Poster Presentations

. 2012 Apr-Jun;4(2):131–152.

Poster Presentations

PMCID: PMC3500072

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P001: Characterization and Use of Neopapillae and Microfollicles

Gerd Lindner, Reyk Horland, IlkaWagner, Beren Atac, Uwe Marx, Roland Lauster

Department of Biotechnology, Technische Universitδt Berlin, Berlin, Germany

We recently described the de novo formation of human hair follicle equivalents in vitro. A dermal papilla fibroblast (DPF) condensate resembles the germ of these in vitro formed microfollicles. In contrast to monolayer-cultured DPF, these self-aggregated neopapillae express different panels of growth factors, cytokines and extracellular matrix proteins necessary to induce organoid formation and fiber production comparable to native anagen dermal papillae.

Gene expression profiling and quantification, protein secretion and ultra-structural analysis of this neopapillae were performed. In addition, we investigated the onset of fiber production in comparison to normal anagen hair follicles and characterized the performance of bioengineered microfollicles introduced into a full-thickness skin equivalent which had been cultured under perfused conditions in a chip-based bioreactor.

Among others, the self-organized neopapillae showed a five-fold increased hepatocyte growth factor and seven-fold elevated BMP-4 expression than monolayer-cultured DPF as shown by RT-PCR. While TNF-alpha and IL-6 protein secretion of neopapillae was dramatically reduced, VEGF and FGF2 were considerably raised in comparison to 2D-cultured DPF.

Transmission electron microscopy showed the peri- and suprapapillary localization of fibrous bundle formation giving rise to the onset of hair shaft production originated by dermal papilla fibroblasts developing a medulla backbone.

We showed that the self-organized formation of human neopapillae and microfollicles in vitro corresponds to basic hair follicle developmental characteristics.

The generated microfollicles can successfully be implemented into skin equivalents, and culture periods can be significantly prolonged rendering this system valuable for in vitro substance testing and to study follicle development in general.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P002: Expression of the Receptor for Advanced Glycation End Products in Aging Hair Follicles

Melanie Giesen*, Sabine Gruedl, Dirk Petersohn, Thomas Foerster

Henkel AG & Co. KGaA, Duesseldorf, Germany

Advanced glycation end products (AGEs) are the result of non-enzymatic chemical reactions of carbohydrates and amino groups of macromolecules such as proteins or nucleic acids. Thus, AGEs adversely affect the functional properties of proteins, lipids and DNA. These chemical modifications accumulate with age and the negative effects on skin relevant molecules such as collagen raise AGEs to a growing target for cosmetic products. The equivalent receptor for advanced glycation end products (RAGE) has been implicated in chronic inflammation which is also associated with aging. However, the relevance of RAGE regarding aging of human hair follicles remains unclear. The aim of this study was to investigate the expression of RAGE and the associated signaling network in aged scalp hair follicles. Therefore we characterized hair roots of two volunteer panels (below 25 years, above 50 years) on the molecular level. We show that follicular aging is linked to an increase in RAGE expression while other AGE receptors remain unaffected. Additionally, expression of S100 proteins, which can also work as RAGE ligands was induced in hair follicles from volunteers above 50 years as well as several mitogen-activated protein kinases and the proinflammatory cytokine IL6, both of which are associated to RAGE-mediated signal transduction.

As our studies reveal a cascade of RAGE-mediated signaling in elder hair follicles, we conclude that RAGE may play a relevant role in follicular aging processes. It remains to be elucidated whether the accumulation of AGE in mature scalp tissue impact phenomena like hair graying or hair cycle misbalances.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P003: Hair Graying is Associated with Active Hair Growth

Hye In Choi, Gue In Choi, Young Lee¹, Jeung Hoon Lee¹, Young Ho Lee*

Departments of Anatomy and ¹Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea

Hair graying is an obvious sign of aging in humans. White (nonpigmented) hair is thicker than black (pigmented) hair. The growth rate of white hair is also significantly higher than that of black hair. However, the mechanism underlying this is largely unknown. To examine the association between hair graying and hair growth patterns, we need to evaluate the expression of the genes or proteins related to hair growth in white and black hairs. Keratin and keratin-associated protein (KRTAP) genes in white hair were upregulated at least two-fold in comparison with black hair in a microarray analysis. Upregulation of selected keratin genes and KRTAP4 isoform genes in white hair was validated by RT-PCR. Immunoreactivity for KRT6, KRT14⁄16 and KRT25 was increased in the hair follicle of white hair compared with black hair. Gene expression of fibroblast growth factor 5 (FGF5) was downregulated in white hair compared with black hair. However, gene expression of FGF7 was upregulated in white hair compared with black hair. Taken together, expression of genes and proteins associated with active hair growth is upregulated in white (nonpigmented) hair compared with black (pigmented) hair. These results suggest that hair graying is associated with active hair growth.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P004: Effect Expression of Bioactive Markers in Cultured Sebocytes is Altered by Exposure to UVB, but not by Visual Light

Weon Ju Lee, Jin Sub Lee, Hyun Wuk Cha, Han Jin Jung, Mi Yeung Sohn, Kyung Duck Park, Hyun Jung Lim, Seok-Jong Lee, Do Won Kim

Department of Dermatology, Kyungpook National University Hospital, Daegu, South Korea

It has been established that many bioactive markers such as differentiation markers including involucrin, loricrin and filaggrin, antimicrobial peptides (AMPs) including psoriasin, human β-defensin (hBD)-2, hBD-3 and LL-37 and inflammatory biomarkers including interleukin-1 (IL-1), IL-6, IL-8, tumor necrosis factor-α and matrix metalloproteinases (MMP) are expressed in a temporally regulated manner during keratinocyte differentiation. Sebocytes also express the bioactive markers even though less than in keratinocytes.

This study was conducted to clarify changes in bioactive marker expression in cultured sebocytes after treatment with UVB and visual light. RT-PCR, immunocytofluorescence and western blotting were performed. Changes in the expression of bioactive markers after treatment with UVB (0.5 or 1 MED for 1, 3 or 5 days) and visual light (20 minutes for 1, 3 or 5 days) were investigated in triplicate. The expression of differentiation markers showed an increased pattern in cultured sebocytes after exposure to UVB (0.5 MED for 3 or 5 days, and 1 MED for 5 days), but not after visual light. The expression of AMPs showed an increased pattern in cultured sebocytes after exposure to UVB (0.5 MED for 3 or 5 days, and 1 MED for 1, 3 or 5 days) and visual light (20 minutes for 1 day). Out of inflammatory biomarkers, the expression of IL-6, IL-8, MMP-1 and MMP-3 showed an increased pattern in cultured sebocytes after exposure to UVB (0.5 MED for 1 or 3 days, and 1 MED for 1 day), but not after visual light.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P005: Comparisons of Biocompatible Scaffolds for Human and Mouse Hair Regeneration Study

Ji Won Oh* Jeong Ok Lim¹, Moonkyu Kim, Jungchul Kim

Department of Immunology and Hair Research Center, Kyungpook National University School of Medicine, Daegu,¹Joint Institute for Regenerative Medicine (JIRM), Kyungpook National University Hospital, Korea

Hair follicle is known for distinct organ of epithelial mesenchymal interaction. Since regenerative medicine start to use biocompatible scaffold, fiber sheet and sponge type of scaffold are commonly used for tissue regeneration. Once the cells are out for growth in vitro, they tend to lose the character they have in vivo. The three-dimensional cell cultivation can enhance the natural property of the cell and restore the functional feature of them. In this study, we tried several scaffold for making functionally working epithelial structure for human and mouse hair regeneration study. The bladder-submucosal sponge (BSM hybrid sponge) could be applicable to the study of epithelial mesenchymal signaling pathway. Fiber sheet has less porous as well as thinner than BSM sponge and has advantage for cell attachments. The human outer root sheath keratinocytes did make cluster onto the mouse newborn epithelial skin scaffold (NESS) unevenly due to the physical damage during preparation. This study speculated the possibility of using scaffold for hair regeneration study as point of epithelial cells. The present findings could be relevant model for epithelial cells to advance our understanding of the hair regeneration and cure for hair loss.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P006: Identification of GJB6 Mutations in Families with Pure Hair and Nail Ectodermal Dysplasis

Abdul Wali^1,2, Hassnaa Mahmoudi¹, Sandra M. Pasternack^1*, Sabrina Wolf¹, Wasim Ahmad³, Regina C. Betz¹

¹Institute of Human Genetics, University of Bonn, 53127 Bonn, Germany, ²Department of Biotechnology and Informatics, Faculty of Life Sciences and Informatics, BUITEMS, Quetta, ³Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, 45320 Islamabad, Pakistan

Ectodermal dysplasias comprise a large group of inherited disorders primarily affecting ectodermal structures as hair, nails, teeth, skin and sweet glands. Among them, pure hair and nail ectodermal dysplasia (PHNED; MIM 602032) is a rare subgroup which is characterized by loss of hair varying from mild hypotrichosis to complete alopecia, and dystrophy of finger and toenails. We have examined a large family from Pakistan with 9 affecteds and a family from Germany with 4 affecteds with autosomal-dominant PHNED. All individuals show dystrophic nails. In most of the affected individuals, hairs were absent from the scalp, face, body, pubic and axillary regions; the patients were born completely devoid of eyebrows and eyelashes. So far, not a single gene/gene locus has been reported exclusively for the autosomal-dominant form of PHNED. Therefore, we performed a genome-wide linkage scan with 9 affected and 5 unaffected members of the Pakistani family and mapped this disease to chromosome 13q12.11-q13.3. Sequence analysis of the candidate gene GJB6 revealed the heterozygous missense mutation c.31G>A (p.G11R) in all affected individuals. Screening of GJB6 in the German family revealed a heterozygous c.263C>T (p.A88V) mutation. Interestingly, both mutations had previously been implicated in a number of cases with Clouston syndrome, a disease characterized by palmoplantar hyperkeratosis, hair defects and nail hypoplasia and deformities. Thus, a single mutation in GJB6 can show different clinical phenotypes. These diverse phenotypes might be due to so far unknown modifier genes. The identified mutations further demonstrate genetic homogeneity for different types of ectodermal dysplasias.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P007: Hypoxia and Human Hair Follicle Stem/Progenitor Cells

Gaïanne Genty, Jennifer Lecardonel, Bruno Bernard, Michelle Rathman-Josserand

L’Oreal Research and Innovation, Clichy, France

Hypoxia is an important characteristic of numerous stem cell reservoirs and recent evidence indicates that this may also hold true for the lower stem cell niche of human hair follicles.

To investigate the potential impact of hypoxia on hair follicle stem and early progenitor cell populations, we measured the colony-forming efficiency (CFE) of keratinocytes derived from the Outer Root Sheath (ORS) of human follicles, cultured under normoxic or hypoxic conditions. Although the absolute number of clones was not statistically different, cell density was reduced under hypoxic culturing conditions, suggesting better control of cell proliferation.

Based on these results, we hypothesized that induction of hypoxia signaling may be important in maintaining hair follicle stem cell functionality. Hypoxia signaling is mediated by HIF1, the a subunit of which is degraded in an oxygen-dependent manner through prolyl-4-hydroxylase (P4H)-mediated hydroxylation. A potent P4H competitive inhibitor, Stemoxydine, was tested for its ability to induce hypoxia-like signaling. Transcriptomic studies show that treatment of hair follicles with Stemoxydine in normoxic conditions modifies the expression of a panel of genes in the same manner as culturing under hypoxic conditions. In addition, when ORS-derived hair follicle cells were grown in normoxic conditions with Stemoxydine, CFE and clone morphology were similar to those observed in hypoxic conditions.

These results suggest that hypoxia may be an important regulator of stem/progenitor cells function in the human hair follicle. We hypothesize that molecules that mimic hypoxic signaling, such as Stemoxydine, may figure as new approach to sustain hair growth and cycling.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P008: Biofunctional, Designed to Boost essentials for Hair Fiber Strength and Clinically Proven Hair maintenance

Paul Mouser, Catherine Gondran, Linda Foltis, Regina Raponi, Nouha Domloge, Cenk Uzel, Jean-Marie Botto, Anand Mahadeshwar

Hair loss can be a considerable psychological and social problem for those affected. About half of men and a quarter of women are afflicted with hair loss. Understanding the roles of different hair follicle components and the possibilities for acting on them are key challenges in hair biology. Therefore, our goals were to identify markers of hair growth and structure in the hair follicle in order to study their expression as well as the incidence on hair loss clinically.

Human scalp skin grafts were maintained at the air-liquid interface and fed with a previously defined serum-free medium. After a 48 h treatment with topical application of an yeast extract (1%), scalp grafts were processed for immuno-fluorescence detection. Our studies (ex-vivo) showed that the yeast extract induced an increase in keratin 14 and keratin 17 in the outer root sheath. Trichohyalin and keratin 71 were increased by the yeast extract in the inner root sheath. CD34 was increased whilst collagen IV staining of the basement membrane was more intense compared to the control. These markers are known to be important for the strength and health of the hair follicle as well as the quality of the anchoring of the hair.

The assessment of the efficacy to help limit hair loss was made with 74 healthy subjects by means of the trichogram technique (3 months monadic, double-blind study). In addition, the assessment of anti-hair fall and likeability was made by applying a sensory questionnaire of perception of efficacy of the products. Statistically significant increase of the anagen/telogen ratio was observed with the yeast extract formulation after 30, 60 and 90 days application. The hair maintenance effect was also consumer perceivable with subjects noticing anti-hair fall benefits after 3 weeks.

Using scalp skin, human follicles were maintained in their physiological environment and the interactions between the different cellular compartments were preserved. This extract boosts markers related to structural strength essential for stronger and healthier looking hair. In addition the clinical results show the yeast extract to be effective for hair fall.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P009: Development of a Model of Stress-Induced Senescence on Dermal Papilla Cells

Catherine Gondran, Sandrine Ratz, Armelle Perrin, Céline Meyrignac, Paul Mouser¹, Jean-Marie Botto, Nouha Domloge

Ashland Speciality Ingredients, Vincience Sophia-Antipolis, France, ¹Ashland, Wayne, NJ, USA

The incidence of dermal papilla cell aging on hair follicle functionality is still poorly understood. In the present study, we have developed a model of senescent human dermal papilla cells (HDPCs), using methylglyoxal (MGO) stress. This highly reactive dicarbonyl compound causes oxidative damage, including advanced glycation end-products.

Our results showed that HDPC in culture displayed heterogeneity in their morphology. When MGO stress was applied, cellular damage and cell loss were observed. Moreover, this stress led to an increase in beta-1 galactosidase (GLB1) staining and a decrease in alkaline phosphatase activity. Cells stressed by MGO exhibited a reduction of Ki67 staining, as well as disorganization in the secreted fibronectin network.

After having characterized HDPC senescent phenotype, we used this model to test the effect of a biofunctional, designed to target the expression of circadian proteins. Indeed, previous studies demonstrate that the circadian system is connected to stress response and aging. We observed that application of the biofunctional on senescent cells helped mitigate the damage induced by MGO.

