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Alopecia

Alopecia Areata

 1. Postepy Dermatol Alergol. 2020 Jun;37(3):412-416. doi: 10.5114/ada.2019.83879. 

Epub 2019 Mar 26.


Effects of anxiety and depression symptoms on oxidative stress in patients with 

alopecia areata.


Cakirca G(1), Manav V(2), Celik H(3), Saracoglu G(4), Yetkin EN(1).


Author information:

(1)Department of Biochemistry, Sanliurfa Mehmet Akif Inan Training and Research 

Hospital, Sanliurfa, Turkey.

(2)Department of Dermatology, Istanbul Training and Research Hospital, Istanbul, 

Turkey.

(3)Department of Physiology, Faculty of Medicine, Harran University, Sanlıurfa, 

Turkey.

(4)Department of Psychiatry, Sanliurfa Training and Research Hospital, 

Sanliurfa, Turkey.


INTRODUCTION: Increased oxidative stress (OXS) and a high prevalence of 

psychiatric disorders are seen in alopecia areata (AA). However, OXS and 

psychiatric disorders have been studied separately in AA patients.

AIM: To determine the effects of anxiety and depression symptoms on OXS in AA 

patients.

MATERIAL AND METHODS: The anxiety and depression levels of 33 AA patients and 33 

normal controls (NC) were determined using the Hospital Anxiety and Depression 

Scale. The oxidative stress index (OSI) was calculated by measuring serum total 

antioxidant status (TAS) and total oxidant status (TOS) levels in AA patients 

and NC.

RESULTS: The AA patients had higher anxiety and depression scores than NC (p < 

0.001 for both). Total oxidant status (p = 0.002) and OSI (p < 0.001) values 

were higher, and TAS (p < 0.001) levels were lower, in patients with AA compared 

to NC. However, patients' anxiety and depression scores were not correlated with 

the TAS, TOS, or OSI values (p > 0.05). There was no significant difference in 

TAS, TOS, or OSI values between patients with high and low anxiety or depression 

scores (p > 0.05).

CONCLUSIONS: These results show that OXS, anxiety, and depression scores were 

higher in patients with AA compared to NC. However, anxiety and depression 

scores were not associated with OXS in AA patients. More extensive studies 

should be performed to investigate the relationship between psychological status 

and OXS in patients with AA.


Copyright: © 2019 Termedia Sp. z o. o.


DOI: 10.5114/ada.2019.83879

PMCID: PMC7394168

PMID: 32792885


Conflict of interest statement: The authors declare no conflict of interest.


2. J Cutan Aesthet Surg. 2020 Apr-Jun;13(2):103-111. doi: 10.4103/JCAS.JCAS_16_19.


Comparative Evaluation of Therapeutic Efficacy of Intralesional Injection of 

Triamcinolone Acetonide versus Intralesional Autologous Platelet-rich Plasma 

Injection in Alopecia Areata.


Kapoor P(1), Kumar S(1), Brar BK(1), Kukar N(2), Arora H(3), Brar SK(4).


Author information:

(1)Department of Dermatology, Guru Gobind Singh Medical College and Hospital, 

Faridkot, India.

(2)Department of Immunohaematology and Blood Transfusion, Guru Gobind Singh 

Medical College and Hospital, Faridkot, India.

(3)Department of Community Medicine, Guru Gobind Singh Medical College and 

Hospital, Faridkot, India.

(4)Department of Dermatology, Adesh Institute of Medical Sciences and Research, 

Bathinda, Punjab, India.


CONTEXT: Alopecia areata is a chronic non-scarring alopecia that involves scalp 

and/or body. Corticosteroids are the most popular drugs for its treatment.

AIM: The aim of the study was to evaluate the therapeutic efficacy of 

intralesional injection of triamcinolone acetonide and platelet-rich plasma 

(PRP) in alopecia areata and to compare the efficacy of these modalities in 

alopecia areata.

SETTINGS AND DESIGN: This was a randomized controlled comparative study.

SUBJECTS AND METHODS: Forty patients were enrolled from the outpatient 

department and divided into two groups of 20 patients each. Group A and B 

randomly received intradermal triamcinolone acetonide suspension (10 mg/mL) and 

PRP, respectively, into the lesion using an insulin syringe in multiple 0.1 mL 

injections 1cm apart. The injections were repeated every 3 weeks till 12 weeks. 

The patients were evaluated by Severity of Alopecia Tool (SALT) score and 

photographically every 3 weeks till the end of 12 weeks and then at the end of 6 

months. Statistical analysis used descriptive analysis along with Pearson 

chi-square test or Fisher exact test, paired samples, and independent samples t 

test or their nonparametric analogs for continuous variables.

RESULTS: The reduction in SALT score at each visit with respect to baseline was 

greater in the triamcinolone group as compared to PRP group. This signifies 

greater effect of triamcinolone in alopecia areata. Around 50% patients in 

triamcinolone group and 5% patients in PRP group showed grade V improvement. 

Pain during intralesional injection was higher in the PRP group.

CONCLUSION: Both intralesional triamcinolone and PRP were found to be 

efficacious in alopecia areata but the latter produced lesser improvement.


Copyright: © 2020 Journal of Cutaneous and Aesthetic Surgery.


DOI: 10.4103/JCAS.JCAS_16_19

PMCID: PMC7394112

PMID: 32792771


Conflict of interest statement: There are no conflicts of interest.


3. Australas J Dermatol. 2020 Aug 13. doi: 10.1111/ajd.13428. Online ahead of 

print.


Impact of alopecia areata on subsequent pregnancy rate: A retrospective cohort 

study.


Kim JC(1), Choi JW(1).

Author information:

(1)Department of Dermatology, Ajou University School of Medicine, Suwon, Korea.

DOI: 10.1111/ajd.13428

PMID: 32790070



4. JAMA Dermatol. 2020 Aug 12. doi: 10.1001/jamadermatol.2020.2188. Online ahead of 

print.


Clinically Applicable Deep Learning Framework for Measurement of the Extent of 

Hair Loss in Patients With Alopecia Areata.


Lee S(1), Lee JW(2), Choe SJ(2), Yang S(3), Koh SB(4), Ahn YS(4), Lee WS(2).

Author information:

(1)Department of Dermatology and Preventive Medicine, Yonsei University Wonju 

College of Medicine, Wonju, Republic of Korea.

(2)Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei 

University Wonju College of Medicine, Wonju, Republic of Korea.

(3)Department of Biomedical Engineering, Yonsei University, Wonju, Republic of 

Korea.

(4)Department of Preventive Medicine, Yonsei University Wonju College of 

Medicine, Wonju, Republic of Korea.

DOI: 10.1001/jamadermatol.2020.2188

PMID: 32785607


5. Einstein (Sao Paulo). 2020;18:eAI5452. doi: 

10.31744/einstein_journal/2020ai5452. Epub 2020 Aug 10.


Topical tofacitinib in treatment of alopecia areata.


