tacrolimus and Alopecia

Topics: Adult; Alopecia; Azetidines; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Janus Kinase 1; Janus Kinase 2; Janus Kinase Inhibitors; Lupus Erythematosus, Systemic; Mycophenolic Acid; Prednisolone; Purines; Pyrazoles; Retreatment; Risk Assessment; Sulfonamides; Tacrolimus; Treatment Outcome

Treatment of frontal fibrosing alopecia (FFA) is complicated and challenging. In this study, we evaluated the efficacy of combining topical tacrolimus with isotretinoin versus finasteride in patients with FFA.. Thirty-one patients with FFA were divided randomly into two groups. Therapeutic regimen of the first group (group A, n = 16) was isotretinoin and tacrolimus (Capsule isotretinoin 20 mg daily and topical tacrolimus 0.1% BD). The second group (group B, n = 15) was given finasteride and tacrolimus (Tablet finasteride 2.5 mg daily and topical tacrolimus 0.1% BD). Patients were treated and followed up periodically for 12 weeks. Evaluation of the treatment efficacy was based on Patient Global Assessment and Physician Global Assessment scales. Objective evaluation was based on improving the severity of skin lesions by viewing serial images taken from the affected areas.. Physician Global Assessment (PGA) was significantly better in the group A as compared with the group B at 4 weeks (p = 0.038). Physician satisfaction in the group A was better than the group B at 12 weeks, but this was not statistically significant (p > 0.05). Patient Global Assessment and patient satisfaction in the group A was better than the group B at 8 and 12 weeks, but it was not statistically significant (p > 0.05).. Although both therapeutic regimens were effective in the treatment of FFA, treatment with tacrolimus and isotretinoin is significantly more effective than tacrolimus and finasteride.

Topics: Alopecia; Finasteride; Humans; Isotretinoin; Lichen Planus; Tacrolimus; Treatment Outcome

Frontal fibrosing alopecia (FFA) is a scarring alopecia with no promising treatment.. To evaluate the additive efficacy of oral isotretinoin to topical treatments.. Between November 2017 and August 2018, FFA patients were randomly assigned to receive either isotretinoin (20 mg/d) plus topical treatments (clobetasol 0.05% and tacrolimus 0.1%) or monotherapy with topical treatments. Treatments' efficacy was evaluated through Frontal Fibrosing Alopecia Severity Index (FFASI) after two and 6 months.. From 38 participants, 28 patients completed the study. Facial papules improved after 6 months (. Small sample size and lost to follow-up.. Isotretinoin combined with topical treatments is more effective than monotherapy with clobetasol and tacrolimus for FFA.. (IRCT.ir) IRCT2017091736173N1.

Topics: Alopecia; Clobetasol; Forehead; Humans; Isotretinoin; Tacrolimus

Topics: Adrenal Cortex Hormones; Alopecia; Child; Doxycycline; Humans; Indomethacin; Male; Scalp; Scalp Dermatoses; Tacrolimus

Topics: Alopecia; Humans; Lichen Planus; Tacrolimus

Erosive pustular dermatosis of the scalp (EPDS) is characterized by crusted erosions or superficial ulcerations that lead to scarring alopecia.. We performed a multicentre retrospective clinical study including 56 patients (29 females and 27 males, mean age 62.7) with a confirmed EPDS in order to describe epidemiology, clinical findings and therapeutic choices of this disease.. Mechanical/chemical trauma was reported in 28.6%, a previous infection in 10.7%, a previous cryotherapy in 5.4% androgenetic alopecia in 48.2% and severe actinic damage in 25%. Trichoscopy showed absence of follicular ostia, tufted and broken hair, crusts, serous exudate, dilated vessels, pustules and hyperkeratosis. Histopathology revealed three different features, depending on the disease duration. The most prescribed therapy was topical steroids (62.5%), followed by the combination of topical steroids and topical tacrolimus (8.9%), systemic steroids (7.1%) and topical tacrolimus (5.4%). A reduction of inflammatory signs was observed in 28 patients (50%) treated with topical steroids and in all three patients treated with topical tacrolimus.. The relatively high number of patients collected allowed us to identify a better diagnostic approach, using trichoscopy and a more effective therapeutic strategy, with high-potency steroids or tacrolimus, which should be considered as first-line treatment.