In conclusion, in vitro senescence induced by MGO appearsto be a reliable model to study some characteristics of HDPC aging, such as matrix production and proliferation capacity.Circadian protein modulation could limit the appearance of senescence-associated markers in dermal papilla cells. The circadian system may play a crucial role inside the hair follicle, by orchestrating cellular functions and participating in the maintenance of hair growth conditions, especially during hair aging process.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P010: Induction of Hair Growth Bby Phytosphingosine-1-Phosphate in C3H/Hej Mice Model

Hyun Kyu Kim, Yun Young Lim, Hyeong Mi Kim, Myeong Jun Choi¹, Yang Won Lee², Chong Hyun Won³, Chang Hun Huh⁴, Chang Kwun Hong, Beom Joon Kim*

Department of Dermatology, Chung-Ang University, College of Medicine, Seoul, ¹Phytos, Gyeonggi, ²Department of Dermatology, Konkuk University, College of Medicine, ³Asan Medical Center, University of Ulsan College of Medicine, Seoul, ⁴Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Korea

Sphingosine-1-phosphate (S1P) which is stored in and released from platelet seems to play various roles physiologically. S1P through S1P receptor induces angiogenesis which is one of the major therapeutic strategies of hair growth. Phytosphingosine-1-phosphate (PhS1P), a S1P receptor agonist, has been shown to have angiogenic activity. We investigated the efficacy of PhS1P to hair growth in C3H/HeJ mice. After setting same hair cycle using a grainer and hair loss cream, the mice were divided into 5 groups: normal hair (no treatment), a vehicle material of PhS1P, a positive control of 3% minoxidil, treatment of PhS1P, and cyclic PhS1P group. The efficacy was assessed by dermoscope and histologic analysis was made by hematoxylin and eosin staining. We observed that topical application of 3% minoxidil, PhS1P and cyclic PhS1P solution promoted hair growth earlier and faster than the negative control group. PhS1P group showed better hair growth effect than cyclic PhS1P group. And increased expression of Wnt3a, Wnt5a, and mice hair growth-related molecules was observed in PhS1P and cyclic PhS1P group. These findings suggest that PhS1P could be one of the treatment options for hair growth. This study was supported by a Korea Research Foundation Grant funded by the Korea Government (2010-0021960).

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P011: Keratins and Lipids in Ethnic Hair

Célia Cruz^*, Margarida Fernandes, Andreia Gomes¹, Luisa Coderch², Maritxel Marti², Sandra Mendez², Luís Gales³, Nuno Azoia, Ulyana Shimanovich, Artur Cavaco-Paulo

Department of Textile Engineering, Campus of Azurém, University of Minho, Guimarães,¹Department of Biology, Centre of Molecular and Environmental Biology (CBMA), University of Minho, Braga, Portugal,²IQAC (CSIC), Barcelona, Spain,³INEB, Porto, Portugal

Human hair has an important role in visual appearance and social communication. It is mainly composed of structural proteins and lipids. Thin layer chromatography and fluorescence probing methods, in combination with X-ray analysis, fluorescence and confocal microscopy, were used to characterize and image the lipids and keratin present in hairs from different ethnicities: Asian, Caucasian and African. The results indicate that African hair has higher lipid content, mainly free fatty acids and cholesterol esters, however lipids localization varies depending on the hair ethnicity. The X-ray analysis of the hair indicates that, in African hair, the lipids influence the structure of the hair proteins, as the axial order of keratin was lost when lipids were removed from these hairs.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P012: Identification of a Novel U2HR Mutation in a Korean Woman with Marie-Unna Hereditary Hypotrichosis

Jin Park, Ki-Hun Song, Kyung-Hwa Nam, Seok-Kweon Yun, Han-Uk Kim

Department of Dermatology, Chonbuk National University Medical School, Jeonju, South Korea

Marie-Unna hereditary hypotrichosis (MUHH) is a rare autosomal dominant hair loss disorder with progressive alopecia. Recently, researchers have identified mutations in U2HR, an upstream regulator of the Hr gene, as genetically responsible for MUHH. So far, 16 mutations in U2HR gene have been identified as far as we know.

We report a novel heterozygous missense mutation within U2HR of the HR gene that was identified in a Korean woman with MUHH. A 24-year-old woman presented with progressive hair loss. Since puberty, she showed decreased hair density and coarse hair texture on vertex and occipital scalp. Her eyebrows, eyelashes and pubic hairs were scanty. But there were no other ectodermal abnormalities. On her pedigree, at least 7 people of her family members, including her father, had similar symptoms. Light and scanning electron microscopy revealed hair shaft thickening, longitudinal grooving and irregular hair shaft twists which are characteristics of MUHH. Sequencing of the upstream ORF U2HR in the 5′UTR of the hairless gene resulted in the identification of a novel heterozygous missense mutation c.80C>T that has not been yet reported worldwide. This observation contributes to the mutation spectrum of U2HR underlying MUHH.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P013: Identification and Isolation of Melanocytes in Human Sebaceous Glands

Yong Hyun Jang^*, Kun-Young Kwon¹, Seok-Jong Lee², Do Won Kim², Weon Ju Lee²

Department of Dermatology, Ajou University School of Medicine, Suwon,¹Department of Pathology, Keimyung University School of Medicine, Daegu,²Department of Dermatology, Kyungpook National University School of Medicine, Daegu, Korea

Melanocytes follow an interesting and diverse developmental pathway. Most melanocytes originate in the neural crest and migrate from there to populate specific regions including the skin and hair follicles, the inner ear and the Harderian gland and choroid of the eye. However, very little is known about the presence of melanocytes and their role in human sebaceous glands. Elucidation of the possible distribution of melanocytes within sebaceous glands and of their pathogenic significance will be the intriguing subjects for investigation in the field of sebaceous gland biology.

The purpose of this study was to identify the presence and distribution of melanocytes in human sebaceous glands by electron microscopy and immunohistochemical staining with S-100. of 49 specimens of human sebaceous glands, 12 showed S-100 positive melanocytes at the periphery of the sebaceous glands. In addition, a small number of melanocytes were admixed within sebocytes. Electron micrograph demonstrated a melanocyte in suprabasal portion of the sebaceous gland. The melanocyte showed a small number of melanin-containing granules compared to the melanocyte of suprabasal portion of the epidermis. The melanosomes individually distributed tended to have a larger size than those of epidermal melanocytes. We also isolated primary melanocytes from human sebaceous glands in vitro.

In this study, we confirmed the presence of melanocytes in human sebaceous glands. Additional studies focusing on the structural and functional importance of the melanocytes distributed in sebaceous glands might provide better insight into the role of melanocytes in human sebaceous glands.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P014: Histone H4 Promotes Catagen Progression by Regulating the Activity of Follicular Dermal Papilla Cells and Keratinocytes

Seung Hyun Shin*, Moon Kyu Kim, Jung Chul Kim, Young Kwan Sung

Department of Immunology, School of Medicine, Kyungpook National University, Daegu 700-422, Korea

Recent studies have shown that the extracellular histones exhibit diverse biological functions. Very recently, histone H4 was reported to be released by rat vibrissa dermal papilla (DP) cells exposed to sub-toxic dose of colchicines and recombinant histone H4 inhibited the proliferation of vibrissa DP cells and reduced the alkaline phosphatase (ALP) activity, an important indicator of DP activity, suggesting that histone H4 may affect hair growth by regulating activity of DP cells. This suggestion prompted us to investigate the role of histone H4 on hair growth. Herein we report that histone H4 significantly inhibited the growth of human DP cells and outer root sheath keratinocytes. Also, histone H4 significantly suppressed the growth of hair shafts in cultured human hair follicles, reduced Ki-67-positive signal of matrix keratinocytes surrounding the DP and decreased insulin-like growth factor-1 expression in DP cells. Moreover, histone H4 injection into the hypodermis of mice during anagen caused premature onset of catagen. Taken together, our data strongly suggest that histone H4 promotes regression of hair follicles by regulating the activity of follicular dermal papilla cells and keratinocytes.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P015: Spirodela Polyrhiza L. Extract Induced Hair Growth Mediated Through the Activation of Wnt/Β-Catenin Signaling and the Regulation of DHT Induced Genes

Ho Song Cho, Jongmin Bak, Sanghwa Lee

Bio Research Center, LG Household & Healthcare Ltd, 84 Jang-dong, Yuseong-gu, Daejeon, 305-343, Korea.

0Wnt/β-catenin signaling plays important role in many developmental processes, including hair follicle morphogenesis and stem cell differentiation. In search of novel hair-growth stimulating agents, ethanolic extracts of herbal medicinal plants were screened for Wnt/β-catenin signaling in human DP cells. Among them, the extract of Spirodela polyrhiza L. (S. polyrhiza) showed potent inducing effect of β-catenin responsive transcription in TOP Flash reporter assay. In addition, topical application of S. polyrhiza extract onto the back of C57BL/6 mice, earlier conversion of telogen-to-anagen was induced. To investigate the action mechanism, we treated cultured human dermal papilla cells with S. polyrhiza extract. RT-PCR analysis showed that S. polyrhiza extract enhanced β-catenin mRNA level. Also, S. polyrhiza extract reduced DHT-induced androgen receptor (AR), DKK-1 and TGF-β mRNA levels, suggesting that the effects of S. polyrhiza extract on hair growth may be mediated through the activation of Wnt/β-catenin signaling and the regulation of DHT-induced genes in dermal papilla cells.

We further investigate the effect of S. polyrhiza extract on glycogen synthase kinase-3 (GSK-3) using phosphor GSK-3 Ab, which is a key regulator of Wnt signaling. S. polyrhiza extract decreased the GSK-3 phosphorylation in a dose-dependent manner, suggesting that S. polyrhiza extract may have an impact on intracellular β-catenin signaling via GSK-3 dephosphorylation. Taken together, these results suggest that S. polyrhiza extract has hair growth promoting potential and can be used for hair growth stimulating formulations.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P016: Impairment of Hair Follicle Neogenesis by Ablation of Alkaline Phosphatase Activity in Mouse Neonatal Dermal Cells

Gong Hee Won, Seung Hyun Shin, Moon Kyu Kim, Jung Chul Kim, Young Kwan Sun

Department of Immunology, School of Medicine, Kyungpook National University, Daegu, Korea

Alkaline phosphatase (ALP) is a plasma membrane-bound enzyme with phosphohydrolase activity. ALP activity is regarded as a useful marker of the location, shape, and size of dermal papilla (DP). A recent study by McElwee et al (2003) reported on induction of hair follicle (HF) development by ALP-expressing cells cultured from DP and dermal sheath cup (DSC) after implantation. Non-ALP expressing, non-bulbar dermal sheath cells did not induce development of new hair follicles. In addition, Rendl et al (2008) provided evidence for ALP activity as a marker of hair follicle-inducing ability (trichogenicity) of DP cells. These reports prompted us to investigate the role of ALP in trichogenicity of dermal cells. To examine involvement of ALP activity in dermal cells in hair follicle neogenesis, we employed a small interfering (si) RNA-mediated gene knockdown approach together with the patch assay. Here, we demonstrate that ALP activity of dermal cells is crucial to hair follicle neogenesis, and we strongly suggest that ALP activity-dependent cellular changes are involved in trichogenicity of dermal cells.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P017: A Cell Culture System for Undifferentiated Hair Follicle Stem Cells

Antonia Kellenberger¹, David F. Woodward², Miyuki Tauchi^1,3*

¹Division of Molecular Neurology and³Department of Neurology, University Hospital Erlangen, Germany,²Department of Biological Sciences, Allergan Inc. Irvine, CA, USA

Many hair growth-stimulating agents, such as prostaglandin analogues, affect the growth cycle of hair follicles, in particular, stimulate early entry of resting follicles (telogen) into the growth phase (anagen), presumably by activating hair follicle stem cell (HFSC). The underlying molecular mechanisms are still unknown. We aimed to establish an in vitro model to investigate the effects of those agents on hair follicle stem cells.

Whisker hair follicles of 3-5-week-old male C57Bl/6 mice were collected and infundibulum and dermal papilla were mechanically removed. The remaining part of follicles was digested and single cell suspension was obtained. Isolated cells were slow growing and sphere forming. Total RNA was isolated and characterized by reverse transcription PCR. We found that the cells expressed several stem cell markers such as CD200, CD34, Nestin and K15. Furthermore, the cells expressed prostaglandin receptors, such as EP1-4 and FP. Next, we treated the cultured cells with Bimatoprost, a prostaglandin ethanolamide F2a mimetic. After 7 days of treatment, cells were harvested and mRNA expressions were analyzed. Bimatoprost treatment reduced the expression of stem cell markers in a dose-dependent manner. FP was also downregulated, but EP receptors did not show an obvious tendency in three independent experiments.

We concluded that HFSC was successfully collected and cultured with the method, and bimatoprost treatment was able to reduce the stemness of these cells, possibly stimulating differentiation.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P018: The Expression Pattern of Sortilin in Human Hair Follicle and its Essential Role in Hair Growth

Xing-Hai Jin*, Long-Quan Pi, Sungjoo Tommy Hwang¹, Won- Soo Lee

Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju,¹Dr. Hwang's Hair-Hair Clinic, Seoul, Korea

The pro-nerve growth factor (proNGF) and its apoptosis-promoting low-affinity receptor (p75NTR) regulate apoptosis process in human hair follicle. Sortilin is well known as a required component for transmitting proNGF-dependent death signals via p75NTR. However, the expression and role of sortilin in human hair follicles (HFs) has not yet been clearly shown.

The purpose of current study was to investigate the expression and role of sortilin in human HFs. We examined the expression of sortilin in human HFs and its expression change according to the hair cycle. Furthermore, we examined the effects of sortilin on human hair growth. We observed that HFs expressed sortilin at mRNA and protein level. Sortilin immunoreactivity can be detected in the epithelium of human anagen hair follicles. During the transformation from anagen to catagen, sortilin expression appeared to be upregulated. ProNGF significantly inhibited the human hair growth and promoted apoptosis process in organ-cultured human follicles. Moreover, sortilin antagonist inhibited the apoptosis process induced by proNGF.

Altogether, these results indicate that sortilin might be an important regulatory factor for human hair cycle.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P019: The Physical Model of the Interaction of Thiols with Human Hair at Nanolevel

Anastasiia Kasprova*, Sergiy Senchurov*, Yurii Zabashta*

Department of Molecular Physics, Physics Faculty, Taras Shevchenko University of Kyiv, Kyiv, Ukraine

The influence of an aqueous solution of thioglycolic acid on the structure and mechanical, relaxation, optical and thermal properties of human hair has been studied. None of the existing physical models of human hair fully explains the whole complex of observed physical phenomena which occur during the thiol interaction with human hair. The three-component model is proposed to describe the physical mechanisms of the interaction of an aqueous solution of thioglycolic acid with hair. This model is tree-component as well-known Feughelman's model but has significant differences. The model describes well the structure of human hair at nanoscale. The model is shown schematically in Figure 1. According to the model, human hair is a composite structure of microfibrils embedded into amorphous matrix. Average microfibril's diameter is about 10 nm. Microfibrils are composed of crystalline areas where alpha-helixes are regularly packed and intrafibrillar unordered areas where keratins molecules are oriented mainly perpendicular to the axis of the fiber. During the human hair chemical treatment with thiols the main interaction which causes the changes of the fiber's structure and the appropriate changes of macroscopic shape occurs in the intrafibrillar unordered areas.

