Hair loss and pemphigus vulgaris

J Eur Acad Dermatol Venereol. 2011 Nov 28. doi: 10.1111/j.1468-3083.2011.04363.x. [Epub ahead of print]

Alopecia as a rare but distinct manifestation of pemphigus vulgaris.

Veraitch O,  et al.


Background  Pemphigus vulgaris (PV) patients may develop scalp erosions, however, the development of alopecia has been reported to be extremely rare. Objective  To delineate the clinicopathological features of alopecia in PV and provide insight into the pathogenesis of this rarely observed manifestation. Methods  A retrospective case note review was performed on five PV patients presenting with progressive hair loss and alopecic patches. Data were collected on demographics and clinical findings. Results for hair pull tests, direct immunofluorescence study of plucked hairs,established laboratory tests to detect anti-desmoglein 1 and 3 autoantibodies and scalp swab culture were recorded. A combination of vertical and horizontal sectioning technique enabled detailed histopathological analysis of alopecic patches. Clinical course was monitored. Results  Anagen hairfollicles with the outer root sheath structure were easily pulled from perilesional scalp, with intercellular IgG deposition on the outer root sheath keratinocytes. Acantholysis between outer root sheath keratinocytes extending from the infundibulum to suprabalbar level was evident in anagen hair follicles  of affected lesions. Perifollicular cell infiltration was observed in the lesions where scalp swabs detected micro-organisms. The bulge stem  cell area was mostly intact. Alopecia was non-scarring and following 4 weeks of therapy hair re-growth was seen in all patients. Conclusion  In PV, the combination of anti-desmoglein autoantibody-mediated acantholysis in conjunction  with secondary factors, such as inflammatory changes due to infection, may cause weakening of hair follicle anchorage resulting in hair loss and alopecic patches. This unusual clinical phenotype should alert physicians to PV as a potential diagnosis.

Edited for hair loss blog use


Natural shampoos

Natural Shampoos

Int J Cosmet Sci. 2001 Jun;23(3):139-45.

A study on the conditioning effects of natural shampoos using the
scanning electron microscope.

Bellare J, Iyer R, Mainkar AR, Jolly CI.

The scanning electron microscope (SEM) was successfully used to
study the effects of toiletry treatment with shampoo on the
microstructure of hair. This paper describes the use of SEM for
comparing the conditioning effects of herbal shampoos. Commercially available herbal shampoos are not completely natural, but contain herbal extracts in a synthetic detergent base, along with other chemical additives. Completely natural shampoos were formulated in the laboratory and their conditioning effects were evaluated by comparing with a commercially available herbal
shampoo. The micrographs were studied quantitatively using Image
Analyser Software’ and the extent to which the hair scales were
uplifted was measured. The results obtained from the quantitative comparison were in agreement with those obtained from other tests, such as protein loss determination. The damage caused to the hair due to sodium lauryl sulphate was visible in the micrographs. The laboratory formulations were found to be better than the commercially available product. Thus, quantitative measurements from SEM micrographs are a valuable tool to compare the conditioning effects of hair care products.

PMID: 18498466

Related Links

Conditioning polymers in today’s shampoo formulations – efficacy, mechanism and test methods. [Int J Cosmet Sci. 2000]

The antifungal action of dandruff shampoos. [Mycopathologia. 1999]

Evaluation of commercial herbal shampoos. [Int J Cosmet Sci. 2000]

Shampoos: ingredients, efficacy and adverse effects. [J Dtsch
Dermatol Ges. 2007]

[Formaldehyde in hair shampoos] [Derm Beruf Umwelt. 1979]

Hair Loss and Depression

Hair loss and depression

July 20th, 2010

Psychiatr Danub. 2010 Jun;22(2):293-5.

Depressive disorder and alopecia.

Grahovac T, Ruzi? K, Sepi?-Grahovac D, Dadi?-Hero E, Radonja AP.

Psychophysical dermatitis is frequently manifested in patients
that suffer from psychiatric illnesses and disorders as well as in patients that suffer from depressive disorders. These diseases occur or worsen after acute stress that may trigger them.Difficulties in expressing feelings or impossibility to verbalise them are connected to somatic diseases. In order to
emphasize their importance, we will present a case of a 58 years
old woman who has been suffering from alopecia areata that
developed after her husband’s death. The patient doesn’t function well since then – she is socially isolated, she has lost self confidence and self esteem. As she has realised it was impossible to live like that, she decided to seek psychiatric help. The patient should be examined through theprism of the
interdisciplinary treatment and as an integral structure of the mindand body.

hair loss regrowth and hair loss treatment

Hair loss after maprotiline

Hair loss after maprotiline

Hautarzt. 1991;42(7):455

Ichthyosis and alopecia after maprotiline: corneolysis caused by
temporary disorder of keratinization

Niederauer HH, Bacharach-Buhles M,
Altmeyer P.

A 37-year-old woman developed ichthyosiform desquamation of the
skin and a severe diffuse alopecia 3 weeks after taking the
antidepressant maprotilin. No signs of inflammation were present.
Histology revealed acanthosis with preserved stratum granulosum,
follicular hyperkeratosis and dystrophic changes of the hair follicle. Electron microscopy revealed rarefication of tonofilaments and necrobiotic changes of epidermal keratinocytes with vacuolar degeneration of the cytoplasm and disorganization of the organelles. Pathogenetically this disease represents a drug-induced transitory disorder to keratinization, which had resulted in desquamation of the stratum corneum and hair loss. The authors propose the designation corneolysis for this pathogenetic principle.

Edited for hair loss blog