[Article in English, Portuguese]

Ferreira SB(1), Ferreira RB(2), Scheinberg MA(3).

Author information:

(1)Clínica de Dermatologia Sineida Ferreira, Maringá, PR, Brazil.

(2)Centro Universitário de Maringá, Maringá, PR, Brazil.

(3)Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.

DOI: 10.31744/einstein_journal/2020ai5452

PMID: 32785452



6. J Eur Acad Dermatol Venereol. 2020 Aug 11. doi: 10.1111/jdv.16864. Online ahead 

of print.


Prevalence of Cardiac and Metabolic Diseases among Alopecia Areata Patients.


Conic RRZ(1)(2), Chu S(3)(4), Tamashunas NL(5), Damiani G(3)(6)(7)(8), Bergfeld 

W(4).

Author information:

(1)Department of Surgery, University of Maryland, Baltimore, MD, USA.

(2)Department of Family Medicine and Public Health, University of California, 

San Diego, CA, USA.

(3)Department of Dermatology, Case Western Reserve University, Cleveland, OH, 

USA.

(4)Department of Dermatology, Cleveland Clinic, Cleveland, OH, USA.

(5)Case Western Reserve University, School of Medicine, Cleveland, OH, USA.

(6)Young Dermatologists Italian Network, Centro Studi GISED, Bergamo, Italy.

(7)Clinical Dermatology, IRCCS Instituto Ortopedico Galeazzi, Milan, Italy.

(8)Department of Biomedical, Surgical and Dental Sciences, University of Milan, 

Milan, Italy.

Alopecia areata (AA) is an autoimmune disease that may present with non-scarring 

alopecic patches to complete hair loss. Since other autoimmune diseases are 

associated with an increased risk of cardiac and metabolic diseases, we aimed to 

determine the prevalence of cardiac and metabolic comorbidities in AA. In this 

cross-sectional study, data were analyzed from the Explorys electronic aggregate 

database, a previously validated dataset which consists of over 50 million 

patients across 360 hospitals in the United States.

This article is protected by copyright. All rights reserved.

DOI: 10.1111/jdv.16864

PMID: 32780884


7. Dermatol Ther. 2020 Aug 10:e14169. doi: 10.1111/dth.14169. Online ahead of 

print.


Psoriasis onset under dupilumab treatment in two patients affected by Atopic 

Dermatitis and one patient affected by Alopecia Areata: clinical and dermoscopic 

patterns.


D'Ambra I(1), Babino G(1), Fulgione E(1), Calabrese G(1), Ronchi A(2), Alfano 

R(3), Argenziano G(1), Piccolo V(1).

Author information:

(1)Dermatology Unit, Department of Mental and Physical Health and Preventive 

Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.

(2)Pathology Unit, Department of Mental and Physical Health and Preventive 

Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.

(3)Department of Anesthesiology, Surgery and Emergency, University of Campania 

"Luigi Vanvitelli", Naples, Italy.

DOI: 10.1111/dth.14169

PMID: 32779323


8. J Eur Acad Dermatol Venereol. 2020 Aug 10. doi: 10.1111/jdv.16858. Online ahead 

of print.


Utility of Azathioprine, Methotrexate and Cyclosporine as Steroid-Sparing Agents 

in Chronic Alopecia Areata: A Retrospective Study of Continuation Rates in 138 

Patients.


Lai VWY(1), Sinclair R(2).

Author information:

(1)Alfred Hospital, Department of Medicine, Melbourne, VIC, Australia.

(2)Sinclair Dermatology, East Melbourne, VIC, Australia.

BACKGROUND: The management of chronic alopecia areata (CAA) is challenging. 

There is currently no therapy that produces consistent successful hair regrowth. 

Systemic therapies, including prednisolone and steroid-sparing agents (SSA), are 

often tried in patients with CAA. As there are no head-to-head clinical trials 

that compare efficacy of one SSA over another, retrospective studies of 

treatment in clinical practice may help guide clinical practice.

OBJECTIVE: To investigate the utility of SSAs in the treatment of AA.

METHODS: An electronic medical records search identified patients with AA and 

those prescribed azathioprine, cyclosporine or methotrexate between 2002 and 

2019. Type of AA, treatment duration, reason for cessation, use of concurrent 

prednisolone, dose of prednisolone and duration of prednisolone use were 

recorded. The primary outcome was SSA continuation rate at 6 and 12 months.

RESULTS: A total of 852 AA patients were identified, among whom 138 patients had 

been treated with azathioprine, methotrexate or cyclosporine. Of these 138 

patients treated with a SSA, 92 (66.7%) continued treatment for at least 12 

months: 75.3% (55/73) of azathioprine users, 50% (11/22) of methotrexate users 

and 60.5% (26/43) of cyclosporine users. At 12 months, 67.3% of azathioprine 

users required concurrent prednisolone at a mean dose of 5.6mg daily, 63.6% of 

methotrexate users required prednisolone at a mean dose of 5mg daily and 57.7% 

of cyclosporine users required prednisolone at a mean dose of 8.7mg daily. The 

SSA was ceased due to an adverse event in 15.9% of patients and a lack of 

efficacy in 17.4%.

CONCLUSION: The most well-utilised SSA for CAA patients at our clinic was 

azathioprine. This study highlights that most CAA patients who commence 

treatment with azathioprine, methotrexate or cyclosporine, continue that 

treatment for at least 12 months and most require concurrent low-dose 

prednisolone to maintain remission or promote continued hair regrowth.

This article is protected by copyright. All rights reserved.

DOI: 10.1111/jdv.16858

PMID: 32779249


9. Case Rep Oncol. 2020 Jun 11;13(2):627-632. doi: 10.1159/000507694. eCollection 

2020 May-Aug.


Secondary Alopecia Neoplastica Mimicking Alopecia Areata following Breast 

Cancer.


Skafida E(1), Triantafyllopoulou I(2), Flessas I(2), Liontos M(1), Koutsoukos 

K(1), Zagouri F(1), Dimopoulos AM(1).

Author information:

(1)Haematology-Oncology Unit, Department of Clinical Therapeutics, National and 

Kapodistrian University of Athens, Alexandra General Hospital, Athens, Greece.

(2)General and Breast Surgery Unit, General and Maternity Hospital "Helena 

Venizelou,", Athens, Greece.

Cutaneous metastases from visceral carcinomas are relatively uncommon, with an 

overall incidence ranging from 0.7 to 9%. Diagnosis of scalp metastases usually 

escapes clinicians and dermatologists due to the fact that these metastases are 

mimicking other benign dermatological conditions. Herein, we present an uncommon 

case of scalp alopecia neoplastica mimicking alopecia areata due to breast 

cancer; a 43-year-old woman diagnosed with lobular cancer 3 years previously 

presented with acute loss of hair in well-circumscribed areas of the scalp and 

was diagnosed with alopecia areata by a private-practice dermatologist. She was 

then reevaluated, and due to her history of breast cancer, a biopsy from the 

scalp was performed and revealed alopecia neoplastica. At the same time that the 

skin lesions were recognized as disease involvement, the patient presented with 

dyspepsia, and endoscopy of the upper and lower gastrointestinal tract also 

revealed metastasis to the stomach and bowel. Gastrointestinal metastasis may 

occur with several types of cancer, but the stomach and bowel are rare 

metastatic sites for breast cancer.

