Topical minoxidil is the only US FDA approved OTC drug for the treatment of androgenetic alopecia (AGA). Minoxidil is a pro-drug converted into its active form, minoxidil sulfate, by the sulfotransferase enzymes in the outer root sheath of hair follicles. Previously, we demonstrated that sulfotransferase activity in hair follicles predicts response to topical minoxidil in the treatment of AGA. In the human liver, sulfotransferase activity is significantly inhibited by salicylic acid. Low dose OTC aspirin (75mg-81mg), a derivative of salicylic acid, is used by millions of people daily for the prevention of coronary heart disease and cancer. It is not known whether oral aspirin inhibits sulfotransferase activity in hair follicles, potentially affecting minoxidil response in AGA patients. In this study, we determined the follicular sulfotransferase enzymatic activity following 14 days of oral aspirin administration. In our cohort of 24 subjects, 50% were initially predicted to be responders to minoxidil. However, following 14 days of aspirin administration, only 27% of the subjects were predicted to respond to topical minoxidil. To the best of our knowledge, this is the first study to report the effect of low dose daily aspirin use on the efficacy of topical minoxidil. This article is protected by copyright. All rights reserved.

The antimalarials chloroquine and hydroxychloroquine are key medications in the long-term therapy of systemic and cutaneous lupus erythematosus, a disease characterized by a plethora of potential cutaneous manifestations. Reports on the frequency and type of dermatologic side effects of antimalarials are sparse and heterogenous, ranging from 0.1% to more than 10% of treated patients and including the very general term "cutaneous eruption" as well as dyspigmentation, alopecia, hair bleaching, pruritus, polymorphous light eruption, Stevens-Johnson syndrome and toxic epidermal necrolysis. This article is protected by copyright. All rights reserved.

Alopecia areata (AA) is an autoimmune disease causing non-scarring hair loss. In many cases, regrowth of hair can be expected either with or without treatment. In vitiligo, which has similarities in pathogenesis with AA, repigmentation patterns have been classified into 5 distinct patterns: diffuse, marginal, perifollicular, combined, and medium-spotted. This article is protected by copyright. All rights reserved.

An association between alopecia areata (AA) and other autoimmune diseases has been reported. We investigated the associations between AA and overt autoimmune thyroid diseases. A nationwide, population-based, cross-sectional study was performed using the Korea National Health Insurance claims database. We defined patients with AA as those whose records showed at least four physician contacts in which AA, alopecia totalis (AT) or alopecia universalis (AU) was the principal diagnosis. We also established an age- and sex-matched control group without AA. In a subgroup analysis, patients with AT or AU were classified into the severe AA group, and the remainder were classified into the mild to moderate AA group. Patients with AA were at an increased risk of Graves' disease (odds ratio [OR], 1.415; 95% confidence interval [CI], 1.317-1.520) and Hashimoto thyroiditis (OR, 1.157; 95% CI, 1.081-1.237), and the associations were stronger in the severe AA group (Graves' disease: OR, 1.714; 95% CI, 1.387-2.118; Hashimoto thyroiditis: OR, 1.398; 95% CI, 1.137-1.719). In conclusion, AA was significantly associated with overt autoimmune thyroid diseases. Furthermore, the risk was much higher in the severe AA group.

We present the case of a 3-month-old girl who was admitted with complaints of loose stools and respiratory distress. She also had a history of rash and alopecia. Laboratory investigations revealed lymphopenia with reduced immunoglobulin G and immunoglobulin A. Lymphocyte subset analysis by flow cytometry revealed T-B+NK+ severe combined immunodeficiency (SCID). She died due to severe pneumonia, shock and pulmonary hemorrhage. Autopsy findings revealed disseminated cytomegalovirus infection in the lung, liver, adrenals and heart. Thymus was found to be dysplastic and showed characteristic histopathologic features of SCID.

Androgenetic alopecia (AGA) is a common hair loss disorder, especially in men and the elderly. In this study, we analyzed the therapeutic effects of platelet-rich plasma (PRP) injections and embedded sutures in patients with AGA. In each participant, we administered different treatments in one area of hair loss that was divided into four sections. Each section received one of the following treatments: No treatment, PRP injection, suture embedding, and combined PRP injection/suture-embedded areas. The thickness of the scalp, and scalp perfusion were measured using an ultrasound imaging system and Moor FLPI full-field laser perfusion imaging system, respectively. The diameters of the hair were measured using optical microscopy. Our results show that PRP injection treatments increased the diameter of the hair (P = 0.034), and the combined PRP injection/suture-embedded treatments had a significant effect on the thickness of the scalp (P = 0.002), the blood flow (P = 0.014) through the scalp, and the diameter of the hair (P= 0.013). This study has demonstrated that there is a synergistic effect between PRP injections and suture embedding for increasing the thickness and blood flow of the scalp, and diameter of the hair. Combined PRP injection/suture-embedded PRP injections might have therapeutic benefit for patients with AGA.

Atopic dermatitis is a common chronic pruritic inflammatory skin disorder, characterized by an abnormal skin barrier, immune dysfunction, and an altered skin microbiome. Atopic dermatitis may be seen in conjunction with a variety of other skin disorders due to the complex pathogenesis of atopic dermatitis, involving genetic and environmental factors that are associated with immune dysfunction, barrier defects, and altered skin microbiomes. Skin disorders associated with atopic dermatitis include diseases sharing similar genetic origins like ichthyosis vulgaris, infectious diseases such as impetigo, and eczema herpeticum, in addition to the cutaneous autoimmune diseases, alopecia areata, and vitiligo. Atopic dermatitis is also often linked to such benign conditions as pityriasis alba and keratosis pilaris. This review discusses the cutaneous comorbidities of atopic dermatitis and their relationship via their occurrence in conjunction with atopic dermatitis.

Cutaneous inflammatory conditions such as psoriasis, atopic dermatitis, alopecia areata, vitiligo, and connective tissue diseases often remain a challenge to treat. Although there is an in-depth understanding of the clinical presentation of these diseases, much less is known regarding the pathophysiology. This has limited the effective treatment options for patients. A more detailed understanding of the pathogenesis of each disease will lead to newer targeted medications with less morbidity. Though there are different pathways involved in these diseases, the Janus Kinase (JAK)-Signal Transducer and Activator of Transcription proteins (STAT) signaling pathway is common to them all. Therefore, this review article endeavors to substantiate the immunopathology and clinical utility of the JAK inhibitors as treatments for different chronic inflammatory diseases of the skin.

The current state of the applicability of cell therapy for the treatment of various conditions of hair loss reveals a promising and potentially effective role. Further research, based on published work to date, is indicated to further explore the potential roles of autologous fat grafting, mesenchymal stem cells, and stromal vascular fraction therapy. The authors' evolving experience matches these promising scientific findings.