Am J Clin Dermatol. 2011 Sep 6;12 Suppl 1:13-9. doi: 10.2165/1153875-S0-000000000-00000.
Ethinylestradiol/Chlormadinone acetate for use in dermatological disorders.
Gómez Vázquez M,et al
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The diagnosis and management of four cases of dermatological disorders, most of which are related to the endocrine disorder of androgen excess, are presented. Combined oral contraceptives (COCs) may be useful when well-tolerated hormonal therapy and/or when contraception is required. A female patient with androgenetic alopecia or female pattern balding, without underlying hyperandrogenism, was treated with ethinylestradiol/chlormadinone acetate (EE/CMA) 0.03 mg/2 mg for 6 months and experienced stabilization of pattern hair loss (case report 1). A patient who had previously received a COC for an irregular menstrual pattern but again experienced irregular menses and also acne after stopping treatment was diagnosed with acne associated with polycystic ovary syndrome (PCOS) [case report 2]. After 6 month's treatment with EE/CMA 0.03 mg/2 mg, this patient had fewer acne lesions and became eumenorrheic. A third patient who had excess hair since childhood was diagnosed with idiopathic hirsutism (no underlying gynecological or endocrinological disorder was found) and was treated with EE/CMA 0.03 mg/2 mg (case report 3). Less hair growth was reported after 6 months' treatment. Case report 4 describes a patient who presented with oligomenorrhea and acne. She was diagnosed with PCOS with acne, seborrhea and mild hirsutism. Treatment with EE/CMA 0.03 mg/2 mg for 6 months resulted in improvements in her facial acne, seborrhea and hirsutism; she also became eumenorrheic. These four cases illustrate that EE/CMA may be a useful and well tolerated treatment option in the management of patients with dermatological disorders with or without hyperandrogenization.
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JAMA Dermatol. 2013 May 22:1-5. doi: 10.1001/jamadermatol.2013.3049. [Epub ahead of print]
Autoimmune, Atopic, and Mental Health Comorbid Conditions Associated With Alopecia Areata in the United States.
Huang KP, Mullangi S, Guo Y, Qureshi AA.
OBJECTIVE To evaluate the prevalence of comorbid conditions among patients with alopecia areata (AA) seen at tertiary care hospitals in Boston, Massachusetts, during an 11-year period. DESIGN Retrospective cross-sectional study. SETTING Tertiary care hospitals in Boston, including Brigham and Women's Hospital and Massachusetts General Hospital. PARTICIPANTS We identified 3568 individuals with AA seen in the Partners health care system in Boston between January 1, 2000, and January 1, 2011. We performed comprehensive searches of the Research Patient Data Repository using International Classification of Diseases, Ninth Revision code 704.01. We randomly selected 350 patients and manually reviewed their medical records to train and validate a novel artificial intelligence program. This program then used natural language processing to review free-text medical records and confirm a diagnosis of AA. To confirm the algorithm, we manually reviewed a subset of records and found 93.9% validity. MAIN OUTCOMES AND MEASURES The prevalence of comorbid conditions was assessed. RESULTS Common comorbid conditions included autoimmune diagnoses (thyroid disease in 14.6%, diabetes mellitus in 11.1%, inflammatory bowel disease in 6.3%, systemic lupus erythematosus in 4.3%, rheumatoid arthritis in 3.9%, and psoriasis and psoriatic arthritis in 2.0%), atopy (allergic rhinitis, asthma, and/or eczema in 38.2% and contact dermatitis and other eczema in 35.9%), and mental health problems (depression or anxiety in 25.5%). We also found high prevalences of hyperlipidemia (24.5%), hypertension (21.9%), and gastroesophageal reflux disease (17.3%). This profile was different from that seen in a comparison psoriasis and psoriatic arthritis group. CONCLUSIONS AND RELEVANCE We found a high prevalence of comorbid conditions among individuals with AA presenting to academic medical centers in Boston. Physicians caring for patients with AA should consider screening for comorbid conditions.
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Adv Nurse Pract. 1999 Apr;7(4):39-42, 83. Hair-raising. The latest news on male-pattern baldness.
The initiating event in balding seems to be an abnormal sensitivity to the male sex hormones. In addition, a multifactorial model is emerging in which hormones affect the hair follicle in a way that causes it to be perceived as a foreign body by the immune system, which then mounts an attack. Several new classes of agents have the potential to treat hair loss. More than 40 U.S. and several hundred foreign patents have been issued for hair-loss treatment agents. As is common in dermatology, no single agent works universally against hair loss, so the treatment process is often one of trial and error.
This is a paper by Dr. Proctor