Copyright © 2020 by S. Karger AG, Basel.

DOI: 10.1159/000507694

PMCID: PMC7383155

PMID: 32774247

Conflict of interest statement: F. Zagouri has received honoraria for lectures 

and has served in an advisory role for AstraZeneca, Daiichi, Eli Lilly, Merck, 

Novartis, Pfizer, and Roche. A.-M. Dimopoulos has received honoraria for 

participation in advisory boards for Amgen, Bristol Myers Squibb, Celgene, 

Janssen, and Takeda.


10. Dermatol Ther (Heidelb). 2020 Aug 9. doi: 10.1007/s13555-020-00433-4. Online 

ahead of print.


Association of Alopecia Areata with Vitamin D and Calcium Levels: A Systematic 

Review and Meta-analysis.


Liu Y(1), Li J(2), Liang G(2), Cheng C(2), Li Y(2), Wu X(3).

Author information:

(1)Department of Plastic and Reconstructive Surgery, Institute of Dermatology, 

Chinese Academy of Medical Sciences, Peking Union Medical College, Nanjing, 

China. liuyi0513@aliyun.com.

(2)Department of Plastic and Reconstructive Surgery, Institute of Dermatology, 

Chinese Academy of Medical Sciences, Peking Union Medical College, Nanjing, 

China.

(3)Department of Plastic and Reconstructive Surgery, Institute of Dermatology, 

Chinese Academy of Medical Sciences, Peking Union Medical College, Nanjing, 

China. wuxinfengdr@163.com.

INTRODUCTION: To investigate the associations of alopecia areata (AA) with serum 

vitamin D and calcium levels.

METHODS: A systematic review of all relevant articles published up to February 

2020 in PubMed, Embase, and Cochrane Library databases was conducted. Primary 

endpoints were serum 25-hydroxyvitamin D [25(OH)D] levels and vitamin D 

deficiency, and the secondary endpoint was serum calcium level. Odds ratio (OR) 

and standardized mean difference (SMD) with 95% CI across studies were analyzed.

RESULTS: Data on 1585 patients with AA and 1114 controls from 16 case-control 

studies and three cross-sectional studies were included in this meta-analysis. A 

pooled meta-analysis was conducted using the random-effects model because of 

inter-study heterogeneity (vitamin D level, I2 = 87.90%; vitamin D deficiency, 

I2 = 81.10%; serum calcium level, I2 = 83.80%). A combined analysis revealed 

that patients with AA had significantly lower mean serum 25(OH)D level compared 

with control (WMD - 9.08, 95% CI - 11.65, - 6.50, p < 0.001), and were more 

likely to have vitamin D deficiency (OR 4.14, 95% CI 2.34, 7.35, p < 0.001). 

However, the pooled analysis revealed that patients with AA did not have 

significantly lower serum calcium levels compared with control (WMD - 0.17, 95% 

CI - 0.40, 0.06, p = 0.143). Subgroup analysis suggested that matched control, 

mean age, and country might contribute to the heterogeneity of serum vitamin D 

level, while study design, matched control, and country might contribute to the 

heterogeneity of vitamin D deficiency.

CONCLUSION: Deficiency of serum 25(OH)D level, rather than calcium level, was 

present in patients with AA. Screening for vitamin D deficiency and vitamin D 

supplementation may be beneficial in the treatment of patients with AA.

DOI: 10.1007/s13555-020-00433-4

PMID: 32772238

Alopecia Areata

 1. Arch Dermatol Res. 2020 Jul 23. doi: 10.1007/s00403-020-02109-7. Online ahead of 

print.

Bidirectional association between alopecia areata and thyroid diseases: a 

nationwide population-based cohort study.

Dai YX(1)(2), Tai YH(2)(3)(4), Chang YT(1)(2), Chen TJ(2)(5), Chen MH(6)(7).

Author information:

(1)Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan.

(2)School of Medicine, National Yang-Ming University, Taipei, Taiwan.

(3)Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, 

New Taipei City, Taiwan.

(4)Department of Anesthesiology, School of Medicine, College of Medicine, Taipei 

Medical University, Taipei, Taiwan.

(5)Department of Family Medicine, Taipei Veterans General Hospital, Taipei, 

Taiwan.

(6)School of Medicine, National Yang-Ming University, Taipei, Taiwan. 

kremer7119@gmail.com.

(7)Department of Psychiatry, Taipei Veterans General Hospital, No.201, Sec. 2, 

Shipai Rd, Beitou District, Taipei, 11217, Taiwan ROC. kremer7119@gmail.com.

Alopecia areata (AA) has long been associated with thyroid diseases; however, 

the temporality of their association remains unclear. This study aimed to 

investigate the bidirectional association between AA and thyroid diseases. In 

analysis 1, we included 5929 AA patients and 59,290 matched controls to assess 

the risk of thyroid diseases. In analysis 2, we included 35,071 patients with 

thyrotoxicosis, 19,227 patients with Graves' disease, 5460 patients with 

thyroiditis, 3352 patients with Hashimoto's thyroiditis, and their matched 

controls (1:10) to assess the risk of AA. Incidence of thyroid diseases and AA 

were the outcomes in analysis 1 and analysis 2, respectively. After adjusting 

the potential confounders, AA patients had an increased risk of all thyroid 

diseases, including toxic nodular goiter, (aHR 10.17; 95% confidence interval 

[CI] 5.32-19.44), nontoxic nodular goiter (aHR 5.23; 95% CI 3.76-7.28), 

thyrotoxicosis (aHR 7.96; 95% CI 6.01-10.54), Graves' disease (aHR 8.36; 95% CI 

5.66-12.35), thyroiditis (aHR 4.04; 95% CI 2.12-7.73), and Hashimoto thyroiditis 

(aHR 4.35; 95% CI 1.88-10.04). On the contrary, a significantly increased risk 

of developing AA was observed among patients with thyrotoxicosis (aHR 9.29; 95% 

CI, 7.11-12.14), Graves' disease (aHR 8.66; 95% CI 6.03-12.42), and thyroiditis 

(aHR 6.42; 95% CI 3.15-13.11) but not in patients with Hashimoto's thyroiditis. 

In conclusion, our study found a bidirectional association between AA and 

thyroid diseases, suggesting shared biological mechanisms underlying these two 

diseases.

DOI: 10.1007/s00403-020-02109-7

PMID: 32705333

2. Cureus. 2020 Jun 20;12(6):e8724. doi: 10.7759/cureus.8724.

Systemic Lupus Erythematosus Presenting as Alopecia Areata.

