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  1. Fibromyalgia

    MedlinePlus

    ... Fibromyalgia? National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Information Clearinghouse National Institutes of Health ... from: National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Information Clearinghouse National Institutes of Health ...

  2. Dissociative depression among women with fibromyalgia or rheumatoid arthritis.

    PubMed

    Kilic, Ozge; Sar, Vedat; Taycan, Okan; Aksoy-Poyraz, Cana; Erol, Turgut C; Tecer, Ozlem; Emul, Murat H; Ozmen, Mine

    2014-01-01

    The aim of this study was to inquire about the possible relations of childhood trauma, anger, and dissociation to depression among women with fibromyalgia or rheumatoid arthritis. Fifty female patients diagnosed as having fibromyalgia (n = 30) or rheumatoid arthritis (n = 20) participated in the study. The Childhood Trauma Questionnaire, Somatoform Dissociation Questionnaire (SDQ), Dissociation Questionnaire (DIS-Q), Beck Depression Inventory (BDI), Spielberger State-Trait Anger Expression Inventory, and Dissociative Disorders Interview Schedule were administered to all participants. Women with a lifetime diagnosis of depressive disorder had higher scores for somatoform and psychoform dissociation than the nondepressive patients. However, childhood trauma scores did not differ between the 2 groups. In regression analysis, current severity of depression (BDI) was predicted by psychoform dissociation (DIS-Q) and lower education, and lifetime diagnosis of major depression was predicted by somatoform dissociation (SDQ). Whereas childhood emotional neglect predicted somatoform dissociation, psychoform dissociation was predicted by childhood sexual abuse. Mental processing of anger seems to be 1 of the dimensions of psychodynamics in trauma-related depressive conditions. In the context of the perceived threat of loss of control due to expressed anger and mental disintegration, somatoform dissociation seems to contribute to overmodulation of emotions in dissociative depression. Among patients suffering from physical illness with possible psychosomatic dimensions, assessment of somatoform dissociation in addition to psychoform dissociation may be helpful to understand diverse psychopathological trajectories emerging in the aftermath of childhood adversities. The recently proposed category of "dissociative depression" (Sar, 2011) seems to be a promising concept for future research on psychosomatic aspects of traumatic stress. PMID:24228798

  3. Fibromyalgia

    MedlinePlus

    Fibromyalgia is a disorder that causes muscle pain and fatigue. People with fibromyalgia have "tender points" on the body. Tender points ... when pressure is put on them. People with fibromyalgia may also have other symptoms, such as Trouble ...

  4. Fibromyalgia

    MedlinePlus

    Fibromyalgia is a disorder that causes muscle pain and fatigue. People with fibromyalgia have "tender points" on the body. Tender points are specific places on the neck, shoulders, back, hips, arms, and ...

  5. Pain mystery score beliefs: a comparison of fibromyalgia and rheumatoid arthritis.

    PubMed

    Ferrari, Robert; Russell, Anthony Science

    2014-01-01

    Objectives. To compare the mysteriousness scores of the Pain Beliefs and Perceptions Inventory in fibromyalgia. Methods. Two cohorts of patients, one with fibromyalgia (FM) and one with rheumatoid arthritis (RA), completed the Mystery Scale component of the Pain Beliefs and Perceptions Inventory to determine whether subjects in the two diagnostic groups had significantly different scores on the Mystery Scale. Results. A total of 126 subjects (64 FM, 62 RA) completed all questionnaires. The FM group had a greater percentage of female subjects, more severe pain, more severe anxiety, more severe depression, and a higher perceived injustice score. When the RA and FM group scores for the Mystery Scale were adjusted for age, sex, pain severity, HADS scores, and perceived injustice scores, the FM group still had a higher Mystery Scale score. Discussion. Fibromyalgia is associated with a higher level of perception of mysteriousness in the Pain Beliefs and Perceptions Inventory than is seen with rheumatoid arthritis. This difference appears to be independent of levels of pain, depression, anxiety, and perceived injustice. This sense of mysteriousness may reflect a lack of understanding of pain in fibromyalgia as previously reported and may be an area to be addressed in therapy. PMID:25548570

  6. Fibromyalgia

    MedlinePlus

    ... from the joints. People with fibromyalgia tend to wake up with body aches and stiffness. For some people, pain improves during the day and gets worse at night. Some people have pain all day long. Pain may get worse with activity, cold or ...

  7. Fibromyalgia.

    PubMed

    Häuser, Winfried; Ablin, Jacob; Fitzcharles, Mary-Ann; Littlejohn, Geoffrey; Luciano, Juan V; Usui, Chie; Walitt, Brian

    2015-01-01

    Fibromyalgia is a common illness characterized by chronic widespread pain, sleep problems (including unrefreshing sleep), physical exhaustion and cognitive difficulties. The definition, pathogenesis and treatment are controversial, and some even contest the existence of this disorder. In 1990, the American College of Rheumatology (ACR) defined classification criteria that required multiple tender points (areas of tenderness occurring in muscles and muscle-tendon junctions) and chronic widespread pain. In 2010, the ACR preliminary diagnostic criteria excluded tender points, allowed less extensive pain and placed reliance on patient-reported somatic symptoms and cognitive difficulties. Fibromyalgia occurs in all populations worldwide, and symptom prevalence ranges between 2% and 4% in the general population. The prevalence of people who are actually diagnosed with fibromyalgia ('administrative prevalence') is much lower. A model of fibromyalgia pathogenesis has been suggested in which biological and psychosocial variables interact to influence the predisposition, triggering and aggravation of a chronic disease, but the details are unclear. Diagnosis requires the history of a typical cluster of symptoms and the exclusion of a somatic disease that sufficiently explains the symptoms by medical examination. Current evidence-based guidelines emphasize the value of multimodal treatments, which encompass both non-pharmacological and selected pharmacological treatments tailored to individual symptoms, including pain, fatigue, sleep problems and mood problems. For an illustrated summary of this Primer, visit: http://go.nature.com/LIBdDX. PMID:27189527

  8. Arthritis and Rheumatic Diseases

    MedlinePlus

    ... Bursitis and Tendinitis, Q&A Fibromyalgia, Q&A Gout, Q&A Juvenile Arthritis, Q&A Childhood Arthritis ( ... Many people also experience fatigue and sleep disturbances. Gout. A type of arthritis resulting from deposits of ...

  9. Comparisons of Body Image Perceptions of a Sample of Black and White Women with Rheumatoid Arthritis and Fibromyalgia in the US

    PubMed Central

    Boyington, Josephine E.A; Schoster, Britta; Callahan, Leigh F

    2015-01-01

    Objective : To explore the disease-related, body image (BI) perceptions of women diagnosed with, rheumatoid arthritis (RA) and fibromyalgia (FM). Methods : A purposive sample of twenty-seven females participated in individual semi-structured phone interviews to elicit BI perceptions relative to pain, activity limitations and coping measures. Sessions were digitally recorded, transcribed verbatim, and content analyzed. Results : Body image perceptions relative to 5 major themes emerged in the analysis. They focused on Pain, Disease Impact on Physical and Mental Function, Weight, Diseased-Induced Fears and, Coping measures. Pain was a common experience of all participants. Other troubling factors verbalized by participants included dislike and shame of visibly affected body parts, and disease-induced social, psychological and physical limitations. RA participants thought that manifested joint changes, such as swelling and redness, undergirded their prompt diagnosis and receipt of health care. Contrarily, women with fibromyalgia perceived that the lack of visible, disease-related, physical signs led to a discounting of their disease, which led to delayed health care and subsequent frustrations and anger. All but one participant used prayer and meditation as a coping measure. Conclusion : The body image perceptions evidenced by the majority of participants were generally negative and included specific focus on their disease-affected body parts (e.g. joints), mental function, self-identity, health care experiences, activity limitations and overall quality of life. Given the global effect of RA and FM, assessment and integration of findings about the BI perceptions of individuals with FM and RA may help define suitable interdisciplinary strategies for managing these conditions and improving participants’ quality of life. PMID:25674181

  10. Arthritis

    MedlinePlus

    ... or have trouble moving around, you might have arthritis. Most kinds of arthritis cause pain and swelling in your joints. Joints ... joint can become severely damaged. Some kinds of arthritis can also cause problems in your organs, such ...

  11. Scarring alopecia.

    PubMed

    Newton, R C; Hebert, A A; Freese, T W; Solomon, A R

    1987-07-01

    The scarring alopecias are a diverse group of diseases characterized by the combination of follicular destruction and dermal scarring. In this article we divide scarring alopecias into three broad categories, pediatric diseases, perifollicular lymphocytic diseases, and folliculopustular diseases, and discuss selected entities from each category. PMID:3301117

  12. Psoriatic alopecia.

    PubMed

    George, S M C; Taylor, M R; Farrant, P B J

    2015-10-01

    Alopecia and other hair abnormalities occurring in patients with psoriasis were first recognized over four decades ago, yet psoriatic alopecia is not a well-known concept among clinicians. Alopecia may be directly related to the psoriasis itself, and can affect both the scalp and other parts of the body. On the scalp, psoriatic alopecia most commonly affects lesional skin, but may present as a generalized telogen effluvium. In most cases, there is regrowth of hair, but in rare cases it can cause scarring alopecia. Histological findings include features of psoriasis in the interfollicular epithelium, along with perifollicular inflammation and atrophy or loss of the sebaceous glands. Late changes include destruction of the hair follicle, with perifollicular fibrosis and 'naked' hair shafts lying free in the dermis. In addition to the hair loss caused by the psoriasis itself, data from population and genetic studies reveal that patients with psoriasis are at greater risk of developing alopecia areata. Psoriasis treatments may also contribute to hair loss. Application of topical preparations may cause hair loss through friction, and many of the systemic treatments used for psoriasis can also cause hair problems. Treatment with anti-tumour necrosis factor-α agents can precipitate de novo psoriasis and subsequent psoriatic alopecia. PMID:26202646

  13. Arthritis

    MedlinePlus

    ... when taking arthritis medicines . Over-the-counter medicines: Acetaminophen (Tylenol) is often the first medicine tried. Take up to 4000 mg a day (two arthritis-strength Tylenol every 8 hours). To prevent damage to your ...

  14. Facing Fibromyalgia | NIH MedlinePlus the Magazine

    MedlinePlus

    ... effective treatments. Studies are examining the use of cognitive behavioral therapy and transcutaneous electrical nerve stimulation (TENS) in people with fibromyalgia, which researchers hope will result in better management of the disorder. Find Out More National Institute of Arthritis and ...

  15. [Alopecia areata].

    PubMed

    von Felbert, V; Merk, H F

    2013-11-01

    The epidemiology of alopecia areata as well as murine models of this disease and genome-wide association studies support the concept of alopecia areata as an autoimmune disease. In addition, the genome-wide association studies have led to the identification of new potential therapeutic targets such as CTLA4; these results have already led to the initiation of clinical studies, for example, with abatacept. Currently topical and intralesional corticosteroids as well as immunotherapy with diphenylcyclopropenone are most common therapeutic approaches. PMID:24177663

  16. [Alopecia areata].

    PubMed

    Friedli, A; Harms, M

    2002-05-01

    Alopecia areata is a frequent cause of hair loss. The origin of disease is not fully understood. However there are indications for a T-cell mediated autoimmune process. Genetic, immunologic and psychologic factors are important for the outbreak of disease. Most patients show localized patches of acute hair loss, where regrowth is observed spontaneously or with simple topical treatment within few months. In up to 15% of patients severe forms of disease can develop with total scalp (alopecia totalis) or scalp and body hair loss (alopecia universalis). There are only few known risk factors for development of a severe form. Although spontaneous remission is possible in these cases, it occurs rarely and treatment is difficult. Multifocal alopecia areata responds to intravenous high-dose corticosteroids. Topical immunotherapy with diphenylcyclopropenone (DPC) or PUVA therapy may be effective in longstanding and widespread disease. The unpredictable course of disease is a major handicap for clinical trials and treatment recommendations. Contact of patients with self-help organisations may be of help for coping with the disease. PMID:12090120

  17. What Is Alopecia Areata?

    MedlinePlus

    ... Alopecia Areata Find a Clinical Trial Journal Articles Alopecia Areata PDF Version Size: 79 KB Audio Version ... Size: 8.5 MB April 2015 What Is Alopecia Areata? Fast Facts: An Easy-to-Read Series ...

  18. Arthritis

    MedlinePlus

    ... Difficulty moving a joint (called "limited range of motion") Some types of arthritis may cause joint deformity. ... exercise). Walking is a good example. Range of motion exercises for flexibility. Strength training for muscle tone. ...

  19. Alopecia: evaluation and treatment

    PubMed Central

    Gordon, Katherine A; Tosti, Antonella

    2011-01-01

    Hair loss is a very common complaint. Patients may describe increased shedding and diffuse or localized alopecia. The differential diagnosis of hair loss includes a number of disorders causing cicatricial or noncicatricial alopecias. This paper describes the clinical approaches and diagnostic tests that are useful in the evaluation of patients presenting with alopecia. It also reviews treatments for noncicatricial alopecias, including androgenetic alopecia, alopecia areata, and telogen effluvium, as well as cicatricial alopecias, including lichen planopilaris, its clinical variant frontal fibrosing alopecia, and discoid lupus erythematosus. PMID:21833160

  20. Androgenetic alopecia.

    PubMed

    Piraccini, B M; Alessandrini, A

    2014-02-01

    Androgenetic alopecia (AGA) is the most common form of alopecia, affecting up to 80% of men and 50% of women in the course of their life. AGA is caused by a progressive reduction in the diameter, length and pigmentation of the hair. Hair thinning results from the effects of the testosterone metabolite dehydrotestosterone (DHT) on androgen-sensitive hair follicles. In women, AGA produces diffuse thinning of the crown region with maintenance of the frontal hairline (Ludwig pattern AGA). In premenopausal women, AGA can be a sign of hyperandrogenism, together with hirsutism and acnes. Male pattern is characterized by bitemporal recession of the frontal hairline, followed by diffuse thinning at the vertex. Today, scalp dermoscopy is used routinely in patients with androgenetic alopecia, as it facilitates the diagnosis and differential diagnosis with other diseases, allows staging of severity, and allows you to monitor the progress of the disease in time and response to treatment. AGA is a progressive disease that tends to worsen with time. Medical treatment of AGA includes topical minoxidil, antiandrogen agents, 5-alpha reductase inhibitors. PMID:24566563

  1. Fibromyalgia and arthritides.

    PubMed

    Atzeni, F; Sallì, S; Benucci, M; Di Franco, M; Alciati, A; Sarzi-Puttini, P

    2012-01-01

    Fibromyalgia (FM) is a chronic pain syndrome that affects at least 2% of the adult population. It is characterised by widespread pain, fatigue, sleep alterations and distress, and emerging evidence suggests a central nervous system (CNS) malfunction that increases pain transmission and perception. FM is often associated with other diseases that act as confounding and aggravating factors, such as rheumatoid arthritis (RA), spondyloarthritides (SpA), osteoarthritis (OA) and thyroid disease. Mechanism-based FM management should consider both peripheral and central pain, including effects due to cerebral input and that come from the descending inhibitory pathways. Rheumatologists should be able to distinguish primary and secondary FM, and need new guidelines and instruments to avoid making mistakes, bearing in mind that the diffuse pain of arthritides compromises the patients' quality of life. PMID:23024973

  2. Alopecia areata.

    PubMed

    Wasserman, Dan; Guzman-Sanchez, Daniela Araucaria; Scott, Kimberly; McMichael, Amy

    2007-02-01

    Alopecia areata (AA) is a nonscarring, autoimmune, inflammatory, hair loss on the scalp, and/or body. Etiology and pathogenesis are still unknown. The most common site affected is the scalp. Histopathology is characterized by an increased number of the catagen and telogen follicles, the presence of inflammatory lymphocytic infiltrate in the peribulbar region ("swarm of bees"). Corticosteroids are the most popular drugs for the treatment of this disease. Etiologic and pathogenic mechanisms, as well as other current treatments available will be discussed in this article. PMID:17269961

  3. Androgenetic alopecia.

    PubMed

    Otberg, Nina; Finner, Andreas M; Shapiro, Jerry

    2007-06-01

    Androgenetic alopecia (AGA), or male pattern hair loss, affects approximately 50% of the male population. AGA is an androgen-related condition in genetically predisposed individuals. There is no treatment to completely reverse AGA in advanced stages, but with medical treatment (eg, finasteride, minoxidil, or a combination of both), the progression can be arrested and partly reversed in the majority of patients who have mild to moderate AGA. Combination with hair restoration surgery leads to best results in suitable candidates. Physicians who specialize in male health issues should be familiar with this common condition and all the available approved treatment options. PMID:17543725

  4. Alopecia areata

    PubMed Central

    Spano, Frank; Donovan, Jeff C.

