.疗效判定中对头皮斑秃进行分级,共分6级.治疗前     

内蒙古海拉尔地区雄激素性秃发流行病学调查

目的通过调查了解海拉尔地区雄激素性秃发患病率及影响因素。方法调查采用整群抽样的方法入户进行现场问卷,包括皮肤健康情况调查和秃发两部分。结果共调查2166例,男性患病率22.44%,标化患病率17.93%,女性患病率5.89%,标化患病率4.89%,男性总患病率明显高于女性(P<0.01)。有阳性家族史的男性为31.25%,女性为24.66%。蒙古族发病率(14.49%)与汉族(12.81%)差异无统计学意义(P>0.05)。结论海拉尔地区雄激素性秃发患病率男性明显高于女性,蒙古族患病率与汉族无差异。     

我国10城市学龄前儿童特应性皮炎现况调查

目的了解我国城市1~7岁儿童特应性皮炎(AD)的发病情况。方法对我国不同地区10个城市1~7岁年龄段的儿童进行调查,调查以问卷的方式进行。结果本次调查人口总数49241人。符合AD诊断标准者共1371例,其中男768例,女603例,男性患病率为3.03%,女性患病率为2.53%,总患病率为2.78%。患病率经标化后,总标化患病率为3.07%,其中男性标化患病率为3.86%,女性标化患病率为2.20%,男女标化患病率间差异有显著性(P<0.01)。患病率随年龄增长而呈下降趋势,经相关分析,r=-0.17,P<0.05。10个城市中,患病率以北京最高,沈阳最低。结论2002年10-11月间我国10个城市1～7岁儿童AD的时点患病率经标化后,表现为男性高于女性,且患病率与年龄呈负相关。     

毛发疾病

20043065　儿童斑秃340例调查/曾敬思(华中科技大学同济医学院协和医院皮肤科)…//中华皮肤科杂志.-2004,37(2).-110男女比例为1.09∶1;初发年龄以5～8岁最多,占35.29%,3～4岁,9～12岁次之,1岁以内较少。临床以斑片型多,占79.4%,全秃次之,普秃最少。有家族史者占8.8%,其中I级亲属居多占73.3%。说明与遗传因素有关。学龄儿童中有21例因学习或考核而常处于精神紧张状态。与甲损害的关系尚待进一步探讨。参3　(张孝友)20043066　中西医结合治疗重型斑秃64例/刘军(青海西宁解放军第四医院皮肤科)…//中国中西医结合皮肤性病学杂志.-2004,3(1).-…     

HLA class II alleles in patients with alopecia areata

Our purpose was to determine which HLA class II alleles are associated with Turkish alopecia areata patients. Also we investigated whether there was a relationship between the age of onset and severity of disease and HLA alleles or not. Sixty-five patients with alopecia areata were included in this study, and 50 healthy transplant donors were used as a control group. The total group of alopecia areata patients as well as various subgroups according to scalp hair loss were compared to the control group. HLA DNA typing was performed by polymerase chain reaction/sequence specific primer method. The frequency of DQB1*03 allele was 86.1% in all patients compared to 62.0% in controls (P = 0.005). While the frequency of DQB1*03 was significantly increased, the frequency of DRB1*03 was decreased in the all patients group (4.6% versus 22.0%, P = 0.01). In the group of scalp hair loss less than 25%; the frequency of DRB1*03 was decreased (3.2%, P = 0.02). The group of patients with 25-75% scalp hair loss was compared to control group; the frequencies of DRB1*04 (66.7% versus 28.0%, P = 0.02) was increased. When the alopecia totalis, alopecia universalis or alopecia totalis/alopecia universalis group was compared to control group; DQB1*03 was associated with an increased frequency in this group versus control group (90.9%, P = 0.03). There were no significant differences for the other DQ alleles and the DR alleles tested in the patients and in the controls. When patients with early onset were compared to patients with late onset; no significant allele differences were found. Our findings suggested that DQB1*03 allele is a marker for general susceptibility to alopecia areata and may also serve as special genetic marker for susceptibility for the severe form of alopecia areata in our population. However, this association is not related to age at onset of the disease.     