Schematic outline of the structure of human hair. Shaded regions are interfibrillar unordered areas: 1 - unshaded regions are microfibrils: 2 - crystalline areas, 3 - intrafibrillar unordered.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P020: The Changes of Integral Hair Lipids might be Related to Hair Cycle

Hannah Hong, Long-quan Pi, Xinghai Jin, Sung-yul Lee, Won- Soo Lee

Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea

Integral hair lipid (IHL) plays key roles in maintenance of structural integrity of hair. IHL is composed of ceramide, cholesterol, free fatty acid, cholesterol sulfate, fatty alcohol and phytosphingosine. It has not been studied whether there are any relationship between IHL and hair cycle. In this study, we investigated the contents of IHL and expressions of genes related to lipid synthesis according to the hair cycle. As results, the expressions of genes related to lipid synthesis, neutral ceramidase (nCDase), acetyl-CoA carboxylase (ACC), fatty acid synthase (FAS), stearoyl-CoA desaturase (SCD), and sterol regulatory element binding proteins (SREBPs) were markedly decreased in catagen hair follicles. To determine the amount of IHL, HPTLC was performed. There were some differences in the amount of IHL according to hair cycle. These results suggest that changes of IHL might be related to hair cycle.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P021: Evaluation of Isolation and Initial Characterization of Human Hair Follicle (HF) Mesenchymal Stem Cells (MSC) From the Bulge Area (BG) and Dermal Papilla (DP) Region

Corina Peste¹, Eleni Iliopoulou¹, Vardis Korderas², Christine Spilioti¹, Marilena Nikolopoulou¹, Vasiliki Kordera^1,2, Christos Christakis^1,2

¹Hair Aplenty Ltd. 4, Er. Stavrou & Kifisias,²BERGMANN KORD 348, Kifissias Ave., Athens, Greece

Introduction: Isolation of MSCs from HF has been reported. However, elucidation of MSC isolation from different parts of human HF (dermal papilla, bulge region) could be a step forward to understanding the biology of hair.

Aim: Evaluation of isolation efficiency of MSC from different parts of HF with or without enzymatic digestion.

Materials and Methods: HF were obtained from 7 volunteer donors. Anagen HFs were sectioned to: 1) the part above the epidermis, which was discarded, 2) the BG region, 3) the DP region. BG and DP parts were either set into culture without further processing, or digested with 0.25% trypsin for 30 min. When cultures reached 80% confluency, expression of CD90, CD73, CD105, CD44, CD200, CD49b, CD34 and viability was estimated using flow cytometry. Differentiation towards adipogenic and osteogenic lineage was performed.

Results: Cell number per HF from BG cultures was greater than the respective cell number from DP cultures (average 99760±34780 cells/HF versus 61410±22361, Ρ<0.05). Enzyme digestion did not significantly affect the cell yield in both culture groups. Expression of MSC markers was increased within the DP population, while CD34, CD200 and CD49b were not detected in any group. Enzymatically isolated cells showed reduced expression of MSC markers in both groups (BG cultures: 42.2±15.8% versus 72.5±16.5% respectively, DP cultures 61.9±10.7% versus 91.16±5.86% respectively). All culture groups demonstrated differentiation potential.

Conclusion: Although the DP region of HF is a richer source of MSC, such cells can be isolated from the whole part of hair below the epidermis.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P022: Ultraviolet Radiation Alters Lipid Metabolism in Human Hair Follicle

Long-Quan Pi, Xing-Hai Jin, Sungjoo Tommy Hwang¹, Won- Soo Lee

Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju,¹Dr. Hwang's Hair-Hair Clinic, Seoul, Korea

Although integral hair lipid (IHL) plays essential roles in hair morphogenesis and formation of lipid envelop of hair cells, their roles on ultraviolet (UV)-induced photoaging in human hair follicle are poorly understood. In this study, we investigated the photo-degradation of IHL in human hair follicle. Organ-cultured human anagen hair follicles were irradiated with UV, and IHL metabolism was studied. We observed that UV irradiation decreased the free fatty acid contents, but increased the ceramide and sphingomyelin contents. The expressions of genes related to lipid synthesis, including acetyl-CoA carboxylase (ACC), fatty acid synthase (FAS), stearoyl-CoA desaturase (SCD), and sterol regulatory element binding proteins (SREBPs) were also markedly decreased. These results suggest that UV radiation alters IHL in human hair follicle and IHL may play important roles in photoaging of human hair follicle.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P023: Ultrastructural Localization and Maturation of Integral Hair Lipid in Human Hair Follicle

Long-Quan Pi^*, Sungjoo Tommy Hwang¹, Won-Soo Lee

Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju,¹Dr. Hwang's Hair-Hair Clinic, Seoul, Korea

Integral hair lipid (IHL) plays an important role in all compartments of hair and skin substructures and also in involvement of hair development and function. In this study, we described the ultrastructural localization and maturation of IHL in human hair follicle. Electron microscopy was performed to observe the ultrastructure of the hair lipid. Hair follicles were cut and observed longitudinally along the hair axis. For revealing IHL with electron microscopy, Lee's fixative, composed of OsO4 and RuO4 was designed and used. Ultrastructure of anagen hair follicle at the level where Henle layers are keratinizing, showed the intercellular lipid layer (IL) and lamellar structure (LS). Ultrastructure of anagen hair follicle at the level where the inner root sheath (IRS) is completely keratinized showed multiple LS and lamellar granules (LG). Multitudes of LS and IL are observed between the keratinized cells in IRS. The IHL in the hair follicle may be regarded as hair barrier to be similar to the epidermal lipid layer functioning as skin barrier.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P024: Effects of Cannabidiol on Human Hair Follicle Derived Outer Root Sheath Keratinocytes

Erika Lisztes, Imre Lórinc Szabó, Attila G. Szöllósi, Balázs I. Tóth, Attila Oláh, Tamás Bíró

DE-MTA “Lendület” Cellular Physiology Research Group, Department of Physiology, University of Debrecen, Medical and Health Science Center, Research Center for Molecular Medicine, Debrecen, Hungary

Using human hair follicle (HF) organ-culture, we have previously shown that the endocannabinoid anandamide (AEA) inhibited hair shaft elongation and induced catagen regression via cannabinoid receptor-1 (CB1). Since AEA is produced by the HF, it can therefore be assumed that the activation of the endocannabinoid system negatively regulates the hair cycle.

In our present study, we have investigated how human HF derived outer root sheath keratinocytes (ORSK) respond to cannabidiol (CBD; the major non-psychotropic phytocannabinoid) treatment.

Up to 5 µM, CBD did not alter proliferation and viability of ORSKs. At 5 µM, as revealed by determining expressions of various cytokeratins, CBD shifted the proliferation-differentiation balance of the cells towards proliferation. In good accord with these findings, CBD increased the levels of anagen-promoting growth factors (e.g. SCF), whereas suppressed the expression of catagen-inducers (e.g. EGF). Of further importance, CBD exerted anti-inflammatory effects. Since the actions of CBD were exactly opposite of the CB1-stimulating effects of AEA, our ongoing studies intend to reveal whether CBD acts as an inhibitor of CB1-coupled signaling. Nevertheless, the decrease in viability observed at higher CBD doses may suggest that CBD could act on other targets as well, among which, we have identified the expressions of the Ca2+-permeable ion channels TRPV-1, -2 and -4, and found that cytotoxic concentrations of CBD elevated [Ca2+]ic. Identification of the exact molecular targets of CBD is under progress.

Collectively, these data suggest that CBD may function as a promising, novel pharmacological tool for the manipulations of hair growth disorders and inflammatory diseases.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P025: Hair-Growth Formulation Mediated UV-Protection in a Novel in vitro Model of Human Keratinocytes

Thomas Hengl, Jörn Herfert, Kim Schlinzig, Harry F. Abts*

Merz Pharmaceuticals GmbH, Frankfurt, Germany

UV radiation (UVR) has a known major impact on the skin. In addition to its inhibitory effect on epidermal keratinocyte proliferation and induction of apoptosis, UVR promotes skin aging and carcinogenesis. A damaging effect of UVR on the hair has been described for the extracutaneous human hair shaft in vivo and also in vitro on the cellular level for organ-cultured hair follicles.

Susceptibility to UVR in different skin depths is wavelength dependent, and thus epidermal keratinocytes are a primary UVR target.

We describe here the use of a novel 2D in vitro model with human keratinocytes for the evaluation of potential UVR-protective capacity of a hair-growth promoting formulation (Pantogar). As UVR-source a solar-simulating device (290-800 nm) was used.

A combination of L-cystine, thiamine, sodium pantothenate and folate was established as in vitro correlate (IC) to the orally applied Pantogar-formulation.

Our data demonstrate that this Pantogar-IC was able to prevent UVR-associated decrease of metabolic activity as well as to prevent UVR-induced apoptosis. Our data indicate that the concentration-dependant UV-protective capacity of Pantogar-IC is due to a metabolic reinforcement of keratinocytes.

Our results are supportive for a potential novel UVR-protective role for the tested hair-growth formulation. While direct protective effects could be expected for the skin, protection of the hair follicle might also result from indirect effects involving secondary mediators of UVR.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P026: Evaluation of a Hair-Growth Promoting Formulation in a Human Keratinocytes in vitro Model for Situations of Diminished Hair Growth

Thomas Hengl, Alexander Solimann, Kim Schlinzig, Harry F. Abts*

Merz Pharmaceuticals GmbH, Frankfurt, Germany

in vitro 2D cultures of normal, human, epidermal keratinocytes (NHEKs) have been established as an important tool for investigating general aspects of skin physiology. In addition, keratinocytes are also the primary cell type of the hair follicle. Measuring the metabolic activity and proliferation of NHEKs can therefore be considered as robust surrogate read-out for improvement of the hair-follicle function and thus as indirect indicator for enhanced hair growth.

Optimal growth environment and resulting maximum proliferation of conventional cell culture poorly resembles the situation at the hair follicle in case of diffuse hair loss. To mimic the reduced activity of keratinocytes associated with diminished hair-growth, we established a novel in vitro system using NHEKs for screening of hair-growth promoting formulations like Pantogar.

Pantogar, a combination of L-cystine, thiamine, sodium pantothenate, yeast, GABA and keratin is used successfully to treat diffuse hair loss. Based on our data a combination of L-cystine, thiamine, sodium pantothenate and folate could be established as Pantogar in-vitro correlate (IC). In our novel keratinocyte in vitro model, this Pantogar-IC demonstrates a greater positive impact on metabolic activity and proliferation than the single compounds alone. Although Pantogar might have additional effects on hair growth in vivo, the presented data underscore the essential role of the tested Pantogar ingredients for optimal growth of human keratinocytes.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P027: UV Irradiation Alters Integral Hair Lipid Differently According to Age Groups

Sung Yul Lee, Hannah Hong, Long-Quan Pi, Xinghai Jin, Won-Soo Lee

Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea

Integral hair lipids (IHL) are thought to have major roles in structural integrity of hair shaft, and hair biology. However, there are scanty of reports that reveal the importance of integral hair lipids in hair photoaging. Photoaging of hair represent as a change of hair texture and hair photoyellowing in gross spectrum.

This study was aimed to evaluate the change of integral hair lipid caused by acute UVB damage in experimental setting. We collected the normal hair shafts from the healthy volunteers whose hair were not manipulated with various treatments such as hair perm or permanent waving for last 6 months. The hair samples were cut at the level of 4~5cm above from the scalp surface and were separated into two groups; UV treated and untreated group. UV treated hairs were irradiated with UVB lamps for 96 hours in 0.35 mJ energy. After the irradiation, HPTLC and LC-Mass were performed to determine the composition change of IHL. Also, we evaluated the amount of IHL changes according to the age. We defined older and younger age group by older than 40 years and younger than 40 years, respectively.

As a result greater changes appeared in older age group and the main difference was free fatty acid composition. Therefore, we could suggest that hair photoaging may cause decrease of free fatty acids and this change is greater in hair shaft of older age group.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P028: Ecklonia Cava Containing 7′-Phroloeckol and Dioxinodehydroekol Promotes Hair Growth

Soon-Sun Bak¹*, Byul-Nim Ahn², Jung-Ae Kim², Seung Hyun hin³, Jung Chul Kim³, Moon Kyu Kim³, Young Kwan Sung³, Se-Kwon Kim^1,2

¹Marine Bioprocess Research Center,²Department of Chemistry, Pukyong National University, Busan 608-737,³Department of Immunology, School of Medicine, Kyungpook National University, Daegu 700-422, Republic of Korea

Previous studies have reported on the protective effects of Ecklonia cava on skin elasticity through regulation of both anti-oxidative and anti-inflammatory responses. In this study, we evaluated the effect of E. cava on hair growth. Among other fractions tested in this study, the ethyl acetate soluble fraction of E. cava (EAFE) showed the highest proliferation activity in human hair follicle dermal papilla cells (DPCs) and outer root sheath (ORS) cells. Treatment with EAFE resulted in elongation of the hair shaft in cultured human hair follicles and promoted induction of anagen phase from telogen phase of the hair shaft on the dorsal skin of C57BL/6 mice. In addition, EAFE induced an increase in insulin-like growth factor-1 (IGF-1) expression in DPCs. 7′-phroloeckol and dioxinodehydroeckol, metabolites of E. cava, induced an increase in proliferation of DPCs and ORS cells, elongation of the hair shaft, and expression of IGF-1 in DPCs. Altogether, these results suggest that E. cava containing 7′-phroloeckol and dioxinodehydroeckol promotes hair growth through stimulation of DPCs and ORS cells.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P029: Modern Approaches to the Treatment of Limited Forms of Alopecia Areata

Nino V. Tsiskarishvili, Maia Eradze, Tsiskari Tsiskarishvili

Department of Dermatology and Venereology, Tbilisi State Medical University, Tbilisi, Georgia

Research data of recent decades show the importance of immune disorders in pathogenesis of alopecia areata (AA). At the same time the results of research concerning the mechanism of narrow-band UV 311 nm action indicate a selective effect of this irradiation on the skin's immunity, which is associated with a decrease in the number of epidermal Langerhans cells and T-lymphocytes.

The primary role of stress in the pathogenesis of AA is not in doubt. Based on the above mentioned, the aim of this study was to establish the effectiveness of local phototherapy on patients with AA in combination with impulse currents that affect the periventricular zone of the hypothalamus.

Under observation were 18-65 years old, 27 patients with disease (AA) duration up to 1 year, 7 patients and over 1 year were 20 patients. Treatment of focal forms of baldness was carried out on erythema doses with irradiation regimes of 2-3 procedures per week. The course of treatment were provided for no more than 10-15 procedures. Subsequent course of physiotherapy on the central nervous system conducted in intervals between courses of phototherapy consisted of 11.5 sessions. During the first 3 weeks of therapy, reduction of "rickety" hair zone has been observed in 23 patients (88%), which indicates the stop of disease progression. In the remaining 3 patients (8%), the process stretched out for 5 weeks. The use of pulsed currents contributed to the improvement of emotional status of patients. In 21 (84%) patients with positive dynamics there was no relapse within 2 years of follow up, 6 patients relapse occurred within 1 year, but the foci of alopecia were significantly smaller in size. Thus, treatment of AA with phototherapy and pulse currents can be considered as a modern and highly effective method, an advantage which can be described as a well tolerated and reduced risk of side effects.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P030: Association Between EGF and EGFR Gene Polymorphisms and Susceptibility to Alopecia Areata in Korean Population

Woo-Young Sim, Sik Haw¹, Eun-Ju Lee, Joo-Ho Jung², Bark- Lynn Lew,

Department of Dermatology, College of Medicine, Kyung Hee University, Seoul,¹Department of Dermatology, College of Medicine, Inje University, Ilsan Paik Hospital, Goyang,²Department of Pharmacology, College of Medicine, Kyung Hee University, Seoul, Korea

Background: Epidermal growth factor (EGF) is a growth factor that plays an important role in the regulation of cell growth, proliferation, and differentiation by binding to epidermal growth factor receptor (EGFR). The roles of EGF and EGFR on the pathogenesis of alopecia areata (AA) are uncertain. However, several reports suggest the association between EGF signaling and AA.