    2015-01-01

    Abstract Objective To provide family physicians with a background understanding of the therapeutic regimens and treatment outcomes for alopecia areata (AA), as well as to help identify those patients for whom dermatologist referral might be required. Sources of information PubMed was searched for relevant articles regarding the treatment of AA. Main message Alopecia areata is a form of autoimmune hair loss affecting both children and adults. While there is no associated mortality with the disease, morbidity from the psychological effects of hair loss can be devastating. Upon identification of AA and the disease subtype, an appropriate therapeutic regimen can be instituted to help halt hair loss or possibly initiate hair regrowth. First-line treatment involves intralesional triamcinolone with topical steroids or minoxidil or both. Primary care physicians can safely prescribe and institute these treatments. More advanced or refractory cases might require oral immunosuppressants, topical diphenylcyclopropenone, or topical anthralin. Eyelash loss can be treated with prostaglandin analogues. Those with extensive loss might choose camouflaging options or a hair prosthesis. It is important to monitor for psychiatric disorders owing to the profound psychological effects of hair loss. Conclusion Family physicians will encounter many patients experiencing hair loss. Recognition of AA and an understanding of the underlying disease process will allow an appropriate therapeutic regimen to be instituted. More advanced or refractory cases need to be identified, allowing for an appropriate dermatologist referral when necessary. PMID:26371098

  5. Alopecia areata.

    PubMed

    Perera, Eshini; Yip, Leona; Sinclair, Rodney

    2015-01-01

    Alopecia areata (AA) is a common, non-scarring alopecia that usually presents as well-circumscribed patches of sudden hair loss and affects 0.1-0.2% of the population. The aetiology of AA is thought to be both genetic and autoimmune in nature. One hundred and thirty-nine single nucleotide polymorphisms linked to AA have been identified in 8 regions of the genome and have been found to be associated with T cells or the hair follicle. Furthermore, patients with AA have been found to have an increased frequency of hair follicle-specific auto-antibodies. The diagnosis of AA is usually made on clinical grounds, and further investigations are not usually needed. Intralesional corticosteroids remain the treatment of choice. Systemic steroids are also highly effective; however, side effects make them less desirable to both patients and physicians. Other available treatment options include anthralin, minoxidil, topical immunotherapy and systemic immunosuppressants. These treatments will be discussed in depth in this chapter. The morbidity of AA is largely psychological; therefore, the successful treatment of AA should include focusing on improving the psychological impact of this condition. PMID:26370645

  6. Primary scarring alopecias.

    PubMed

    Rigopoulos, Dimitrios; Stamatios, Gregoriou; Ioannides, Dimitrios

    2015-01-01

    Scarring alopecia or cicatricial alopecia results from follicular damage that is sufficient to cause the destruction and replacement of pilosebaceous structures by scar tissue. Primary scarring alopecias represent a group of disorders that primarily affect the hair follicles, as opposed to secondary scarring alopecias, which affect the dermis and secondarily cause follicular destruction. Inflammation may predominantly involve lymphocytes or neutrophils. Cicatricial alopecias that mainly involve lymphocytic inflammation include discoid lupus erythematosus, lichen planopilaris, frontal fibrosing alopecia, central centrifugal alopecia, and pseudopelade (Brocq). Cicatricial alopecias that are due to predominantly neutrophilic inflammation include folliculitis decalvans, tufted folliculitis, and dissecting cellulitis of the scalp. Folliculitis keloidalis is a cicatricial alopecia with a mixed inflammatory infiltrate. PMID:26370646

  7. Personality and Fibromyalgia Syndrome

    PubMed Central

    Malin, Katrina; Littlejohn, Geoffrey O

    2012-01-01

    Objectives: We aimed to review how personality characteristics contribute to the onset, maintenance or modulation of fibromyalgia. Method: The databases Medline and PsychINFO were examined from 1967 to 2012 to identify studies that investigated associations between fibromyalgia and personality. Search terms included fibromyalgia and personality, trait psychology, characteristics and individual differences. Results: Numerous studies indicate that patients with fibromyalgia experience psychological distress. Various instruments have been used to evaluate distress and related psychological domains, such as anxiety or depression, in fibromyalgia. In many cases, these same instruments have been used to study personality characteristics in fibromyalgia with a subsequent blurring of cause and effect between personality and psychological distress. In addition, the symptoms of fibromyalgia may change pre-illness personality characteristics themselves. These issues make it difficult to identify specific personality characteristics that might influence the fibromyalgia process. Despite this inherent problem with the methodologies used in the studies that make up this literature review, or perhaps because of it, we found no defined personality profile specific to fibromyalgia. However, many patients with fibromyalgia do show personality characteristics that facilitate psychological responses to stressful situations, such as catastrophising or poor coping techniques, and these in turn associate with mechanisms contributing to fibromyalgia. Conclusion: No specific fibromyalgia personality is defined but it is proposed that personality is an important filter that modulates a person’s response to psychological stressors. Certain personalities may facilitate translation of these stressors to physiological responses driving the fibromyalgia mechanism. PMID:23002409

  8. National Alopecia Areata Foundation

    MedlinePlus

    ... their families. Research Summits The National Alopecia Areata Foundation conducts research summits every two years, bringing together ... to their company through the National Alopecia Areata Foundation, each company listed has generously offered to contribute ...

  9. What Is Fibromyalgia?

    MedlinePlus

    ... Size: 129 KB November 2014 What Is Fibromyalgia? Fast Facts: An Easy-to-Read Series of Publications ... linked to: Stressful or traumatic events, such as car accidents Repetitive injuries Illness Certain diseases. Fibromyalgia can ...

  10. Central centrifugal cicatricial alopecia

    PubMed Central

    Blattner, Collin; Polley, Dennis C.; Ferritto, Frank; Elston, Dirk M.

    2013-01-01

    Central centrifugal cicatricial alopecia is a common cause of progressive permanent apical alopecia. This unique form of alopecia includes entities previously know as “hot comb alopecia,” “follicular degeneration syndrome,” “pseudopelade” in African Americans and “central elliptical pseudopelade” in Caucasians. The etiology appears to be multifactorial and the condition occurs in all races. PMID:23440368

  11. Isoniazid-induced alopecia

    PubMed Central

    Gupta, K. B.; Kumar, V.; Vishvkarma, S.; Shandily, R.

    2011-01-01

    Isoniazid is a safe and very effective antituberculosis drug. Antimitotic agents routinely cause alopecia. Drug-induced alopecia is usually reversible upon withdrawal of the drug. Isoniazid, thiacetazone and ethionamide are the antituberculosis drugs which have been associated with alopecia. Isoniazid-induced alopecia was observed in one case and confirmed by the finding that hair growth resumed when drug removed from the regimen. PMID:21654989

  12. Alopecia caused by isoniazid

    PubMed Central

    Dixit, Ramakant; Qureshi, Danish; Mathur, Sunil

    2014-01-01

    Drug-induced alopecia is a known clinical entity and mainly seen with anti-mitotic drug therapy. Alopecia during anti-tuberculosis therapy is very uncommon and previously observed with isoniazid, thiacetazone, and ethionamide. Present communication describes an additional case of isoniazid-induced alopecia in a 10-year-old male child, which was reversible after isoniazid withdrawal. Possible mechanisms of drug-induced alopecia are also briefly discussed. PMID:24799819

  13. Exposure to a specific pulsed low-frequency magnetic field: A double-blind placebo-controlled study of effects on pain ratings in rheumatoid arthritis and fibromyalgia patients

    PubMed Central

    Shupak, Naomi M; McKay, Julia C; Nielson, Warren R; Rollman, Gary B; Prato, Frank S; Thomas, Alex W

    2006-01-01

    BACKGROUND Specific pulsed electromagnetic fields (PEMFs) have been shown to induce analgesia (antinociception) in snails, rodents and healthy human volunteers. OBJECTIVE The effect of specific PEMF exposure on pain and anxiety ratings was investigated in two patient populations. DESIGN A double-blind, randomized, placebo-controlled parallel design was used. METHOD The present study investigated the effects of an acute 30 min magnetic field exposure (less than or equal to 400 μTpk; less than 3 kHz) on pain (McGill Pain Questionnaire [MPQ], visual analogue scale [VAS]) and anxiety (VAS) ratings in female rheumatoid arthritis (RA) (n=13; mean age 52 years) and fibromyalgia (FM) patients (n=18; mean age 51 years) who received either the PEMF or sham exposure treatment. RESULTS A repeated measures analysis revealed a significant pre-post-testing by condition interaction for the MPQ Pain Rating Index total for the RA patients, F(1,11)=5.09, P<0.05, estimate of effect size = 0.32, power = 0.54. A significant pre-post-effect for the same variable was present for the FM patients, F(1,15=16.2, P<0.01, estimate of effect size = 0.52, power =0.96. Similar findings were found for MPQ subcomponents and the VAS (pain). There was no significant reduction in VAS anxiety ratings pre- to post-exposure for either the RA or FM patients. CONCLUSION These findings provide some initial support for the use of PEMF exposure in reducing pain in chronic pain populations and warrants continued investigation into the use of PEMF exposure for short-term pain relief. PMID:16770449

  14. Interesting Patchy Alopecia

    PubMed Central

    Jadhav, Prashant; Zawar, Vijay

    2015-01-01

    Patchy alopecias of the scalp are frequently seen in clinical practice. We report a young man who presented with progressive patchy alopecia of the scalp, which was finally diagnosed to be due to tuberculoid leprosy. Progression of alopecia was stopped after anti-leprosy treatment was instituted. Despite high prevalence of leprosy in our country, scalp affection due to leprosy is extremely rare but important to recognize. PMID:26180453

  15. Interesting Patchy Alopecia.

    PubMed

    Jadhav, Prashant; Zawar, Vijay

    2015-01-01

    Patchy alopecias of the scalp are frequently seen in clinical practice. We report a young man who presented with progressive patchy alopecia of the scalp, which was finally diagnosed to be due to tuberculoid leprosy. Progression of alopecia was stopped after anti-leprosy treatment was instituted. Despite high prevalence of leprosy in our country, scalp affection due to leprosy is extremely rare but important to recognize. PMID:26180453

  16. Linear Alopecia Areata

    PubMed Central

    Shetty, Shricharith; Rao, Raghavendra; Kudva, R Ranjini; Subramanian, Kumudhini

    2016-01-01

    Alopecia areata (AA) over scalp is known to present in various shapes and extents of hair loss. Typically it presents as circumscribed patches of alopecia with underlying skin remaining normal. We describe a rare variant of AA presenting in linear band-like form. Only four cases of linear alopecia have been reported in medical literature till today, all four being diagnosed as lupus erythematosus profundus. PMID:27625568

  17. Fibromyalgia and seizures.

    PubMed

    Tatum, William O; Langston, Michael E; Acton, Emily K

    2016-06-01

    The purpose of this case-matched study was to determine how frequently fibromyalgia is associated with different paroxysmal neurological disorders and explore the utility of fibromyalgia as a predictor for the diagnosis of psychogenic non-epileptic seizures. The billing diagnosis codes of 1,730 new, non-selected patient encounters were reviewed over a three-year period for an epileptologist in a neurology clinic to identify all patients with historical diagnoses of fibromyalgia. The frequency with which epileptic seizures, psychogenic non-epileptic seizures, and physiological non-epileptic events were comorbid with fibromyalgia was assessed. Age and gender case-matched controls were used for a between-group comparison. Wilcoxon tests were used to analyse interval data, and Chi-square was used to analyse categorical data (p<0.05). Fibromyalgia was retrospectively identified in 95/1,730 (5.5%) patients in this cohort. Females represented 95% of the fibromyalgia sample (age: 53 years; 95% CI: 57, 51). Forty-three percent of those with fibromyalgia had a non-paroxysmal, neurological primary clinical diagnosis, most commonly chronic pain. Paroxysmal events were present in 57% of fibromyalgia patients and 54% of case-matched controls. Among patients with fibromyalgia and paroxysmal disorders, 11% had epileptic seizures, 74% had psychogenic non-epileptic seizures, and 15% had physiological non-epileptic events, compared to case-matched controls with 37% epileptic seizures, 51% psychogenic non-epileptic events, and 12% physiological non-epileptic events (p = 0.009). Fibromyalgia was shown to be a predictor for the diagnosis of psychogenic non-epileptic seizures in patients with undifferentiated paroxysmal spells. However, our results suggest that the specificity and sensitivity of fibromyalgia as a marker for psychogenic non-epileptic seizures in a mixed general neurological population of patients is less than previously described. PMID:27238051

  18. Myalgias and Myopathies: Fibromyalgia.

    PubMed

    McCarthy, Jason

    2016-01-01

    Fibromyalgia is a syndrome of chronic widespread pain typically accompanied by fatigue, nonrestorative sleep, cognitive dysfunction, and mood disorders. As defined by the 2010 American College of Rheumatology criteria, fibromyalgia affects approximately 5% of the population and is the second most common disorder, after osteoarthritis, for which patients are referred to rheumatology subspecialists. These criteria provide a framework for diagnosing fibromyalgia that does not require tender points and incorporates other symptoms of the syndrome in addition to pain. Extensive laboratory tests and imaging are not required to diagnose fibromyalgia. A patient-centered, multimodal approach that includes patient education, behavioral therapy, a graded exercise program, and pharmacotherapy should be used for patients with fibromyalgia. Prescribers must be mindful of adverse drug effects and should tailor therapy to the individual patient. Strong evidence of benefit exists for tricyclic antidepressants, cyclobenzaprine, and serotonin-norepinephrine reuptake inhibitors in fibromyalgia management, whereas nonsteroidal anti-inflammatory drugs and opioids have limited proven benefit. Fibromyalgia can cause significant disability and loss of function. Family physicians are well equipped to direct the multimodal care of patients with fibromyalgia. PMID:26734831

  19. Fibromyalgia: present to future.

    PubMed

    Bennett, Robert

    2004-10-01

    There has been a dramatic increase in our understanding of fibromyalgia throughout the past 14 years since the publication of the 1990 American College of Rheumatology classification criteria. Before 1990, and for most of the 20th century, fibromyalgia was considered to be predominantly a muscle disorder; now the critical abnormality is described as "central sensitization." However, central sensitization has to have an initial genesis and nociceptive stimuli from painful foci in muscle are increasingly recognized as being relevant to the development of fibromyalgia. Clinicians also recognize an association between the initiation of fibromyalgia and chronic psychologic stressors and inflammatory disorders. It has been more difficult to understand how two such apparently diverse events could affect central pain physiology. However, some clues are emerging from the role of diverse stimuli in activating glial cells and the role of disordered cytokine networks. Some predictions about future developments in fibromyalgia are ventured based on the current state of knowledge. PMID:15361322

  20. Fibromyalgia syndrome. New associations.

    PubMed

    Waylonis, G W; Heck, W

    1992-12-01

    Previous research has demonstrated a number of conditions, such as sleep disturbance, fatigue, depression, spastic colon and mitral valve prolapse, associated with fibromyalgia. The present report describes additional symptoms and medical conditions that appear to be associated with the syndrome based on a survey of 554 individuals with fibromyalgia compared with a group of 169 controls. Individuals with fibromyalgia self report a greater incidence of bursitis, chondromalacia, constipation, diarrhea, temporomandibular joint dysfunction, vertigo, sinus and thyroid problems. Symptomatic complaints found statistically more prevalent in fibromyalgia patients included concentration problems, sensory symptoms, swollen glands and tinnitus. Other associations occurring with significant increased frequency were chronic cough, coccygeal and pelvic pain, tachycardia and weakness. Our previous report on inheritance patterns in fibromyalgia was reaffirmed with 12% reporting symptomatic children and 25% reporting symptomatic parents. Of the respondents, 70% noted that their symptoms were aggravated by noise, lights, stress, posture and weather. PMID:1466872

  1. An Overview of Alopecias

    PubMed Central

    Qi, Ji; Garza, Luis A.