308-nm Excimer Laser for the Treatment of Alopecia Areata in Children

Abstract:  Alopecia areata (AA) is a common skin disease which is characterized by nonscarring localized or diffused hair loss. In this study we assessed the efficacy of 308-nm Excimer laser in the treatment of alopecia areata in children. A total of 9 children with 30 recalcitrant patches alopecia areata and two children with alopecia areata totalis were enrolled in this study which included seven male and four female patients, aged between 4 and 14 years and the durations of their disease were between 7 and 25 months. All of these patients had more than one lesion of alopecia areata and at least one of them was left as a control for comparison. The lesions were treated with the 308-nm Excimer laser twice a week for a period of 12 weeks. Regrowth of hair was observed in 18 (60%) alopecia patches in the scalp, while there was no response in the control patches and over the extremities. Only four patients with scalp lesions showed a recurrence of alopecia after 6 months post laser therapy. So, 308-nm Excimer laser is considered an effective safe therapeutic option for patchy alopecia areata in children.     

Could azathioprine be considered as a therapeutic alternative in the treatment of alopecia areata? A pilot study

Alopecia areata is an autoimmune disease resulting in partial or total nonscarring hair loss and the treatment of severe alopecia areata is difficult. The aim of this study was to evaluate the efficacy and safety of azathioprine as a systemic monotherapy for moderate to severe alopecia areata. A total of 20 patients [14 men (70%) and six women (30%)] with minimum 6 months history of alopecia areata were included. The extent of scalp hair regrowth during and after the completion of the 6 months treatment was evaluated by the Severity of Alopecia Tool (the SALT score). The daily drug intake was calculated as 2 mg/kg of body weight. Mean duration of current episode of scalp hair loss was 26.4 (26.4 ± 17) months. Mean regrowth percentage was 52.3% (52.3 ± 38.4). Mean hair loss percentage before treatment was 72.7% (72.7 ± 28.3) compared with 33.5% (33.5 ± 30.7) after 6 months of azathioprine treatment. This showed a highly significant statistical difference (Paired t‐test, CI 95% = 21.5–54.1). Mean hair loss score (S₀–S₅) before treatment was 3.9 (3.9 ± 1.6) and after 6 months of azathioprine treatment was 1.8 (1.8 ± 1.3). Assessment showed significant difference from baseline score (sign test, P < 0.0001). No significant statistical difference was observed with respect to gender before and after azathioprine treatment. Treatment with azathioprine as a systemic monotherapy clinically produces relevant improvement in moderate‐to‐severe alopecia areata. Generally azathioprine is a low‐cost and well‐tolerated drug and with controlled studies on larger number of patients, long‐term efficacy and safety of this treatment should be investigated.     

Interleukin-1 receptor antagonist allele 2 and familial alopecia areata

Alopecia areata affects 1%-2% of the population and is hypothesized to be an autoimmune, organ specific T-cell mediated reaction directed against the human hair follicle. It is characterized by loss of hair in patches (alopecia areata) with progression in some individuals to total loss of scalp hair (alopecia totalis) or to loss of all scalp and body hair (alopecia universalis). The interleukin-1 receptor antagonist (IL-1RN) gene was found to be associated with more severe clinical outcome in several chronic inflammatory diseases, including alopecia areata. The IL-1RN*2 allele was found to be associated with alopecia areata severity in a British case-control study. In this paper, we analyzed alopecia areata probands in a family-based sample (n = 131 parent-offspring trios) to study the association between alleles of the IL-1RN and various phenotypes of alopecia areata. In considering all patients with any form of alopecia areata, no association was found with IL-1RN. IL-1RN*2 allele was not associated with alopecia totalis and alopecia universalis. A borderline association was observed between IL-1RN and patchy alopecia areata but it was not statistically significant (p =0.06). We also observed an association between IL1-RN*1 allele and patchy alopecia areata (p =0.045).     

Intravenous pulse methylprednisolone therapy for severe alopecia areata: an open study of 66 patients

INTRODUCTION: Treatment of alopecia areata is a difficult challenge. Some European publications have shown encouraging results with high dose pulse corticosteroid therapy in extensive plurifocal alopecia areata. We undertook a prospective open study between January 2000 and December 2001 using repeated pulse each month, with the aim of identifying the effects of this repetition and underlining the best indications. PATIENTS AND METHODS: Sixty-six patients aged 9 to 60 years old presenting an extensive alopecia areata exceeding 30% of the scalp surface (n=47), alopecia totalis (n=8), alopecia universalis (n=8), ophiasic alopecia (n=3), for less than 12 months entered this study. The administered treatment was methylprednisolone 500 mg/d during 3 days or 5 mg/kg twice per day during 3 days in children. These pulses were repeated after 4 and 8 weeks, then a second series was carried out or not according to cases. The main evaluation criterion was the percentage of new terminal hair appearing on the bald areas, appreciated by clinical and photographic evaluation at 3 and 6 months. RESULTS: Ophiasic alopecia areata did not respond to treatment. A quarter of patients presenting universal alopecia had a good response (higher than 80 p. 100) followed by a relapse in half the cases. Half of the patients presenting alopecia totalis had a good response, which was maintained three times out of four. Multifocal alopecia areata seems the best indication since the patients under study presented a good response in 63.8 p. 100 of cases (78 p. 100 when it was a first episode and 90.5 p. 100 if the treatment had been started in less than 3 months before). The repetition of the pulses did not appear to increase the number of responders. CONCLUSION: This study provides the best indication of pulse methylprednisolone therapy: first recent episode of extensive plurifocal alopecia areata. These results are less convincing in long term history or other forms of alopecia areata.     