Objective: To investigate the significance of EGF and EGFR gene polymorphisms in the susceptibility to AA and understand the pathogenesis of AA.

Methods: Two hundred thirty-one AA patients and 270 healthy controls were enrolled in this study. Genotype frequency of 5 single nucleotide polymorphisms (SNPs) in EGF gene and 5 SNPs in EGFR gene were studied. The statistical analyses were performed according to onset age, the family history, clinical subtypes of AA, and presence of nail involvement or body hair involvement.

Result: One SNP (rs11569017) of EGF gene and one SNP (rs6965469) of EGFR gene showed significant difference between AA patients and controls group. One SNP (rs2237051) of EGF gene showed significant difference between the AA patients with nail involvement and without. One SNP (rs17337023) of EGFR showed a significant difference between the patch type AA and alopecia totalis, and another SNP (rs1050171) showed significant differences according to body hair loss and nail involvement.

Conclusion: EGF and EGFR gene polymorphisms might contribute to the increased susceptibility to AA in Korean population. EGF gene polymorphisms could be associated with nail involvement and EGFR gene polymorphisms could be associated with body hair loss and nail involvement.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P031: Follow-Up Study of the First Genome-Wide Association Scan in Alopecia Areata: IL13 and KIAA0350 as New Susceptibility LOCI Supported with Genome-Wide Significance

Silke Redler,^1*Dagny Jagielska^1,2, Felix F. Brockschmidt^1,3, Christine Herold⁴, Sandra M. Pasternack¹, Natalie Garcia Bartels², Sandra Hanneken⁵, Sibylle Eigelshoven⁵, Melanie Refke¹, Sandra Barth³, Kathrin A. Giehl⁶, Roland Kruse⁷, Gerhard Lutz⁸, Hans Wolff⁶, Bettina Blaumeiser⁹, Markus Böhm¹⁰, Ulrike Blume-Peytavi², Tim Becker,^4,11Markus M. Nöthen^1,3, Regina C. Betz¹

¹Institute of Human Genetics, University of Bonn, Bonn, Germany,²Department of Infection and Immunity, University of Sheffield,³Department of Dermatology, Royal Hallamshire Hospital, Sheffield, UK,⁴Department of Genomics, Life & Brain Center, University of Bonn,⁵German Center for Neurodegenerative Diseases (DZNE), Bonn,⁶Institute for Medical Biometry, Informatics and Epidemiology, University of Bonn, Bonn, Germany⁷Department of Dermatology, University of Munich, Munich,⁸Dermatological Practice, Paderborn,⁹Dermatological practice, Hair & Nail, Wesseling,¹⁰Department of Dermatology, University of Münster, Münster, Germany.

Alopecia areata (AA) is a common hair loss disorder which affects approximately 1-2% of the general population, including both sexes and all age groups. The pattern of familiarity suggests that the genetic basis is multifactorial. Although the scalp is the most commonly affected site in AA, all hair-bearing areas of the skin may be affected. Recently, the first genome-wide association study (GWAS) of AA was performed in a North American sample, and this identified eight susceptibility loci surpassing genome-wide significance. We performed a follow-up association analysis to determine five of these eight loci (SNPs from the CTLA4, IL-2RA, and the HLA regions were not included due to previous own findings) and to test 12 other loci from the GWAS which did not surpass the threshold for genome-wide significance. Twenty three SNPs from the 17 loci were investigated using a sample of 1702 Central European AA patients and 1723 controls. Of the five loci with previously reported genome-wide significance, association was confirmed for all of these: ULBP3/ULBP6, PRDX5, IL-2/IL-21, STX17, and IKZF4/ERBB3 (P value < 0.05). To detect robust evidence for association among the 12 other loci, a meta-analysis of the present association data and the data of the recent GWAS was performed. Genome-wide significant association was found for rs20541 (P_comb= 7.52*10^- 10; OR=1.30 [1.23-1.38]) and rs998592 (P_comb =1.11*10^-11; OR=1.28 [1.21-1.36]), thus establishing IL-13 and KIAA0350/CLEC16A as two new susceptibility loci for AA. Interestingly, IL-13 and KIAA0350/CLEC16A are susceptibility loci for other autoimmune diseases, supporting the hypothesis of shared pathways of autoimmune susceptibility.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P032: Inhibitory effect of Tianeptine on Catagen Induction in Ultrasound Wave Stress-induced Alopecia Areata-like Lesions of C57BL/6 mice

Hyeong Mi Kim, Yun Young Lim, Hyun Kyu Kim, So Ra Park¹, Sung Ki Seo¹, Mase Lee¹, Yang Won Lee², Chong Hyun Won³, Chang Hun Huh⁴, Myeung Nam Kim, Beom Joon Kim*

Department of Dermatology, Chung-Ang University, College of Medicine,¹Kuhnil Pharmaceutical Co. Ltd.,²Department of Dermatology, Konkuk University, College of Medicine,³Asan Medical Center, University of Ulsan College of Medicine,⁴Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Korea

Alopecia areata is characterized by rapid and complete hair loss in one or multiple lesions on the scalp. Stress is one of the important triggering factors in alopecia areata. We were to identify inhibitory effect of tianeptine on catagen induction in C57BL/6 mice with ultrasound wave stress-induced alopecia areata-like lesions. The mice were divided into three groups: Oral administration of tianeptine before and after ultrasound wave stress (group 1), oral administration of tianeptine only after ultrasound wave stress (group 2), and control group (group 3). The assessment was made by phototrichigram and dermoscopy. Group 1 mice presented increased hair growth rate and thickness of hair shaft than group 2 and group 3 mice. In addition, increase of anagen hair follicle, increased collagen and elastin synthesis, decreased mast cell degranulation, reduction of cell apoptosis in hair follicle, and recovery of vitamin D receptor expression were prominent in group 1 mice. But, expression of neuropeptides (substance P, calcitonin gene-related peptide) was not altered. These results suggest that tianeptine might play a role in suppressing catagen induction in stress-induced alopecia areata mice model. This study was supported by a Korea Research Foundation Grant funded by the Korea Government (2010-0021960).

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P033: Targeted Photochemotherapy in Alopecia Areata

Mustafa Tunca, Ahmet Akar, Hakan Yeşil, Gurol Acikgoz

Department of Dermatology, Gulhane Military Medical Academy, and School of Medicine, Ankara, Turkey

Background: Alopecia areata is a localized non-scarring alopecia of scalp and other hair-bearing areas and its treatment is often challenging. Although systemic photochemotherapy is a well-known treatment, targeted UVA phototherapy is not so often used in combination with topical 8-methoxypsoralen for the treatment of alopecia areata.

Objective: To assess the efficacy and safety of topical 8-methoxypsoralen plus targeted UVA phototherapy in alopecia areata.

Patients/Methods: The results of 7 patients with patchy alopecia areata of the scalp, treated with targeted UVA phototherapy following application of topical 8-methoxypsoralen were retrospectively analyzed.

Results: None of the patients were non-responsive. In 3 patients out of 7 there was vellus hair regrowth. One patient had cosmetically acceptable hair regrowth and 3 patients had complete hair regrowth.

There were no serious side effects, only transient erythema was observed in 2 patients during the treatment.

Conclusion: Targeted UVA photochemotherapy with topical 8-methoxypsoralen may be an effective and safe treatment option for patchy alopecia areata.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P034: Oral Cyclosporine in the Treatment of Alopecia Areata

Ahmet Akar, Mustafa Tunca, Yıldıray Yeniay, Ercan Caliskan

Department of Dermatology, Gulhane Military Medical Academy, and School of Medicine, Ankara, Turkey

Background: Alopecia areata is a common non-scarring hair loss condition which has an unpredictable prognosis and treatment refractory course in severe cases. Since the most accepted pathogenesis is based on immunologic factors especially T-cell-mediated autoimmune process, oral cyclosporine therapy have been widely used with various response rates.

Objective: We performed a retrospective study to evaluate therapeutic effect of oral cyclosporine treatment in severe alopecia areata, defined as multifocal alopecia areata, alopecia totalis and alopecia universalis.

Patients/Methods A total of 25 patients with severe alopecia areata were treated with oral cyclosporine, 200-400 mg/day for 2-12 months between the years 2004 and 2011.

Results: Twelve patients had multifocal alopecia areata, nine patients had alopecia universalis and four patients had alopecia totalis. Three of 25 (16%) patients discontinued treatment due to adverse events. Of remaining 22 patients, significant hair growth was observed in 10 (45,4%) patients; five patients with multifocal alopecia areata, three patients with alopecia universalis and two patients with alopecia totalis.

Conclusion: Although we have relatively small number of cases, and we do not have enough data on long-term results, this study indicates that oral cyclosporine treatment may be a beneficial treatment option for severe alopecia areata.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P035: Lesional Cytokine Profiles in Alopecia Areata

Xingqi Zhang, Zemin Cai, Bin Zhang, Ying Zhao, Yugang Gong, Xiaoting Zhang, Yanting Ye, Jian Yang, Wenna Chen

Department of Dermatology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China

Objective: To investigate the local profile of cytokines in hair loss lesion of alopecia areata (AA), with regard to the upper/superficial layer and the deeper layer of lesional skin.

Methods: 25 AA at early stage (<3 months) and 15 control scalp tissue were used for QRT-PCR to determine mRNA expression levels of Th1 cytokines (IL-1β, IFN-ã, IL-12) and Th2 cytokines (IL-4, IL-10). Scalp sample were divided into superficial and deep layers at the level of the sebaceous glands.

Results: In normal scalp skin, IL-1β, IL-4, IL-12 and TGF-β1 expression levels were significantly higher in the deep layers as compared to the superficial layers. IL-12 and IFN-ã mRNA expression levels were increased while IL-10 mRNA expression level was decreased in the superficial layer, IL-12 and TGF-β1 mRNA were increased in the deep scalp skin layer of early AA lesions, in comparison to normal skin. In the superficial layer in AA lesions, the level of decrease of IL-10 expression was found significantly higher, and the level of increase of TGF-β1 was greatly lower, in comparison to deeper layer.

Conclusions: The result from this study regarding cytokine profiles of the superficial and the deeper layers of scalp skin implies that during early AA process, Th1/Th2 imbalance in the superficial layers may have a more influential effect to local hair follicles than that in the deep layers.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P036: Clinical Research of Finasteride and Minoxidil for Treating Androgenic Alopecia

Weixin Fan*, Yiting Wang, Zihai Li, Xiaoqing Yin, Xiaoyan Chu, Zhongming Li, Wenrong Xu, Jin Wu, Lei Chen, Ningning Guan, Leilei Li, Weiling Sun

Department of Dermatovenereology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.

Objective: To observe the efficacy of finasteride, 5% minoxidil alone and their combination on the treatment of male androgenic alopecia (AGA).

Methods: Three groups were designed for male AGA patients: the 5% minoxidil topical therapy group, the finasteride oral treatment group, and the combined application group. The follow-up period was twelve months and upon each follow-up visit, the experimental subjects were being taken photos for record, assessed and classified accordingly.

Results: After six to twelve months of drug administration, the combined application group demonstrated a more satisfying clinical effect than that of the oral therapy group or the topical group. In addition, the positive correlations between the treatment course and the therapeutic effectiveness were found in the male AGA oral treatment group, the combined application group. The therapeutic effect of medication, as demonstrated by patients of the above groups, was related to the degree of alopecia severity but not to their family history and alopecia onset age.

Conclusion: The results of the study indicate that the combined medication has a shorter effectuated time and more significant clinical effect compared to that of orally intake finasteride alone or topically applying finasteride alone. Comparing to both cases of single-drug groups, combined application treatment group demonstrated better curative effectiveness.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P037: Efficacy and Tolerability of 5% Minoxidil Solution in Male and Female Androgenetic Alopecia: An Open Multicentric Italian Study of 6 to 24 Month Duration.

Bianca Maria Piraccini, Michela Starace, Francesca Bruni, Sandra Lorenzi¹, Maria Cristina Fiorucci², Marcella Guarrera²

Department of Dermatology, University of Bologna,¹IDE- Instituto Dermatologico Europeo-Milano,²Department of Dermatology, University of Genoa, Italy

The aim of the study was to evaluate efficacy and safety of 5% minoxidil solution, applied twice a day on the scalp, on male and female androgenetic alopecia.

The 6-month study was performed in three Italian dermatological centers.

Efficacy was evaluated with subjective and objective methods, including operator and patient assessments, global photography and video dermoscopy.

The global photography revealed that after 6 months of treatment with 5% minoxidil solution, androgenetic alopecia was improved in all 32 females and 16 males. Alopecia did not progress in 6 males. Scalp video dermoscopy confirmed the results. Some patients complained of increased hair greasiness, others complained of mild scalp itching. Two female patients developed contact sensitization to minoxidil, confirmed by patch test and 2 patients developed a mild malar-temporal hypertrichosis.

All patients were satisfied by the treatment and continued it after the end of the study.

Our study confirms the data of the literature and the evidence coming from years of clinical experience, that twice a day topical application of 5% minoxidil solution is effective in the treatment of male and female androgenetic alopecia.

The improvement was evident already after 6 months.

Thirty-two patient were followed up for a maximum time of 24 months (range 6-24). All of them experienced a marked clinical improvement that corresponded to the improvement of all parameters of video dermoscopy.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P038: Investigation of the Hair Loss Involvement of the Temporal and Occipital Area According to the Severity of Androgenetic Alopecia

Bark-Lynn Lew, Min-Joong Kim, Eun-Ju Lee, Woo-Young Sim,

Department of Dermatology, College of Medicine, Kyung Hee University, Seoul, Korea

Introduction: Androgenetic alopecia (AGA), commonly known in men as male pattern baldness, is the gradual balding of the scalp in response to androgens in genetically predisposed individuals. In men, the two major features of AGA are recession of the frontal hair line and balding of the scalp vertex. This patterned baldness is thought to be due to varying degrees of sensitivity to androgen with different areas. And previous reports had relatively little attention to the hair loss of the temporal and occipital areas.

Objective: To investigate whether hair loss is involved on temporal and occipital area not only frontal and vertex area according to severity of AGA.

Methods: We evaluated 100 patients with AGA not on any treatment. We measured changes of the position of the frontal, temporal, occipital hairline according to the modified Norwood-Hamilton classification. And hair density, and hair diameter of each sites were analyzed by phototrichogram.