Topics: Alopecia; Female; Humans; Male; Middle Aged; Retrospective Studies; Scalp; Scalp Dermatoses; Tacrolimus

Frontal fibrosing alopecia (FFA) describes the scarring, band-like recession of the frontotemporal hairline. Treatment is difficult, and currently, no evidence-based therapy exists. The purpose of this study is to report clinical features and treatment responses in a large cohort of patients with FFA. The authors analyzed a series of 72 patients with a clinical or histologic diagnosis of FFA. A total of 70 patients were female (97.2%), and 2 were male (2.8%). In females, the first onset of FFA was postmenopausal in 81.4% (

Topics: Adult; Aged; Aged, 80 and over; Alopecia; Cicatrix; Dermatologic Agents; Drug Therapy, Combination; Eyebrows; Female; Fibrosis; Forehead; Glucocorticoids; Humans; Male; Middle Aged; Retrospective Studies; Tacrolimus

Topics: Alopecia; Erythema; Graft vs Host Disease; Hematopoietic Stem Cell Transplantation; Humans; Immunosuppressive Agents; Infant; Male; Nail Diseases; Tacrolimus; Wiskott-Aldrich Syndrome

Frontal fibrosing alopecia (FFA) is a lichen planopilaris-variant scarring alopecia that has rarely been described in men.. To characterize the clinicopathologic findings of FFA in men by studying a series of 7 male patients.. We conducted a retrospective review of all cases of male patients with FFA at the Mayo Clinic from 1992 to 2016.. Seven male patients with FFA were identified. The frontal scalp (in 6 of 7 patients), sideburns (in 4 of 7), and temporal scalp (in 4 of 7) were most frequently involved. Three patients had involvement of the eyebrows. One patient had hair loss of the upper cutaneous lip. All patients had biopsy evidence of lichen planopilaris. None of the patients had associated autoimmune or thyroid disease. Two patients had hypogonadism upon testosterone studies.. Limitations include small sample size and varied follow-up.. Although most often reported among postmenopausal women, FFA also occurs among men. The clinical and histopathologic characteristics of FFA in men parallel those described in women with FFA. Unique areas of involvement in men include sideburns and facial hair. Concomitant mucocutaneous lichen planus, autoimmune disease, and thyroid disease are infrequent among men with FFA. Distribution of hair loss and associated hormonal abnormalities aid in the recognition of FFA in men.

Topics: Adult; Aged; Alopecia; Anti-Inflammatory Agents; Cheek; Cicatrix; Clobetasol; Dermatologic Agents; Eyebrows; Forehead; Humans; Hydroxychloroquine; Lichen Planus; Male; Middle Aged; Retrospective Studies; Scalp; Tacrolimus

Treatment of coup de sabre must remain conservative until the disease is no longer in an active state. When activity has ceased, some operative intervention is safe and effective for the correction of deformity. While hair transplantation showed high survival rates for the correction of cicatricial alopecia, it has rarely reported to be performed for the correction of coup de sabre.. To assess the therapeutic possibility of hair transplantation for the correction of coup de sabre.. Follicular units consisting of two to three hairs from the patient's occipital scalp were transplanted and followed-up for 12 months.. After 12 months of follow-up, treatment outcomes showed an 86.7% survival rate and 12-16 cm (mean 14 cm) length of the transplanted hairs.. When coup de sabre is no longer in an active state, hair transplantation is a useful method for cosmetic improvement of the alopecia.

