斑秃患者临床特征分析研究

目的调查斑秃患者的临床特征,分析影响斑秃病情轻重的相关因素,为临床诊治和预后判定提供依据。方法制作斑秃患者临床及流行病学调查表,通过对患者问诊填写相关项目,总结分析斑秃的临床特征,评价斑秃病情轻重的相关因素。结果283例斑秃患者入组,男性135例(47.70%),女性148例(52.30%),男女比例1︰1.10。发病年龄为9个月～74岁,中位数为29岁。29例S3～S4型斑秃、19例全秃、13例普秃定义为重型斑秃。重型斑秃患者较轻型斑秃患者发病年龄小、首发病情重、复发率高、多伴有家族史(P<0.01)。结论发病年龄小、首发病情严重、有斑秃家族史是重型斑秃的重要临床特征,可作为斑秃预后的评价指针之一。     

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.     

斑秃患者的临床特征-附524例临床、皮肤镜及病理特点

目的:总结斑秃患者临床和实验室特点、皮肤镜征象及病理特点.方法:回顾性分析524例斑秃的临床资料及部分患者血清学检查、皮肤镜特点、病理检查并比较其相关关系.结果:脱发面积与患者的年龄、发病年龄呈明显负相关,与甲改变发生率呈正相关,即脱发面积大的重型患者,其发病年龄较小且伴有甲改变.全、普秃患者血清IgE浓度高于斑片型和弥漫型患者.拉发试验阳性率与皮肤镜下断发、黑点、感叹号发的发生率呈正相关.34.6％的患者皮损中可见毛囊周围或血管周围嗜酸粒细胞浸润,弥漫型斑秃患者嗜酸粒细胞浸润发生率高于斑片型和全、普秃患者.结论:通过皮肤镜征象和病理表现可以进一步了解患者皮损的发展阶段以及监测疾病活动性.     

斑秃患者血清γ干扰素和白介素10水平的研究

目的 :通过对斑秃患者血清γ干扰素和白细胞介素 1 0检测 ,了解斑秃患者的Th1和Th2免疫功能状况 ,探讨其在斑秃发病中的作用。方法 :根据病情将 61例患者分为限局性斑秃 (AA ,n=5 1 )、全秃 /普秃 (AT/AU ,n =1 0 )患者两组 ,健康对照组 (control,n =1 8)年龄、性别与两患者组相匹配。采用酶联免疫吸附试验法 (ELISA)检测 3组血清的IFN -γ和IL -1 0水平。结果 :( 1 )IFN -γ水平 :AT/AU组明显高于对照组 ,有显著性差异 (P <0 0 1 ) ,AT/AU组与AA组以及AA组与对照组间的差异无统计学意义 ;( 2 )IL -1 0水平 :AT/AU组、AA组和对照组三组间的差别无统计学意义 (P >0 7)。结论 :IFN -γ可能与病情严重的全秃 /普秃有关 ,IL -1 0可能与斑秃的发病无关。     

斑秃655例伴发疾病分析

目的探讨斑秃发病的临床特点及伴发疾病分析。方法收集本科门诊2006年1月-2008年5月确诊的斑秃患者,以调查表的形式收集患者临床资料及伴发疾病情况,包括斑秃发病年龄、病程、严重程度、家族史和复发情况等,用SPSS13.0软件分析。结果 655例斑秃患者,男320例,女335例,平均年龄(38.4±12.4)岁,平均病程(14.8±35.7)个月,88例(13.44%)为全秃/普秃,84例(12.82%)家族史阳性,195例(29.77%)斑秃反复发作。655例患者中,190例(29.01%)除斑秃外,还伴发至少1种过敏性疾病或自身免疫性疾病,仅伴过敏性疾病者123例(18.78%)。未发现伴发疾病与性别、发病年龄、病程、斑秃类型、既往史及家族史相关联(P>0.05)。全秃/普秃更易伴发过敏性疾病,包括湿疹、荨麻疹、哮喘和药物过敏(P=0.004),与无伴发过敏性疾病的斑秃患者相比,伴发者发病更早(P=0.033)。结论斑秃与伴发的其他疾病可能有着相同的遗传学、免疫学基础,不同的伴发疾病可能对斑秃的发生、发展和预后产生不同的影响。     