Results: The mean age of patients was 31.9 years. The most frequent AGA type of our patients was IIIv, followed by II, IIIa, and III. By gradual shift in the type of AGA from the earlier types to a more severe type, the recession of the frontal, temporal, occipital hairline was moving upward, and hair density and hair diameter was progressive declining.

Conclusion: To worsen the severity of AGA, as well as recession of the frontal hair line and balding of the scalp vertex, hair loss involvement of temporal and occipital area also can be seen.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P039: The Hair Growth Promoting Effects of Eucheuma Cottonii

Soon-Sun Bak¹*, Ratih Pangestuti², Byul-Nim Ahn², Jung-Ae Kim², Jin Eun Lee³, Jung Chul Kim³, Moon Kyu Kim³, Young Kwan Sung³, Se-Kwon Kim^1,2,

¹Marine Bioprocess Research Center,²Department of Chemistry, Pukyong National University, Busan 608-737,³Department of Immunology, School of Medicine, Kyungpook National University, Daegu 700-422, Republic of Korea

Eucheuma cottonii, an edible species of pacific red algae, has a high amount of polyunsaturated fatty acids and phenol compounds. Previous studies have reported that intake of E. cottonii has antioxidant activity in hypercholesterolemic rat and wound healing and hair growth promoting activities in wounded SD rat. In this study, we evaluated the effects of E. cottonii on elongation of the human hair shaft in vitro and promotion of hair growth in C57BL/6 mice. Treatment with E. cottonii extract significantly increased the proliferation of human follicle dermal papilla cells (DPCs) and outer root sheath (ORS) cells. It also stimulated hair shaft elongation in cultured human hair follicles. In addition, treatment with E. cottonii extract induced expression of keratinocyte growth factor (KGF), insulin like growth factor-1 (IGF-1) and hepatocyte growth factor (HGF) in DPCs. Moreover, E. cottonii promoted induction of anagen phase from telogen phase of the hair shaft on the dorsal skin of C57BL/6 mice. These results suggest that E. cottonii promotes hair growth through stimulation of DPCs and ORS cells.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P040: Stemoxydine^® and Hair Kenogen Phase in Androgenetic Alopecia (AGA)

Geneviève Loussouarn*, Charles El Rawadi, Isabelle Pineau, Corinne Jouanique¹, Zohr Hamidou¹, Céline Michelin,

Pascal Reygagne¹

L’Oréal Recherche,¹Centre de Santé Sabouraud, Hôpital St Louis, France

Introduction: Hair kenogen phase is the latency period required for a new hair growth to engage contributes in part to a decreased hair density, a hallmark of AGA. in vitro findings on a new compound, Stemoxydine^® , led us to assess, in vivo, its potential in shortening the hair kenogen phase, through three vehicle-controlled protocols.

Methods: Three double-blind and randomized clinical studies were conducted on healthy male subjects aged 18-55 with AGA grade III to V:

1) Two intra-individual studies on 16 and 23 men, respectively, with 5 days a week product application

2) One inter-individual study on 100 men with daily application.

Stemoxydine^® 5% hydro-alcoholic lotion was assessed versus vehicle using the phototrichogram technique (PTG).

Results: In the three studies, after 3 month treatment, the results showed a significant increase in hair density with Stemoxydine^® 5% versus vehicle, without any difference in telogen percentage.

1a) Stemoxydine^® +4.5% versus control -0.3% (P=0.04)

1b) Stemoxydine^® +11% versus control +7% (P=0.029)

2) Stemoxydine^® +8% versus control +4% (P=0.036)

Additionally, a significant decrease (P=0.02) in the percentage of hair in kenogen phase was found in study 1b) where a PTG follow-up was monthly performed.

Conclusion: This converging data suggests that, in AGA, Stemoxydine^® acts as a hair kenogen phase shortener, leading to an increase in visible scalp hair density.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P041: Prevalence of Androgenetic Alopecia and its Pattern of Hair Loss in Patients with Cardiovascular Diseases

Sung Yul Lee, Hannah Hong, Noo Ri Lee, Won-Soo Lee

Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea

Androgenetic alopecia (AGA) is considered as a risk factor of the medical co-morbidities such as cardiovascular, cerebrovascular and metabolic disease. Especially, there are many reports about the association between AGA and cardiovascular disease in Caucasian population. However, there is lack of evidence in Asian population of this kind of association. The aim of this study was evaluating the prevalence of AGA in cardiovascular in-patients and classifying type of AGA in these patients. We interviewed cardiovascular disease in-patients who were already diagnosed as myocardial infarction and stable/unstable angina by coronary angiography. Then we reviewed the type of AGA with BASP classification of AGA and also analyzed other laboratory findings and family history of the patients. The mean age of the patients was over sixties; most of the patients showed evidence of AGA. We compared all data obtained from patients with the data of age/sex-matched normal control group. There was a tendency that high prevalence of ′V (vertex involved type)′ type in cardiovascular disease patients group compared with control group. So, we suggest that the ′V′ type is the more risky than other types (M or F type) for cardiovascular disease.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P042: Medical Comorbidities in Early Onset Androgenetic Alopecia Patients

Sung-yul Lee, Noo Ri Lee, Won-Soo Lee

Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea

Androgenetic alopecia (AGA) is a specific type of hair loss mediated by systemic androgen and genetic factors, and is the most common type of hair loss in both sexes. Epidemiological studies have shown that insulin resistance and coronary artery disease are more frequently observed in men with AGA, and early-onset AGA patients (younger than 35 years) were shown to have higher risk for systemic diseases such as insulin resistance and hypercholesterolemia than late-onset AGA patients. There have been several reports on the epidemiologic studies of medical comorbidities in early onset AGA in Caucasians, but few studies on Asians have been reported.

We performed a retrospective study with early onset AGA by reviewing 810 medical records of patients diagnosed as AGA before 35 years who visited Yonsei Wonju Christian Hospital in the last 10 years. We checked their laboratory findings that represent risk factors of cardiovascular and cerebrovascular diseases, such as fasting glucose level, lipid profiles, and insulin level. Also, we reviewed their medical histories. As a result, early onset Korean AGA patients group showed no significant differences compared to non-AGA control group with similar ages in the laboratory findings that indicate cardiovascular and cerebrovascular disease risk. This is notable that ethnic difference is likely to present in relevance of medical comorbidities with early onset AGA patients.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P043: Characteristic Aging Features in Korean Women's Hair

Su-na Kim, Ahreum Kim, Soo-yeon Lee¹, Won-Seok Park

Advanced Hair Research Lab, Amorepacific R&D Center, Yong-in,¹Dermapro/Skin Research Center, Seoul, South Korea

There have been few studies of the characteristic features of hair with aging in Korean women. We investigated the changes of various features of Korean women's hair with aging with 150 Korean women aged 23-69 years in five age groups. For the characteristic hair loss, hair density and hair diameter were analyzed by phototrichogram, and the tensile strength of hair shaft was measured with rheometer. Hair graying severity was observed by investigators in five grades and the hair color was measured using chromometer. Hair luster was evaluated with the maximum brightness (L) value of the luster ring under the fixed light source. The mineral, amino acids and steroidal hormones compositions of hair shaft were analyzed by conventional method.

The hair loss parameter (hair density, diameter and tensile strength) and hair luster decline with age significantly from the age of 50. The hair brightness (L) value increases with aging significantly in 60s due to hair graying ratio growth. In the hair mineral analysis, calcium and magnesium decrease with aging while potassium and phosphorus increase with age-dependent manner. In case of amino acids in hair shaft, there are no significant changes in each group. The contents of steroid hormone precursors (cholesterol, pregnenolone, desmosterol and lanosterol) increase significantly with age in all groups, but there are no correlation between the steroidal hormone level and age. These results show that intrinsic aging cause changes in various hair and scalp features of Korean women.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P044: Evaluation Study of Active Materials for Scalp Seborrheic Dermatitis by Co-Culturing Keratinocyte and Sebocyte

Ah-Reum Kim, Su-Na Kim, Hyun-Gee Lee, Byeongbae Jeon, Won-Seok Park

Advanced Hair Research Lab, Amorepacific R&D Center, Yongin-si, South Korea

Seborrheic dermatitis (SD) is the skin disease occurred because of Malassezia yeast which grows on the skin and scalp, and this yeast lives on sebum lipid, and their metabolite, free lipid acids are thought to be the main irritant on skin. To find out effective cosmeceutical ingredients to treat SD symptoms, we established novel cell-based in vitro model mimicking SD symptoms. This in vitro model adopted the co-culture system with primary sebocyte and HaCaT keratinocyte. We used Malassezia globosa yeast extract, arachidonic acid, linoleic acid and dihydrotestosterone as SD inducers. In the co-culture system with optimized concentrations for SD-inducing cocktail, the production of IL-8 and sebum lipids increased up to two-fold, and then we screened with commercial essential oils by monitoring IL-8 as a key inflammatory biomarker. Then we found that Cinnamomum zeylanicum oil, Mentha arvensis oil effectively downregulated IL-1á, IL-6, IL-8 cytokines which over-produced by SD-inducing cocktail. Additionally, two essential oils also showed inhibitory effect on sebum lipid synthesis from primary sebocyte and growth inhibitory effect to Malassezia globosa yeast (MICs were lower than 0.0625%). Our recent results suggest that Cinnamomum zeylanicum oil and Mentha arvensis oil could be effective natural herbal remedies to relieve or protect scalp seborrheic dermatitis.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P045: Improvement in Scalp Hair Growth in Androgen-Deficient Women Treated with Testosterone: A Questionnaire Study

Rebecca Glaser, Constantine Dimitrakakis¹,

Andrew Messenger

Millennium Wellness Center, Dayton, Ohio, USA,¹1st Department of Ob/Gyn, Athens University Medical School, Athens, Greece; Department of Dermatology, Royal Hallamshire Hospital, Sheffield, UK

Androgens are thought to have an adverse effect on female scalp hair growth. However, our clinical experience of androgen replacement therapy in women with androgen deficiency, in which hair loss was seldom reported, led us to question this concept. In this study, 285 women, treated for a minimum of 1 year with subcutaneous testosterone implants for symptoms of androgen deficiency, were asked to complete a survey that included questions on scalp and facial hair. Age, BMI, and serum testosterone levels were examined.

76 patients (26.7%) reported hair thinning prior to treatment. 47 of these patients (63%) reported hair re-growth on testosterone therapy (responders). Non-responders had significantly higher BMIs than responders (P=0.05). Baseline serum testosterone levels were significantly lower in women reporting hair loss prior to therapy than those who did not (P=0.0001). There was no significant difference in serum testosterone levels, measured four weeks after testosterone implantation, between responders and non-responders. No patient in this cohort reported scalp hair loss on testosterone therapy. 262 women (92%) reported some increase in facial hair growth.

Subcutaneous testosterone therapy had a beneficial effect on scalp hair growth in female patients treated for symptoms of androgen deficiency. We propose this is due to an anabolic of testosterone on hair growth. The fact that no subject complained of hair loss as a result of treatment casts doubt on the presumed role of testosterone in driving female scalp hair loss. These results need to be confirmed by formal measurements of hair growth.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P046: A Comparison Between the Modifed Wash Test, Trichogram and Trichoscan^®

Marcella Guarrera, Maria Cristina Fiorucci, Alfredo Rebora

Department of Dermatology, Director Aurora Parodi, University of Genoa, Italy

The trichogram and the modified wash test (MWT) lack satisfying information about their repeatability and reproducibility. We compared the results of the two methods with those obtained by the computer-aided dermoscopy (CAD). For comparing MWT with CAD (TrichoScan^® ), 41 subjects complaining of hair loss were studied, while 121 were studied for comparing MWT with trichogram. No less than 60 hairs were extracted in each trichogram test. Data were analysed statistically with the t test and the Cohen k statistic. In the first study, the total MWT count ranged between 6 and 431 (mean 100.6±107.8), and the percentage of vellus hairs was 7.1±6.36. With CAD, the percentage of vellus hairs averaged 8.4±4.55. The concordance between the clinical diagnosis and that of MWT was fair (κ=0.33), while that between clinical diagnosis and CAD was unsatisfactory (κ=-0.18). In the second study, the concordance between MWT and trichogram diagnoses was unsatisfactory (κ=0.06). Only in 17 patients (41%) were the MWT and CAD diagnoses concordant. MWT was better in general and especially at detecting TE (80% of cases, vs 30%), whilst CAD was better at detecting AGA (78% of cases vs 37%). Trichogram agreed with neither MWT nor the clinical diagnosis. Normality was the condition trichogram detected best (55% of cases). In conclusion, the clinical observation is insufficient to make a correct diagnosis. It should be assisted by both MWT and dermoscopy, leaving the biopsy for very difficult cases. The trichogram should be abandoned.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P047: Telogen Effluvium is a Heterogeneous Entity: A Tentative Classification

Alfredo Rebora

University of Genoa, Italy

As Kligman suggested in his original article, telogen effluvium (TE) is a heterogeneous entity. I propose that TE comprises three clinical entities that correspond to three different pathogenetic mechanisms: the premature teloptosis, the collective teloptosis and the premature entry into telogen phase. The premature teloptosis characterizes forms in which the club hair is dislodged prematurely because of endogenous and exogenous factors, like topical medications and sun exposure. The collective teloptosis occurs when the club hair are shed in a moult way. It is typical of the neonatal hair loss, of the post-partum hair loss and of the interruption of some medication ("pill", minoxidil, finasteride). In the premature entry into telogen phase type, the hair follicle accelerates its way to catagen and reaches its telogen phase prematurely, but the club hair is dislodged timely, after its normal 3 month rest. The untimely interruption of the anagen phase requires necessarily the interruption of the mitoses of the hair matrix keratinocytes. This is clearly apparent in the hair loss due to antimitotic drugs, but is only putative in other circumstances, namely hair loss due to diet inadequacy and stress-related hair loss. The latter is probably "inflammatory" in nature, for many of its clinical, dermoscopic and histologic features recall those described in alopecia areata.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P048: Psychological Assessment in Alopecia Patients

Nayra Merino de Paz, Marina Rodríguez-Martin, Patricia Contreras-Ferrer, Mónica Merino de Paz, Miguel Sáez, Marta Garcia-Bustinduy, Francisco Guimera

Department of Dermatology, Hospital Universitario de Canarias, Tenerife, Spain.

Introduction: A high prevalence of anxiety and depression has been described in alopecia patients. Other entities, as psychogenic pseudo-effluvium (alopecia-phobia, telogen mania and dysmorphic disorder) or alexithymic trait, could make more difficult alopecia patient's management. The aim of this study is to assess the prevalence of psychological co-morbidities in alopecia patients.

Methods and Material: We have analyzed the prevalence of psychological co-morbidities in a group of 100 alopecia outpatients. The presence of anxiety and depression has been measured with HADS test and frequency of alexithymia with TAS-20. Pseudo-effluvium disorder has been diagnosed by clinical criteria.

Results: Psychological co-morbidities are frequent in alopecia patients and we have observed patients with mood disorders, pseudo-effluvium and alexithymic features in our sample.