Topics: Administration, Oral; Adult; Alopecia; Drug Administration Schedule; Female; Hair; Humans; Immunosuppressive Agents; Male; Tacrolimus; Treatment Outcome

Topics: Aged; Alopecia; Chloroquine; Diagnosis, Differential; Female; Humans; Hyperpigmentation; Lichen Planus; Tacrolimus; Treatment Outcome

Discoid lupus erythematosus (DLE) is a chronic variant of cutaneous lupus erythematosus, an autoimmune inflammatory disorder of the skin. Lesions are often localized to the scalp and can result in permanent scarring, disfiguration, and irreversible alopecia. Although DLE usually responds to topical or intralesional corticosteroids and/or oral antimalarials, some DLE is resistant to these treatments or adverse effects limit their effectiveness.. Three patients with treatment-refractory, biopsy-proved DLE were prescribed a novel, off-label preparation of tacrolimus lotion, 0.3%, in an alcohol base as an adjunct to oral antimalarial therapy. All 3 patients demonstrated improvement in lesion severity and hair regrowth with the use of this regimen after 3 months and continued improvement thereafter. We report a retrospective analysis of these 3 cases.. This report is, to our knowledge, the first mention of tacrolimus being used in a lotion formulation to treat DLE lesions, resulting in hair regrowth. Topical tacrolimus lotion, 0.3%, in an alcohol base may be a potential therapeutic option for patients with DLE that is refractory to first-line therapies and who risk late-stage disease with permanent scarring alopecia.

Topics: Administration, Topical; Adult; Alopecia; Cicatrix; Female; Humans; Immunosuppressive Agents; Lupus Erythematosus, Discoid; Middle Aged; Retrospective Studies; Tacrolimus; Treatment Outcome

Frontal fibrosing alopecia (FFA) is a type of scarring hair loss primarily observed in postmenopausal women and characterized by fronto-tempero-parietal hairline recession, perifollicular erythema, and loss of eyebrows. The incidence is unknown, but the number of women presenting with this condition has significantly increased in recent years. No effective therapy has been established.. The purpose of this study is to present pertinent demographic and clinical findings of patients with FFA seen at an academic hair loss clinic and their responses to various therapeutic interventions.. Patients seen at the Duke University Hair Disorders Research and Treatment Center, Durham, NC, between 2004 and 2011 who met FFA inclusion criteria and signed an informed consent form for participation in the Duke University Hair Disorders Research and Treatment Center database were included in this review.. Nineteen female patients with FFA met our inclusion criteria, the majority of whom were white and postmenopausal. A number of treatments, including topical and intralesional steroids, antibiotics, and immunomodulators, were used with disappointing results in most patients. However, the majority of patients on dutasteride experienced disease stabilization.. This was a retrospective review and outside clinic records were occasionally incomplete.. FFA is an increasingly common form of scarring hair loss, but the origin remains unknown. Without clear understanding of the pathogenesis and evolution of this condition, it is not surprising that treatments to date have been minimally or not effective. At our institution, dutasteride was most effective in halting disease progression, although no therapy was associated with significant hair regrowth.

Topics: 5-alpha Reductase Inhibitors; Adult; Aged; Alopecia; Anti-Bacterial Agents; Azasteroids; Cicatrix; Dutasteride; Enzyme Inhibitors; Eyebrows; Female; Fibrosis; Forehead; Hospitals, University; Humans; Hydroxychloroquine; Immunosuppressive Agents; Lichen Planus; Methotrexate; Middle Aged; Minocycline; Osteoporosis, Postmenopausal; Retrospective Studies; Scalp; Tacrolimus; Treatment Outcome

Topics: Alopecia; Cafe-au-Lait Spots; Child; Drug Therapy, Combination; Female; Humans; Lentigo; Minoxidil; Tacrolimus