斑秃患者2000例中甲病变的临床分析

我们对2000例斑秃（alopecia areata,简称AA）患者甲病变的临床表现，发生率及病理改变，进行了观察，并以2130例普通人群作为对照，结果AA的甲病变明显高于普通人群，尤其是全秃和普秃型的患者，甲病变以凹点和白点为最多，病理改变以聚集大量的角化不全细胞为主，本文还分析了甲病变与AA的病程及病情的关系。     

毛发疾病

20 0 13346　 81例儿童斑秃发病相关因素分析 /熊春萍(广州医学院一附院皮肤科 )…∥华中医学杂志 .-2 0 0 1,2 5 (2 ) .- 6 9采用回顾分析法对近 3年诊治的 81例儿童斑秃病例的发病因素进行分析。≥ 7岁者占 79.0 %,初次发病年龄 <7岁者 81.5 %为男性 ;≥ 13岁者 76 .9%为女性。重型斑秃占 32 .1%,重型斑秃病程明显长于局限性斑秃 (P<0 .0 1) ,初次发病年龄较局限性斑秃早 (P<0 .0 5 )。17.4 %有家族斑秃史 ,其秃发严重程度、发病早晚和病程与无家族史者无显著性差异 (P>0 .0 5 )。5 6 .9%伴指 (趾 )甲改变 ,尤其是重型斑秃及病程长者(P<…     

斑秃患者血清TNFα水平观察

测定７０例斑秃患者血清肿瘤坏死因子－α水平。测定结果示斑秃患者ＴＮＦα明显高于对照组。活动期患者明显高表静止期。而单纯斑秃组与全，普秃组相比，则无明显差异。表明斑秃患者存在着免疫功能异常，并与斑秃的发病及病情活动有关。     

难治性斑秃的诊治经验

重型斑秃如全/普秃和小儿斑秃的治疗困难,多数病人对治疗抵抗,而且即使有效,极易复发。因此,治疗原则总体偏于保守,慎用系统性皮质激素治疗,尤其是儿童斑秃、全/普秃、以及病程长或复发性的重症斑秃。本文着重介绍数种难治性斑秃的治疗方法,如适用于儿童重症斑秃的强效激素软膏外用封包治疗;用于活动期、进展性、病程短的长效激素肌注;以及适用于病程长、对激素治疗抵抗全/普秃患者的局部免疫疗法,即使用二苯环丙烯酮(DPCP)导致患者头皮人工性接触性皮炎,达到生发的目的。而对部分难治性病人,放弃药物治疗使用遮饰不失为一种良好的临床处理选择。     

精神应激事件与斑秃发病的相关性分析

目的：通过对斑秃患者各种精神应激事件的临床调查，探讨精神应激因素与斑秃发生发展之问的关系。方法：应用应激事件量表对124例斑秃病人与124例正常对照进行回顾性病例-对照调查研究。结果：斑秃患者发病前半年内重大生活事件的发生率和精神压力积分值均比正常对照组高，而且轻型斑秃患者的发生率和分值均高于重型患者。在诸多因素中，斑秃组睡眠习惯的改变发生率比正常人高。在调查斑秃患者本人对精神压力与斑秃发病关系的感知项目中，78．2％患者认为自身斑秃的发生与精神压力有关，76．6％病人感觉精神压力使斑秃加重，轻型与重型之间无差异。结论：心理社会因素的刺激在斑秃的发病中起重要诱发作用，而轻型斑秃患者发病前精神压力高于重型患者。临床工作中对斑秃患者进行有效的药物治疗的同时，需要根据具体情况对其提供心理治疗及推荐减压措施。     