Discussion and conclusions: Psychological tools should be included in our clinical approach to alopecia patients. Psychological assessment may improve our global patient evaluation and treatment.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P049: Quality of Life in Korean Female Patients with Female Pattern Hair

Gwang-Seong Choi, Bo-Hee Yang, Won-Soo Lee¹, Hoon Kang², Chang-Hoon Huh³, Seung-Sik Hwang⁴

Department of Dermatology, Inha University School of Medicine,¹Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University, Wonju College of Medicine,²Department of Dermatology, The Catholic University of Korea,³Seoul National University School of Medicine,⁴Department of Social and Preventive Medicine, Inha University School of Medicine

Background: Female pattern hair loss (FPHL) may significantly affect a variety of psychological and social experience and the individual's quality of life (QoL). It has been reported that men with androgenetic alopecia (AGA) suffer a decrease in their quality of life. However, few studies have been conducted on the QoL of women with FPHL. It is believed that when it comes to hair loss, women's QoL will suffer more than that of men.

Objectives: The aim of this research was to evaluate QoL in Korean female patients with FPHL.

Methods: This research surveyed 200 women with FPHL who visited Inha University Hospital and four other university hospitals between April and October 2010. All patients were interviewed with ′hair specific skindex-29′. And this results were compared with the quality of life in Korean men with AGA.

Results: The mean global Hair Specific Skindex-29 score of the FPHL patients was 39.3 (SD±17.9). The symptom scale score was 35.1 (SD±17.3), the function scale score was 35.0 (SD±20.1) and emotion scale score was 42.1 (SD±24.2). The total hair-specific skindex-29, emotion, function and symptom scores were significantly lower in women with FPHL than in men with AGA.

Conclusions: This study showed that the FPHL damages the patient's QoL. The FPHL patients had deteriorated QoL similarly to the case of the AGA patients. However, we could see that the degree of deterioration was severer in the FPHL than AGA patients.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P050: Pediatric Tele-Trichology - Observations Based on 1765 Clinical E-Mail Exchanges

D. Dinesh Kumar*, Jayakar Thomas

Department of Dermatology, KK CHILDS Trust Hospital, Chennai, India

Aim: The objective of this study was to evaluate the content of clinical e-mails regarding scalp disorders in children exchanged among dermatologists/general practitioners.

Materials and Methods: 1765 clinical e-mails, exchanged over a period of thirty six months (i.e., from Jan 2007 to Dec 2009) were studied. Those e-mails with scalp disorders were studied in detail and divided into two categories based on their

content:

1. For the purpose of diagnosis and

2. For the purpose of management options.

The mails include requests for diagnosis, treatment, investigations and prognosis.

Result: Fifty eight (3%) consults out of 1765 emails were with reference to scalp disorders. Of these, 23 (1.3%) consults were pertaining to scalp disorders in children. Thirteen (0.74%) of them were in the first category asking for diagnosis and five (0.28%) of them were of the second category asking for management. There were five (0.28%) where both diagnosis and management were requested.

Conclusion: Pediatric tele-trichology comprises 1% of all tele-consults. Pediatric tele-trichology helps to a great extent, the general practitioners and dermatologists alike in treating children. Further improvement of the technical and legal shortcoming will make tele-consultation a boon for managing scalp disorders especially in pediatric cases as it also facilitates consultation with other dermatologists.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P051: Hair Mineral Analysis in Patients with Chronic Diffuse Telogen Effluvium

Alexandra A. Altaeva¹, Saule A. Rustembekova², Natalia P. Tepliouk³

¹Dermatology and Venereology Department of Federal State Institution of Management, Department of the President of Russian Federation, Moscow, Russia,^1,2Research Medical Center, I.M. Sechenov First Moscow State Medical University (MSMU),³State Educational Institution of Higher Professional Training of the Ministry of Health Care and Social Development

It is known that one of the reasons of chronic diffuse telogen effluvium is the dietary, trace elements imbalances (Gummer C.L., 1985; Trueb R.M., 2008).

There are few ways to determine the concentration of trace element composition of the human organism: by the examination of body fluids (blood, urine etc.) and tissues. The concentration of trace element composition in the blood often does not provide a complete picture of the content of these elements in the organism. The concentration of elements in blood depends on presently used diet. The composition of plasma depends on homeostatic mechanisms. Hair and nails are excluded from metabolic processes (Rustembekova S.A., 2005).

We investigated the trace element composition of hair of 13 women of 18-50 years old with chronic diffuse telogen effluvium and 13 women of the same age without hair loss. We diagnosed chronic diffuse telogen effluvium under: women's complaints - with period of (telogen) hair loss over 3 months, and instrumental examination: determination of the telogen hair (more than 20%) and vellus hair (no more than 10%) of the crown by special diagnostic computer program Trichoscience 1.7 and camera Aramo SG. The trace element composition of hair (Mg, S, P, Ca, Cr, Mn, Cu, Zn, Se, Mo) was examined by atomic emission spectrometer Optima -4300 DV (“Perkin-Elmer”, USA) and mass spectral spectrometer Elan - 6100 (“Perkin-Elmer”, USA).

The results are presented in a Table 1.

Table 1.

Hair mineral analysis of patients with chronic diffuse telogen effluvium and without hair loss

graphic file with name IJT-4-131-g002.jpg

Open in a new tab

In the group of patients with chronic diffuse telogen effluvium, we indicated the deficiency of Mg, Ca, Cr, Mn, Se and Mo. We registered the imbalance Zn/Cu that mark the latent deficiency of Zn. The results of this examination show the necessity of investigation of the trace elements composition of hair of each patient with complaints on the hair loss prior to prescribing medical mineral correction.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P052: Alopecia and Localized Scalp Hyperhidrosis: A Potential Link?

Sharon Wong*, Bav Shergill¹, Mark Taylor¹, Paul Farrant¹

*Royal Free NHS Trust, London, UK,¹Brighton and Sussex University Hospital,

Patient 1: A 75-year-old female presented with a two year history of frontotemporal hair loss, itching of the scalp and excessive sweating over the hairline, which would leave her skin ′dripping wet′.

Patient 2: A 67-year-old female presented with a six-year history of progressive recession of the frontal hair line, itching and erythema of the scalp, generalized hair thinning and loss of the outer eyebrows. Over the last 2 years she developed ′drenching sweats′ over the entire scalp.

Histology and immunofluorescence studies confirmed lichen planopilaris (LPP). On clinicopathological correlation, patient 1 had frontal fibrosing alopecia (FFA) and patient 2 had both FFA and classic LPP.

Patient 1 received Botox injections to the frontotemporal hairline with complete resolution of both the hyperhidrosis and pruritus within 2 weeks of treatment. 6 months post-Botox treatment the sweating remains controlled, however the itching has started to recur.

Local axon reflex stimulation of eccrine sweat glands is a recognized cause of focal hyperhidrosis. It is a peripheral reflex that bypasses higher integration centers in the central nervous system. Whilst it may be possible that the coexistence of scalp hyperhidrosis and alopecia in our 2 patients is coincidental, we propose an alternative explanation that scalp inflammation activates this local axon reflex pathway, inducing localized sweat secretion. The high density of sweat glands in scalp skin (>250/ cm²) and rich neural innervation contributes to the potential for profuse sweating at this site.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P053: Report of Two Patients of Ukrainian Origin with Trichorhinophalangeal Syndrome Type I Caused by Frameshift Mutations in TRPS1 Gene

Julya Ovcharenko^*, Yuval Ramot¹, Kuzma Khobzey², Sofia Babay¹, Liran Horev¹, Vered Molho-Pessach¹, Oleksandr Litus³, Abraham Zlotogorski¹

Department of Dermatovenerology, Kharkiv Medical Academy of Postgraduate Education, Kharkiv,¹Department of Dermatology and the Center for Genetic Diseases of the Skin and Hair, Jerusalem, Israel,²Medical Centre EuroDerm, Kyiv,³Department of Skin and Sexually Transmitted Diseases of Uzhgorod National University, Uzhgorod, Ukraine

The trichorhinophalangeal syndrome type I (TRPS1) is a rare autosomal-dominant disease, characterized by various skeletal and facial abnormalities, along with a typical hair phenotype which includes sparse and slow-growing scalp hair and laterally sparse eyebrows. Mutations in the TRPS1 gene at chromosome 8q24.1 were found to be responsible for this syndrome. We describe two patients of Ukrainian origin, ages 17 and 19, who presented with slow-growing hair and craniofacial features typical of TRPS1. Sequence analysis of the TRPS1 gene revealed a novel c.2396_2397 insG frameshift mutation in exon 5 in patient 1 and a c.1031delG frameshift mutation in exon 4 in patient 2. These mutations result in a premature stop at codon 800 and 351, respectively. Both patients were diagnosed with TRPS1 owing to their hair complaints, emphasizing the importance of the hair phenotype to the diagnosis of this syndrome. Additionally, the relatively advanced age of the patients at diagnosis underlines that the prevalence of TRPS I is probably still underestimated, and should be considered by trichologists when examining new patients. The present report not only highlights the clinical features of TRPS1 but also adds a new mutation to the spectrum of mutations, so far described in this disorder. Considering the fact that the correlation between genotype and phenotype of TRPS I is still obscure, the report of additional mutations can enhance our knowledge on this complicated and severe genetic disease.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P054: Braids or Pony-Tail-associated Traction Alopecia in Childhood

Moon-Bum Kim, Woo-Haing Sim, Margaret Song,

Hoon-Soo Kim, Hyun-Chang Ko, Byung-Soo Kim

Department of Dermatology, College of Medicine, Pusan National University, Busan, Korea

In kindergarten or early elementary school, it is common to find girls with their hairs braided or pony-tailed. Furthermore, some girls and their mother or grandma tend to make braided or pony-tailed daily style, because this hair style usually look neat. This can lead to braids or pony tail-associated traction alopecia. This pattern of traction alopecia generally appear as small round or oval hairless patches, and could be difficult to differentiate from early alopecia areata.

Objectives: To find out what are the important characteristics of braids or pony-tail-associated traction alopecia compared to alopecia areata

Method: In seven girls with braids or pony-tail-associated traction alopecia, their clinical characteristics and dermoscopic findings were investigated. To evaluate the dermoscopic differences between this particular type of traction alopecia and alopecia areata, dermoscopic data were collected in early alopecia areata with small round or oval hairless patches.

Result: In braids or pony-tail-associated traction alopecia, the mean age of 7 girls was 5.6 year-old and all the hairless patches were very small (less than 1 cm diameter), and located usually on the temporal or parietal scalp. In dermoscopic analysis, short broken hairs with or without cracked ends were observed in all the 7 patients. Furthermore, black dots and clustered short vellus hairs were observed in 6 (85.7%) and 2 (28.6%) patients, respectively. On the other hand, yellow dots, clustered short vellus hairs, black dots and tapering hairs were common dermoscopic findings in alopecia areata.

Conclusion: Some physicians including non-experienced dermatologists tend to believe small round or oval hairless patches are alopecia areata. But this diagnosis should be cautious when girls in kindergarten or elementary school presented with small round or oval hairless patches. In these cases, the site of alopecia, dermoscopic finding, and spontaneous rapid regrowth only after changing hair style could be very helpful to tell braids or pony-tail-associated traction alopecia from alopecia areata.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P055: Pattern Alopecia During Anti-estrogen Therapy in Patients with Breast Cancer

Jin Park*, Su-Ran Hwang, Seok-Kweon Yun, Han-Uk Kim

Department of Dermatology, Chonbuk National University Medical School, Jeonju, South Korea

Hormonal therapy using anti-estrogen drugs is widely used in the management of estrogen-dependent primary or metastatic breast cancer. However, the hair loss due to its complication is hardly evaluated by dermatologist.

We report five cases of pattern alopecia developed during anti-estrogen therapy in patients with breast cancer. Three patients had family history of androgenetic alopecia and four patients were in postmenopausal period. Clinically, three patients showed typical male pattern alopecia with recession of frontal hairline, other two patients revealed female pattern hair loss. There were no other virilization signs and laboratory studies including serum sex hormones were within normal ranges. Among them, two patients received selective estrogen receptor modulators (tamoxifen, toremifene), two patients were administered non-steroidal aromatase inhibitors (anastrozole, letrozole) and one patient received both drugs. Although the mechanisms responsible for the hair loss are unclear, it is assumed that the inhibitory effect on estrogen of these drugs stimulates the activation of androgen and may cause pattern alopecia.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P056: Increased Expression of Nerve Growth Factor and Neurokinin-1 Alarm the Hair Loss in Female with Trichodynia

Hoon Kang, Kwanho Jeong, Hee Dam Jung, Sang Hyun Cho, Young Min Park, Jung Eun Kim

Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea

Many women worrying about hair loss by themselves usually complain about trichodynia. We want to evaluate the relationship between hair loss and trichodynia through checking out the expressional changes of several inflammatory and nociceptive mediators.

Forty five female pattern hair loss (FPHL) Korean patients (26-55 years) with M0F1 BASP type were enrolled. Tissue specimens were obtained by 4 mm punch skin biopsy from the suspected hair loss area. mRNA expressions of IL-1 beta, IL-2, IL-4, IL-6, TGF beta, INF gamma, nerve growth factor (NGF), substance P and neurokinin-1 (NK-1) receptor were determined by RT-PCR. These mediators were also checked in peripheral blood leukocytes. Eight scalp skin specimens were obtained from normal haired subjects during cosmetic surgery (22-53 years) as controls.

The mRNA expression of NGF and NK-1 was significantly increased (P<0.1). Inflammatory cytokine TGF beta1 and IL-6 mRNA levels were significantly higher as compared to controls (P<0.1). Although IL-1 and IL-2 mRNA was upregulated, it had not reached statistically significance. There were no mRNA expressional correlations between tissue and peripheral blood leukocytes.

NGF and NK-1 is closely treated to trichodynia with hair loss in female. Its alteration did not influence the peripheral blood gene expressions. Albeit trichodynia associated hair loss is still controversial, our study proposes the possibility of its involvement into hair loss through nociceptive mediators.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P057: Congenital Trichorrhexis Nodosa as a Marker of Systemic Diseases in Children

Gloria M Garnacho Saucedo, Rafael Salido Vallejo, Jose Rumbao Aguirre¹, Rafael González de Caldas Marchal¹, Jose Carlos Moreno Giménez, Juan Ferrando Barbera²

Department of Dermatology and¹Pediatrics Hospital Universitario Reina Sofía Córdoba, Spain²Department of Dermatology, Hospital Clinic and University of Barcelona, Spain

Introduction: Trichorrhexis nodosa is the most common hair shaft anomaly and usually occurs as an acquired form unassociated with other problems; however, the condition may be genetic and manifest during infancy as a manifestation of children with the late-onset form of argininosuccinase.

Case Report: We report a 2-year-old boy with intrauterine growth restricted and severe intractable diarrhea since 3 months of life accompanied by severe malabsorption requiring total parenteral nutrition. Histopathological analysis of small intestine biopsy showed non-specific villous atrophy with low mononuclear cell infiltration and no specific histological abnormalities involving the epithelium. He also had functional T-cell immune deficiency with defective antibody production, interauricular communication and persistent ductus arteriosus. Metabolic diseases were ruled out and there were no specific signs of any entity. The patient was referred to our dermatology clinic for woolly, brittle and poorly pigmented hair and hipopigmented macules on his legs. The boy had facial dysmorphism, with a prominent forehead and cheeks, broad flat nose, and hypertelorism. The hair microscopically demonstrated trichorrhexis nodosa.