The purpose of this study was to characterize the effects of clinical and genetic variables on the pharmacokinetics and complications of tacrolimus during the first year after kidney transplantation.. One hundred and thirty-two Korean kidney recipients who received tacrolimus were genotyped for ABCB1 (exons 12, 21, and 26) and CYP3A5 (intron 3). Tacrolimus trough levels, dose, or dose-adjusted trough levels and complications were compared among patients during the early stage (3, 7, 14, 30, and 90 days) and up to 1 year according to the genotypes.. A donor source-adjusted linear mixed model with multilevel analysis adjusting for age, body weight, hematocrit, and serum creatinine showed that CYP3A5 genotype is associated with dose-adjusted level of tacrolimus (p < 0.001). The influence of ABCB1 polymorphisms on the pharmacokinetics or complications of tacrolimus was less certain in our study. The incidence of acute rejections was significantly higher in recipients of cadaveric donor kidney (p < 0.05).. A generalized estimating equation model analysis showed that alopecia and hyperlipidemia were associated with dose-adjusted level of tacrolimus (p < 0.001). Genotype of CYP3A5 variants along with significant clinical covariates may be useful in individualizing tacrolimus therapy in kidney transplantation patients.

Topics: Adult; Aged; Alopecia; ATP Binding Cassette Transporter, Subfamily B; ATP Binding Cassette Transporter, Subfamily B, Member 1; Calcineurin Inhibitors; Cytochrome P-450 CYP3A; Drug Monitoring; Female; Genetic Association Studies; Graft Rejection; Humans; Hyperlipidemias; Immunosuppressive Agents; Incidence; Kidney Transplantation; Male; Middle Aged; Polymorphism, Genetic; Republic of Korea; Retrospective Studies; Tacrolimus; Young Adult

Topics: Administration, Topical; Adolescent; Alopecia; Alopecia Areata; Child; Drug Administration Schedule; Female; Follow-Up Studies; Humans; Immunosuppressive Agents; Infusions, Intravenous; Methylprednisolone; Phobic Disorders; Psychophysiologic Disorders; Tacrolimus

Most degenerative diseases begin with a gradual loss of specific cell types before reaching a threshold for symptomatic onset. However, the endogenous regenerative capacities of different tissues are difficult to study, because of the limitations of models for early stages of cell loss. Therefore, we generated a transgenic mouse line (Mos-iCsp3) in which a lox-mismatched Cre/lox cassette can be activated to produce a drug-regulated dimerizable caspase-3. Tissue-restricted Cre expression yielded stochastic Casp3 expression, randomly ablating a subset of specific cell types in a defined domain. The limited and mosaic cell loss led to distinct responses in 3 different tissues targeted using respective Cre mice: reversible, impaired glucose tolerance with normoglycemia in pancreatic β cells; wound healing and irreversible hair loss in the skin; and permanent moderate deafness due to the loss of auditory hair cells in the inner ear. These mice will be important for assessing the repair capacities of tissues and the potential effectiveness of new regenerative therapies.

Topics: Alopecia; Animals; Apoptosis; Caspase 3; Cell Lineage; Dimerization; Disease Models, Animal; Epidermis; Gene Expression Regulation; Gene Knockdown Techniques; Genes, Transgenic, Suicide; Glucose Intolerance; Hair Cells, Auditory, Inner; Hearing Loss, Bilateral; Hearing Loss, Sensorineural; Homeodomain Proteins; Insulin; Islets of Langerhans; Keratin-14; Mice; Mice, Inbred C57BL; Mice, Transgenic; Mosaicism; Organ Specificity; Phenotype; Tacrolimus; Transcription Factor Brn-3C; Transgenes; Wound Healing

Topics: Administration, Topical; Aged; Alopecia; Diagnosis, Differential; Female; Humans; Immunosuppressive Agents; Scalp Dermatoses; Tacrolimus

Topics: Administration, Oral; Administration, Topical; Alopecia; Azasteroids; Dermatologic Agents; Dutasteride; Enzyme Inhibitors; Female; Humans; Middle Aged; Tacrolimus

Omenn syndrome is a severe combined immunodeficiency with features of generalised erythroderma alopecia and evidence of Th2 inflammation (eosinophilia and raised IgE). We describe a differential effect of 2 calcineurin inhibitors, cyclosporine A (CsA) and tacrolimus, with CsA rapidly improving the erythroderma and lymphocytosis but tacrolimus having little effect.