Forouzan P(1), Cohen PR(2).

Author information:

(1)Dermatology, McGovern Medical School, University of Texas Health Science 

Center at Houston, Houston, USA.

(2)Dermatology, San Diego Family Dermatology, National City, USA.

Alopecia areata is an inflammatory, non-scarring hair loss associated with 

autoimmune conditions. It is more commonly seen with thyroid disorders and 

vitiligo, but alopecia areata has also been linked to diabetes, psoriasis, 

rheumatoid arthritis, and systemic lupus erythematosus. Indeed, individuals with 

alopecia areata have an increased risk of developing systemic lupus 

erythematosus. A 36-year-old woman presented with hair loss characteristic of 

alopecia areata. After intralesional injections with triamcinolone acetonide, 

the areas of hair loss exhibited near complete hair regrowth. Laboratory 

examination and additional history were suggestive of systemic lupus 

erythematosus. She was referred to a rheumatologist who confirmed the diagnosis. 

Awareness of the comorbidities associated with alopecia areata can uncover other 

autoimmune conditions, such as thyroid disorders and systemic lupus 

erythematosus. The diagnosis of a new-onset alopecia areata may prompt a deeper 

investigation of potentially associated conditions.

Copyright © 2020, Forouzan et al.

DOI: 10.7759/cureus.8724

PMCID: PMC7372242

PMID: 32699719

Conflict of interest statement: The authors have declared financial 

relationships, which are detailed in the next section.

3. Int J Mol Sci. 2020 Jul 20;21(14):E5137. doi: 10.3390/ijms21145137.

The Effect of JAK Inhibitor on the Survival, Anagen Re-Entry, and Hair Follicle 

Immune Privilege Restoration in Human Dermal Papilla Cells.

Kim JE(1), Lee YJ(1), Park HR(1), Lee DG(1), Jeong KH(1), Kang H(1).

Author information:

(1)Department of Dermatology, Eunpyeong St. Mary's Hospital, College of 

Medicine, The Catholic University of Korea, Seoul 03312, Korea.

Topical or systemic administration of JAK inhibitors has been shown to be a new 

treatment modality for severe alopecia areata (AA). Some patients show a good 

response to JAK inhibitors, but frequently relapse after cessation of the 

treatment. There have been no guidelines about the indications and use of JAK 

inhibitors in treating AA. The basic pathomechanism of AA and the relevant role 

of JAK inhibitors should support how to efficiently use JAK inhibitors. We 

sought to investigate the effect of JAK1/2 inhibitor on an in vitro model of AA 

and to examine the possible mechanisms. We used interferon gamma-pretreated 

human dermal papilla cells (hDPCs) as an in vitro model of AA. Ruxolitinib was 

administered to the hDPCs, and cell viability was assessed. The change of 

expression of the Wnt/β-catenin pathway, molecules related to the JAK-STAT 

pathway, and growth factors in ruxolitinib-treated hDPCs was also examined by 

reverse transcription PCR and Western blot assay. We examined 

immune-privilege-related molecules by immunohistochemistry in hair-follicle 

culture models. Ruxolitinib did not affect the cell viability of the hDPCs. 

Ruxolitinib activated several molecules in the Wnt/β-catenin signaling pathway, 

including Lef1 and β-catenin, and suppressed the transcription of DKK1 in hDPCs, 

but not its translation. Ruxolitinib reverted IFN-γ-induced expression of 

caspase-1, IL-1β, IL-15, and IL-18, and stimulated several growth factors, such 

as FGF7. Ruxolitinib suppressed the phosphorylation of JAK1, JAK2 and JAK3, and 

STAT1 and 3 compared to IFN-γ pretreated hDPCs. Ruxolitinib pretreatment showed 

a protective effect on IFN-γ-induced expression of MHC-class II molecules in 

cultured hair follicles. In conclusion, ruxolitinib modulated and reverted the 

interferon-induced inflammatory changes by blocking the JAK-STAT pathway in 

hDPCs under an AA-like environment. Ruxolitinib directly stimulated 

anagen-re-entry signals in hDPCs by affecting the Wnt/β-catenin pathway and 

promoting growth factors in hDPCs. Ruxolitinib treatment prevented IFN-γ-induced 

collapse of hair-follicle immune privilege.

DOI: 10.3390/ijms21145137

PMID: 32698510

4. Pediatr Dermatol. 2020 Jul 21. doi: 10.1111/pde.14294. Online ahead of print.

"Doll #135 with vitiligo": Are alopecia and vitiligo Barbie worth the hype?

Shah SFH(1).

Author information:

(1)Faculty of Medicine, University of Cambridge, Cambridge, UK.

Toy manufacturer Mattel released a new line of diverse Barbie dolls earlier this 

year, including dolls with alopecia and vitiligo. The new dolls have been widely 

celebrated, with both media and dermatologists proposing that the dolls could 

provide significant benefits for the low self-esteem and societal exclusion 

suffered by children with similar dermatoses. However, the reality may be very 

different. Here, we present existing research on the impact of diverse dolls on 

children's play and psychology to argue that the dolls' proposed benefits for 

children with alopecia and vitiligo are unlikely to materialize; rather, 

alopecia and vitiligo Barbie could prove more harmful than beneficial.

© 2020 Wiley Periodicals LLC.

DOI: 10.1111/pde.14294

PMID: 32696526

5. Int J Trichology. 2020 Mar-Apr;12(2):89-92. doi: 10.4103/ijt.ijt_4_20. Epub 2020 

May 5.

Congenital Triangular Alopecia - A Case Report.

Patel DR(1), Tandel JJ(1), Nair PA(1).

Author information:

(1)Department of Dermatology, Shree Krishna Hospital, Karamsad, Gujarat, India.

Congenital triangular alopecia also known as temporal triangular alopecia or 

Brauer nevus may be present at birth or acquired during the first decade of 

life. It can present as triangular, oval, or lancet-shaped patch of alopecia. It 

may be misdiagnosed as alopecia areata, traction alopecia, trichotillomania, 

tinea capitis, and aplasia cutis congenita. Histopathological features and 

dermoscopic features help in its diagnosis. There is no effective treatment for 

it and, in most cases, there is no need for therapeutic intervention. 

Therapeutic modalities include topical minoxidil, surgical excision, and hair 

transplantation.

Copyright: © 2020 International Journal of Trichology.

DOI: 10.4103/ijt.ijt_4_20

PMCID: PMC7362965

PMID: 32684683

Conflict of interest statement: There are no conflicts of interest.

6. J Eur Acad Dermatol Venereol. 2020 Jul 19. doi: 10.1111/jdv.16820. Online ahead 

of print.

Yellow dots in Frontal Fibrosing Alopecia.

Thompson CT(1)(2), Martínez-Velasco MA(3), Tosti A(4).

Author information:

(1)Department of Pathology, Oregon Health and Science University, Portland, 

Oregon, USA.

(2)Department of Dermatology, Oregon Health and Science University, Portland, 

Oregon, USA.