Topical 5-fluorouracil is ineffective in the treatment of extensive alopecia areata

We report the results of a pilot study of topical 5% 5-fluorouracil (FU) cream for the treatment of alopecia areata, an immunologically modulated disorder of hair growth. Patients with extensive (>50% scalp surface area involvement) alopecia areata that was refractory to previous treatments applied 5-FU to one side of their scalp twice daily for 3 to 6 months. In all, 9 patients enrolled, and 8 completed the study. No patient experienced measurable hair growth on the treated side. Only mild irritation was observed in a subset of patients with application of 5-FU to the nonphotodamaged scalp skin. Based on these results, we cannot recommend the use of topical 5-FU for treatment of alopecia areata without further evidence of therapeutic benefit.     

Melanocyte-associated T cell epitopes can function as autoantigens for transfer of alopecia areata to human scalp explants on Prkdc(scid) mice

Alopecia areata is a tissue restricted autoimmune condition affecting the hair follicle, resulting in hair loss. The goal of this study was to test the hypothesis that the autoantigen of alopecia areata is melanocyte associated. Potential autoantigens were tested in the human scalp explant/Prkd(scid) CB-17 mouse transfer system. Scalp T cells from lesional (bald) alopecia areata scalp were cultured with antigen-presenting cells, and antigen, along with interleukin-2. The T cells were then injected into autologous lesional scalp grafts on SCID mice, and hair regrowth was measured. Hair follicle homogenate was used as an autoantigen control. T cells cultured with melanoma homogenate induced statistically significant reduction in hair growth (p <0.01 by ANOVA). HLA-A2-restricted melanocyte peptide epitopes were then tested with lesional scalp T cells from HLA-A2-positive alopecia areata patients. Melanocyte-peptide-activated T cells significantly reduced the number of hairs regrowing in two experiments with six patients (p <0.001 by ANOVA). Injected scalp grafts showed histologic and immunochemical changes of alopecia areata. The most consistent peptide autoantigens were the Gp100-derived G9-209 and G9-280 peptides, as well as MART-1 (27-35). Melanocyte peptide epitopes can function as autoantigens for alopecia areata. Multiple peptides were recognized, suggesting epitope spreading.     

Direct immunofluorescence studies in alopecia areata and male pattern alopecia.

Direct immunofluroescence studies were performed on hairy and alopecic areas of scalp in patients with alopecia areata, alopecia totalis and male pattern alopecia. Abnormal deposits of C3 and occasionally of IgG and IgM were found in 92% of 12 patients with alopecia areata and in 21% of patients with male pattern alopecia. No abnormalities were seen in 4 patients with alopecia totalis. In both alopecia areata and male pattern alopecia, the deposits were most common along the basement zone of the inferior segment of hair follicles and occurred with equal frequency in alopecic and normal scalp. These observations suggest that immune factors may play a role in the pathogenesis of alopecia areata.     

PUVA treatment of alopecia areata

Twenty-three patients with alopecia areata were treated with photochemotherapy combining oral or topical methoxsalen and UV-A irradiation of the scalp or of the whole body. Eleven of 17 patients with multiple plaques of alopecia areata, alopecia totalis, and alopecia universalis, who were treated with oral methoxsalen and total body irradiation, had complete or more than 90% hair regrowth. Three patients had a relapse. The mean energy required was 505 joules/sq cm. In six cases, topical applications of methoxsalen or oral methoxsalen combined with local irradiation of the scalp were treatment failures. In the patients responding to treatment, the result did not seem to depend on the age of onset or the extent or duration of disease. However, patients with long-lasting alopecia had a higher risk of recurrence notwithstanding a good initial regrowth of hair. Few side effects of psoralens and UV-A (PUVA) treatment were noted. The mean follow-up period was 18.6 months after the completion of treatment. We discuss the possible mechanisms of action of PUVA in the treatment of alopecia areata.