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Is there a correlation between Androgenetic Alopecia Severity and Epicardial Fat Thickness?
Ann Dermatol. 2016 Apr;28(2):205-9
Epicardial fat tissue is found on the cardiac surface between the myocardium and the visceral pericardium and can be measured by using echocardiography, computed tomography, or magnetic resonance imaging. Both Androgenetic alopecia (AGA) and epicardial fat thickness (EFT) are related to coronary artery disease, which is also reflected by an increase in carotid intima media thickness (CIMT). A study was designed to to investigate the relation of AGA severity with EFT.

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Comparison of the groups in terms of epicardial fat thickness.AGA: androgenetic alopecia.

126 male patients with AGA were divided into three groups (mild, moderate, and severe) on the basis of the Hamilton baldness scale as modified by Norwood. The severe group had a higher EFT compared with the moderate (p<0.001) and mild (p <0.001) groups, and the moderate group had a statistically higher EFT than the mild group (p<0.001). Lipid profile, age, and BMI values were similar across the groups. Those findings indicate a strong correlation between AGA status and EFT. EFT of 0.7 cm or more is considered abnormal and indicates subclinical atherosclerosis, hence subjects with severe AGA should be evaluated for possible cardiovascular disease due to atherosclerosis.

UL16 binding protein-3 (ULBP3) may act as a confirmatory test for Alopecia areata incognita (AAI)
Arch Dermatol Res. 2016 May 3. [Epub ahead of print], Image from CLINICS 2011;66(3):513-515
Alopecia areata incognita (AAI), also known as diffuse alopecia areata, is a rare form of alopecia areata described predominantly in young women and has no confirmatory diagnostic test. In cases of AAI, the typical patchy distribution of hair loss in classical alopecia areata is absent, but abrupt and intense hair loss is characteristic. While the clinical picture presented by this disease closely resembles that of telogen effluvium, specific clinical and dermoscopic findings of alopecia areata are invariably present along the disease course.

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Clinical picture of Alopecia areata incognita at 2 weeks from the onset of hair shedding

UL16 binding protein-3 (ULBP3) is a key regulator of both innate and adaptive immune responses. In the normal hair follicle, ULBP3 is turned off. However, studies have reported its high level in alopecia areata.

A study by Moftah NH et al found a high statistically significant increase in ULBP3 level in AAI patient group compared with telogen effluvium (TE), female pattern hair loss (FPHL), and normal hair. ULBP3 levels were positively correlated with the age and duration of the disease. Accordingly, ULBP3 may act as a confirmatory test for AAI and may be implicated in the disease pathogenesis, progression, and chronicity.

Vitamin D deficiency can be a significant risk factor for occurrence of Alopecia areata
J Cosmet Dermatol. 2016 May 6. doi: 10.1111/jocd.12224. [Epub ahead of print], Br J Dermatol. 2014 Jun;170(6):1299-304, Isr Med Assoc J. 2014 Jun;16(6):367-70.
Expression of vitamin D receptors (VDRs) on keratinocytes is essential for maintenance of normal hair cycle, especially anagen initiation.

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A latest study suggested an important role for VDR in the pathogenesis of alopecia through documenting lower serum and tissue VDR levels in Alopecia areata (AA) and Androgenetic alopecia (AGA) patients in comparison with controls. Another study by Cerman et al. showed significantly higher prevalence of 25(OH)D deficiency in patients with AA (91%) compared with healthy controls (33%) (P < 0·001). Furthermore, a significant inverse correlation was found between disease severity and serum 25(OH)D level in patients with AA (r = -0·409; P < 0·001).

As shown in the table, the multivariate analysis by Mahamid M showed that vitamin D levels < 30 ng/ml (odds ratio 2.3, 95% confidence interval 2.2–3.1, P = 0.02) and high CRP levels > 1 (OR5 3.1, 95%CI6 2.6–4.2, P = 0.04) were associated with AA occurrence.

Association of Urinary stone disease with androgenetic alopecia
Ren Fail. 2016 Feb;38(1):84-8, Urolithiasis. 2016 May 7. [Epub ahead of print]
Resorlu and his colleagues determined a significant correlation between vertex pattern and total alopecia with urolithiasis in patients younger than 60 years old. Three hundred and two male patients were categorized as follows:

• Group I: No baldness (Hamilton-Norwood Scala [HNS] stage I)
• Group II: Hair loss in the frontal region (HNS stages II, III, IIIa, and IVa)
• Group III: Hair loss in the vertex region (HNS stage III-vertex, V)
• Group IV: Hair loss in both vertex and frontal regions (HNS stages IV, Va, VI, and VII)

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As seen in the graph, a significant correlation between alopecia and urolithiasis was observed.

In another study, between January 2008 and November 2015, Polat and his colleagues retrospectively investigated the biochemical parameters and anthropometric characteristics (height and weight) of 200 patients who had urinary tract stones. They found that risk of urolithiasis increased 1.3-fold in patients with vertex pattern alopecia and 2.1-fold in patients with total alopecia compared with those with no hair loss.

Low-level laser therapy - a promising therapy for Androgenetic alopecia (AGA)
Lasers Surg Med. 2016 Apr 25. doi: 10.1002/lsm.22512. [Epub ahead of print], International Journal of Trichology. 2014;6(2):45-49.
Despite the current treatment options for different types of alopecia, there is a need for more effective management options. Recently, the use of low-level laser therapy (LLLT) has been proposed as a treatment for hair loss and to stimulate hair regrowth in AGA.

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Concomitant treatment with topical 5% minoxidil and low-level laser therapy (LLLT) in a 55-yearold male (a) Before, and (b) After 3 months of added LLLT

A systematic literature review evaluated 11 studies involving a total of 680 patients, consisting of 444 males and 236 females. 9 out of 11 studies assessing hair count/hair density found statistically significant improvements in both males and females following LLLT treatment. Additionally, hair thickness and tensile strength significantly improved in two out of four studies. Patient satisfaction was investigated in five studies, and was overall positive, though not as profound as the objective outcomes.

Based on the evidence, FDA-cleared LLLT devices as safe and effective in patients with AGA who did not respond or were not tolerant to standard treatments. Thus LLLT represents a potentially effective treatment for both male and female AGA, either as monotherapy or concomitant therapy. Combination treatments with minoxidil and LLLT may act synergistic to enhance hair growth.
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