Topics: Alopecia; Bone Marrow Transplantation; Calcineurin Inhibitors; Cyclosporine; Dermatitis, Exfoliative; Female; Hepatomegaly; Humans; Infant, Newborn; Lymphocytosis; Mothers; Severe Combined Immunodeficiency; Syndrome; Tacrolimus; Treatment Failure

Topics: Administration, Topical; Alopecia; Child; Female; Humans; Immunosuppressive Agents; Male; Ointments; Tacrolimus; Vitiligo; Warts

Immunosuppressive drugs given to solid organ transplant recipients may be responsible for cosmetic side effects which can endanger patient compliance. Cyclosporine is associated with hirsutism whereas tacrolimus has been associated with rare cases of alopecia. Since 1998, we have included tacrolimus within the immunosuppressive regimen following kidney-pancreas transplantation. The aim of this study was to evaluate the incidence of alopecia in this population and possible risk factors.. Between January 1, 1995 and October 31, 2003, 59 consecutive simultaneous kidney-pancreas (SPK) transplants were performed in 58 recipients (27 females and 31 males). The immunosuppressive regimen comprised corticosteroids, calcineurin inhibitor (cyclosporine, n=11; or tacrolimus, n=40) and a purine inhibitor (azathioprine or mycophenolate mofetil).. Clinically significant alopecia occurred in 13 patients (28.9%) receiving tacrolimus versus none receiving cyclosporine (P<0.001). Of those who experienced alopecia, 11 were female and two were male (P=0.02). The mean delay between transplantation and alopecia was 422 days (range 100-1,567). Other causes of alopecia were excluded. Treatment of alopecia with topic minoxidil was successful in all cases but one, which required conversion from tacrolimus to cyclosporine.. Alopecia is a frequent complication in women receiving tacrolimus therapy following SPK transplantation. Its pathogenesis is unknown. This cosmetic complication must be discussed with patients before transplantation to minimize the risk of noncompliance.

Topics: Alopecia; Antilymphocyte Serum; Cyclosporine; Drug Therapy, Combination; Female; Humans; Immunosuppressive Agents; Incidence; Kidney Transplantation; Lymphocyte Count; Male; Pancreas Transplantation; Postoperative Complications; Retrospective Studies; Sex Characteristics; Tacrolimus

The patient is a 62-year-old man who was diagnosed with myasthenia gravis and invasive thymoma at the age of 45 years, and had received treatment by extended thymectomy and radiotherapy. At the age of 61, he had suffered from a myasthenic crisis, and been administered immunoadsorption therapy under managed ventilatory care. Treatment had then been continued with steroids; however, due to subsequent deterioration of his diabetic state, treatment was switched to the immunosuppressant drug tacrolimus. Three months after the commencement of tacrolimus administration, the patient developed generalized malaise and dyspnea. The serum creatine phosphokinase (CPK) level was abnormally elevated, and abnormal electrocardiographic findings were noted, including atrioventricular dissociation and ventricular escape contraction. Steroid pulse therapy was therefore initiated, however, 4 days later, the patient suddenly died. Autopsy examination revealed inflammatory cell infiltration with giant cells in the myocardium, diffuse myocardial degeneration, and polymyositis. The case was therefore considered as one with the syndrome of myasthenia gravis, polymyositis, giant cell myocarditis, and thymoma.