    2014-01-01

    Hair loss is a topic of enormous public interest and understanding the pathophysiology and treatment of various alopecias will likely make a large impact on patients’ lives. The investigation of alopecias also provides important insight in the basic sciences; for instance, the abundance of stem cell populations and regenerative cycles that characterize a hair follicle render it an excellent model for the study of stem cell biology. This review seeks to provide a concise summary of the major alopecias with regard to presentation and management, and correlate these to recent advances in relevant research on pathogenesis. PMID:24591533

  2. Prominent follicular mucinosis with diffuse scalp alopecia resembling alopecia areata.

    PubMed

    Missall, Tricia A; Hurley, M Yadira; Burkemper, Nicole M

    2013-10-01

    A 56-year-old Caucasian female presented with a 2-month history of alopecia. On examination, she had diffuse hair loss of her scalp with some discrete patches of nonscarring alopecia. Histopathology revealed an inflammatory nonscarring alopecia with prominent follicular mucinosis and findings suggestive of alopecia areata. The patient's alopecia completely resolved with oral prednisone. The histopathologic findings and clinical presentation are most consistent with a diagnosis of alopecia areata with follicular mucinosis, although the differential diagnosis is broad. As follicular mucinosis may be associated with both benign and malignant conditions, it is important to be cautious regarding the clinical diagnosis when this reaction pattern is observed histopathologically. PMID:23962142

  3. Alopecia in general medicine.

    PubMed

    Nalluri, Rajani; Harries, Matthew

    2016-02-01

    Appreciation of different types of hair loss (alopecia) that may be encountered in hospital medicine is important to ensure accurate diagnosis and management, identify underlying medical conditions or treatments that may present with increased hair loss, recognise autoimmune alopecias and their associations, and understand the significant psychological impact of hair loss on an individual. This article discusses common causes of hair loss, as well as those conditions that may be associated with systemic disease, relevant to a general physician. PMID:26833522

  4. Fibromyalgia and Complementary Health Approaches

    MedlinePlus

    ... research has been done on chiropractic care and hypnosis for fibromyalgia that no conclusions can be reached ... Füber N, Klose P, et al. Efficacy of hypnosis/guided imagery in fibromyalgia syndrome—a systematic review ...

  5. Trichoscopy of Noncicatricial Pressure-induced Alopecia Resembling Alopecia Areata.

    PubMed

    Papaiordanou, Francine; da Silveira, Bruno Rebelo Lages; Piñeiro-Maceira, Juan; Pirmez, Rodrigo

    2016-01-01

    Pressure-induced alopecia is an unusual cause of hair loss, and reports of its trichoscopic features are scarce. In this paper, we describe a case of pressure-induced alopecia in which trichoscopic and histopathological findings overlap with those described for alopecia areata. PMID:27601865

  6. Trichoscopy of Noncicatricial Pressure-induced Alopecia Resembling Alopecia Areata

    PubMed Central

    Papaiordanou, Francine; da Silveira, Bruno Rebelo Lages; Piñeiro-Maceira, Juan; Pirmez, Rodrigo

    2016-01-01

    Pressure-induced alopecia is an unusual cause of hair loss, and reports of its trichoscopic features are scarce. In this paper, we describe a case of pressure-induced alopecia in which trichoscopic and histopathological findings overlap with those described for alopecia areata. PMID:27601865

  7. Patchy Traction Alopecia Mimicking Areata

    PubMed Central

    Barbosa, Aline Blanco; Donati, Aline; Valente, Neusa S; Romiti, Ricardo

    2015-01-01

    Acute traction alopecia is a diagnostic challenge when the external factor is not suspected or admitted. We report two female patients with non-scarring patchy alopecia resulting from traction of video-electroencephalogram electrodes in which the clinical diagnosis of alopecia areata was suspected. Associated diffuse hair disorders might be implicated in these cases. The correct diagnosis of traction alopecia is important in order to avoid unnecessary treatments. PMID:26903751

  8. Congenital Triangular Alopecia.

    PubMed

    Yin Li, Vincent Chum; Yesudian, Paul Devakar

    2015-01-01

    Congenital triangular alopecia (CTA) also known as temporal triangular alopecia is a benign noncicatricial pattern of hair loss. It typically affects the frontotemporal region and rarely involves the temporoparietal or occipital scalp. It is a nonprogressive disorder that presents as a triangular, oval or lancet-shaped patch of alopecia. CTA can manifest at birth or develop later in life. The exact etiology of this condition remains unknown. Rarely, it may be associated with other disorders such as Down's syndrome and phakomatosis pigmentovascularis. The diagnosis is based on its distinct clinical appearance. Histologically, hair follicles are miniaturized and replaced by sparse vellus hair follicles. Tricoscopy using a polarized light handheld dermatoscope can be a useful diagnostic tool. CTA is often asymptomatic and remains unchanged throughout the life. No treatment is required. Surgical intervention with follicular unit hair transplantation can provide a satisfactory cosmetic result. In this paper, we have identified 126 cases of CTA in the published literature cited on PubMed between 1905 and 2015. From the available evidence, 79% of patients with CTA presented with unilateral hair loss, 18.5% with bilateral involvement and rarely, with occipital alopecia (2.5%). There was no gender predilection. These figures are entirely consistent with previously published data. Physicians should remember to consider CTA as a potential diagnosis in any patient presenting with a nonscarring alopecia in order to avoid unnecessary investigations and treatments. PMID:26180448

  9. Management of androgenetic alopecia.

    PubMed

    Bolduc, C; Shapiro, J

    2000-01-01

    Androgenetic alopecia is by far the most common cause of hair loss. It affects approximately 50% of men by the age of 50 and 20 to 53% of women by the age 50. Although it is a medically benign condition, it is a significant psychosocial issue for many patients. Various different treatment options are now available for androgenetic alopecia. The best treatment option for women with androgenetic alopecia Ludwig stage I and II is minoxidil 5% solution. If it is not effective after 1 year, antiandrogens can be tried, but there are no large studies showing their efficacy and they have considerable adverse effects. Also, for patients with alopecia that is unresponsive to treatment or with Ludwig stage III, hair transplantation can be offered if the occipital donor area is sufficient. For men, we always offer minoxidil or finasteride therapy and leave the choice of therapy to the patient. Some patients may prefer a systemic agent, whereas others may favor a topical agent. If the condition is not stabilized after 1 year or if the patient wants greater hair density, hair transplantation can be discussed. There have been tremendous advances in the treatment of hair loss in recent years and the future is very encouraging. As our knowledge of androgenetic alopecia pathophysiology increases, novel targeted treatments will potentially be developed. PMID:11702296

  10. Histopathologic diagnosis of multifactorial alopecia.

    PubMed

    Wohltmann, Wendi E; Sperling, Leonard

    2016-06-01

    Establishing a definitive diagnosis for any form of alopecia can be challenging. Adding to the diagnostic complexity is the fact that many patients have more than one form of alopecia contributing to their hair loss. We conducted a review of 1360 consecutive scalp biopsy specimens submitted for the evaluation of scalp hair loss over a 16-month period, demonstrating that 12.5% of cases had a combination of diagnoses (multifactorial alopecia) accounting for their hair loss. An approach to the histopathologic diagnosis of multifactorial alopecia, particularly multiple forms of alopecia found in a single biopsy, is here presented. PMID:26956781

  11. Conditions simulating androgenetic alopecia.

    PubMed

    Rossi, A; Iorio, A; Di Nunno, D; Priolo, L; Fortuna, M C; Garelli, V; Carlesimo, M; Calvieri, S; Mari, E

    2015-07-01

    Androgenetic alopecia is a common form of hair loss, characterized by a progressive hair follicular miniaturization, caused by androgen hormones on a genetically susceptible hair follicle, in androgenic-dependent areas. Characteristic phenotype of androgenetic alopecia is also observed in many other hair disorders. These disorders are androgenetic-like diseases that cause many differential diagnosis or therapeutic error problems. The objective of this review was to systematically analyse the greatest number of conditions that mimic the AGA pattern and explain their disease pathogenesis. PMID:25571781

  12. Familial occurrence of primary fibromyalgia.

    PubMed

    Pellegrino, M J; Waylonis, G W; Sommer, A

    1989-01-01

    Seventeen families of patients with primary fibromyalgia were studied for evidence of inherited primary fibromyalgia. Fifty parents and siblings were included in the analysis. Twenty-six (52%, mean age 33.5 years) had characteristic symptoms and findings of primary fibromyalgia. Eleven (22%, mean age 28 years) were asymptomatic but had clinical evidence of abnormal muscle consistency to palpation without tender or trigger points. One person had clinical evidence of lupus. Thirteen (26%) had no evidence of fibromyalgia or abnormal muscle consistency. The mode of inheritance was autosomal dominant. Identical twins are described who developed symptoms of primary fibromyalgia within six months of each other, as are two brothers who developed abnormal palpable muscle consistency years before acquiring the characteristic findings of the fibromyalgia syndrome. Primary fibromyalgia may be an inherited condition with a variable latent stage before clinical expression of the disease. PMID:2916922

  13. Animal models of fibromyalgia

    PubMed Central

    2013-01-01

    Animal models of disease states are valuable tools for developing new treatments and investigating underlying mechanisms. They should mimic the symptoms and pathology of the disease and importantly be predictive of effective treatments. Fibromyalgia is characterized by chronic widespread pain with associated co-morbid symptoms that include fatigue, depression, anxiety and sleep dysfunction. In this review, we present different animal models that mimic the signs and symptoms of fibromyalgia. These models are induced by a wide variety of methods that include repeated muscle insults, depletion of biogenic amines, and stress. All potential models produce widespread and long-lasting hyperalgesia without overt peripheral tissue damage and thus mimic the clinical presentation of fibromyalgia. We describe the methods for induction of the model, pathophysiological mechanisms for each model, and treatment profiles. PMID:24314231

  14. Congenital alopecia universalis.

    PubMed

    Saraswat, P K; Laha, N N

    1989-09-01

    A case of congenital alopecia universalis without any other ectodermal defect and mental abnormality is described in a girl of eight years. There was no family history in any of the members. The child was born of a non-consanguineous marriage. PMID:2632563

  15. Frontal Fibrosing Alopecia.

    PubMed

    Holmes, S

    2016-07-01

    Frontal fibrosing alopecia, described just over 20 years ago, has become one of the most frequently seen causes of scarring alopecia at many specialist hair clinics. Considered a clinical variant of lichen planopilaris (LPP), it has distinctive features and associations which distinguish it from LPP. Although largely affecting postmenopausal women, a small but increasing number of men and premenopausal women are affected. The spectrum of the disease has expanded from involvement of the frontal hairline and eyebrows, to potentially affecting the entire hairline, facial and body hair. Genetic and environmental factors have been implicated but the aetiology remains uncertain. A range of treatments have been used in management of the condition, but clinical trials are required to establish effectiveness. PMID:27388531

  16. Molecular genetics of alopecias.

    PubMed

    Ramot, Yuval; Zlotogorski, Abraham

    2015-01-01

    Recent developments in research methods and techniques, such as whole-exome and -genome sequencing, have substantially improved our understanding of genetic conditions. Special progress has been made in the field of genotrichoses, or hereditary hair diseases, a field that has been obscure for many years. The underlying genes for many of the monogenic hair diseases are now known. Additionally, complex analyses of large cohorts of patients have given us the first clues to the genes associated with polygenic hair disorders, such as androgenetic alopecia and alopecia areata. Thanks to these major findings, the sophisticated regulation of the morphogenesis, development and growth of hair follicles has begun to be revealed, and new players in this delicate molecular interplay have been exposed. PMID:26370647

  17. Alopecia areata in Eringer cows.

    PubMed

    Timm, Katrin; Rüfenacht, Silvia; von Tscharner, Claudia; Bornand, Valérie F; Doherr, Marcus G; Oevermann, Anna; Flury, Christine; Rieder, Stefan; Hirsbrunner, Gaby; Drögemüller, Cord; Roosje, Petra J

    2010-12-01

    Alopecia areata is a hair loss disorder in humans, dogs and horses with a suspected autoimmune aetiology targeting anagen hair follicles. Alopecia areata is only sporadically reported in cows. Recently, we observed several cases of suspected alopecia areata in Eringer cows. The aim of this study was to confirm the presumptive diagnosis of alopecia areata and to define the clinical phenotype and histopathological patterns, including characterization of the infiltrating inflammatory cells. Twenty Eringer cows with alopecia and 11 Eringer cows without skin problems were included in this study. Affected cows had either generalized or multifocal alopecia or hypotrichosis. The tail, forehead and distal extremities were usually spared. Punch biopsies were obtained from the centre and margin of alopecic lesions and normal haired skin. Histological examination revealed several alterations in anagen hair bulbs. These included peri- and intrabulbar lymphocytic infiltration, peribulbar fibrosis, degenerate matrix cells with clumped melanosomes and pigmentary incontinence. Mild lymphocytic infiltrative mural folliculitis was seen in the inferior segment and isthmus of the hair follicles. Hair shafts were often unpigmented and dysplastic. The large majority of infiltrating lymphocytes were CD3(+) T cells, whereas only occasional CD20(+) lymphocytes were present in the peribulbar infiltrate. Our findings confirm the diagnosis of T-cell-mediated alopecia areata in these cows. Alopecia areata appears to occur with increased frequency in the Eringer breed, but distinct predisposing factors could not be identified. PMID:20626715

  18. Topical Immunotherapy in Alopecia Areata

    PubMed Central

    Singh, Gurcharan; Lavanya, MS

    2010-01-01

    Alopecia Areata (AA) is a common non-scarring alopecia directed against the anagenic hair follicle. Various treatment modalities have been used for the treatment of severe AA. Topical immunotherapy is the best documented treatment so far for severe and refractory AA. Dinitrochlorobenzene (DNCB), squaric acid dibutylester (SADBE), and diphencyprone (DPCP) are the contact allergens used for this purpose. DNCB has been found to be mutagenic by the Ames test and is largely replaced by DPCP and SADBE. DPCP and SADBE are both known to be non-mutagenic compounds and have comparable efficacy results and relapse rates. SADBE requires special solvents and additives to maintain its potency and is more expensive than the rest. DPCP has a response rate varying from 60% in severe Alopecia Areata to 17% in patients with alopecia totalis or universalis, and shows about 88 to 100% high response rate in patients with patchy Alopecia Areata. PMID:21188022

  19. Arthritis - resources

    MedlinePlus

    Resources - arthritis ... The following organizations provide more information on arthritis : American Academy of Orthopaedic Surgeons -- orthoinfo.aaos.org/menus/arthritis.cfm Arthritis Foundation -- www.arthritis.org Centers for Disease Control and Prevention -- www. ...

  20. Fibromyalgia Impact and Mindfulness Characteristics in 4986 People with Fibromyalgia

    PubMed Central

    Jones, Kim D.; Mist, Scott D.; Casselberry, Marie A.; Ali, Ather; Christopher, Michael S.