136例儿童斑秃发病相关因素分析

目的:了解影响斑秃发病的相关因素。方法:对广州市妇女儿童医疗中心皮肤科收治的136例儿童斑秃临床资料作回顾性分析,包括年龄、性别、既往病史、家族史,首次出现斑秃的年龄,脱发严重程度评分以及实验室结果。结果:136例患儿平均首次发病年龄为(4.66±3.12)岁,85例(62.5%)首次出现斑秃的年龄小于6岁。136例患儿中75例为轻症斑秃,平均发病年龄(4.76±2.02)岁,61例为重症斑秃,平均发病年龄(2.81±2.42)岁。26例(19.12%)患儿患有注意缺陷多动障碍,53例(39%)患有过敏性疾病及9例(6.62%)患有自身免疫性疾病。16例(11.76%)有斑秃家族史,27例(20.59%)有自身免疫性疾病家族史。结论:儿童斑秃可能与遗传、精神心理、自身免疫和变态反应有关。     

Alopecia areata in Turkey: demographic and clinical features

Background  Alopecia areata is a complex genetic disease with still many unknown aspects, and many studies have been tried to find some clues about it.
Objective  We aimed to investigate the demographic and clinical characteristics of alopecia areata in Turkish patients.
Methods  Demographic data, localization, attack number in addition to some parameters such as disease duration, severity, age of onset, family history and ophiasis pattern were evaluated in 539 alopecia areata patients.
Results  The male to female ratio was 1.6 : 1. Occipital and beard-moustache areas were mostly affected. Positive family history was noticed in 24.1% of the patients. The age of onset was earlier in women than in men ( P =  0.04). Severe forms showed more persistent (≥ 1 year) disease duration ( P =  0.00). Ophiasis was more common in severe, long duration (≥ 1 year) and early onset (≤ 18 years) disease ( P =  0.00 for all parameters). Childhood alopecia areata (≤ 18 years) was also associated with long duration of the disease ( P =  0.016) and positive family history ( P =  0.008) when compared with adult onset (> 18 years) alopecia areata.     

Squaric acid dibutyl ester for the treatment of alopecia areata: A retrospective evaluation

Squaric acid dibutyl ester (SADBE) as topical immunotherapy is a good alternative in patients with refractory alopecia areata. In this study, we aimed to evaluate the effectiveness of SADBE treatment in alopecia areata (AA) and alopecia totalis/alopecia universalis (AT/AU) patients and determine the prognostic factors affecting treatment response. Data obtained from 34 (AA/AT/AU) patients treated with SADBE were analyzed retrospectively. Of the 34 patients, 16 (47.1%) were female and 18 (52.9%) were male. Sufficient responses were obtained in 19 (55.9%) patients. About 9 of the 19 patients (47.4%) with sufficient response reached a cosmetically acceptable level. As the severity of disease subsided, response to treatment increased. A better response was obtained when the disease onset in the spring and winter. Patients with a disease duration between 1 and 5 years responded better to the SADBE treatment compared to those with a disease shorter than 1 year and longer than 5 years. Severity of the disease, onset season of the disease, number of flares, duration of disease, and low levels of vitamin D in adult patients were observed to affect the SADBE response negatively.     

Profile of 513 patients with alopecia areata: associations of disease subtypes with atopy, autoimmune disease and positive family history

BACKGROUND: Several lines of evidence support a genetic component to alopecia areata (AA), including differences in patients based on severity of AA, associated diseases and family history. OBJECTIVE: We aimed to examine clinical and genetic features of patients with AA with a focus on associated diseases, especially atopy, and family history of AA in the USA. METHODS: From 1998 to 2001, 513 patients with AA completed interviews consisting of demographic information, patient's medical history, and family history of AA. RESULTS: Forty per cent of respondents had alopecia totalis and/or universalis (AT/AU). These patients were younger at the age of onset than those with patchy AA (P < 0.001), were more likely to have associated autoimmune or atopic disease (P = 0.047), most notably atopic dermatitis (P = 0.021) and thyroid disease (P = 0.012). They also had a greater number of relatives affected by AA (P < 0.05). CONCLUSIONS: Our findings show marked associations between severity of AA, atopic dermatitis, thyroid disease and other autoimmune diseases, and extensive family history of AA, suggesting two clinically distinct subtypes of AA with the severe subtype possibly associated with greater familial autoimmunity. Further research exploring the possibility of a genetic basis to explain these clinical findings will be helpful in clarifying our understanding of AA, leading to improvements in diagnosis and treatment.     