(3)Universidad Nacional Autónoma de México Clínica de Oncodermatología, Circuito 

Escolar S/N, Col. UNAM C.U., Del Coyoacán, Ciudad de México, México, 04510.

(4)University of Miami Miller School of Medicine, Department of Dermatology and 

Cutaneous Surgery, 1475 NW 12th Avenue Suite 2175, Miami, FL, USA, 33136.

Frontal fibrosing alopecia (FFA), a common type of lichen planopilaris most 

frequently affecting postmenopausal women, is characterized by progressive loss 

of the eyebrows and fronto-temporal recession1  Although FFA is a considered 

a scarring alopecia, the hair loss is not always irreversible and regrowth has 

been occasionally reported on the scalp, the limbs, and, more 

consistently, the eyebrows.2,3,4  Preservation of sebaceous glands has been 

proposed as a possible explanation for hair regrowth, especially in the 

eyebrows.4  Yellow dots, first described in alopecia areata, are considered 

a common trichoscopic feature of non-scarring alopecias.5  Yellow 

dots correspond pathologically to dilated follicular infundibula, reminiscent 

of the holes in Swiss cheese in horizontal sections.6 In recent 

years, we have observed the presence of yellow dotsin the affected hairline of 

patients with FFA, interspersed irregularly among the remaining hairs 

and also in the cicatricial band.

This article is protected by copyright. All rights reserved.

DOI: 10.1111/jdv.16820

PMID: 32683726

7. Exp Dermatol. 2020 Jul 18. doi: 10.1111/exd.14155. Online ahead of print.

Hair follicle immune privilege and its collapse in alopecia areata.

Bertolini M(1), McElwee K(1)(2)(3), Gilhar A(4), Bulfone-Paus S(5), Paus 

R(1)(5)(6).

Author information:

(1)Monasterium Laboratory, Münster, Germany.

(2)Centre for Skin Sciences, University of Bradford, Bradford, U.K.

(3)Department of Dermatology and Skin Science, University of British Columbia, 

Vancouver, British Columbia, Canada.

(4)Laboratory for Skin Research, Rappaport Faculty of Medicine, Technion-Israel 

Institute of Technology, Haifa, Israel.

(5)Centre for Dermatology Research, University of Manchester and NIHR Manchester 

Biomedical Research Centre, Manchester, U.K.

(6)Dr. Philip Frost Department of Dermatology & Cutaneous Surgery, University of 

Miami Miller School of Medicine, Miami, FL, U.S.A.

Anagen stage hair follicles (HFs) exhibit "immune privilege (IP)" from the level 

of the bulge downwards to the bulb. Both passive and active IP mechanisms 

protect HFs from physiologically undesired immune responses and limit immune 

surveillance. IP is relative, not absolute, and is primarily based on absent, or 

greatly reduced, intra-follicular antigen presentation via MHC class I and II 

molecules, along with prominent expression of "no danger" signals like CD200, 

and the creation of an immuno-inhibitory signaling milieu generated by the 

secretory activities of HFs. Perifollicular mast cells, Tregs, and other cells 

may also contribute to HF IP maintenance in healthy human skin. Collapse of 

anagen hair bulb IP is an essential prerequisite for the development of alopecia 

areata (AA). In AA, lesional HFs are rapidly infiltrated by NKG2D+ T-lymphocytes 

and natural killer (NK) cells, while perifollicular mast cells acquire a 

profoundly pro-inflammatory phenotype and interact with autoreactive CD8+ T 

cells. Using animal models, significant functional evidence has accumulated that 

demonstrates the dominance of the immune system in AA pathogenesis. Purified 

CD4+, CD8+, and NK cell populations, which secrete IFNg, have each been shown to 

be able to induce AA, whereas Tregs and iNKT cells may provide relative 

protection against AA development. While IP collapse may be induced by exogenous 

agents, inherent IP deficiencies might confer increased susceptibility to AA for 

some individuals. Thus, a key goal for effective AA management is the 

re-establishment of a functional HF IP, which may also provide superior 

protection from disease relapse.

This article is protected by copyright. All rights reserved.

DOI: 10.1111/exd.14155

PMID: 32682334

8. Clin Exp Dermatol. 2020 Jul 18. doi: 10.1111/ced.14381. Online ahead of print.

Drug-induced alopecia areata?

Murad A(1)(2), Maguire J(1), Bergfeld W(2).

Author information:

(1)Department of Dermatology, Mater Misericordiae University, Dublin, Ireland.

(2)Department of Dermatology & Pathology, Cleveland Clinic Foundation, 

Cleveland, Ohio, USA.

Alopecia areata (AA) is a chronic, autoimmune disorder that results in 

non-scarring hair loss. Analysis of affected follicular unit in acute AA and 

regrowing white hair showed that the disease preferentially affected the hair 

bulb melanocytes and differentiating cortical keratinocytes respectively. 

Reports on sparing of senile white hair suggests that melanocytes in the hair 

follicle are favoured as the main target in the pathogenesis. The lifetime 

incidence of idiopathic alopecia areata (IAA) is approximately 2.1% but there is 

limited data on drug-induced alopecia areata (DIAA).

This article is protected by copyright. All rights reserved.

DOI: 10.1111/ced.14381

PMID: 32681530

9. Mediterr J Rheumatol. 2020 Jun 11;31(Suppl 1):137-144. doi: 

10.31138/mjr.31.1.137. eCollection 2020 Jun.

Under Development JAK Inhibitors for Dermatologic Diseases.

Sideris N(1), Vakirlis E(1), Tsentemeidou A(1), Kourouklidou A(1), Ioannides 

D(1), Sotiriou E(1).

Author information:

(1)Dermatology Department, School of Medicine, Aristotle University, 

Thessaloniki, Greece.

Molecular targeting therapies represent a new exciting era in dermatology. A 

promising novel drug class, subject of intense research, is Janus kinase (JAK) 

inhibitors. Multiple cytokine receptors signal through the Janus kinase and 

signal transducer and activator of transcription (STAT) pathway. The pathway 

plays a central role in innate and adaptive immunity, and haematopoiesis. The 

understanding of the contribution of JAKs to the immunologic processes of 

inflammatory diseases led to the development of JAK inhibitors, initially for 

rheumatologic and hematologic diseases. Soon, their efficacy in some 

dermatologic conditions was also demonstrated, and today their role as 

therapeutic agents is thoroughly researched, mainly in atopic dermatitis, 

psoriasis, vitiligo, and alopecia areata. JAK inhibitors can be administered 

orally or used topically. As they are relatively new treatment modalities in 

dermatology, many questions concerning their efficacy and safety remain 

unanswered. Data from ongoing trials are eagerly awaited. Here, we summarize 

under development JAK inhibitors for dermatologic diseases.

© 2020 The Mediterranean Journal of Rheumatology (MJR).