    2015-01-01

    Context and Objective A growing body of literature suggests that mindfulness techniques may be beneficial in fibromyalgia. A recent systematic review and meta-analysis of six trials indicated improvement in depressive symptoms and quality of life, calling for increased rigor and use of standardized measures in future trials. The purpose of the study was to examine the relationship between mindfulness [as measured by the Five Facet Mindfulness Questionnaire (FFMQ)] and fibromyalgia impact [as measured by the Revised Fibromyalgia Impact Questionnaire (FIQR)]. Design, Setting, and Participants A cross-sectional survey was conducted with adults diagnosed with fibromyalgia from a national fibromyalgia advocacy foundation e-mail list. Results A total of 4986 respondents represented all 50 states in the United States and 30 countries. FIQR scores demonstrated moderate to severe fibromyalgia with the majority of subjects (59%) scoring ≤60. Scores on the FFMQ subscales ranged from 20.8 to 27.3, with highest scores for the observe subscale. All subscale correlations were small to moderate and indicated that more severe fibromyalgia impact was associated with less mindfulness except in the observe scale (r = .15, P > .000). No clinical or demographics explained as much variance in the FIQR total as any of the mindfulness subscales. Conclusions Fibromyalgia patients experience symptoms that may be alleviated by mindfulness interventions. Baseline values for the observe subscale of the FFMQ were unexpectedly high. Further research is needed to know if this may be due to non-mindful observations and should be noted when the FFMQ is used in fibromyalgia clinical trials. PMID:26005199

  1. Histologic features of alopecias: part II: scarring alopecias.

    PubMed

    Bernárdez, C; Molina-Ruiz, A M; Requena, L

    2015-05-01

    The diagnosis of disorders of the hair and scalp can generally be made on clinical grounds, but clinical signs are not always diagnostic and in some cases more invasive techniques, such as a biopsy, may be necessary. This 2-part article is a detailed review of the histologic features of the main types of alopecia based on the traditional classification of these disorders into 2 major groups: scarring and nonscarring alopecias. Scarring alopecias are disorders in which the hair follicle is replaced by fibrous scar tissue, a process that leads to permanent hair loss. In nonscarring alopecias, the follicles are preserved and hair growth can resume when the cause of the problem is eliminated. In the second part of this review, we describe the histologic features of the main forms of scarring alopecia. Since a close clinical-pathological correlation is essential for making a correct histopathologic diagnosis of alopecia, we also include a brief description of the clinical features of the principal forms of this disorder. PMID:25439143

  2. Oxidative stress and alopecia areata

    PubMed Central

    Prie, BE; Voiculescu, VM; Ionescu-Bozdog, OB; Petrutescu, B; Iosif, L; Gaman, LE; Clatici, VG; Stoian, I; Giurcaneanu, C

    2015-01-01

    Alopecia areata (AA) is an inflammatory and autoimmune disease presenting with non-scarring hair loss. The aethiopathogenesis of alopecia areata is unclear and many factors including autoimmunity, genetic predisposition, emotional and environmental stress are thought to play important roles in its development. Antioxidant/ oxidant balance perturbation is a common feature in autoimmune, emotional and environmental stress. Therefore, our paper discusses the implications of oxidative stress in alopecia areata. Abbreviations: AA = alopecia areata, ROS = reactive oxygen species, H2O2 = hydrogen peroxide, TBARS = thiobarbituric acid rective substances, MDA = malondialdehyde, TBARS = thiobarbituric acid-reactive substances, SOD = superoxide dismutase, CAT = catalase, GSH-Px = glutathione peroxidase, PON1 = paraoxonase 1, HO-1 = hemoxigenase 1, TrxR = thioredoxin reductase, GSH = glutathione PMID:26361510

  3. Trichoscopy in Alopecias: Diagnosis Simplified

    PubMed Central

    Jain, Nilam; Doshi, Bhavana; Khopkar, Uday

    2013-01-01

    Trichoscopy is the term coined for dermoscopic imaging of the scalp and hair. This novel diagnostic technique, both simple and non-invasive, can be used as a handy bed side tool for diagnosing common hair and scalp disorders. Trichoscopic observations can be broadly grouped as hair signs, vascular patterns, pigment patterns and interfollicular patterns. In this article, we have briefly described the trichoscopic findings in the common categories of cicatricial and non-cicatricial alopecias such as androgenetic alopecia, alopecia areata, telogen effluvium, tinea capitis, trichotillomania, lichen planopilaris, discoid lupus erythematosus and hair shaft disorders. Besides diagnosing alopecia, it has the potential for obviating unnecessary biopsies and when a biopsy is still needed it is helpful in choosing an ideal biopsy site. Moreover, trichoscopy is a valuable tool for evaluating the treatment response photographically at each follow-up. The last statement here is deleted as asked. PMID:24778525

  4. Androgenetic alopecia in adolescents.

    PubMed

    Price, Vera H

    2003-02-01

    Androgenetic alopecia (AGA), or hereditary hair thinning, is a common and unwelcome cause of hair loss in men and women. AGA also occurs in adolescents, though its prevalence in this younger population is not known. Physical appearance is extremely important to most adolescents, and early onset of hair loss can have a definite negative effect on self-image and self-esteem. Minoxidil topical solution is widely used by adults for hair loss, but its use by adolescents has not been systematically evaluated. This article provides an overview of AGA and presents new information on the prevalence and age at onset of hereditary hair thinning in adolescents. In addition, data are presented on the efficacy and proper use of minoxidil topical solution in adolescent boys and girls. PMID:12635889

  5. Disability evaluation of fibromyalgia.

    PubMed

    Wolfe, C V

    2001-08-01

    These cases represent individuals who feel they have a severe impairment and are "disabled." They have been labeled with fibromyalgia. They are truly distressed. Their symptoms, their courses, are more chronic and refractory than those of medically ill patients, and they are high users of medical services, laboratory investigations, and surgical procedures. These patients see multiple providers simultaneously and frequently switch physicians. They are difficult to care for, and they reject psychosocial factors as an influence on their symptoms. Such persons "see themselves as victims worthy of a star appearance on the Oprah Winfrey show. A sense of bitterness emerges...." Shorter, a historian, believes that fibromyalgia is "heaven-sent to doctors as a diagnostic label for pain patients who display an important neurotic component in their illness. Our culture increasingly encourages patients to conceive vague and nonspecific symptoms as evidence of real disease and to seek specialist help for them; and the rising ascendancy of the media and the breakdown of the family encourage patients to acquire the fixed belief that they have a given illness...." Regarding the finding of "disability," this is a social construct, and many authors believe it is society and the judicial system who must decide who can work. To remain objective, the physician should report the objective clinical information. Physicians need not and should not sit in judgment of the veracity of another human being. PMID:11478200

  6. Rheumatoid Arthritis

    MedlinePlus

    ... Rheumatoid Arthritis What Is Rheumatoid Arthritis? An Inflammatory, Autoimmune Disease Rheumatoid arthritis is an inflammatory disease that causes ... sometimes feverish. Rheumatoid arthritis is classified as an autoimmune disease. An autoimmune disease occurs when the immune system ...

  7. Newer treatments for fibromyalgia syndrome

    PubMed Central

    Harris, Richard E; Clauw, Daniel J

    2008-01-01

    Fibromyalgia syndrome is a common chronic pain disorder of unknown etiology. The lack of understanding of the pathophysiology of fibromyalgia has made this condition frustrating for patients and clinicians alike. The most common symptoms of this disorder are chronic widespread pain, fatigue, sleep disturbances, difficulty with memory, and morning stiffness. Emerging evidence points towards augmented pain processing within the central nervous system (CNS) as having a primary role in the pathophysiology of this disorder. Currently the two drugs that are approved by the United States Food and Drug Administration (FDA) for the management of fibromyalgia are pregabalin and duloxetine. Newer data suggests that milnacipran, a dual norepinephrine and serotonin reuptake inhibitor, may be promising for the treatment of fibromyalgia. A double-blind, placebo-controlled trial of milnacipran in 125 fibromyalgia patients showed significant improvements relative to placebo. Milnacipran given either once or twice daily at doses up to 200 mg/day was generally well tolerated and yielded significant improvements relative to placebo on measures of pain, patient’s global impression of change in their disease state, physical function, and fatigue. Future studies are needed to validate the efficacy of milnacipran in fibromyalgia. PMID:19337439

  8. Fibromyalgia: Timely diagnosis and treatment options.

    PubMed

    DʼArcy, Yvonne; Kraus, Susan; Clair, Andrew; Kiley, Deborah

    2016-09-22

    Fibromyalgia can be challenging to diagnose and treat, and patients often feel isolated and misunderstood. Surveys of patients with fibromyalgia suggest that patients would benefit from greater understanding and acceptance. NPs can provide this support and play a prominent role in helping patients manage their fibromyalgia. PMID:27552689

  9. Reported Experiences of Persons with Alopecia Areata

    ERIC Educational Resources Information Center

    Hunt, Nigel; McHale, Sue

    2005-01-01

    Alopecia is a chronic disease of hair loss. The study focuses on psychological issues relating to the experience of alopecia. Previous research has considered psychological problems as secondary to the medical disorder. The first part consisted of spontaneous written accounts (N=162) of the experience of alopecia. The second part was an…

  10. Reported Experiences of Persons with Alopecia Areata

    ERIC Educational Resources Information Center

    Hunt, Nigel; McHale, Sue

    2005-01-01

    Alopecia is a chronic disease of hair loss. The study focuses on psychological issues relating to the experience of alopecia. Previous research has considered psychological problems as secondary to the medical disorder. The first part consisted of spontaneous written accounts (N = 62) of the experience of alopecia. The second part was an…

  11. Androgenetic alopecia in women.

    PubMed

    Price, Vera H

    2003-06-01

    Androgenetic alopecia (AGA), also known in women as female pattern hair loss, is caused by androgens in genetically susceptible women and men. The thinning begins between ages 12 and 40 years, the inheritance pattern is polygenic, and the incidence is the same as in men. In susceptible hair follicles, dihydrotestosterone binds to the androgen receptor, and the hormone-receptor complex activates the genes responsible for the gradual transformation of large terminal follicles to miniaturized follicles. Both young women and young men with AGA have higher levels of 5alpha reductase and androgen receptor in frontal hair follicles compared to occipital follicles. At the same time, young women have much higher levels of cytochrome p-450 aromatase in frontal follicles than men who have minimal aromatase, and women have even higher aromatase levels in occipital follicles. The diagnosis of AGA in women is supported by early age of onset, the pattern of increased thinning over the frontal/parietal scalp with greater density over the occipital scalp, retention of the frontal hairline, and the presence of miniaturized hairs. Most women with AGA have normal menses and pregnancies. Extensive hormonal testing is usually not needed unless symptoms and signs of androgen excess are present such as hirsutism, severe unresponsive cystic acne, virilization, or galactorrhea. Topical minoxidil solution is the only drug available for promoting hair growth in women with AGA. Efficacy has been shown in double-blind studies using hair counts and hair weight. PMID:12894991

  12. What causes alopecia areata?

    PubMed Central

    McElwee, K. J.; Gilhar, A.; Tobin, D. J.; Ramot, Y.; Sundberg, J. P.; Nakamura, M.; Bertolini, M.; Inui, S.; Tokura, Y.; Jr, L. E. King; Duque-Estrada, B.; Tosti, A; Keren, A.; Itami, S.; Shoenfeld, Y.; Zlotogorski, A.; Paus, R.

    2014-01-01

    The pathobiology of alopecia areata (AA), one of the most frequent autoimmune diseases and a major unsolved clinical problem, has intrigued dermatologists, hair biologists and immunologists for decades. Simultaneously, both affected patients and the physicians who take care of them are increasingly frustrated that there is still no fully satisfactory treatment. Much of this frustration results from the fact that the pathobiology of AA remains unclear, and no single AA pathogenesis concept can claim to be universally accepted. In fact, some investigators still harbour doubts whether this even is an autoimmune disease, and the relative importance of CD8+ T cells, CD4+ T cells and NKGD2+ NK or NKT cells and the exact role of genetic factors in AA pathogenesis remain bones of contention. Also, is AA one disease, a spectrum of distinct disease entities or only a response pattern of normal hair follicles to immunologically mediated damage? During the past decade, substantial progress has been made in basic AA-related research, in the development of new models for translationally relevant AA research and in the identification of new therapeutic agents and targets for future AA management. This calls for a re-evaluation and public debate of currently prevalent AA pathobiology concepts. The present Controversies feature takes on this challenge, hoping to attract more skin biologists, immunologists and professional autoimmunity experts to this biologically fascinating and clinically important model disease. PMID:23947678

  13. Current treatment of alopecia areata.

    PubMed

    Shapiro, Jerry

    2013-12-01

    Treatment of alopecia areata is dependent on age of patient as well as the extent and duration of scalp involvement. Treatments include steroids, topical immunotherapy, topical minoxidil, anthralin, and immunosuppressants. Each case must be dealt with on a customized individual basis. PMID:24326551

  14. Pharmacotherapy for Fibromyalgia

    PubMed Central

    Smith, Howard S.; Bracken, Donna; Smith, Joshua M.

    2010-01-01

    Fibromyalgia (FM) is a chronic disorder characterized by multifocal pain and other associated somatic symptoms including fatigue, insomnia, cognitive/memory problems, and even psychological distress. It appears that 2–4% of the general population suffers from FM. FM negatively impacts the physical functioning of its patients, as evidenced by difficulties with multiple daily activities, as well as affecting emotional health, social functioning, and health related quality of life. This review will discuss the potential theories that possibly contribute to the pathogenesis of FM, although the precise mechanism is unknown. The evolution of the assessment of FM will also be examined, with the waning use of tender point examinations and the appearance of new simple, practical diagnostic criteria. Although non-pharmacologic therapeutic options (exercise, education, cognitive–behavioral therapy) have been shown to be extremely effective in FM, the focus of this article will be on pharmacologic strategies. Non-Food and Drug Administration (FDA) approved as well as FDA approved agents will be presented. Each agent's therapeutic “niche” in FM management will be discussed based on its pharmacologic profile, patient responsiveness, and tolerability. Finally a clinical algorithm will be presented for the step-wise management of pain and other associated symptoms of FM. PMID:21772818

  15. Pharmacotherapy for fibromyalgia.

    PubMed

    Smith, Howard S; Bracken, Donna; Smith, Joshua M

    2011-01-01

    Fibromyalgia (FM) is a chronic disorder characterized by multifocal pain and other associated somatic symptoms including fatigue, insomnia, cognitive/memory problems, and even psychological distress. It appears that 2-4% of the general population suffers from FM. FM negatively impacts the physical functioning of its patients, as evidenced by difficulties with multiple daily activities, as well as affecting emotional health, social functioning, and health related quality of life. This review will discuss the potential theories that possibly contribute to the pathogenesis of FM, although the precise mechanism is unknown. The evolution of the assessment of FM will also be examined, with the waning use of tender point examinations and the appearance of new simple, practical diagnostic criteria. Although non-pharmacologic therapeutic options (exercise, education, cognitive-behavioral therapy) have been shown to be extremely effective in FM, the focus of this article will be on pharmacologic strategies. Non-Food and Drug Administration (FDA) approved as well as FDA approved agents will be presented. Each agent's therapeutic "niche" in FM management will be discussed based on its pharmacologic profile, patient responsiveness, and tolerability. Finally a clinical algorithm will be presented for the step-wise management of pain and other associated symptoms of FM. PMID:21772818

  16. Patient Perspectives on the Impact of Fibromyalgia

    PubMed Central

    Arnold, Lesley M.; Crofford, Leslie J.; Mease, Philip J.; Burgess, Somali Misra; Palmer, Susan C.; Abetz, Linda; Martin, Susan A.

    2008-01-01

    Objective The objective of this study was to elicit and assess important symptom domains and the impact of fibromyalgia on patients’ quality of life and functioning from a patient’s perspective. The intention was to collect this information as part of an overall effort to overcome shortcomings of existing outcome measures in fibromyalgia. Methods This was a qualitative study in which six focus group sessions with 48 women diagnosed with fibromyalgia were conducted to elicit concepts and ideas to assess the impact of fibromyalgia on their lives. Results The focus groups conducted with fibromyalgia patients identified symptom domains that had the greatest impact on their quality of life including pain, sleep disturbance, fatigue depression, anxiety, and cognitive impairment. Fibromyalgia had a substantial negative impact on social and occupational function. Patients reported disrupted relationships with family and friends, social isolation, reduced activities of daily living and leisure activities, avoidance of physical activity, and loss of career or inability to advance in careers or education. Conclusion The findings from the focus groups revealed that fibromyalgia has a substantial negative impact on patients’ lives. Practice Implications A comprehensive assessment of the multiple symptoms domains associated with fibromyalgia and the impact of fibromyalgia on multidimensional aspects of function should be a routine part of the care of fibromyalgia patients. PMID:18640807

  17. Viral arthritis

    MedlinePlus

    Infectious arthritis - viral ... Arthritis may be a symptom of many virus-related illnesses. It usually disappears on its own without ... the rubella vaccine, only a few people develop arthritis. No risk factors are known.