Systemic treatment for alopecia areata

Of the world population, 1.7% is suffering from alopecia areata at some point in their lives. The exact etiology of this disease is still unknown, and the course of the disease is unpredictable. Effective treatments, especially for severe multifocal alopecia areata, alopecia areata totalis, and alopecia areata universalis, are lacking. The present article will discuss side effects and relapse rates of different systemic agents for treatment of severe and rapid progressive alopecia areata.     

Prevalence of Nail Abnormalities in Children With Alopecia Areata

Abstract: We assessed the prevalence of nail abnormalities in 272 children with alopecia areata who were seen in our department during an eight-year period. Of these, 126(46%; 50 girls, 76 boys) had nail abnormalities that were related to alopecia areata. Nail pitting was detected in 92 patients, Including 37 with alopecia totalis or alopecia universalis. Three patients experienced an onychomadesis of all 20 nails during the acute onset of alopecia areata universalis. Thirty-two (11.7%) had nail thinning and severe nail plate surface abnormalities that were consistent with a diagnosis of trachyonychia.     

HLA in alopecia areata

BACKGROUND: The aim of this study was to investigate the human leukocyte antigen (HLA) characteristics of Turkish alopecia areata patients, and the correlation of the HLA profile with age of onset, severity and duration of the disease, presence of ophiasis, and family history. METHODS: A total of 88 patients with alopecia areata, alopecia totalis, or alopecia universalis were compared with 100 healthy controls. HLA typing was performed by the Terasaki microlymphocytotoxicity method. RESULTS: The frequency of HLA-A1, HLA-B62(15), HLA-DQ1, and HLA-DQ3 was significantly higher in patients than in controls. HLA-DR16 was significantly less common in patients than in the control group, and we concluded that this allele might have a protective role for alopecia areata. Juvenile onset and severe involvement were related with HLA-Cw7 and HLA-DR1, respectively. The HLA profile was independent of the existence of long-standing disease, presence of ophiasis, and a positive family history. CONCLUSIONS: In HLA-alopecia areata association, ethnic differences may play a role.     

Alopecia areata treatment with a phototoxic dose of UVA and topical 8-methoxypsoralen

Twenty-five patients with alopecia totalis (AT) or alopecia universalis and 124 patients with alopecia areata (AA) were treated with photochemotherapy, combining topical 8-methoxypsoralen (8-MOP) with UV irradiation of the scalp at a phototoxic dose. The mean energy required was 15 J/cm2 for AA and 42 J/cm2 for AT. Ninety-four patients had multiple bald patches and 12 with AT had complete or > 50% hair regrowth. Positive treatment results did not seem to depend on the age of onset or the duration of the disease. Few side-effects of topical psoralens plus UVA (PUVA) treatment were noted, except a for few days of slight erythema caused by the high dose of UV.     

Reappraisal of Ikeda's Classification of Alopecia Areata: Analysis of 356 Cases from Chandigarh,India

Three hundred and fifty six patients (234 males, 122 females) with alopecia areata were classified according to Ikeda's classification. The common type of alopecia areata was most frequently seen in 239 (67.13%) patients, followed by atopic in 60 (16.85%), prehypertensive in 48 (13.4%), and autoimmune/endocrine in 9 (2.52%) patients. Severe alopecia did not occur with a higher frequency in atopic or endocrine/autoimmune alopecia areata than in the common type (p>0.05). Prehypertensive alopecia areata had the lowest frequency of severe alopecia in the present study. The odds for developing severe alopecia were highest (2.6) when onset was before 16 years of age, followed by female sex (2.12), atopy (0.86), autoimmune/endocrine (0.53), and prehypertensive (0.28) types. Alopecia areata should be broadly classified as childhood (<16 years) and adult onset with subtypes of atopic, autoimmune/endocrine, and common type under both. The prehypertensive type should be combined with the common type of alopecia areata.