Childhood Alopecia Areata: An Overview of Treatment and Recent Patents.

IF 4.2 Q3 Pharmacology, Toxicology and Pharmaceutics
Kam L Hon, David C K Luk, Alexander K C Leung, Chantel Ng, Steven K F Loo
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引用次数: 4

Abstract

BACKGROUND Alopecia Areata (AA) is a systemic autoimmune condition which usually starts in childhood. OBJECTIVE This article aims to review genetics, therapy, prognosis and recent patents for AA. METHODS We used clinical queries and keywords of "alopecia areata" AND "childhood" as search engine. Patents were searched using the key term "alopecia areata" in Patents.google.com and freepatentsonline.com. RESULTS Due to an immune mediated damage of the hair follicles, hair is lost from the scalp and other areas of the body temporarily or even permanently. Children with AA are generally healthy. Evidence of genetic association and increased predisposition for AA was found by studying families with affected members. Pathophysiologically, T- lymphocytes attack hair follicles and cause inflammation and destruction of the hair follicles and hair loss. In mild cases, there would be well demarcated round patchy scalp hair loss. The pathognomonic "exclamation mark hairs" may be seen at lesion periphery. In more severe cases, the hair loss may affect the whole scalp and even the whole body. The clinical course is also variable which may range from transient episodes of recurrent patchy hair loss to an indolent gradually deteriorating severe hair loss. The treatment of AA depends on factors including patients' age, extent of the hair loss, duration of disease, psychological impact, availability and side effect profile of the treatments. For localized patchy alopecia, topical application of corticosteroids and/or intralesional corticosteroids are the treatment of choice. Other topical treatments include minoxidil, anthralin, coal tar and immunotherapy. In severe resistant cases, systemic immunosuppressants may be considered. Although herbal medicine, acupuncture, complementary and alternative medicine may be tried on children in some Asian communities, the evidence to support these practices are lacking. To date, only few recent patents exist in topical treatments including Il-31, laser and herbal medications. Clinical efficacy is pending for these treatment modalities. CONCLUSIONS None of the established therapeutic options are curative. However, newer treatment modalities including excimer laser, interleukin-31 antibodies and biologics are evolving so that there may be significant advances in treatment in the near future. AA can be psychosocially devastating. It is important to assess the quality of life, degree of anxiety, social phobia and mood of the patients and their families. Psychological support is imperative for those who are adversely affected psychosocially.
儿童斑秃:治疗综述及近期专利。
背景:斑秃(AA)是一种全身性自身免疫性疾病,通常开始于儿童时期。目的:综述AA的遗传学、治疗、预后及近期专利。方法:以临床查询和关键词“斑秃”、“童年”为搜索引擎。在Patents.google.com和frepatentsonline上以“斑秃”为关键词搜索专利。com。结果:由于免疫介导的毛囊损伤,头发会从头皮和身体其他部位暂时甚至永久性地脱落。嗜酒成瘾的儿童通常是健康的。通过研究有AA患者的家庭,发现了遗传关联和增加AA易感性的证据。病理生理上,T淋巴细胞攻击毛囊,引起炎症和破坏毛囊和脱发。在轻微的情况下,会有明确划分的圆形斑驳头皮脱发。病变周围可见典型的“感叹号毛”。在更严重的情况下,脱发可能会影响整个头皮甚至整个身体。临床过程也是多变的,其范围可以从短暂的复发性斑状脱发到逐渐恶化的惰性严重脱发。AA的治疗取决于患者的年龄、脱发程度、疾病持续时间、心理影响、治疗的可用性和副作用等因素。对于局部斑秃,局部应用皮质类固醇和/或局部皮质类固醇是治疗的选择。其他局部治疗包括米诺地尔、炭疽病、煤焦油和免疫疗法。在严重耐药病例中,可以考虑使用全身免疫抑制剂。虽然一些亚洲社区的儿童可以尝试使用草药、针灸、补充和替代医学,但缺乏支持这些做法的证据。到目前为止,只有一些最近的专利存在于局部治疗,包括Il-31,激光和草药。这些治疗方式的临床疗效尚待确定。结论:现有的治疗方案均无疗效。然而,新的治疗方式,包括准分子激光、白介素-31抗体和生物制剂,正在不断发展,因此在不久的将来可能会有重大的治疗进展。嗜酒者互戒会对心理社会造成毁灭性的影响。重要的是评估患者及其家属的生活质量、焦虑程度、社交恐惧症和情绪。心理支持对于那些受到不良社会心理影响的人来说是必不可少的。
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来源期刊
CiteScore
3.90
自引率
0.00%
发文量
0
期刊介绍: Recent Patents on Inflammation & Allergy Drug Discovery publishes review articles by experts on recent patents in the field of inflammation and allergy drug discovery e.g. on novel bioactive compounds, analogs and targets. A selection of important and recent patents in the field is also included in the journal. The journal is essential reading for all researchers involved in inflammation and allergy drug design and discovery.
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