  18. Rheumatoid Arthritis

    MedlinePlus

    Rheumatoid arthritis (RA) is a form of arthritis that causes pain, swelling, stiffness and loss of function in ... wrist and fingers. More women than men get rheumatoid arthritis. It often starts in middle age and is ...

  19. Alopecia: Kids are not just little people.

    PubMed

    Goldberg, Lynne J; Castelo-Soccio, Leslie A

    2015-01-01

    Alopecia is a disorder that affects all patients, young and old. Many diagnoses, particularly the scarring alopecias, are more common in adults; however, others, such as tinea capitis, are more common in children, and some, such as alopecia areata, often affect both age groups. The approach to, and evaluation of, an alopecia patient is thus highly dependent on his or her age. In adults with diffuse, non-scarring hair loss, a part-width examination can help detect pattern hair loss, the most common cause of diffuse loss in this age group. In children this is much less likely, and a careful evaluation for tinea capitis is in order. The same holds true for patchy alopecia in children, as well as scarring alopecia-tinea needs to always be considered. In adults, patchy alopecia is often due to alopecia areata and sometimes to one of the primary scarring alopecias. A laboratory evaluation, and especially a biopsy, would be a more appropriate undertaking for an adult than a child, and an adult would be more likely to tolerate certain therapeutic regimens such as intralesional injections. In a conversational manner, the authors discuss their individual approaches to the alopecia patient, highlighting the differences in diagnosis, workup, and management that depend on whether the affected individual is an adult or a child. PMID:26686014

  20. Fibromyalgia, Fibro Fog, and Exercise.

    PubMed

    Karper, William B; Letvak, Susan A

    2015-01-01

    Fibro fog causes serious problems for those with fibromyalgia syndrome. The mechanisms that cause it have not been well identified. Since prescription medication and other conventional medical interventions have proven less than satisfactory, and while waiting for more investigational information, research suggests that exercise might be helpful. PMID:26086462

  1. Female pattern alopecia and telogen effluvium: figuring out diffuse alopecia.

    PubMed

    Torres, Fernanda; Tosti, Antonella

    2015-06-01

    Diffuse hair loss in women causes a significant impact on quality of life, reduces self-esteem, and increases stress. One of the major challenges when evaluating patients with diffuse hair loss is to determine whether you are dealing with either female pattern alopecia, telogen effluvium, or both, as they can coexist. Establishing the correct diagnosis is mandatory for optimal patient care. This article will highlight how to distinguish between and properly manage these 2 conditions. PMID:26176282

  2. Cutaneous mastocytosis associated with congenital alopecia.

    PubMed

    Kim, Cho Rok; Kim, Hyun-Je; Jung, Mi-Young; Lee, Jae-Hyung; Park, Ji-Hye; Lee, Dong-Youn; Lee, Joo-Heung; Yang, Jun-Mo

    2012-07-01

    Mastocytosis is a rare disorder that shows accumulation of mast cells in tissues. Atypical clinical features may mimic impetigo, Langerhans cell histiocytosis, and carcinoid syndrome; however, only 1 case of scarring alopecia associated with mastocytosis has been reported. We present the first case of cutaneous mastocytosis associated with congenital alopecia areata in a 3-year-old Korean girl. This case showed an atypical clinical presentation of congenital alopecia areata, but histopathological results confirmed the diagnosis of cutaneous mastocytosis. PMID:22356916

  3. Universal protocol for alopecia areata clinical studies.

    PubMed

    Mesinkovska, Natasha A; Bergfeld, Wilma F

    2013-12-01

    Within the area of alopecia areata research, there is an obvious need for well-designed clinical trials of therapeutic agents. The National Alopecia Areata Foundation (NAAF) has created an initiative for the development of a unified protocol with guidelines for clinical studies. The NAAF universal protocol represents a joint effort of clinicians and investigators with experience in treating alopecia areata. This protocol will serve as a tremendous resource to facilitate future clinical studies. PMID:24326554

  4. Acquired scalp alopecia. Part II: A review.

    PubMed

    Sullivan, J R; Kossard, S

    1999-05-01

    The neutrophil-associated and infiltrative scarring alopecias are reviewed including folliculitis decalvans, tufted folliculitis, dissecting cellulitis of the scalp, acne keloidalis and follicular degeneration syndrome. The management of acquired scalp alopecia is also reviewed including newer, promising therapies. More specific agents targeting components of the androgen system will make the treatment of androgenetic alopecia more rewarding. Similarly new immunomodulatory therapies show great promise for the lymphocyte-associated alopecias and include a new generation of macrolide immunosuppressives (tacrolimus, SDZ ASM 981, and SDZ 281-240), some of which appear to have good transcutaneous absorption. PMID:10333615

  5. Psoriatic arthritis

    SciTech Connect

    Gerber, L.H.; Espinoza, L.R.

    1985-01-01

    This book contains 11 chapters. Some of the titles are: The history and epidemiologic definition of psoriatic arthritis as a distinct entity; Psoriatic arthritis: Further epidemiologic and genetic considerations; The radiologic features of psoriatic arthritis; and Laboratory findings and pathology of psoriatic arthritis.

  6. Juvenile Arthritis

    MedlinePlus

    Juvenile arthritis (JA) is arthritis that happens in children. It causes joint swelling, pain, stiffness, and loss of motion. It can affect any joint, but ... of JA that children get is juvenile idiopathic arthritis. There are several other forms of arthritis affecting ...

  7. Mathematical model for alopecia areata.

    PubMed

    Dobreva, Atanaska; Paus, Ralf; Cogan, N G

    2015-09-01

    Alopecia areata (AA) is an autoimmune disease, and its clinical phenotype is characterized by the formation of distinct hairless patterns on the scalp or other parts of the body. In most cases hair falls out in round patches. A well-established hypothesis for the pathogenesis of AA states that collapse of hair follicle immune privilege is one of the essential elements in disease development. To investigate the dynamics of alopecia areata, we develop a mathematical model that incorporates immune system components and hair follicle immune privilege agents whose involvement in AA has been confirmed in clinical studies and experimentally. We perform parameter sensitivity analysis in order to determine which inputs have the greatest effect on outcome variables. Our findings suggest that, among all processes reflected in the model, immune privilege guardians and the pro-inflammatory cytokine interferon-γ govern disease dynamics. These results agree with the immune privilege collapse hypothesis for the development of AA. PMID:26047853

  8. Temporary alopecia after subarachnoid haemorrhage.

    PubMed

    Nannapaneni, R; Behari, S; Mendelow, D; Gholkar, A

    2007-02-01

    Primary endovascular intervention is increasingly the first choice of treatment for cerebral aneurysms, particularly for those with complex anatomy in the posterior circulation. However, their clinical management and follow-up continue to be predominantly in the hands of neurosurgeons. In this report, the development of alopecia following the coiling of posterior circulation aneurysms is described. The alopecia was transient and lasted for approximately 6 months, and occurred in the occipital and suboccipital regions of the scalp. This report aims to highlight this condition, which has not been previously reported in the neurosurgical literature. The potential hazards of irradiation should be borne in mind while carrying out complex endovascular procedures. The patient should be counselled and all necessary steps undertaken to limit radiation exposure. PMID:17107802

  9. Videocapillaroscopic Alterations in Alopecia Areata

    PubMed Central

    Gerkowicz, Agnieszka; Krasowska, Dorota; Pietrzak, Aldona; Michalak-Stoma, Anna; Bartosińska, Joanna; Juszkiewicz-Borowiec, Maria; Chodorowska, Grażyna

    2013-01-01

    Alopecia areata (AA) is a common hair disorder observed in dermatological practice; however, the exact mechanisms that lead to the hair loss are still unknown. Disturbances in the blood supply of hair follicles may be one of the elements in the complex pathogenesis of AA. Nailfold videocapillaroscopy is a noninvasive technique that allows analysis of skin microcirculation in vivo. The aim of the study was the videocapillaroscopic assessment of skin microcirculation in AA patients. The study included 44 patients with patchy alopecia areata, 27 with alopecia universalis or totalis, and 40 healthy volunteers. Nailfold videocapillaroscopy was performed in all participants according to a standard protocol. Obtained images were assessed qualitatively and quantitatively. Two types of videocapillaroscopic images were distinguished in the study. Abnormal videocapillaroscopic images were found in 42% of patients. Tortuous and branching capillaries (P = 0.013, P = 0.001), decreased density of capillaries (P = 0.009), enlargement of the efferent limb (P < 0.017), or top part of the loop (P = 0.009) were observed significantly more often than in the control group. Only some patients with AA presented with microvascular abnormalities characterised by altered videocapillaroscopic images. More studies, including larger group of patients with AA, are required to determine the role of observed videocapillaroscopic alterations in AA. PMID:24163812

  10. The Prevalence of Fibromyalgia in Other Chronic Pain Conditions

    PubMed Central

    Yunus, Muhammad B.

    2012-01-01

    Central sensitivity syndromes (CSS) include fibromyalgia syndrome (FMS), irritable bowel syndrome, temporomandibular disorder, restless legs syndrome, chronic fatigue syndrome, and other similar chronic painful conditions that are based on central sensitization (CS). CSS are mutually associated. In this paper, prevalence of FMS among other members of CSS has been described. An important recent recognition is an increased prevalence of FMS in other chronic pain conditions with structural pathology, for example, rheumatoid arthritis, systemic lupus, ankylosing spondylitis, osteoarthritis, diabetes mellitus, and inflammatory bowel disease. Diagnosis and proper management of FMS among these diseases are of crucial importance so that unwarranted use of such medications as corticosteroids can be avoided, since FMS often occurs when RA or SLE is relatively mild. PMID:22191024

  11. Nail Involvement in Frontal Fibrosing Alopecia

    PubMed Central

    Macpherson, Melanie; Hohendorf-Ansari, Parinaz; Trüeb, Ralph Michel

    2015-01-01

    A case of frontal fibrosing alopecia with nail involvement is presented. Nail involvement provides evidence for underlying lichen planus, and that the disease represents a rather generalized than localized process. Favorable response of the scalp condition to oral dutasteride points to an inflammatory reaction on the background of androgenetic alopecia. PMID:26180450

  12. Nail Involvement in Frontal Fibrosing Alopecia.

    PubMed

    Macpherson, Melanie; Hohendorf-Ansari, Parinaz; Trüeb, Ralph Michel

    2015-01-01

    A case of frontal fibrosing alopecia with nail involvement is presented. Nail involvement provides evidence for underlying lichen planus, and that the disease represents a rather generalized than localized process. Favorable response of the scalp condition to oral dutasteride points to an inflammatory reaction on the background of androgenetic alopecia. PMID:26180450

  13. Alopecia areata and its effects on patients.

    PubMed

    McGettigan, Maureen L

    2013-12-01

    The onset of alopecia areata creates a roller coaster of emotions. Like the disease, a patient's emotions are unpredictable. The lack of control over one's body is both frightening and intimidating. Alopecia areata not only impacts an individual but it also has a halo effect, impacting family and friends, thereby increasing the number of people affected by the disease. PMID:24326550

  14. Sleep architecture in patients with fibromyalgia.

    PubMed

    Besteiro González, José Luis; Suárez Fernández, Tomás Vicente; Arboleya Rodríguez, Luis; Muñiz, José; Lemos Giráldez, Serafín; Alvarez Fernández, Angel

    2011-08-01

    The main objective of this work was to evaluate the characteristics of sleep in patients diagnosed with fibromyalgia syndrome. Sleep architecture in 32 patients with fibromyalgia and 20 healthy controls was evaluated. Following the recommendations of the International Federation of Clinical Neurophysiology, polysomnographies were conducted with fibromyalgia patients and the control subjects. The fibromyalgia patients showed alterations in cyclic organization of sleep and an increased number of periodic leg movements associated with cortical arousals. No significant differences were found in respiratory and oximetry variables or in alpha-delta sleep. The results support that fibromyalgia patients present an increase of superficial sleep at the expense of deep sleep and also an increase of periodic leg movements, which could have a pathogenic effect, facilitating the onset of the illness. Lastly, we discuss the results and propose some future lines of research. PMID:21774887

  15. Patchy alopecia areata sparing gray hairs: a case series

    PubMed Central

    Jia, Wei-Xue; Mao, Qiu-Xia; Xiao, Xue-Min; Li, Zhi-Liang; Yu, Rui-Xing

    2014-01-01

    Alopecia areata is an unpredictable, non-scarring hair loss condition. Patchy alopecia areata sparing gray hairs is rare. Here we present 4 cases with patchy non-scarring hair loss, which attacked pigmented hairs only and spared gray hairs. It should be differentiated from vitiligo, colocalization of vitiligo and alopecia areata, and depigmented hair regrowth after alopecia areata. PMID:25097478

  16. Emerging Therapies for Androgenetic Alopecia.

    PubMed

    Keaney, Terrence

    2015-09-01

    Androgenetic alopecia is the progressive miniaturization of the scalp's terminal follicles in aging men. Over 40% of Caucasian men develop hair loss by the age of 40. Despite its prevalence, there are only two FDA approved medications to treat the condition. Recognizing the unmet need, new medical, procedural, and surgical treatments are being adopted to combat progressive hair loss. This review examines emerging hair loss treatments including medical therapies that the target prostaglandins, low level light therapy, platelet rich plasma injections, and robotic hair transplantation. PMID:26355625

  17. Use of dermoscopy in the diagnosis of temporal triangular alopecia*

    PubMed Central

    de Campos, Jullyene Gomes; Oliveira, Cláudia Marina Puga Barbosa; Romero, Sandra Adolfina Reyes; Klein, Ana Paula; Akel, Patricia Bandeira de Melo; Pinto, Giselle Martins

    2015-01-01

    Temporal triangular alopecia, also referred as congenital triangular alopecia, is an uncommon dermatosis of unknown etiology. It is characterized by a non-scarring, circumscribed alopecia often located unilaterally in the frontotemporal region. It usually emerges at ages 2-9 years. Alopecia areata is the main differential diagnosis, especially in atypical cases. Dermoscopy is a noninvasive procedure that helps distinguish temporal triangular alopecia from aloepecia areata. Such procedure prevents invasive diagnostic methods as well as ineffective treatments. PMID:25672312

  18. Infectious Arthritis

    MedlinePlus

    Most kinds of arthritis cause pain and swelling in your joints. Joints are places where two bones meet, such as your elbow or knee. Infectious arthritis is an infection in the joint. The infection ...

  19. Psoriatic Arthritis

    MedlinePlus

    ... your body. Some people with psoriasis have psoriatic arthritis. It causes pain, stiffness, and swelling of the ... physical exam and imaging tests to diagnose psoriatic arthritis. There is no cure, but medicines can help ...

  20. Arthritis Foundation

    MedlinePlus

    ... hour massage will be donated to the Arthritis Foundation! Jingle Bell Run Join us for the nation's ... a cure! Answers When You Need Them Arthritis Foundation licensed social workers provide 24/7 assistance on ...

  1. Fungal arthritis

    MedlinePlus

    ... and irritation (inflammation) of a joint by a fungal infection. It is also called mycotic arthritis. Causes Fungal ... symptoms of fungal arthritis. Prevention Thorough treatment of fungal infections elsewhere in the body may help prevent fungal ...