DOI: 10.31138/mjr.31.1.137

PMCID: PMC7361191

PMID: 32676572

10. Proc (Bayl Univ Med Cent). 2020 Apr 22;33(3):413-414. doi: 

10.1080/08998280.2020.1753456. eCollection 2020 Jul.

Ophiasis alopecia areata treated with microneedling.

Asad U(1), Wallis D(2), Tarbox M(2).

Author information:

(1)School of Medicine, Texas Tech University Health Sciences CenterLubbockTexas.

(2)Department of Dermatology, Texas Tech University Health Sciences 

CenterLubbockTexas.

Alopecia areata (AA) is a T cell-mediated autoimmune disease resulting in the 

destruction of hair follicles. Ophiasis refers to a subtype of AA that presents 

as a symmetric, band-like hair loss pattern of the occipital, temporal, and 

parietal regions of the scalp. We present a case of a 58-year-old white man with 

AA, ophiasis pattern, who was treated with clobetasol 0.05% solution and four 

treatments of microneedling with triamcinolone over 6 months. He underwent 

gradual improvement, most notably on his left occipital scalp where his hair 

loss was most prominent, with near complete hair regrowth on his left occipital 

scalp. Microneedling with triamcinolone can be considered as a promising 

treatment in cases of ophiasis AA.

Copyright © 2020 Baylor University Medical Center.

DOI: 10.1080/08998280.2020.1753456

PMCID: PMC7340463

PMID: 32675968

Alopecia

 No reports re Alopecia Areata 

1. Eur Rev Med Pharmacol Sci. 2020 Feb;24(4):2006-2011. doi: 

10.26355/eurrev_202002_20378.

COVID-19 (Novel Coronavirus 2019) - recent trends.

Kannan S(1), Shaik Syed Ali P, Sheeza A, Hemalatha K.

Author information:

(1)School of Medicine, The Maldives National University, Male', Maldives. 

Kannan.subbaram@mnu.edu.mv.

The World Health Organization (WHO) has issued a warning that, although the 2019 

novel coronavirus (COVID-19) from Wuhan City (China), is not pandemic, it should 

be contained to prevent the global spread. The COVID-19 virus was known earlier 

as 2019-nCoV. As of 12 February 2020, WHO reported 45,171 cases and 1115 deaths 

related to COVID-19. COVID-19 is similar to Severe Acute Respiratory Syndrome 

coronavirus (SARS-CoV) virus in its pathogenicity, clinical spectrum, and 

epidemiology. Comparison of the genome sequences of COVID-19, SARS-CoV, and 

Middle East Respiratory Syndrome coronavirus (MERS-CoV) showed that COVID-19 has 

a better sequence identity with SARS-CoV compared to MERS CoV. However, the 

amino acid sequence of COVID-19 differs from other coronaviruses specifically in 

the regions of 1ab polyprotein and surface glycoprotein or S-protein. Although 

several animals have been speculated to be a reservoir for COVID-19, no animal 

reservoir has been already confirmed. COVID-19 causes COVID-19 disease that has 

similar symptoms as SARS-CoV. Studies suggest that the human receptor for 

COVID-19 may be angiotensin-converting enzyme 2 (ACE2) receptor similar to that 

of SARS-CoV. The nucleocapsid (N) protein of COVID-19 has nearly 90% amino acid 

sequence identity with SARS-CoV. The N protein antibodies of SARS-CoV may cross 

react with COVID-19 but may not provide cross-immunity. In a similar fashion to 

SARS-CoV, the N protein of COVID-19 may play an important role in suppressing 

the RNA interference (RNAi) to overcome the host defense. This mini-review aims 

at investigating the most recent trend of COVID-19.

DOI: 10.26355/eurrev_202002_20378

PMID: 32141569 [Indexed for MEDLINE]

Conflict of interest statement: The authors declare no conflict of interest.

2. J Cosmet Dermatol. 2020 Jul;19(7):1542-1543. doi: 10.1111/jocd.13455. Epub 2020 

Jun 14.

Racial variations in COVID-19 deaths may be due to androgen receptor genetic 

variants associated with prostate cancer and androgenetic alopecia. Are 

anti-androgens a potential treatment for COVID-19?

McCoy J(1), Wambier CG(2), Vano-Galvan S(3), Shapiro J(4), Sinclair R(5), Ramos 

PM(6), Washenik K(7), Andrade M(8), Herrera S(9), Goren A(1)(10).

Author information:

(1)Applied Biology, Irvine, CA, USA.

(2)Department of Dermatology, The Warren Alpert Medical School of Brown 

University, Providence, RI, USA.

(3)Trichology Unit, Dermatology Department, Ramon y Cajal Hospital, IRYCIS, 

University of Alcala, Madrid, Spain.

(4)Department of Dermatology, New York University Langone Medical Center, New 

York City, NY, USA.

(5)Department of Medicine, University of Melbourne, Melbourne, Vic., Australia.

(6)Department of Dermatology, São Paulo State University-UNESP, São Paulo, 

Brazil.

(7)Ronald O. Perelman Department of Dermatology, New York University School of 

Medicine, New York, NY, USA.

(8)Division of Urology, Department of Surgery and Anatomy, Ribeirao Preto 

Medical School, University of Sao Paulo, Ribeirao Preto, Brazil.

(9)Infectious Diseases Department, Hospital Universitario Ramón y Cajal, Madrid, 

Spain.

(10)Department of Dermatology and Venereology, Clinical Hospital Center Sestre 

Milosrdnice, Zagreb, Croatia.

Racial disparities in COVID‐19 infection rates and disease severity are due to a 

multifactorial etiology that can include socioeconomic as well as other factors. 

Nevertheless, genetic factors in different ethnic groups often contribute to 

disease severity and treatment response. In particular, the frequency of genetic 

variations in the androgen receptor differs by ethnicity and gender. For 

example, the increased prevalence of prostate cancer and androgenetic alopecia 

among African Americans correlates with the frequency of these variants. In this 

communication, we propose that androgens may be implicated in COVID‐19 disease 

severity. As such, special attention may need to be given to African Americans 

infected by the SARS‐CoV‐2 virus. Finally, if a link to genetic variations in 

the androgen receptor and COVID‐19 disease severity can be established, it would 

suggest new treatment options.

DOI: 10.1111/jocd.13455

PMCID: PMC7267367

PMID: 32333494

3. Drug Dev Res. 2020 May 15:10.1002/ddr.21688. doi: 10.1002/ddr.21688. Online 

ahead of print.

Androgen sensitivity gateway to COVID-19 disease severity.

Wambier CG(1), Goren A(2), Vaño-Galván S(3), Ramos PM(4), Ossimetha A(5), Nau 

G(6), Herrera S(3), McCoy J(2).

Author information:

(1)Department of Dermatology, Warren Alpert Medical School of Brown University, 

Providence, Rhode Island, USA.

(2)Applied Biology, Inc., Irvine, California, USA.

(3)Trichology Unit, Hospital Universitario Ramón y Cajal, Madrid, Spain.