Discussion: Trichohepatoenteric syndrome or phenotypic diarrhea or syndromic diarrhea of infancy is an autosomal recessive disorder characterized by life-threatening diarrhea in infancy, immunodeficiency, liver disease (not always), trichorrhexis nodosa, facial dysmorphism, hypopigmentation and cardiac defects. It is caused by mutations in TTC37 which encodes the tetratricopeptide repeat protein thespin. Thespin is involved in protein-protein interactions or chaperone and have multisystem effects.

Conclusion: Congenital trichorrhexis nodosa must be considered marker of systemic diseases in children, not only argininosuccinate lyase deficiency but trichohepatoenteric syndrome.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P058: Frontal Fibrosing Alopecia in a Man Associated with Non-Scarring Generalized Hair Loss

Rafael Salido Vallejo*, Gloria Garnacho Saucedo, Juan Salvatierra Cuenca¹, Jose Carlos Moreno Giménez.

Department of Dermatology, ¹Department of Pathology, Hospital Universitario Reina Sofía, Córdoba, Spain

Introduction: Frontal fibrosing alopecia (FFA) is a variety of cicatricial alopecia typically observed in postmenopausal women. This condition is exceptional in men.

We report a case of simultaneous presentation of FFA in a male with reversible alopecia in beard and extremities.

Case Report: A 52-year-old man presented with a band of frontoparietal hair recession and marked decrease of the eyebrows. Axillae and pubic hair were normal. No keratotic follicular papules were noted. Histopathological examination of a scalp specimen revealed hair follicles replaced by fibrous tracts and a chronic lymphocytic infiltrate surrounding follicles. These findings led us to the diagnosis of frontal fibrosing alopecia.

In addition, the patient complained of abrupt relapsing patchy hair loss on beard, upper and lower limbs with positive pull test. Lesions resolved spontaneously in several weeks with no scarring.

Discussion: FFA is a primary lymphocytic cicatricial alopecia with a distinctive clinical pattern of progressive frontotemporal hairline recession and marked decrease or a complete loss of the eyebrows. Involvement of other sites has been occasionally reported. Acute hair loss on the limbs in FFA has been reported in only two cases.

Piccardi-Lassuer-Graham-Little syndrome (PLGLS) is characterized by the triad of multifocal scalp cicatricial alopecia, non-scarring alopecia of the axillae and/or groin, and keratotic follicular papules. Some authors suggest that FFA and PLGLS could be phenotypically related.

Our case could represent a case of FFA with acute hair loss of the beard and limbs. However, the relapsing non-scarring alopecia patches suggests the possibility of a collision between alopecia areata and FFA.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P059: Low Level Light Therapy for Androgenetic Alopecia: A 24-Week Randomized Double-Blind Placebo-Controlled Trial

Soon Hyo Kwon, Hyo Jin Kim, Jee Woong Choi, Jun Young Kim¹, Jung Won Shin, Jung Im Na, Weon Ju Lee¹, Sang Woong Youn, Seok Jong Lee¹, Do Won Kim¹, Kyoung Chan Park, Chang Hun Huh^*

Department of Dermatology, Seoul National University Bundang Hospital, Seongnam,¹Kyungpook National University School of Medicine, Daegu, Korea

Background: Androgenetic alopecia (AGA) is a common disorder affecting both men and women. Finasteride and minoxidil are well-known, effective treatment methods, but those who have poor response with them have limited other treatment modalities. Low-level light therapy (LLLT) has been reported to stimulate hair growth with a wavelength ranged from red to infrared.

Objective: To evaluate the efficacy and safety of LLLT device for AGA.

Methods: This study was designed as a 24-week randomized double-blind sham device-controlled trial. Forty subjects with AGA were enrolled into the LLLT group treated with helmet-type, home-use LLLT device emitting 630, 650 and 660 nm wavelength, or sham group. All subjects were treated 18 minutes daily. After 24 weeks, hair density and thickness assessment by phototrichogram and global assessment of hair growth by both investigator and subject were performed.

Results: After 24 weeks of treatment, subjects treated with LLLT showed significant improvement in hair density (17.20±12.15/ cm²vs. -2.14 ±18.30/cm², P<0.01) as well as mean hair diameter (12.60±9.44 mm vs. 3.86±7.34 mm, P<0.05) compared to those treated with the sham device. Global assessment of investigator showed a significant difference between the two groups, but that of subject did not. No serious adverse reaction was reported.

Conclusion: Our results suggest that LLLT might be an effective, safe and well-tolerated treatment for AGA.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P060: Efficacy and Safety of Pueraria Lobata Extract in Prevention of Hair Graying: A Randomized, Double-Blind, Placebo-Controlled Study

Seong Jin Jo¹, Seung Hwan Paik¹, Sun Jae Na¹, Ji Ying Jin^1,2,, Won Seok Park³, Soo Na Kim³, Oh Sang Kwon¹

¹Department of Dermatology, Seoul National University Hospital, Seoul, Korea,²Yanbian University Hospital, Jilin, China,³Skin Research Institute, AmorePacific R&D Center, Korea

Hair-graying, one of the conspicuous signs of aging, leads to a cosmetic concern because people with gray hair look older for their age and some old people make their hair dyed for aesthetic purposes. However, hair colorants have many adverse effects including skin irritation, allergic reaction, hair-breakage and so on. Although the mechanism of hair graying is not fully understood, the association with oxidative stress of hair melanocytes was suggested. This randomized, double-blind clinical trial was performed to examine the change of hair graying by APHG-1001, a compound including extracts from Pueraria lobata which activates microphthalmia-associated transcriptional factor (MITF), a transcriptional factor associated with melanin synthesis, as well as reduces oxidative stress. A total of 43 female subjects, 40 to 63 years old, were randomized to spray either of APHG-1001 (21 subjects) or placebo (22 subjects) twice a day for 24 weeks. Count of the newly developed gray hair, subject self-assessment and photographic assessment by investigators were used for the evaluation of efficacy. Subject self-assessment and photographic assessment did not show a certain notable difference in efficacy between groups. However, mean count of newly developed gray hair for 24 weeks was 6.3/cm²in APHG-1001 group and 11.4/cm²in placebo group and the difference was statistically significant (P=0.049). There were no severe adverse events in both groups and the difference between groups was insignificant. In conclusion, although it was difficult to globally detect the efficacy by naked eyes, this clinical trial showed APHG-1001 containing Pueraria lobata extract that could prevent hair graying in phototrichogram analysis without any remarkable adverse event and be considered as an available treatment option for gray hair

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P061: Hair Growth Promoting Effect of Red Ginseng on Cultured Human Hair Follicles

Gyeong-Hun Park^1,*, Jee-Soo An^1,2, Chong-Hyun Won¹, Ki- young Park³, Sang-Min Lee¹, Sung-Eun Chang¹, Mi-Woo Lee¹, Jee-Ho Choi¹, Kee-Chan Moon¹, Beom-Joon Kim⁴, Yang-Won Lee⁵, Chang-Hun Huh⁶

¹Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine,²Modelo Clinic, Seoul,³Asan Institute for Life Sciences,⁴Department of Dermatology, Chung-Ang University College of Medicine,⁵Konkuk University College of Medicine, Seoul,⁶Seoul National University Bundang Hospital, Seongnam, Korea

Background: Ginseng is a medicinal plant which has long been used in oriental medicine. Recently, several murine studies showed that ginseng and its bioactive components, saponins, may be beneficial to hair growth promotion. However, the effects on human hair follicles have not yet been elucidated sufficiently.

Objective: To investigate the hair growth promoting effect of red ginseng and its saponins, ginsenoside Rb1 and Rg1 in vitro.

Methods: We determined the proliferation of HaCaT cells and human dermal papilla cells after treatment of red ginseng extract, ginsenoside Rb1 and Rg1 using MTT assay. To evaluate the effects of red ginseng extract, ginsenoside Rb1 and Rg1 on cultured human hair follicles, we measured the hair shaft elongation and determined the proliferation of hair matrix keratinocytes with immunofluorescence staining of Ki67. In addition, we investigated the signal changes of human dermal papilla cells in the presence of red ginseng extract and ginsenoside Rb1.

Results: Both ginsenoside Rb1 and Rg1 enhanced the proliferation of HaCaT cells and human dermal papilla cells. Red ginseng extract also increased the proliferation of human dermal papilla cells. In the cultured human hair follicles, both ginsenoside Rb1 and Rg1 upregulated the proliferation of hair matrix keratinocytes, and ginsenoside Rg1 promoted hair shaft elongation.

Conclusion: The red ginseng extract, ginsenoside Rb1 and Rg1 enhanced the proliferation of human dermal papilla cells and both ginsenosides upregulated the proliferation of hair matrix keratinocytes. These results indicate that red ginseng can be beneficial for human hair growth promotion.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P062: Hair-growth-promoting Effect of Conditioned Medium of Keratinocyte Stem/Progenitor Cells

Yun-Mi Jeong^1,2*, Chong Hyun Won^3*,, Sangjin Kang^1,4,

Tae-Sung Koo⁵, So-Hyun Park¹, Young-Kwan Sung⁶, Jong-Hyuk Sung^1,2,4

¹Department of Applied Bioscience, CHA University,²Stem Cell Research Laboratory, CHA Stem Cell Institute,³Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine,⁴CHA Bio and Diostech Co., Ltd., Seoul,⁵Life Science R&D Park, SK Biopharmaceuticals, Daejeon,⁶Department of Immunology, School of Medicine, Kyungpook National University, Daegu, Korea

Keratinocyte stem/progenitor cells (KSCs) reside in a bulge region and may be involved in hair growth. In the present study, we investigated 1) whether conditioned medium of keratinocyte stem/progenitor cells (KSC-CM) promotes hair growth and 2) which growth factor(s) mediate(s) hair-growth promotion? To test this hypothesis, we firstly treated hair follicle dermal papilla cells (HFDPC) and outer root sheath (ORS) cells with concentrated KSC-CM. KSC-CM significantly increased the proliferation of HFDPCs and ORS cells. FACS analysis showed that KSC-CM increased the length of the S phase of the cell cycle in HFDPCs. Western blot analysis demonstrated that KSC-CM led to the phosphorylation of Akt and ERK1/2 in HFDPCs and ORS cells. KSC-CM also increased the Ki67-positive hair matrix keratinocytes proliferation ex vivo. A significant increase of individual hair growth was observed after subcutaneous injection of KSC-CM onto the backs of C3H/HeN mice. We also attempted to identify the active proteins from KSC-CM and determined that it contains a higher concentration of six growth factors compared with conditioned medium of keratinocyte. The growth-factor cocktail which contains six, recombinant growth factors significantly increased the proliferation of HFDPCs and ORS cells and enhanced the hair growth in animal models. These results collectively indicate that KSC-CM has the potential to increase hair growth via the proliferative capacity of HFDPCs and ORS cells and could thus be used to stimulate hair growth.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P063: Dietary Supplement and its Active Ingredient to Counteract Hair Loss in Women Over 45: A Randomized Double-Blind Clinical Study

Barbara Marzani*, Giammaria Giuliani, Anna Benedusi, Beatrice Tenconi¹, Ileana De Ponti¹, Adele Sparavigna¹

¹R&D, Giuliani SpA, Milan, Italy,¹Derming, Istituto di Ricerche Cliniche e Bioingegneria di Monza, Monza

Diffuse loss of scalp hair is a common problem in middle-aged women. Factors predisposing to this situation can be correlated to aging, lifestyle and hormonal changes that mark the transition to menopause.

The purpose of this three arms double-blind randomized clinical study was to evaluate the tolerability and efficacy of: a dietary supplement with fermented soya and ingredients such as vitamins, minerals, N-(3-aminopropil)-tetramethylenediamine and Ajuga reptans extract (Bioscalin TricoAGE+, Giuliani SpA, Milan, Italy), a supplement containing one component (fermented soy) and placebo in 66 healthy women older than 45 years with a percentage of anagen phase hair <80%. In particular, the study included dermatological evaluations and non-invasive measures of the product activities on hair growth, resistance and diameter variations.

The dermatological and instrumental analysis showed that the product containing fermented soya and TricoAGE+ presented trophic activity with a significantly reductions of hair loss, determined by significant increase of hair in anagen and reduction of hair in the telogen phase.

The Tricoage+ supplement, due to its complete formula rich in vitamins and minerals, induced also a clinically important reduction of vellus hair improving the transformation into terminal hair and improvement of hair diameter. In conclusion this study demonstrated that tested dietary supplements improve thinning hair and positively affected hair scalp growth in women through menopause transition period.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P064: Frontal Fibrosing Alopecia Successfully Treated with Oral Finasteride

Sang-Yeon Park, Sung-yul Lee, Won-Soo Lee

Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea

Frontal fibrosing alopecia (FFA) is characterized by progressive frontal hairline recession associated with scarring. The progress of FFA can be slowed down by use of moderate potency topical steroids, oral prednisone or chloroquine but efficacy of these treatments vary with patients. A 46-year-old Korean patient visited our department for frontotemporal hair loss lasting about four years. She had been treated in various primary clinics with 3% minoxidil and pantothenic acid compound for four years but there has been no improvement. On the histological examination, the scalp biopsy specimen revealed minimal perivascular and perifollicular lymphocytic infiltration with perifollicular fibrosis. Considering clinical and histopathological manifestations, we diagnosed the patient as FFA. We started to treat the patient with oral prednisolone 20 mg and topical tacrolimus 0.1%. After a week, we had tapered prednisolone by 5 mg in every two weeks for six weeks, but there had been no improvement. FFA is considered as a disorder related to androgen and T-lymphocyte mediated reaction. Recently, some patients with Caucasian ethnicity have been reported as successfully treated with oral finasteride and dutasteride. We started to prescribe oral finasteride 1 mg daily with explanation of complications and precautions. The patient had been using special contraceptive device. After three months of 1 mg daily dose of finasteride, hair growth at both frontal hairline was observed. Currently, she is still treated with same dose for 7 months showing marked improvement with remarkable decrease of hair loss. This patient might be the first case with successful outcome of oral 5 alpha reductase inhibitor for the treatment of FFA in Asian ethnicity.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P065: Highly Effective Anti-dandruff Shampoo/Tonic Combination

Alexander Filbry, Frank Rippke, Marie-Christine Leneveu-Duchemin, Heiner Max, Dorothea Schweiger, Beiersdorf AG

Research and Development, Hamburg, Germany

Dandruff is a common scalp problem associated with flaky and inflamed skin. In the present study we investigated the efficacy of a shampoo containing climbazole and piroctone olamine and its combination with a scalp tonic containing piroctone olamine and glycyrrhiza inflata root extract to reduce dandruff and its symptoms. 102 subjects (♂ 56 and 46 ♀) with moderate to very strong dandruff affection underwent a randomized half-head study for 4 weeks. The heads of the volunteers were washed regularly either with a placebo or the anti-dandruff shampoo, followed by the anti-dandruff tonic application or no treatment. Subsequently, 2 week after-treatment phase with the placebo shampoo followed. Trained experts scored dandruff affection in 6 scales every week. Cytokine concentrations were determined in scalp wash-ups by enzyme-linked immunosorbent assays at study start and every 2 weeks. The expert grading and volunteers′ perception supported a significant reduction in dandruff after treatment with the anti-dandruff shampoo or its combination with the tonic. Cytokine analyses of scalp wash-ups proved a significant reduction in pro-inflammatory dandruff markers for both anti-dandruff product treatments with a superior reduction for the combination in the after-treatment phase. Both the rinse-off shampoo as well as its combination with the leave-on tonic excellently alleviated dandruff and its associated micro-inflammation. The superior benefit for the combination is mainly based on the known anti-inflammatory effect of licochalcone A in the glycyrrhiza inflata root extract beside the better scalp substantivity of leave-on applications.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P066: Fighting Hair Thinning with an Energizing and Anti-Inflammatory Hair Tonic