  2. Fibromyalgia: A Critical and Comprehensive Review.

    PubMed

    Borchers, Andrea T; Gershwin, M Eric

    2015-10-01

    Fibromyalgia is a disorder that is part of a spectrum of syndromes that lack precise classification. It is often considered as part of the global overview of functional somatic syndromes that are otherwise medically unexplained or part of a somatization disorder. Patients with fibromyalgia share symptoms with other functional somatic problems, including issues of myalgias, arthralgias, fatigue and sleep disturbances. Indeed, there is often diagnostic and classification overlap for the case definitions of a variety of somatization disorders. Fibromyalgia, however, is a critically important syndrome for physicians and scientists to be aware of. Patients should be taken very seriously and provided optimal care. Although inflammatory, infectious, and autoimmune disorders have all been ascribed to be etiological events in the development of fibromyalgia, there is very little data to support such a thesis. Many of these disorders are associated with depression and anxiety and may even be part of what has been sometimes called affected spectrum disorders. There is no evidence that physical trauma, i.e., automobile accidents, is associated with the development or exacerbation of fibromyalgia. Treatment should be placed on education, patient support, physical therapy, nutrition, and exercise, including the use of drugs that are approved for the treatment of fibromyalgia. Treatment should not include opiates and patients should not become poly pharmacies in which the treatment itself can lead to significant morbidities. Patients with fibromyalgia are living and not dying of this disorder and positive outlooks and family support are key elements in the management of patients. PMID:26445775

  3. Fibromyalgia: A Primer for the Anesthesia Community

    PubMed Central

    Brummett, Chad M.; Clauw, Daniel J.

    2012-01-01

    Purpose of the Review The present review is intended to give an overview of fibromyalgia for the anesthesiologist. While the basics of the treatment of fibromyalgia are included, the intent is to provide context to discuss the potential implications in perioperative management. Recent Findings One of the most important changes in the last year is the new criteria established by the American College of Rheumatology for the diagnosis of fibromyalgia. Instead of a combination of self-report and a tender point examination, there is a new self-report questionnaire that is now used diagnose fibromyalgia. This tool incorporates aspects of widespread body pain and some of the known comorbid symptoms. A score of 0-31 is given, which allows for the disease to be viewed as a continuum of sensitivity and symptomatology, instead of as a binary diagnosis. This continuum has been termed “fibromyalgia-ness.” This article also reviews the advances in understanding of the pathophysiology and emerging therapies. Little is known about the impact of fibromyalgia in the perioperative period. Summary The impact of fibromyalgia on anesthesia care is not known. Years of quality research have clearly demonstrated multiple pathophysiologic changes that could impact anesthesia care and future study is needed. PMID:21799404

  4. Androgenetic Alopecia: An Update of Treatment Options.

    PubMed

    Kelly, Yanna; Blanco, Aline; Tosti, Antonella

    2016-09-01

    Androgenetic alopecia (AGA) is characterized by a non-scarring progressive miniaturization of the hair follicle in predisposed men and women with a pattern distribution. Although AGA is a very prevalent condition, approved therapeutic options are limited. This article discusses the current treatment alternatives including their efficacy, safety profile, and quality of evidence. Finasteride and minoxidil for male androgenetic alopecia and minoxidil for female androgenetic alopecia still are the therapeutic options with the highest level evidence. The role of antiandrogens for female patients, the importance of adjuvant therapies, as well as new drugs and procedures are also addressed. PMID:27554257

  5. Fibromyalgia syndrome: novel therapeutic targets.

    PubMed

    Ablin, Jacob N; Häuser, Winfried

    2016-05-01

    Fibromyalgia syndrome (FMS) is a chronic disorder characterized by widespread pain and tenderness, accompanied by disturbed sleep, chronic fatigue and multiple additional functional symptoms. FMS continues to pose an unmet need regarding pharmacological treatment and many patients fail to achieve sufficient relief from existing treatments. As FMS is considered to be a condition in which pain amplification occurs within the CNS, therapeutic interventions, both pharmacological and otherwise, have revolved around attempts to influence pain processing in the CNS. In the current review, we present an update on novel targets in the search for effective treatment of FMS. PMID:27296699

  6. Treatment of alopecia areata with topical sensitizers.

    PubMed

    Sutherland, Lesley; Laschinger, Mary; Syed, Zain U; Gaspari, Anthony

    2015-01-01

    For those with severe alopecia areata, with greater than 50% scalp involvement, topical immunotherapy with diphenylcyclopropenone or squaric acid dibutylester is considered the treatment of choice. This article not only reviews the safety and efficacy of topical sensitizers for the treatment of alopecia areata but also highlights strides that have been made in the literature concerning their use in pediatric populations, molecular mechanisms of efficacy, and improved safety through targeted delivery methods. PMID:25581667

  7. Concentric Polycyclic Regrowth Pattern in Alopecia Areata.

    PubMed

    Delorenze, Lilian Mathias; Gavazzoni-Dias, Maria Fernanada Reis; Teixeira, Marcelo S; Aide, Marcia Kalil

    2016-01-01

    Alopecia areata (AA) is a common form of autoimmune nonscarring hair loss of scalp and/or body. Atypical hair regrowth in AA is considered a rare phenomenon. It includes atypical pattern of hair growth (sudden graying, perinevoid alopecia, Renbok phenomenon, castling phenomenon, and concentric or targetoid regrowth) and atypical dark color hair regrowth. We report a case of AA that resulted in a concentric targetoid hair regrowth and discuss the possible related theories regarding the significance of this phenomenon. PMID:27127376

  8. Bilateral treatment for alopecia areata.

    PubMed

    Torchia, Daniele; Schachner, Lawrence A

    2010-01-01

    A 4-year-old, otherwise healthy white girl was referred for a 15-month history of alopecia areata. Anthralin 0.1% cream was prescribed for the left side of the scalp, while corticosteroids for the right side. After 4 months, only the right side of the scalp showed hair regrowth. Half-side strategy, that is, treating one side and managing the other--divided by the mid sagittal suture--as an internal control for no treatment, placebo or other treatment, has been commonly used in clinical studies for decades. In everyday practice, bilateral treatment is useful to evaluate the responsiveness to two topically delivered interventions and diminishes the time necessary to identify an effective one. PMID:20653874

  9. What Is Reactive Arthritis?

    MedlinePlus

    ... Arthritis PDF Version Size: 69 KB November 2014 What is Reactive Arthritis? Fast Facts: An Easy-to- ... Information About Reactive Arthritis and Other Related Conditions What Causes Reactive Arthritis? Sometimes, reactive arthritis is set ...

  10. Association between alcohol consumption and symptom severity and quality of life in patients with fibromyalgia

    PubMed Central

    2013-01-01

    Introduction Although alcohol consumption is a common lifestyle behavior with previous studies reporting positive effects of alcohol on chronic pain and rheumatoid arthritis, no studies to this date have examined alcohol consumption in patients with fibromyalgia. We examined the association between alcohol consumption and symptom severity and quality of life (QOL) in patients with fibromyalgia. Methods Data on self-reported alcohol consumption from 946 patients were analyzed. Subjects were grouped by level of alcohol consumption (number of drinks/week): none, low (≤3), moderate (>3 to 7), and heavy (>7). Univariate analyses were used to find potential confounders, and analysis of covariance was used to adjust for these confounders. Tukey HSD pairwise comparisons were used to determine differences between alcohol groups. Results Five hundred and forty-six subjects (58%) did not consume alcohol. Low, moderate, and heavy levels of alcohol consumption were reported for 338 (36%), 31 (3%), and 31 patients (3%), respectively. Employment status (P <0.001), education level (P = 0.009), body mass index (P = 0.002) and opioid use (P = 0.002) differed significantly among groups with drinkers having higher education, a lower BMI, and a lower frequency of unemployment and opioid use than nondrinkers. After adjusting for these differences, the measures including the number of tender points (P = 0.01), FIQ total score (P = 0.01), physical function (P <0.001), work missed (P = 0.005), job ability (P = 0.03), and pain (P = 0.001) differed across groups, as did the SF-36 subscales of physical functioning (P <0.001), pain index (P = 0.002), general health perception (P = 0.02), social functioning (P = 0.02), and the physical component summary (P <0.001). Pairwise comparison among the 4 groups showed that the moderate and low alcohol drinkers had lower severity of fibromyalgia symptoms and better physical QOL than nondrinkers. Conclusions Our study demonstrates that low and moderate

  11. Alopecia of myxedema: clinical response to levothyroxine sodium.

    PubMed

    Signore, R J; von Weiss, J

    1991-11-01

    Noncicatricial alopecia resulting from myxedema developed in a 58-year-old woman. We report the response of her alopecia to treatment with levothyroxine sodium and review the literature on the subject. PMID:1761768

  12. Exploring Genetic Susceptibility to Fibromyalgia

    PubMed Central

    Park, Dong-Jin; Kang, Ji-Hyoun; Yim, Yi-Rang; Kim, Ji-Eun; Lee, Jeong-Won; Lee, Kyung-Eun; Wen, Lihui; Kim, Tae-Jong; Park, Yong-Wook

    2015-01-01

    Fibromyalgia (FM) affects 1% to 5% of the population, and approximately 90% of the affected individuals are women. FM patients experience impaired quality of life and the disorder places a considerable economic burden on the medical care system. With the recognition of FM as a major health problem, many recent studies have evaluated the pathophysiology of FM. Although the etiology of FM remains unknown, it is thought to involve some combination of genetic susceptibility and environmental exposure that triggers further alterations in gene expression. Because FM shows marked familial aggregation, most previous research has focused on genetic predisposition to FM and has revealed associations between genetic factors and the development of FM, including specific gene polymorphisms involved in the serotonergic, dopaminergic, and catecholaminergic pathways. The aim of this review was to discuss the current evidence regarding genetic factors that may play a role in the development and symptom severity of FM. PMID:26306300

  13. Alopecia in calves associated with milk substitute feeding.

    PubMed

    Pritchard, G C; Hill, M R; Slater, A J

    1983-04-30

    Outbreaks of alopecia with unusually high morbidity occurred among calves reared on milk substitutes on two unrelated farms in Suffolk. On one farm alopecia occurred for three consecutive years; during the winter of 1981-82 there were also clinical signs of muscular dystrophy among the same calves. On the second farm calves with alopecia also showed signs of muscular dystrophy. The apparent relationship between alopecia and milk substitute feeding is discussed together with the possible involvement of vitamin E. PMID:6868307

  14. Circadian rhythms of women with fibromyalgia

    NASA Technical Reports Server (NTRS)

    Klerman, E. B.; Goldenberg, D. L.; Brown, E. N.; Maliszewski, A. M.; Adler, G. K.

    2001-01-01

    Fibromyalgia syndrome is a chronic and debilitating disorder characterized by widespread nonarticular musculoskeletal pain whose etiology is unknown. Many of the symptoms of this syndrome, including difficulty sleeping, fatigue, malaise, myalgias, gastrointestinal complaints, and decreased cognitive function, are similar to those observed in individuals whose circadian pacemaker is abnormally aligned with their sleep-wake schedule or with local environmental time. Abnormalities in melatonin and cortisol, two hormones whose secretion is strongly influenced by the circadian pacemaker, have been reported in women with fibromyalgia. We studied the circadian rhythms of 10 women with fibromyalgia and 12 control healthy women. The protocol controlled factors known to affect markers of the circadian system, including light levels, posture, sleep-wake state, meals, and activity. The timing of the events in the protocol were calculated relative to the habitual sleep-wake schedule of each individual subject. Under these conditions, we found no significant difference between the women with fibromyalgia and control women in the circadian amplitude or phase of rhythms of melatonin, cortisol, and core body temperature. The average circadian phases expressed in hours posthabitual bedtime for women with and without fibromyalgia were 3:43 +/- 0:19 and 3:46 +/- 0:13, respectively, for melatonin; 10:13 +/- 0:23 and 10:32 +/- 0:20, respectively for cortisol; and 5:19 +/- 0:19 and 4:57 +/- 0:33, respectively, for core body temperature phases. Both groups of women had similar circadian rhythms in self-reported alertness. Although pain and stiffness were significantly increased in women with fibromyalgia compared with healthy women, there were no circadian rhythms in either parameter. We suggest that abnormalities in circadian rhythmicity are not a primary cause of fibromyalgia or its symptoms.

  15. Psoriatic Arthritis

    MedlinePlus

    ... physical exam as well as x rays or magnetic resonance imaging (MRI) of the affected joints. Although there is no lab test to diagnose psoriatic arthritis, your doctor may order tests on blood or joint fluid to rule out other forms of arthritis with ...

  16. Infectious Arthritis

    MedlinePlus

    ... Another form of reactive arthritis starts with eating food or handling something that has bacteria on it. To diagnose infectious arthritis, your health care provider may do tests of your blood, urine, and joint fluid. Treatment includes medicines and sometimes surgery.

  17. Reactive arthritis

    MedlinePlus

    Reactive arthritis is a group of conditions that may involve the joints, eyes, and urinary and genital systems. ... The exact cause of reactive arthritis is unknown. It occurs most often in men younger than age 40. It may follow an infection in the urethra ...

  18. Modified immunotherapy for alopecia areata.

    PubMed

    Yoshimasu, Takashi; Furukawa, Fukumi

    2016-07-01

    Squaric acid dibutylester (SADBE) is a commonly used contact sensitizer in immunotherapy for alopecia areata (AA). Severe contact dermatitis is induced by the currently high recommended sensitization dose of 1%-2% SADBE, often decreasing patient compliance. We assessed a modified immunotherapy for AA using SADBE at a starting concentration of 0.01% without sensitization. After one or two weeks of initial 0.01% SADBE application, the concentration of SADBE was increased gradually to 0.025%, 0.05%, 0.1%, 0.25%, 0.5%, 1% and 2% until the patients felt itching or erythema at the AA lesion site. The modified immunotherapy showed a response rate of 69.4% (25/36), equivalent to conventional immunotherapy using SADBE starting at 1%-2% sensitization. Furthermore, we investigated the combination therapy of SADBE and multiple courses of steroid pulses for AA. The response rate for combination therapy was 73.7% (28/38); however, the group receiving combination therapy showed a significant prevalence of severe AA compared with the group receiving modified immunotherapy only. We reviewed the efficacy and safety of modified immunotherapy without initial sensitization and combination therapy with immunotherapy and multiple courses of pulses for AA. PMID:26932732

  19. Current Treatments for Alopecia Areata.

    PubMed

    Hordinsky, Maria K

    2015-11-01

    Selection of a therapy for a patient with alopecia areata (AA) is frequently based on the age of the patient, disease extent, perhaps disease duration, patient expectations, cost of therapy in terms of time commitment, and financial resources, as well as the results of screening laboratory studies that rule out the presence of other co-morbidities such as anemia, low iron stores, thyroid abnormalities, low vitamin D, or other autoimmune diseases. Although there is currently no cure for AA and no universally proven therapy that induces and sustains remission, many therapies are available which can be of benefit to both affected children and adults. Before selecting a treatment for patients with extensive long-standing AA, a scalp biopsy may provide useful information about the degree of inflammation and follicle differentiation. Recent clinical and translational research observations with the systemic Janus kinase (JAK) inhibitors and interleukin-2 (IL-2) have excited the clinical and AA patient communities and have led to clinical trials, as well as to the off-label use of these more expensive and targeted systemic therapies. PMID:26551946

  20. Female pattern alopecia: current perspectives

    PubMed Central

    Levy, Lauren L; Emer, Jason J

    2013-01-01

    Hair loss is a commonly encountered problem in clinical practice, with men presenting with a distinctive pattern involving hairline recession and vertex balding (Norwood-Hamilton classification) and women exhibiting diffuse hair thinning over the crown (increased part width) and sparing of the frontal hairline (Ludwig classification). Female pattern hair loss has a strikingly overwhelming psychological effect; thus, successful treatments are necessary. Difficulty lies in successful treatment interventions, as only two medications – minoxidil and finasteride – are approved for the treatment of androgenetic alopecia, and these medications offer mediocre results, lack of a permanent cure, and potential complications. Hair transplantation is the only current successful permanent option, and it requires surgical procedures. Several other medical options, such as antiandrogens (eg, spironolactone, oral contraceptives, cyproterone, flutamide, dutasteride), prostaglandin analogs (eg, bimatoprost, latanoprost), and ketoconazole are reported to be beneficial. Laser and light therapies have also become popular despite the lack of a profound benefit. Management of expectations is crucial, and the aim of therapy, given the current therapeutic options, is to slow or stop disease progression with contentment despite patient expectations of permanent hair regrowth. This article reviews current perspectives on therapeutic options for female pattern hair loss. PMID:24039457

