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dc.contributor.authorZhang, X.
dc.contributor.authorYe, Y.
dc.contributor.authorZhu, Z.
dc.contributor.authorYang, Y.
dc.contributor.authorCao, H.
dc.contributor.authorMcElwee, Kevin J.
dc.contributor.authorLing, Y.
dc.date.accessioned2019-03-12T10:45:55Z
dc.date.accessioned2019-09-03T15:09:42Z
dc.date.available2019-03-12T10:45:55Z
dc.date.available2019-09-03T15:09:42Z
dc.date.issued2020
dc.identifier.citationZhang X, Ye Y, Zhu Z et al (2020) Sequential cyclic changes of hair roots revealed by dermoscopy demonstrate a progressive mechanism of diffuse alopecia areata over time. Experimental Dermatology. 29: 223-230.en_US
dc.identifier.urihttp://hdl.handle.net/10454/17237
dc.descriptionYesen_US
dc.description.abstractBACKGROUND: Diffuse alopecia areata (DAA) often leads to a complete hair shedding within a few months. OBJECTIVE: To explore features and mechanisms underlying DAA. MATERIALS AND METHODS: Scalp and hair root dermoscopy were conducted on 23 DAA patients throughout the disease process, 20 patchy Alopecia areata patients, 23 acute telogen effluvium (ATE) patients and 10 normal controls. Histopathology was also evaluated. RESULTS: We found almost all hair roots were anagen in early stage DAA in 18 patients (18/23, 78.3%) within the first 4-8 weeks after hair loss onset. Anagen effluvium (~4 weeks) was followed by catagen (~4 weeks) and then telogen/exogen (~8 weeks) effluvium with overlap. Hair root and proximal hair shaft depigmentation was more prominent in later DAA disease stages. Black dots, exclamation mark hairs and inconsistent thickness of hair shafts were found more often in early than later DAA (Ps < 0.01). Early DAA histopathology revealed more prominent inflammation and hair follicle regression than that observed in the later stages. Patchy alopecia areata patients showed mixed anagen, catagen and telogen hair roots while ATE patients showed increased exogen and mildly decreased hair root pigmentation. CONCLUSION: Sequential cyclic staging of shed hairs in DAA indicates the insult may be hair-cycle specific. We suggest that DAA is initially an anagen effluvium disease involving an intense inflammatory insult, later progressing to a brief catagen effluvium, and then to telogen effluvium with premature exogen, in later stages of DAA.en_US
dc.description.sponsorshipThis study was supported by the following grants to Xingqi Zhang: National Natural Science Foundation of China (81573066); Natural Science Foundation of Guangdong Province (2014A030313098).en_US
dc.language.isoenen_US
dc.relation.isreferencedbyhttps://doi.org/10.1111/exd.13799en_US
dc.rights© 2018 Wiley This is the peer reviewed version of the following article: Zhang X, Ye Y, Zhu Z et al (2020) Sequential cyclic changes of hair roots revealed by dermoscopy demonstrate a progressive mechanism of diffuse alopecia areata over time. Experimental Dermatology. 29: 223-230. which has been published in final form at https://doi.org/10.1111/exd.13799. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
dc.subjectAcute telogen effluviumen_US
dc.subjectAlopecia areataen_US
dc.subjectAlopecia areata incognitaen_US
dc.subjectAnagenen_US
dc.subjectCatagenen_US
dc.subjectClub hairsen_US
dc.subjectDermoscopyen_US
dc.subjectDiffuse alopecia areataen_US
dc.subjectHair rootsen_US
dc.subjectTrichoscopyen_US
dc.titleSequential cyclic changes of hair roots revealed by dermoscopy demonstrate a progressive mechanism of diffuse alopecia areata over time.en_US
dc.status.refereedYesen_US
dc.date.Accepted2018-10-05
dc.date.application2018-10-11
dc.typeArticleen_US
dc.type.versionAccepted manuscripten_US
dc.date.updated2019-03-12T10:45:56Z
refterms.dateFOA2019-09-03T15:12:40Z


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