Alexander Filbry, Frank Rippke,

Marie-Christine Leneveu-Duchemin, Heiner Max,

Thomas Schmidt-Rose, Dorothea Schweiger

Beiersdorf AG, Research and Development, Hamburg, Germany

Hair loss is triggered by various intrinsic and extrinsic factors. In the present study we investigated the efficacy of a hair tonic containing L-carnitine, creatine and glycyrrhiza inflata root extract to support hair growth. To determine in vitro effects of the active tonic ingredients, we determined impacts on hair cycle in the hair follicle model of Philpott, changes in energy metabolisms in cultivated outer root sheath cells (ORS) by measuring radioactive CO ₂ release from radiolabelled palmitic acid during beta-oxidation and effects on microinflammation in cultivated human hair follicles and cells by ELISA. In two controlled, randomized half-head studies with 93 women (normal hair or Ludwig scale 1) and 60 men (Hamilton score ≤5), the tonic effects on hair parameters were analyzed by contrast-enhanced phototrichogram. Our in vitro results indicated for L-carnitine and creatine an extended active hair follicle growth. Moreover, a concentration-dependent enhancement of beta-oxidation in ORS by L-carnitine and an anti-inflammatory effect of licochalcone A on hair follicles and ORS could be proved. In vivo we found significantly increased hair diameters for total hair fibers and intermediate-type hair fibers (20 - 50 µm of diameter) as well as significantly improved daily hair growth on the tonic treated scalp sides compared to control areas after a few months. The tonic remarkably stimulated hair roots, supported hair growth and reduced hair thinning wherein L-carnitine and creatine vitalized the energy consuming hair growth and licochalcone A alleviated the microinflammation associated with hair loss.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P067: New Leave-on Tonic Improves Dry, Itchy and Inflamed Scalp Symptoms

Alexander Filbry, Frank Rippke,

Marie-Christine Leneveu-Duchemin, Heiner Max,

Dorothea Schweiger

Beiersdorf AG, Research and Development, Hamburg, Germany

Dry, itchy and inflamed scalp symptoms are common and often associated with diseases like atopic eczema or psoriasis. In the present study we investigated the efficacy of a new tonic containing the active ingredients urea, polidocanol and glycyrrhiza inflata root extract to improve these symptoms. 30 subjects (13 ♂ and 17 ♀) between 26 and 73 years of age with dry and itchy scalp condition underwent a randomized half-head study for 4 weeks. The heads of the volunteers were washed three times per week with a standard shampoo, followed by a tonic application on one side of the scalp whereas the contralateral side was left untreated. Scalp conditions were determined by volunteers′ self assessment, corneometry and enzyme-linked immunosorbent assays with aqueous scalp wash-ups at study start and after 2 and 4 weeks of tonic treatment. In the volunteers′ perception and corneometric data, a significantly increase in scalp moisture and reduction in scalp dryness was seen after tonic treatment. The subjects also described significantly reduced scalp itching and tautness and assessed positively the calming effect of the tonic which did also not affect hair management. Cytokine analyses of scalp wash-ups proved a significant reduction of pro-inflammatory markers (e.g. IL-8) due to the tonic treatment. The scalp tonic excellently alleviated scalp dryness, itching and microinflammation. This is the result of the tonic ingredients like the humectant urea, the skin calming polidocanol and the anti-inflammatory licochalcone A of the glycyrrhiza inflata root extract.

Int J Trichology. 2012 Apr-Jun;4(2):131–152.

P068: Coadyuvant Treatment of Androgenetic Alopecia with Platelet-Rich Growth Factors.

Juan Ferrando, Esperanza Navarra

Gabinete Dermatológico, Barcelona, Spain

Background: Platelet-rich growth factors (PRGF) are peptides or bioactive-fragmented proteins that have been demonstrated to be involved in both epidermis-follicle and dermal mesenchyme interaction required for canal formation and growth of dermal mesenchyme.[1] Their stimulation as well as access to high concentrations has been shown to generate new hair growth, thicken existing hair growth and make hair transplant grow thicker.[1] Other studies confirm that PGF result in stimulation in hair cross-section, thickening the epithelium, proliferation of collagen and fibroblast and increasing vessels around follicles.[1]

Material and Methods: Twenty patients (5 men and 15 women) aged between 26 and 66 affected by grade II to IV of Ebling scale for androgenetic alopecia (AGA) were treated with a periodic intralesional injections of autologous PRGF and the maintenance of their regular treatment: topical 5% minoxidil or oral 1 mg (males) or 5 mgs (women) finasteride after, at least, of more than one year without improvement. The evaluation was performed every 2 months with the global photography and trichoscopy of the same area.

Results: In all the patients we observe a relevant improvement of their alopecia after the third session of treatment (3 month) with a decrease of one degree in the Ebling scale, at least. We also observe new vellus hair and better quality of hair.

Comment: PGF have been established as a new coadyuvant treatment for AGA in men and in women besides the regular minoxidil or finasteride regimens. The best results were obtained in FAGA and in fronto-parietal areas.

References

1.Takakura N, Yoshida H, Kunisada T, Nishikawa S, Nishikawa SI SL, Takakura N, Yoshida H, Kunisada T, Nishikawa S, Nishikawa SI. Involvement of platelet-derived growth factor receptor-alpha in hair canal formation. J Invest Dermatol. 1996;107:770–7. doi: 10.1111/1523-1747.ep12371802. [DOI] [PubMed] [Google Scholar]
2.Takikawa M, Nakamura S, Ishirara M, Kishimoto S, Sasaki K, et al. Enhanced effect of platelet-rich plasma containing a new carrier on hair growth. Dermatol Surg. 2011;37:1721–9. doi: 10.1111/j.1524-4725.2011.02123.x. [DOI] [PubMed] [Google Scholar]
3.Uebel CO, da Silva JB, Cantarelli D, Martins P. The role of platelet plasma growth factors in male pattern baldness surgery. Plast Reconstr Surg. 2006;118:1458–66. doi: 10.1097/01.prs.0000239560.29172.33. [DOI] [PubMed] [Google Scholar]

[ref1] 1.Takakura N, Yoshida H, Kunisada T, Nishikawa S, Nishikawa SI SL, Takakura N, Yoshida H, Kunisada T, Nishikawa S, Nishikawa SI. Involvement of platelet-derived growth factor receptor-alpha in hair canal formation. J Invest Dermatol. 1996;107:770–7. doi: 10.1111/1523-1747.ep12371802. [DOI] [PubMed] [Google Scholar]

[ref2] 2.Takikawa M, Nakamura S, Ishirara M, Kishimoto S, Sasaki K, et al. Enhanced effect of platelet-rich plasma containing a new carrier on hair growth. Dermatol Surg. 2011;37:1721–9. doi: 10.1111/j.1524-4725.2011.02123.x. [DOI] [PubMed] [Google Scholar]

[ref3] 3.Uebel CO, da Silva JB, Cantarelli D, Martins P. The role of platelet plasma growth factors in male pattern baldness surgery. Plast Reconstr Surg. 2006;118:1458–66. doi: 10.1097/01.prs.0000239560.29172.33. [DOI] [PubMed] [Google Scholar]

PERMALINK

Poster Presentations

P001: Characterization and Use of Neopapillae and Microfollicles

P002: Expression of the Receptor for Advanced Glycation End Products in Aging Hair Follicles

P003: Hair Graying is Associated with Active Hair Growth

P004: Effect Expression of Bioactive Markers in Cultured Sebocytes is Altered by Exposure to UVB, but not by Visual Light

P005: Comparisons of Biocompatible Scaffolds for Human and Mouse Hair Regeneration Study

P006: Identification of GJB6 Mutations in Families with Pure Hair and Nail Ectodermal Dysplasis

P007: Hypoxia and Human Hair Follicle Stem/Progenitor Cells

P008: Biofunctional, Designed to Boost essentials for Hair Fiber Strength and Clinically Proven Hair maintenance

P009: Development of a Model of Stress-Induced Senescence on Dermal Papilla Cells

P010: Induction of Hair Growth Bby Phytosphingosine-1-Phosphate in C3H/Hej Mice Model

P011: Keratins and Lipids in Ethnic Hair

P012: Identification of a Novel U2HR Mutation in a Korean Woman with Marie-Unna Hereditary Hypotrichosis

P013: Identification and Isolation of Melanocytes in Human Sebaceous Glands

P014: Histone H4 Promotes Catagen Progression by Regulating the Activity of Follicular Dermal Papilla Cells and Keratinocytes

P015: Spirodela Polyrhiza L. Extract Induced Hair Growth Mediated Through the Activation of Wnt/Β-Catenin Signaling and the Regulation of DHT Induced Genes

P016: Impairment of Hair Follicle Neogenesis by Ablation of Alkaline Phosphatase Activity in Mouse Neonatal Dermal Cells

P017: A Cell Culture System for Undifferentiated Hair Follicle Stem Cells

P018: The Expression Pattern of Sortilin in Human Hair Follicle and its Essential Role in Hair Growth

P019: The Physical Model of the Interaction of Thiols with Human Hair at Nanolevel

Figure 1.

P020: The Changes of Integral Hair Lipids might be Related to Hair Cycle

P021: Evaluation of Isolation and Initial Characterization of Human Hair Follicle (HF) Mesenchymal Stem Cells (MSC) From the Bulge Area (BG) and Dermal Papilla (DP) Region

P022: Ultraviolet Radiation Alters Lipid Metabolism in Human Hair Follicle

P023: Ultrastructural Localization and Maturation of Integral Hair Lipid in Human Hair Follicle

P024: Effects of Cannabidiol on Human Hair Follicle Derived Outer Root Sheath Keratinocytes

P025: Hair-Growth Formulation Mediated UV-Protection in a Novel in vitro Model of Human Keratinocytes

P026: Evaluation of a Hair-Growth Promoting Formulation in a Human Keratinocytes in vitro Model for Situations of Diminished Hair Growth

P027: UV Irradiation Alters Integral Hair Lipid Differently According to Age Groups

P028: Ecklonia Cava Containing 7′-Phroloeckol and Dioxinodehydroekol Promotes Hair Growth

P029: Modern Approaches to the Treatment of Limited Forms of Alopecia Areata

P030: Association Between EGF and EGFR Gene Polymorphisms and Susceptibility to Alopecia Areata in Korean Population

P031: Follow-Up Study of the First Genome-Wide Association Scan in Alopecia Areata: IL13 and KIAA0350 as New Susceptibility LOCI Supported with Genome-Wide Significance

P032: Inhibitory effect of Tianeptine on Catagen Induction in Ultrasound Wave Stress-induced Alopecia Areata-like Lesions of C57BL/6 mice

P033: Targeted Photochemotherapy in Alopecia Areata

P034: Oral Cyclosporine in the Treatment of Alopecia Areata

P035: Lesional Cytokine Profiles in Alopecia Areata

P036: Clinical Research of Finasteride and Minoxidil for Treating Androgenic Alopecia

P037: Efficacy and Tolerability of 5% Minoxidil Solution in Male and Female Androgenetic Alopecia: An Open Multicentric Italian Study of 6 to 24 Month Duration.

P038: Investigation of the Hair Loss Involvement of the Temporal and Occipital Area According to the Severity of Androgenetic Alopecia

P039: The Hair Growth Promoting Effects of Eucheuma Cottonii

P040: Stemoxydine® and Hair Kenogen Phase in Androgenetic Alopecia (AGA)

P041: Prevalence of Androgenetic Alopecia and its Pattern of Hair Loss in Patients with Cardiovascular Diseases

P042: Medical Comorbidities in Early Onset Androgenetic Alopecia Patients

P043: Characteristic Aging Features in Korean Women's Hair

P044: Evaluation Study of Active Materials for Scalp Seborrheic Dermatitis by Co-Culturing Keratinocyte and Sebocyte

P045: Improvement in Scalp Hair Growth in Androgen-Deficient Women Treated with Testosterone: A Questionnaire Study

P046: A Comparison Between the Modifed Wash Test, Trichogram and Trichoscan®

P047: Telogen Effluvium is a Heterogeneous Entity: A Tentative Classification

P048: Psychological Assessment in Alopecia Patients

P049: Quality of Life in Korean Female Patients with Female Pattern Hair

P050: Pediatric Tele-Trichology - Observations Based on 1765 Clinical E-Mail Exchanges

P051: Hair Mineral Analysis in Patients with Chronic Diffuse Telogen Effluvium

Table 1.

P052: Alopecia and Localized Scalp Hyperhidrosis: A Potential Link?

P053: Report of Two Patients of Ukrainian Origin with Trichorhinophalangeal Syndrome Type I Caused by Frameshift Mutations in TRPS1 Gene

P054: Braids or Pony-Tail-associated Traction Alopecia in Childhood

P055: Pattern Alopecia During Anti-estrogen Therapy in Patients with Breast Cancer

P056: Increased Expression of Nerve Growth Factor and Neurokinin-1 Alarm the Hair Loss in Female with Trichodynia

P057: Congenital Trichorrhexis Nodosa as a Marker of Systemic Diseases in Children

P058: Frontal Fibrosing Alopecia in a Man Associated with Non-Scarring Generalized Hair Loss

P059: Low Level Light Therapy for Androgenetic Alopecia: A 24-Week Randomized Double-Blind Placebo-Controlled Trial

P060: Efficacy and Safety of Pueraria Lobata Extract in Prevention of Hair Graying: A Randomized, Double-Blind, Placebo-Controlled Study

P061: Hair Growth Promoting Effect of Red Ginseng on Cultured Human Hair Follicles

P062: Hair-growth-promoting Effect of Conditioned Medium of Keratinocyte Stem/Progenitor Cells

P063: Dietary Supplement and its Active Ingredient to Counteract Hair Loss in Women Over 45: A Randomized Double-Blind Clinical Study

P064: Frontal Fibrosing Alopecia Successfully Treated with Oral Finasteride

P065: Highly Effective Anti-dandruff Shampoo/Tonic Combination

P066: Fighting Hair Thinning with an Energizing and Anti-Inflammatory Hair Tonic

P067: New Leave-on Tonic Improves Dry, Itchy and Inflamed Scalp Symptoms

P068: Coadyuvant Treatment of Androgenetic Alopecia with Platelet-Rich Growth Factors.

References

ACTIONS

PERMALINK

RESOURCES

Similar articles

Cited by other articles

Links to NCBI Databases

P040: Stemoxydine^® and Hair Kenogen Phase in Androgenetic Alopecia (AGA)

P046: A Comparison Between the Modifed Wash Test, Trichogram and Trichoscan^®