  1. Female pattern alopecia: current perspectives.

    PubMed

    Levy, Lauren L; Emer, Jason J

    2013-01-01

    Hair loss is a commonly encountered problem in clinical practice, with men presenting with a distinctive pattern involving hairline recession and vertex balding (Norwood-Hamilton classification) and women exhibiting diffuse hair thinning over the crown (increased part width) and sparing of the frontal hairline (Ludwig classification). Female pattern hair loss has a strikingly overwhelming psychological effect; thus, successful treatments are necessary. Difficulty lies in successful treatment interventions, as only two medications - minoxidil and finasteride - are approved for the treatment of androgenetic alopecia, and these medications offer mediocre results, lack of a permanent cure, and potential complications. Hair transplantation is the only current successful permanent option, and it requires surgical procedures. Several other medical options, such as antiandrogens (eg, spironolactone, oral contraceptives, cyproterone, flutamide, dutasteride), prostaglandin analogs (eg, bimatoprost, latanoprost), and ketoconazole are reported to be beneficial. Laser and light therapies have also become popular despite the lack of a profound benefit. Management of expectations is crucial, and the aim of therapy, given the current therapeutic options, is to slow or stop disease progression with contentment despite patient expectations of permanent hair regrowth. This article reviews current perspectives on therapeutic options for female pattern hair loss. PMID:24039457

  2. Fibromyalgia: pathogenetic, diagnostic and therapeutic concerns.

    PubMed

    Podolecki, Tomasz; Podolecki, Andrzej; Hrycek, Antoni

    2009-03-01

    Musculoskeletal pains are one of the most common complaints reported by patients. In 1972, Smythe described the generalized pain and tenderness on palpation at specific points and, 4 years later, the term fibromyalgia was introduced for determining the disease syndrome. The etiology and pathogenesis of fibromyalgia are still unknown. This disease appears probably multi-factorial. It is considered that the changes in the neuronal activity in the central nervous system, abnormal metabolism of biogenic amines and immunological disorders may among other things, contribute to the development of the disease. The complaints are non characteristic and highly sujective, which makes it substantially difficult to differentiate between fibromialgia and both chronic fatigue syndrome and psychosomatic diseases. The treatment of fibromyalgia is complex and long-term. The antidepressants and psychotherapy is of vital importance. The effectiveness of locally used agents is also being emphasized. Fibromyalgia has become a serious social problem in the well developed countries in the recent years. Therefore, of importance are efforts to appropriately diagnose fibromyalgia and to implement its appropriate treatment that resolves disease symptoms in a possibly maximum degree. PMID:19514645

  3. Chronic rhinitis: an underrecognized association with fibromyalgia.

    PubMed

    Cleveland, C H; Fisher, R H; Brestel, E P; Esinhart, J D; Metzger, W J

    1992-01-01

    We prospectively studied 47 consecutive patients with either seasonal or perennial allergic rhinitis or nonallergic rhinitis in a general allergy clinic. A diagnostic questionnaire was administered for symptoms of rhinitis and fibromyalgia, and patients were examined for tender points. A history of congestion was present in 91%, rhinorrhea in 87%, and postnasal drip in 83%. Forty-nine percent had a history of diffuse, aching pain, or tiredness for at least 3 months; 49% percent had 11 or more tender points; and 38% had both a history of widespread pain plus 11 or more tender points (the 1990 criteria of the American College of Rheumatology for fibromyalgia). This frequency is much higher than the expected 4 to 5% prevalence of fibromyalgia in a general population. Seventy-nine percent of all subjects were skin-test positive to inhalant allergens, but positive skin tests alone did not correlate with the number of tender points or criteria for fibromyalgia. Rhinitis, rather than atopy, is associated with fibromyalgia and may be an underdiagnosed, but important causative factor. PMID:1483577

  4. Biology and therapy of fibromyalgia. Stress, the stress response system, and fibromyalgia

    PubMed Central

    Martinez-Lavin, Manuel

    2007-01-01

    Stress is a state of disharmony, or threatened homeostasis. A stressor could have a psychological origin or a biological origin. Societies have become more intricate with industrialization, and modern individuals try to adapt to the new defiance by forcing their stress response system. The main component of the stress response network is the autonomic nervous system. The present article reviews current knowledge on autonomic dysfunction in fibromyalgia. Sympathetic hyperactivity has been consistently described by diverse groups of investigators. Fibromyalgia is proposed to be a sympathetically maintained neuropathic pain syndrome, and genomic data support this contention. Autonomic dysfunction may also explain other fibromyalgia features not related to pain. PMID:17626613

  5. [Scalp cooling for chemotherapy-induced alopecia].

    PubMed

    Komen, Marion M C; Smorenburg, Carolien H; van den Hurk, Corina J G; Nortier, J W R Hans

    2011-01-01

    Alopecia is a very common side effect of cytostatic therapy and is considered one of the most emotionally distressing effects. To prevent alopecia scalp cooling is currently used in some indications in medical oncology in 59 hospitals in the Netherlands. The success of scalp cooling depends on various factors such as type of chemotherapy, dose, infusion time, number of treatment cycles and combinations of drugs. In general, scalp cooling is well tolerated. The reported side-effects are headache, coldness, dizziness and sometimes claustrophobia. An increase in the risk of scalp metastases has not been demonstrated. Proceeding from the South Netherlands Comprehensive Cancer Centre a national working group is put together in order to draw up a national guideline for chemotherapy-induced alopecia. PMID:22085565

  6. Novel agents for the treatment of alopecia.

    PubMed

    Sawaya, M E

    1998-12-01

    Recent approval in the United States of two new products, Propecia (Merck Co, Rahway, NJ) and Rogaine Extra Strength 5% (Pharmacia & UpJohn Co, Kalamazoo, MI), indicated in men to promote scalp hair growth, have added a new dimension to treatment options offered by physicians in treating androgenetic alopecia (AGA). The search for new and effective agents to treat many different hair loss problems has been intensified by the increase in hair biology research taking place worldwide, from university academic institutions to the pharmaceutical companies. All have a desire to profit from marketing such drugs that have been termed, "cosmeceuticals". Millions of men and women of every race suffer from various forms of alopecia, the most common being AGA where the target tissue active androgen, 5 alpha-dihydrotestosterone (DHT) aggravates genetically programmed scalp hair follicles that results in short, fine, miniaturized hairs. Currently available to treat alopecia are drugs indicated for other disease processes because no other agents are accessible; some have severe side-effects and many are minimally effective. These prescription drugs were not originally indicated for alopecia and have not been adequately tested in controlled clinical trials to assess for efficacy, safety, and toxicity. These agents continue to be used clinically to treat patients with various forms of alopecia. As a result, a variety of new agents are emerging in the patient application process to gain protection and approval specifically for various forms of alopecia. This report reviews the most recently approved products, some of the more promising compounds in clinical trial development, as well as those in the over-the-counter (OTC) "natural" treatments category. PMID:9859915

  7. Alopecia in Systemic Amyloidosis: Trichoscopic-Pathologic Correlation

    PubMed Central

    Miteva, Mariya; Wei, Erin; Milikowski, Clara; Tosti, Antonella

    2015-01-01

    Alopecia in systemic amyloidosis is very rare and has been described as individual cases of diffuse nonscarring alopecia and a case of alopecia universalis. We report the trichoscopic findings in alopecia associated with systemic amyloidosis. The most prominent feature was a salmon colored halo (0.3-1 mm in diameter) surrounding the follicular ostia. Other features included broken hairs and black dots. The salmon colored halo correlated on pathology with the perifollicular deposition of amyloid. The horizontal sections showed that the sebaceous glands were preserved which supports the nonscarring pattern of the alopecia. PMID:26903748

  8. Current Treatment Strategies in Pediatric Alopecia Areata

    PubMed Central

    Wang, Etienne; Lee, Joyce SS; Tang, Mark

    2012-01-01

    Alopecia areata (AA) is a non-scarring autoimmune disease of the hair follicle that can present at any age. Pediatric cases are commonly seen in a dermatology clinic, and management can potentially be challenging, with a small proportion of cases experiencing a chronic relapsing course marked by distressing hair loss that can bring about significant psychosocial morbidity. We review the established treatments for pediatric alopecia areata, alongside second and third line therapies that have shown to be efficacious. We also offer a treatment algorithm as a guide to the treatment of pediatric AA. PMID:23248364

  9. Fibromyalgia

    MedlinePlus

    ... to Provider Outreach Provider Outreach Videos Developing a Marketing and Promotion Plan Preparing for Provider Outreach Conducting Provider Outreach Evaluating Your Efforts FAQs ... this Page Background Prevalence ...

  10. Fibromyalgia

    MedlinePlus

    ... Security Disability Insurance (SSDI) and Supplemental Security Insurance (SSI) are the largest Federal programs providing financial assistance ... how much they have paid into the system. SSI is funded by general tax revenues, and those ...

  11. Fibromyalgia

    MedlinePlus

    ... first. He or she may also recommend an anti-depressant, such as duloxetine or milnacipran. Anti-seizure medicines, such as preglabin, may also be effective in managing your pain. Nonsteroidal anti-inflammatory medicines (which include ibuprofen, aspirin and naproxen) ...

  12. Fibromyalgia

    MedlinePlus

    ... or more of the following: Ongoing problems with sleep Fatigue Thinking or memory problems It is no longer necessary to find tender points during the exam to make a diagnosis. Results from ... be done to find out if you have a condition called sleep apnea .

  13. Time to Talk: 6 Things to Know about Mind and Body Practices for Fibromyalgia

    MedlinePlus

    ... X Y Z 6 Things To Know About Mind and Body Practices for Fibromyalgia Share: Fibromyalgia syndrome is a ... should know about what the science says about mind and body practices for fibromyalgia: Research on complementary health approaches ...

  14. Reactive arthritis.

    PubMed

    Keat, A

    1999-01-01

    Reactive arthritis is one of the spondyloarthropathy family of clinical syndromes. The clinical features are those shared by other members of the spondyloarthritis family, though it is distinguished by a clear relationship with a precipitating infection. Susceptibility to reactive arthritis is closely linked with the class 1 HLA allele B27; it is likely that all sub-types pre-dispose to this condition. The link between HLA B27 and infection is mirrored by the development of arthritis in HLA B27-transgenic rats. In this model, arthritis does not develop in animals maintained in a germ-free environment. Infections of the gastrointestinal, genitourinary and respiratory tract appear to provoke reactive arthritis and a wide range of pathogens has now been implicated. Although mechanistic parallels may exist, reactive arthritis is distinguished from Lyme disease, rheumatic fever and Whipple's disease by virtue of the distinct clinical features and the link with HLA B27. As in these conditions both antigens and DNA of several micro-organisms have been detected in joint material from patients with reactive arthritis. The role of such disseminated microbial elements in the provocation or maintenance of arthritis remains unclear. HLA B27-restricted T-cell responses to microbial antigens have been demonstrated and these may be important in disease pathogenesis. The importance of dissemination of bacteria from sites of mucosal infection and their deposition in joints has yet to be fully understood. The role of antibiotic therapy in the treatment of reactive arthritis is being explored; in some circumstances, both the anti-inflammatory and anti-microbial effects of certain antibiotics appear to be valuable. The term reactive arthritis should be seen as a transitory one, reflecting a concept which may itself be on the verge of replacement, as our understanding of the condition develops. Nevertheless it appropriately describes arthritis that is associated with demonstrable

  15. Calcium pyrophosphate arthritis

    MedlinePlus

    ... that can cause attacks of arthritis. Like with gout, crystals form in the joints. But in calcium ... pyrophosphate arthritis can be misdiagnosed as: Gouty arthritis (gout) Osteoarthritis Rheumatoid arthritis

  16. Juvenile Idiopathic Arthritis

    MedlinePlus

    ... Is Juvenile Idiopathic Arthritis the same as Juvenile Rheumatoid Arthritis? Yes, Juvenile Idiopathic Arthritis (JIA) is a new ... of chronic inflammatory diseases that affect children. Juvenile Rheumatoid Arthritis (JRA) is the older term that was used ...

  17. Calcium pyrophosphate arthritis

    MedlinePlus

    ... disease that can cause attacks of arthritis. Like gout, crystals form in the joints. But in this ... CPPD arthritis can be confused with: Gouty arthritis (gout) Osteoarthritis Rheumatoid arthritis Exams and Tests Most arthritic ...

  18. Reactive Arthritis

    MedlinePlus

    ... with treatment and may cause joint damage. What Research Is Being Conducted on Reactive Arthritis? Researchers continue ... such as methotrexate and sulfasalazine. More information on research is available from the following websites: National Institutes ...

  19. Gonococcal arthritis

    MedlinePlus

    ... people who have gonorrhea caused by the bacteria Neisseria gonorrhoeae . Gonococcal arthritis affects women more often than men. ... Saunders; 2013:chap 109. Marrazzo JM, Apicella MA. Neisseria gonorrhoeae (gonnorrhea). In: Bennett JE, Dolin R, Blaser MJ, ...

  20. Psoriatic arthritis

    MedlinePlus

    ... that often occurs with a skin condition called psoriasis . ... inflammatory condition. About 1 in 20 people with psoriasis may develop arthritis with the skin condition. In most cases, psoriasis ...

  1. Rheumatoid arthritis

    MedlinePlus

    ... rheumatoid arthritis drugs. However, because they are very expensive, insurance approval is generally required. Most of them ... rich in fish oils (omega-3 fatty acids). Smoking cigarettes should be stopped. Excessive alcohol should also ...

  2. Enteropathic Arthritis

    MedlinePlus

    ... as well. Those who test positive for the HLA-B27 genetic marker are much more likely to have spinal involvement with enteropathic arthritis than those who test negative. Disease Course/Prognosis ...

  3. Septic arthritis

    MedlinePlus

    ... 2013:chap 109. Krogstad P. Septic arthritis. In: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ. Feigin and Cherry's Textbook of Pediatric Infectious Diseases . 7th ed. Philadelphia, ...

  4. Psoriatic arthritis

    MedlinePlus

    ... that often occurs with a skin condition called psoriasis . Causes Psoriasis is a common skin problem that causes red ... inflammatory condition. About 1 in 20 people with psoriasis may develop arthritis with the skin condition. In ...

  5. Fibromyalgia and Chronic Pain Syndromes

    PubMed Central

    Choy, Ernest; Clauw, Daniel J.; Goldenberg, Don L.; Harris, Richard E.; Helfenstein, Milton; Jensen, Troels Staehelin; Noguchi, Koichi; Silverman, Stuart L.; Ushida, Takahiro; Wang, Guochun

    2016-01-01

    This manuscript, developed by a group of chronic pain researchers and clinicians from around the world, aims to address the state of knowledge about fibromyalgia (FM) and identify ongoing challenges in the field of FM and other chronic pain syndromes that may be characterized by pain centralization/amplification/hypersensitivity. There have been many exciting developments in research studies of the pathophysiology and treatment of FM and related syndromes that have the potential to improve the recognition and management of patients with FM and other conditions with FM-like pain. However, much of the new information has not reached all clinicians, especially primary care clinicians, who have the greatest potential to use this new knowledge to positively impact their patients’ lives. Furthermore, there are persistent misconceptions about FM and a lack of consensus regarding the diagnosis and treatment of FM. This paper presents a framework for future global efforts to improve the understanding and treatment of FM and other associated chronic pain syndromes, disseminate research findings, identify ways to enhance advocacy for these patients, and improve global efforts to collaborate and reach consensus about key issues related to FM and chronic pain in general. PMID:27022674

  6. [Fibromyalgia -- a somatoform (pain) disorder?].

