Nina Otberg

Strategy of topical vaccination with nanoparticles

Liposomes in the nanosize range have been recognized as a versatile drug delivery system of both hydrophilic and lipophilic molecules. In order to develop a liposome-based topical vaccination strategy, five different types of liposomes were tested as a putative vaccine delivery system on pig ear skin. The investigated liposomes mainly varied in size, lipid composition, and surface charge. Using hydrophilic and hydrophobic fluorescent dyes as model drugs, penetration behavior was studied by means of confocal laser scanning microscopy of intact skin and histological sections, respectively. Follicular penetration of the liposomes was measured in comparison to a standard, nonliposomal formulation at different time points. Dependent on time but independent of their different characters, the liposomes showed a significantly higher penetration depth into the hair follicles compared to the standard formulation. The standard formulation reached a relative penetration depth of 30% of the full hair follicle length after seven days, whereas amphoteric and cationic liposomes had reached approximately 70%. Penetration depth of negatively charged liposomes did not exceed 50% of the total follicle length. The fluorescence dyes were mainly detected in the hair follicle; only a small amount of dye was found in the upper parts of the epidermis.

Pseudopelade of Brocq

ABSTRACT:u2003 Pseudopelade of Brocq (PPB) is a rare, idiopathic, slowly progressive hair disorder, resulting in cicatricial alopecia. It typically presents in Caucasian adult patients as small, smooth, flesh‐toned and slightly depressed alopecic patches with irregular outlines. It primarily involves the parietal and vertex portions of the scalp with a chronic prolonged course. Controversial opinions still exist as to whether PPB is a single entity or an end stage of several cicatricial alopecic disorders. A practical approach to diagnosis of PPB and therapeutic update are discussed in this review.

Uncombable hair syndrome

Uncombable hair syndrome is a relatively rare anomaly of the hair shaft, with less than 100 cases reported to date, that results in a disorganized, unruly hair pattern that is impossible to comb flat. The characteristic longitudinal grooves along the hair shaft, along with the triangular or kidney-shaped cross section allows this condition to be diagnosed microscopically. The majority of cases are inherited in an autosomal-dominant manner with either complete or incomplete penetrance. There is no definitive treatment, and most cases improve with the onset of puberty.

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.

Secondary Cicatricial and other Permanent Alopecias

ABSTRACT:u2003 Various nonfollicular scalp conditions can cause secondary scarring or permanent alopecia. Possible causes are congenital defects, trauma, inflammatory conditions, infections, and neoplasms (rarely drugs). Associated signs and symptoms and other diagnostic procedures such as histopathology may aid in the diagnosis. Detection of the underlying disorder may be difficult in end‐stage lesions. Treatment is specific for active conditions. Surgery and hair transplantation are options for localized scars.

Successful Treatment of Temporal Triangular Alopecia by Hair Restoration Surgery Using Follicular Unit Transplantation

Sabouraud first described temporal triangular alopecia (TTA), also called congenital triangular alopecia (CTA), in 1905. It was recognized as a scalp condition in 1932. To our knowledge, there are 59 case of TTA reported in the literature; four cases describe a familial involvement. Based on the number of reports published in the literature, this condition seems to be much more common than most dermatologists believe. The term congenital seems to be misleading because most cases develop lesions 2 to 6 years after birth. TTA is a nonscarring, noninflammatory alopecia characterized by an overall normal hair density of only vellus hair and normal epidermis. A few terminal hairs or vellus-like hairs can often be found in the periphery of the lesion. The lesions are usually asymptomatic. TTA presents with roughly triangular, oval, or lancet-shaped patches in the frontotemporal area. The lesions are mostly unilateral (80%) but can occur bitemporally as well (20%). TTA has been reported in Asian and Caucasian patients, with no sexual predilection. There are two case reports of TTA in African-American boys, one with coexisting aplasia cutis congenita occurring. The only known treatment for this condition is complete excision. We know of one case reporting successful treatment with hair punch graft transplantation. We report a case of successful treatment of TTA in a 17-year-old male Caucasian patient with unilateral temporal triangular alopecia by follicular unit transplantation. Case Report

Folliculitis decalvans developing 20 years after hair restoration surgery in punch grafts: case report.

Folliculitis decalvans (FD) is a rare inflammatory scalp disorder that is classified as a neutrophilic primary cicatricial alopecia. The condition occurs mostly in young and middle-aged adults, with a preference for the vertex or occipital area, and leads to scarring alopecia with a lack of follicular ostia, accompanied by diffuse and perifollicular erythema, follicular pustules, follicular tufting, and oftentimes hemorrhagic crusts and erosions. Follicular tufting or tufted folliculitis is a common finding in patients with FD that is characterized by multiple hairs (5–20) emerging from a single dilated follicular orifice. Tufting occurs when the infundibular epithelia of a follicle is damaged and finally heals with the formation of one large, common infundibulum. It has been debated whether tufted folliculitis is an entity on its own or a variant or symptom of FD because of its similar inflammatory infiltrate, presence of Staphylococcus aureus, and frequent occurrence in patients with FD. Patients may complain about symptoms such as pain, itching, or a burning sensation. The extent of the disease can range from discrete scarring to extensive thickly scarred areas with scalp involvement of up to 50%. The pathogenesis is not fully understood. The presence of S. aureus and an abnormality in the host defense mechanism seems to play an important role in the development of FD. Patients occasionally report the development of FD after scalp injury, and reports can be found in literature, but its pathogenetic importance is unclear. We report an unusual case of FD that occurred 20 years after hair restoration surgery exclusively in the area of the punch grafts. This presentation raises questions about the pathogenesis and triggers of this rare, disfiguring scalp condition.

Possibilities and Limitations for Reversal of Age-Related Hair Loss

Our modern society faces an increasing life-expectation, and along with this, an increased desire for a youthful appearance. Hair plays a major role in our overall appearance, our self-conception and self-esteem. The experience of hair loss is distressing at any age and can reveal our aging process. Aging hair becomes more fragile, is thinner and sparser, and shows decreased growth rates. Age-related hair problems include senescent alopecia, androgenetic alopecia, graying, and weathering. Treatment option for androgenetic alopecia and senescent alopecia include, among others, topical minoxidil, oral finasteride, and hair restoration surgery. Hair loss can also be related to medication, underlying diseases, or surgery. Moreover, some inflammatory scalp diseases typically occur in older patients. This chapter discussed the management and treatment option of different forms of age-related hair loss.

Two sisters, two different hair shaft abnormalities.

dermatitis skin symptoms using a Vitreoscilla filiformis bacterial extract. Eur J Dermatol 2006; 16:380–4. 4 Hoenig JM, Heisey DM. The abuse of power: the pervasive fallacy of power calculations in data analysis. Am Stat 2001; 55:19– 24. 5 Mehta CR, Patel Exact NR. Inference for Data Categorical. Cambridge, MA: University Harvard and Corporation Cytel Software, 1997. 6 Weerahandi S. Exact Statistical Methods for Analysis Data. New York: Springer-Verlag, 1995.