(4)Department of Dermatology and Radiotherapy, São Paulo State University - 

UNESP, São Paulo, Brazil.

(5)Brown University, Providence, Rhode Island, USA.

(6)Division of Infectious Diseases, Department of Medicine, Warren Alpert 

Medical School of Brown University, Providence, Rhode Island, USA.

In this communication, we present arguments for androgen sensitivity as a likely 

determinant of COVID-19 disease severity. The androgen sensitivity model 

explains why males are more likely to develop severe symptoms while children are 

ostensibly resistant to infection. Further, the model explains the difference in 

COVID-19 mortality rates among different ethnicities. Androgen sensitivity is 

determined by genetic variants of the androgen receptor. The androgen receptor 

regulates transcription of the transmembrane protease, serine 2 (TMPRSS2), which 

is required for SARS-CoV-2 infectivity. TMPRSS2 primes the Spike protein of the 

virus, which has two consequences: diminishing viral recognition by neutralizing 

antibodies and activating SARS-CoV-2 for virus-cell fusion. Genetic variants 

that have been associated with androgenetic alopecia, prostate cancer, benign 

prostatic hyperplasia and polycystic ovary syndrome could be associated with 

host susceptibility. In addition to theoretical epidemiological and molecular 

mechanisms, there are reports of high rates of androgenetic alopecia of from 

hospitalized COVID-19 patients due to severe symptoms. Androgen sensitivity is a 

likely determinant of COVID-19 disease severity. We believe that the evidence 

presented in this communication warrants the initiation of trials using 

anti-androgen agents.

© 2020 Wiley Periodicals, Inc.

DOI: 10.1002/ddr.21688

PMCID: PMC7273095

PMID: 32412125

4. J Cosmet Dermatol. 2020 Jul;19(7):1545-1547. doi: 10.1111/jocd.13443. Epub 2020 

Apr 23.

A preliminary observation: Male pattern hair loss among hospitalized COVID-19 

patients in Spain - A potential clue to the role of androgens in COVID-19 

severity.

Goren A(1), Vaño-Galván S(2), Wambier CG(3), McCoy J(1), Gomez-Zubiaur A(4), 

Moreno-Arrones OM(2), Shapiro J(5), Sinclair RD(6), Gold MH(7), Kovacevic M(8), 

Mesinkovska NA(9), Goldust M(10), Washenik K(5)(11).

Author information:

(1)Applied Biology, Inc., Irvine, CA, USA.

(2)Dermatology Department, Ramon y Cajal Hospital, IRYCIS, University of Alcala, 

Madrid, Spain.

(3)Department of Dermatology, The Warren Alpert Medical School of Brown 

University, Providence, RI, USA.

(4)Department of Dermatology, Principe de Asturias Hospital, Alcala de Henares, 

Spain.

(5)Ronald O. Perelman Department of Dermatology, New York University School of 

Medicine, New York, NY, USA.

(6)Sinclair Dermatology, Melbourne, Vic., Australia.

(7)Gold Skin Care Center, Advanced Aesthetics Medical Spa, The Laser & 

Rejuvenation Center, Nashville, TN, USA.

(8)Department of Dermatology and Venereology, Clinical Hospital Center Sestre 

Milosrdnice, Zagreb, Croatia.

(9)Department of Dermatology, School of Medicine of the University of California 

Irvine, Irvine, CA, USA.

(10)Department of Dermatology, University Hospital Basel, Basel, Switzerland.

(11)Bosley Medical Group, Beverly Hills, CA, USA.

A preliminary observation of high frequency of male pattern hair loss among 

admitted COVID-19 patients and suggest that androgen expression might be a clue 

to COVID-19 severity.

© 2020 Wiley Periodicals, Inc.

DOI: 10.1111/jocd.13443

PMID: 32301221

5. J Am Acad Dermatol. 2020 Jul;83(1):308-309. doi: 10.1016/j.jaad.2020.04.032. 

Epub 2020 Apr 10.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is likely 

to be androgen mediated.

Wambier CG(1), Goren A(2).

Author information:

(1)Department of Dermatology, The Warren Alpert Medical School of Brown 

University, Providence, Rhode Island. Electronic address: 

carlos_wambier@brown.edu.

(2)Applied Biology, Inc, Irvine, California.

[Figure: see text]

DOI: 10.1016/j.jaad.2020.04.032

PMCID: PMC7151476

PMID: 32283245

6. J Microbiol Immunol Infect. 2020 Jun;53(3):436-443. doi: 

10.1016/j.jmii.2020.03.034. Epub 2020 Apr 4.

Treatment options for COVID-19: The reality and challenges.

Jean SS(1), Lee PI(2), Hsueh PR(3).

Author information:

(1)Department of Emergency, School of Medicine, College of Medicine, Taipei 

Medical University, Taipei, Taiwan; Department of Emergency Medicine, Department 

of Emergency and Critical Care Medicine, Wan Fang Hospital, Taipei Medical 

University, Taipei, Taiwan.

(2)Department of Pediatrics, National Taiwan University Children's Hospital, 

National Taiwan University College of Medicine, Taipei, Taiwan.

(3)Department of Laboratory Medicine, National Taiwan University Hospital, 

National Taiwan University College of Medicine, Taipei, Taiwan; Department of 

Internal Medicine, National Taiwan University Hospital, National Taiwan 

University College of Medicine, Taipei, Taiwan. Electronic address: 

hsporen@ntu.edu.tw.

An outbreak related to the severe acute respiratory syndrome coronavirus 2 

(SARS-CoV-2) was first reported in Wuhan, China in December 2019. An extremely 

high potential for dissemination resulted in the global coronavirus disease 2019 

(COVID-19) pandemic in 2020. Despite the worsening trends of COVID-19, no drugs 

are validated to have significant efficacy in clinical treatment of COVID-19 

patients in large-scale studies. Remdesivir is considered the most promising 

antiviral agent; it works by inhibiting the activity of RNA-dependent RNA 

polymerase (RdRp). A large-scale study investigating the clinical efficacy of 

remdesivir (200 mg on day 1, followed by 100 mg once daily) is on-going. The 

other excellent anti-influenza RdRp inhibitor favipiravir is also being 

clinically evaluated for its efficacy in COVID-19 patients. The protease 

inhibitor lopinavir/ritonavir (LPV/RTV) alone is not shown to provide better 

antiviral efficacy than standard care. However, the regimen of LPV/RTV plus 

ribavirin was shown to be effective against SARS-CoV in vitro. Another promising 

alternative is hydroxychloroquine (200 mg thrice daily) plus azithromycin 

(500 mg on day 1, followed by 250 mg once daily on day 2-5), which showed 

excellent clinical efficacy on Chinese COVID-19 patients and anti-SARS-CoV-2 

potency in vitro. The roles of teicoplanin (which inhibits the viral genome 

exposure in cytoplasm) and monoclonal and polyclonal antibodies in the treatment 

of SARS-CoV-2 are under investigation. Avoiding the prescription of 

non-steroidal anti-inflammatory drugs, angiotensin converting enzyme inhibitors, 

or angiotensin II type I receptor blockers is advised for COVID-19 patients.