Topics: Alopecia; Creatine Kinase; Dyspnea; Electrocardiography; Giant Cells; Humans; Immunosuppressive Agents; Male; Middle Aged; Myasthenia Gravis; Myocarditis; Myocardium; Myositis; Polymyositis; Radiography, Thoracic; Tacrolimus; Thymoma; Thymus Neoplasms; Time Factors; Treatment Outcome

Topics: Adolescent; Alopecia; Amenorrhea; Autoantibodies; Autoimmune Diseases; Drug Therapy, Combination; Female; Humans; Immunoglobulins, Intravenous; Immunosuppressive Agents; Methylprednisolone; Prednisolone; Spasm; Syndrome; Tacrolimus

Topics: Administration, Topical; Adolescent; Adult; Alopecia; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Humans; Immunosuppressive Agents; Male; Risk Assessment; Sampling Studies; Severity of Illness Index; Tacrolimus; Treatment Failure

Alopecia was induced in male and female neonatal C57BL mice by a single intraperitoneal injection of 60 mg/kg N-methyl-N-nitrosourea (MNU). MNU administration was most effective in the 8-day-old mice and less effective in the 5-day-old mice (at active and early anagen stages of the first hair cycle, respectively). No alopecia was seen in the day 14 MNU-treated animals (at telogen stage of the first hair cycle). MNU effectively induced hair follicular cell apoptosis at the anagen stage by up-regulation of Bax protein without down-modulation of Bcl-2 protein. In day 8 MNU-treated mice, the immunosuppressive agent 0.01% tacrolimus hydrate (FK506), when topically applied for 5 days from 1 day after MNU treatment (before the occurrence of alopecia), decreased the severity of alopecia. However, it did not stimulate hair growth when applied for 5 days from 20 days of age (after occurrence of alopecia).

Topics: Alkylating Agents; Alopecia; Animals; Apoptosis; bcl-2-Associated X Protein; Female; Immunosuppressive Agents; Male; Methylnitrosourea; Mice; Mice, Inbred C57BL; Proto-Oncogene Proteins; Proto-Oncogene Proteins c-bcl-2; Tacrolimus; Time Factors; Up-Regulation

Topics: Adult; Alopecia; Azathioprine; Cyclosporine; Drug Therapy, Combination; Female; Humans; Immunosuppressive Agents; Kidney Transplantation; Living Donors; Male; Middle Aged; Prednisolone; Tacrolimus

Topics: Alopecia; Dose-Response Relationship, Drug; Humans; Immunosuppressive Agents; Tacrolimus

Selected immunophilin ligands (IPLs) are not only potent immunosuppressants but also modulate hair growth. Their considerable side effects, however, justify at best topical applications of these drugs for the management of clinical hair growth disorders. Therefore, we have explored hair growth manipulation by topical cyclosporin A (CsA) and FK 506 in previously established murine models that mimic premature hair follicle regression (catagen) or chemotherapy-induced alopecia, two major pathomechanisms underlying human hair loss. We confirm that topical CsA and FK 506 induce active hair growth (anagen) in the back skin of C57BL/6 mice with all follicles in the resting stage (telogen) and show that both IPLs also inhibit massive, dexamethasone-induced, premature catagen development in these mice. Furthermore, we demonstrate that CsA and FK 506 provide relative protection from alopecia and follicle dystrophy induced by cyclophosphamide, possibly by favoring the dystrophic anagen pathway of follicle response to chemical damage. Although it remains to be established whether these IPLs exert the same effects on human hair follicles, our study provides proof of the principle that topical IPLs can act as potent manipulators of clinically relevant hair-cycling pathomechanisms. This strongly encourages one to explore the use of topical IPLs in the management of human hair growth disorders.

Topics: Administration, Topical; Alopecia; Animals; Cyclophosphamide; Cyclosporine; Dexamethasone; Drug-Related Side Effects and Adverse Reactions; Female; Hair Follicle; Ligands; Mice; Mice, Inbred C57BL; Tacrolimus

Topics: Adult; Alopecia; Cyclosporine; Female; Humans; Immunosuppressive Agents; Kidney Failure, Chronic; Kidney Transplantation; Male; Tacrolimus

Topics: Alopecia; Autoimmune Diseases; Graft Rejection; Hair; Humans; Liver Transplantation; Male; Middle Aged; Tacrolimus