Copyright © 2020. Published by Elsevier B.V.

DOI: 10.1016/j.jmii.2020.03.034

PMCID: PMC7129535

PMID: 32307245 [Indexed for MEDLINE]

Conflict of interest statement: Declaration of Competing Interest The authors 

declare that they have no conflicts of interest.

Alopecia

No reports re Alopecia Areata 

Male Pattern Alopecia reported and felt to indicate possible role of androgens in  COVID 19

1. J Cosmet Dermatol. 2020 Apr 25. doi: 10.1111/jocd.13455. [Epub ahead of print]

Racial Variations in COVID-19 Deaths May Be Due to Androgen Receptor Genetic

Variants Associated with Prostate Cancer and Androgenetic Alopecia. Are

Anti-Androgens a Potential Treatment for COVID-19?

McCoy J(1), Wambier CG(2), Vano-Galvan S(3), Shapiro J(4), Sinclair R(5), Müller 

Ramos P(6), Washenik K(7), Andrade M(8), Herrera S(9), Goren A(1)(10).

Author information: 

(1)Applied Biology, Irvine, California, USA.

(2)Department of Dermatology, The Warren Alpert Medical School of Brown

University, Providence, Rhode Island, USA.

(3)Trichology Unit, Dermatology Department, Ramon y Cajal Hospital, IRYCIS,

University of Alcala, Madrid, Spain.

(4)Department of Dermatology, New York University Langone Medical Center, New

York City, New York, USA.

(5)Department of Medicine, University of Melbourne, Victoria, Australia.

(6)Department of Dermatology, São Paulo State University - UNESP, São Paulo,

Brazil.

(7)Ronald O. Perelman Department of Dermatology, New York University School of

Medicine, New York, New York, USA.

(8)Division of Urology, Department of Surgery and Anatomy, Ribeirao Preto Medical

School, University of Sao Paulo, Ribeirao Preto, Brazil.

(9)Infectious Diseases Department, Hospital Universitario Ramón y Cajal, Madrid, 

Spain.

(10)Department of Dermatology and Venereology, Clinical Hospital Center Sestre

Milosrdnice, Croatia, United States.

Racial disparities in COVID-19 infection rates and disease severity are due to a 

multifactorial etiology that can include socioeconomic as well as other factors. 

Nevertheless, genetic factors in different ethnic groups often contribute to

disease severity and treatment response. In particular, the frequency of genetic 

variations in the androgen receptor differs by ethnicity and gender. For example,

the increased prevalence of prostate cancer and androgenetic alopecia among

African Americans correlates with the frequency of these variants. In this

communication, we propose that androgens may be implicated in COVID-19 disease

severity. As such, special attention may need to be given to African Americans

infected by the SARS-CoV-2 virus. Finally, if a link to genetic variations in the

androgen receptor and COVID-19 disease severity can be established, it would

suggest new treatment options.

This article is protected by copyright. All rights reserved.

DOI: 10.1111/jocd.13455 

PMID: 32333494 

2. J Cosmet Dermatol. 2020 Apr 16. doi: 10.1111/jocd.13443. [Epub ahead of print]

A preliminary observation: Male pattern hair loss among hospitalized COVID-19

patients in Spain - A potential clue to the role of androgens in COVID-19

severity.

Goren A(1), Vaño-Galván S(2), Wambier CG(3), McCoy J(1), Gomez-Zubiaur A(4),

Moreno-Arrones OM(2), Shapiro J(5), Sinclair RD(6), Gold MH(7), Kovacevic M(8),

Mesinkovska NA(9), Goldust M(10), Washenik K(5)(11).

Author information: 

(1)Applied Biology, Inc., Irvine, CA, USA.

(2)Dermatology Department, Ramon y Cajal Hospital, IRYCIS, University of Alcala, 

Madrid, Spain.

(3)Department of Dermatology, The Warren Alpert Medical School of Brown

University, Providence, RI, USA.

(4)Department of Dermatology, Principe de Asturias Hospital, Alcala de Henares,

Spain.

(5)Ronald O. Perelman Department of Dermatology, New York University School of

Medicine, New York, NY, USA.

(6)Sinclair Dermatology, Melbourne, Vic., Australia.

(7)Gold Skin Care Center, Advanced Aesthetics Medical Spa, The Laser &

Rejuvenation Center, Nashville, TN, USA.

(8)Department of Dermatology and Venereology, Clinical Hospital Center Sestre

Milosrdnice, Zagreb, Croatia.

(9)Department of Dermatology, School of Medicine of the University of California 

Irvine, Irvine, CA, USA.

(10)Department of Dermatology, University Hospital Basel, Basel, Switzerland.

(11)Bosley Medical Group, Beverly Hills, CA, USA.

A preliminary observation of high frequency of male pattern hair loss among

admitted COVID-19 patients and suggest that androgen expression might be a clue

to COVID-19 severity.

© 2020 Wiley Periodicals, Inc.

DOI: 10.1111/jocd.13443 

PMID: 32301221 

3. J Am Acad Dermatol. 2020 Apr 10. pii: S0190-9622(20)30608-3. doi:

10.1016/j.jaad.2020.04.032. [Epub ahead of print]

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is likely 

to be androgen mediated.

Wambier CG(1), Goren A(2).

Author information: 

(1)Department of Dermatology, The Warren Alpert Medical School of Brown

University, Providence, Rhode Island. Electronic address:

carlos_wambier@brown.edu.

(2)Applied Biology, Inc, Irvine, California.

DOI: 10.1016/j.jaad.2020.04.032 

PMCID: PMC7151476

PMID: 32283245 

4. Dermatol Ther. 2020 Apr 1:e13365. doi: 10.1111/dth.13365. [Epub ahead of print]

What does androgenetic alopecia have to do with COVID-19? An insight into a

potential new therapy.

Goren A(1), McCoy J(1), Wambier CG(2), Vano-Galvan S(3), Shapiro J(4), Dhurat

R(5), Washenik K(4)(6), Lotti T(7).

Author information: 

(1)Applied Biology, Inc., Irvine, California, USA.

(2)Department of Dermatology, The Warren Alpert Medical School of Brown

University, Providence, Rhode Island, USA.

(3)Trichology Unit, Dermatology Department, Ramon y Cajal Hospital, IRYCIS,

University of Alcala, Madrid, Spain.

(4)Ronald O. Perelman Department of Dermatology, New York University School of

Medicine, New York, New York, USA.

(5)Department of Dermatology, LTM Medical College & Hospital Sion, Mumbai, India.

(6)Bosley Medical Group, Beverly Hills, California, USA.

(7)Department of Dermatology and Venereology, University of Rome "G.Marconi",

Rome, Italy.

DOI: 10.1111/dth.13365 

PMID: 32237190 


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