    PubMed

    Häuser, W; Bernardy, K; Arnold, B

    2006-04-01

    The hypothesis that fibromyalgia (FM) should be classified as a somatoform disorder was assessed by reviewing current clinical studies. According to the ICD-10, somatic illness beliefs of the patient, high health care utilization, and frustrating patient-doctor relationships are diagnostic criteria of somatoform disorders. For the diagnosis of a somatoform pain disorder, a temporal association between the manifestation of pain and emotional or psychosocial conflicts and the exclusion of a depressive disorder are additionally required. Empirical studies demonstrate a higher lifetime and current prevalence of psychiatric disorders, childhood adversities, life events, and daily hassles and a higher health care utilization of FM patients. Studies also reveal that most patients believe that both somatic and psychosocial factors have caused their disorder. The patient-doctor relationship is characterized to be disappointing for both. Yet in all studies there were patients who did not fulfill the ICD-10 criteria of a somatoform (pain) disorder. A biopsychosocial model of FM differentiating between biological as well as psychosocial predisposing, triggering, and perpetuating factors in the pathogenesis of FM is presented as an alternative model. Hopefully the biopsychosocial model and the distinction of subgroups will enable more differentiated and tailored psychotherapeutic and pharmacological treatment strategies. PMID:15806384

  7. A practical approach to fibromyalgia.

    PubMed

    Cymet, Tyler Childs

    2003-04-01

    Fibromyalgia is the name given to a collection of symptoms with no clear physiologic cause, The constellation of symptoms are clearly recognizable as a distinct pathologic entity. The diagnosis is made through clinical observations made by the examiner. Differential diagnosis must include other somatic syndromes as well as disease entities like hepatitis, hypothyroidism, diabetes mellitus, electrolyte imbalance, multiple sclerosis, and cancer. Diagnostic criteria are given as guidelines for the diagnosis, not as absolute requirements. Treatment of this condition remains individualized and relies heavily on having a therapeutic relationship with a provider. Treatment of this syndrome needs to be looked at as an ongoing process. Goal oriented treatment aimed at maintaining specific functions can be directed at helping a patient get restorative sleep, alleviating the somatic pains that ail the patient, keeping a person productive, regulating schedules or through goal oriented agreements made with the patient. Since this syndrome is chronic and may effect all areas of a persons functioning the family and social support system of the person being treated need to be evaluated. Patients often seek alternative medical treatments for this problem including diet therapy, acupuncture, and herbal therapy. Treatment must involve more than just the symptoms presented and the patient can only be treated successfully if they are willing to work at changing their own perceptions, and ways of relating to stressors in their world. PMID:12749618

  8. A practical approach to fibromyalgia.

    PubMed Central

    Cymet, Tyler Childs

    2003-01-01

    Fibromyalgia is the name given to a collection of symptoms with no clear physiologic cause, The constellation of symptoms are clearly recognizable as a distinct pathologic entity. The diagnosis is made through clinical observations made by the examiner. Differential diagnosis must include other somatic syndromes as well as disease entities like hepatitis, hypothyroidism, diabetes mellitus, electrolyte imbalance, multiple sclerosis, and cancer. Diagnostic criteria are given as guidelines for the diagnosis, not as absolute requirements. Treatment of this condition remains individualized and relies heavily on having a therapeutic relationship with a provider. Treatment of this syndrome needs to be looked at as an ongoing process. Goal oriented treatment aimed at maintaining specific functions can be directed at helping a patient get restorative sleep, alleviating the somatic pains that ail the patient, keeping a person productive, regulating schedules or through goal oriented agreements made with the patient. Since this syndrome is chronic and may effect all areas of a persons functioning the family and social support system of the person being treated need to be evaluated. Patients often seek alternative medical treatments for this problem including diet therapy, acupuncture, and herbal therapy. Treatment must involve more than just the symptoms presented and the patient can only be treated successfully if they are willing to work at changing their own perceptions, and ways of relating to stressors in their world. PMID:12749618

  9. Can mastalgia be another somatic symptom in fibromyalgia syndrome?

    PubMed Central

    Sen, Meral; Kilic, Murat Ozgur; Cemeroglu, Ozlem; Icen, Duygu

    2015-01-01

    OBJECTIVE: The purposes of this study were to determine the coexistence of mastalgia and fibromyalgia, to investigate the effects of this combination on pain patterns, and to discuss the status of breast pain in the diagnostic algorithm of fibromyalgia syndrome. METHODS: Sixty-one female patients reporting breast pain during the last three months and 53 female patients diagnosed with fibromyalgia syndrome were enrolled in this study. The Breast Pain Questionnaire was administered to all participants in the mastalgia group and to those in the fibromyalgia syndrome group who had experienced mastalgia during the past three months. The patients in the fibromyalgia syndrome group were evaluated using the 2010 preliminary American College of Rheumatology classification criteria. All of the patients in the mastalgia group were evaluated for the diagnosis of fibromyalgia syndrome by a single physiatrist. The coexistence and pain patterns of mastalgia and fibromyalgia were assessed statistically. RESULTS: Approximately half of the patients with fibromyalgia syndrome (47.2%) reported having mastalgia at the time of admission and 37.7% of the patients with mastalgia met the diagnostic criteria for fibromyalgia syndrome. The patients with mastalgia in the fibromyalgia syndrome group had significantly higher total breast pain scores compared with the women in the mastalgia group. In addition, the patients with fibromyalgia syndrome in the mastalgia group had significantly higher Widespread Pain Index and Symptom Severity Scale scores than the patients with fibromyalgia syndrome. CONCLUSIONS: We suggest that mastalgia can be an aspect of the central sensitivity syndrome and can be added to the somatic symptoms of fibromyalgia. PMID:26602519

  10. Bacterial arthritis.

    PubMed

    Ho, G

    1991-08-01

    In this review of the 1990 septic arthritis literature, we revisit synovial fluid leukocytosis, examine the utility of synovial fluid glucose and protein measurements, and look at the levels of two cytokines, tumor necrosis factor and interleukin-1, in infected joint fluids. We see the many faces of gonococcal arthritis and the ravages of septic arthritis when the host has rheumatoid arthritis. Should we recommend antibiotic prophylaxis for the rheumatoid patient with a prosthetic joint who is undergoing a procedure that leads to transient bacteremia? What are some of the salient features of septic arthritis when it involves the sternoclavicular or sacroiliac joints? We also look at some unusual microorganisms, eg, group C Streptococcus, Streptococcus viridans, Listeria monocytogenes, Pseudomonas cepacia, Pseudomonas maltophilia, and Neisseria sicca. In patients with acquired immunodeficiency syndrome, we encounter reports of septic arthritis, osteomyelitis, and spinal epidural abscess caused by opportunistic microorganisms. Two unusual sites of infection include the C1-2 lateral facet joint and subacromial bursa without involvement of the glenohumeral joint. Finally, we examine how to drain a septic knee: the orthopedic point of view. PMID:1911055

  11. Viral arthritis.

    PubMed

    Marks, Michael; Marks, Jonathan L

    2016-04-01

    Acute-onset arthritis is a common clinical problem facing both the general clinician and the rheumatologist. A viral aetiology is though to be responsible for approximately 1% of all cases of acute arthritis with a wide range of causal agents recognised. The epidemiology of acute viral arthritis continues to evolve, with some aetiologies, such as rubella, becoming less common due to vaccination, while some vector-borne viruses have become more widespread. A travel history therefore forms an important part of the assessment of patients presenting with an acute arthritis. Worldwide, parvovirus B19, hepatitis B and C, HIV and the alphaviruses are among the most important causes of virally mediated arthritis. Targeted serological testing may be of value in establishing a diagnosis, and clinicians must also be aware that low-titre autoantibodies, such as rheumatoid factor and antinuclear antibody, can occur in the context of acute viral arthritis. A careful consideration of epidemiological, clinical and serological features is therefore required to guide clinicians in making diagnostic and treatment decisions. While most virally mediated arthritides are self-limiting some warrant the initiation of specific antiviral therapy. PMID:27037381

  12. Managing Chemotherapy Side Effects: Hair Loss (Alopecia)

    MedlinePlus

    ... C ancer I nstitute Managing Chemotherapy Side Effects Hair Loss (Alopecia) “Losing my hair was hard at first. Then I got used ... uncovered.” Questions other people have asked: Why does hair fall out? Chemotherapy can harm the cells that ...

  13. Alopecia Areata After Vaccination: Recurrence with Rechallenge.

    PubMed

    Chu, Chien-Ho; Cheng, Yu-Pin; Chan, Jung-Yi Lisa

    2016-05-01

    Alopecia areata (AA) is the most common form of hair loss in children. We report the case of a child who had two episodes of AA after two different vaccines with complete hair regrowth between the episodes. This case supports the concept that vaccination might be a trigger for the development of AA in genetically predisposed children. PMID:27071855

  14. Fibromyalgia Pathogenesis and Treatment Options Update.

    PubMed

    Chinn, Steven; Caldwell, William; Gritsenko, Karina

    2016-04-01

    This review article presents and summarizes up-to-date literature on the clinical manifestations, diagnosis, pathophysiological mechanisms, and treatment options for fibromyalgia patients. First, the most recent diagnostic criteria for fibromyalgia, as put forth by the American College of Rheumatology will be summarized. Clinical features, including chronic widespread pain, hyperalgesia, mood disorders, anxiety, and disturbed sleep patterns will be explored in-depth. The pathogenesis and pathophysiology of fibromyalgia involves alterations in multiple ascending and descending central nervous system pathways, as well as peripheral pathways, leading to heightened pain sensitivity. Risk factors have been studied extensively, and the most recent research focuses on various genetic influences and the contributions of stress and poor sleep. Lastly, the discussion in this article focuses on treatment options for fibromyalgia; some have been mainstay options for many years. Pharmacological agents include tricyclic antidepressants, anti-epileptic drugs, selective serotonin reuptake inhibitors, norepinephrine/serotonin reuptake inhibitors, as well as some investigational agents. The evidence behind non-pharmacologic treatments, including massage therapy, exercise, and acupuncture, are discussed. PMID:26922414

  15. Physical therapy in the treatment of fibromyalgia.

    PubMed

    Offenbächer, M; Stucki, G

    2000-01-01

    Fibromyalgia (FM) is a syndrome of unknown etiology characterized by chronic wide spread pain, increased tenderness to palpation and additional symptoms such as disturbed sleep, stiffness, fatigue and psychological distress. While medication mainly focus on pain reduction, physical therapy is aimed at disease consequences such as pain, fatigue, deconditioning, muscle weakness and sleep disturbances and other disease consequences. We systematically reviewed current treatment options in the treatment of fibromyalgia. Based on evidence from randomized controlled trials cardiovascular fitness training importantly improves cardiovascular fitness, both subjective and objective measures of pain as well as subjective energy and work capacity and physical and social activities. Based on anecdotal evidence or small observational studies physiotherapy may reduce overloading of the muscle system, improve postural fatigue and positioning, and condition weak muscles. Modalities and whole body cryotherapy may reduce localized as well as generalized pain in short term. Trigger point injection may reduce pain originating from concomitant trigger points in selected FM patient. Massage may reduce muscle tension and may be prescribed as a adjunct with other therapeutic interventions. Acupuncture may reduce pain and increase pain threshold. Biofeedback may positively influence subjective and objective disease measures. TENS may reduce localized musculoskeletal pain in fibromyalgia. While there seems to be no single best treatment option, physical therapy seem to reduce disease consequences. Accordingly a multidisciplinary approach combining these therapies in a well balanced program may be the most promising strategy and is currently recommended in the treatment of fibromyalgia. PMID:11028838

  16. One year in review 2016: fibromyalgia.

    PubMed

    Bazzichi, Laura; Giacomelli, Camillo; Consensi, Arianna; Atzeni, Fabiola; Batticciotto, Alberto; Di Franco, Manuela; Casale, Roberto; Sarzi-Puttini, Piercarlo

    2016-01-01

    Fibromyalgia (FM) syndrome is a chronic disease with unknown aetiology, characterised by widespread pain, fatigue and other functional symptoms. We reviewed the literature of the past year to underline the recent progress in the etiopathogenesis, assessment and therapies of this syndrome, evaluating the articles published between January 2015 and January 2016. PMID:27157400

  17. Fibromyalgia Syndrome: Etiology, Pathogenesis, Diagnosis, and Treatment

    PubMed Central

    Bellato, Enrico; Marini, Eleonora; Castoldi, Filippo; Barbasetti, Nicola; Mattei, Lorenzo; Bonasia, Davide Edoardo; Blonna, Davide

    2012-01-01

    Fibromyalgia syndrome is mainly characterized by pain, fatigue, and sleep disruption. The etiology of fibromyalgia is still unclear: if central sensitization is considered to be the main mechanism involved, then many other factors, genetic, immunological, and hormonal, may play an important role. The diagnosis is typically clinical (there are no laboratory abnormalities) and the physician must concentrate on pain and on its features. Additional symptoms (e.g., Raynaud's phenomenon, irritable bowel disease, and heat and cold intolerance) can be associated with this condition. A careful differential diagnosis is mandatory: fibromyalgia is not a diagnosis of exclusion. Since 1990, diagnosis has been principally based on the two major diagnostic criteria defined by the ACR. Recently, new criteria have been proposed. The main goals of the treatment are to alleviate pain, increase restorative sleep, and improve physical function. A multidisciplinary approach is optimal. While most nonsteroidal anti-inflammatory drugs and opioids have limited benefit, an important role is played by antidepressants and neuromodulating antiepileptics: currently duloxetine (NNT for a 30% pain reduction 7.2), milnacipran (NNT 19), and pregabalin (NNT 8.6) are the only drugs approved by the US Food and Drug Administration for the treatment of fibromyalgia. In addition, nonpharmacological treatments should be associated with drug therapy. PMID:23213512

  18. A profile of fibromyalgia in occupational environments.

    PubMed

    Waylonis, G W; Ronan, P G; Gordon, C

    1994-04-01

    The effect of the occupational environment on fibromyalgic patients has not been well studied. Individuals (321) from across the United States completed a questionnaire regarding effects of their current and past occupations on their fibromyalgia. Occupations with a high percentage of responders were general office workers (20%), health care providers (14%) and educators (11%). Of the respondents, 8% were unemployed. Activities reported to aggravate the symptoms of fibromyalgia were computer or typing (37%), prolonged sitting (37%), prolonged standing and walking (27%), stress (21%), heavy lifting and bending (19%) and repeated moving and lifting (18%). Activities that did not appear to exacerbate the symptoms of fibromyalgia included walking (19%), variable light sedentary work (15%), teaching (8%), light desk work (6%) and phone work (6%). Patients with fibromyalgia report that they do not tolerate prolonged, repetitive activities, maintaining any one position for sustained periods of time and jobs with high stress. Light sedentary occupations that allow varied tasks and changing positions appear to be tolerated the best. PMID:8148100

  19. Differential dopamine function in fibromyalgia.

    PubMed

    Albrecht, Daniel S; MacKie, Palmer J; Kareken, David A; Hutchins, Gary D; Chumin, Evgeny J; Christian, Bradley T; Yoder, Karmen K

    2016-09-01

    Approximately 30 % of Americans suffer from chronic pain disorders, such as fibromyalgia (FM), which can cause debilitating pain. Many pain-killing drugs prescribed for chronic pain disorders are highly addictive, have limited clinical efficacy, and do not treat the cognitive symptoms reported by many patients. The neurobiological substrates of chronic pain are largely unknown, but evidence points to altered dopaminergic transmission in aberrant pain perception. We sought to characterize the dopamine (DA) system in individuals with FM. Positron emission tomography (PET) with [(18)F]fallypride (FAL) was used to assess changes in DA during a working memory challenge relative to a baseline task, and to test for associations between baseline D2/D3 availability and experimental pain measures. Twelve female subjects with FM and 11 female controls completed study procedures. Subjects received one FAL PET scan while performing a "2-back" task, and one while performing a "0-back" (attentional control, "baseline") task. FM subjects had lower baseline FAL binding potential (BP) in several cortical regions relative to controls, including anterior cingulate cortex. In FM subjects, self-reported spontaneous pain negatively correlated with FAL BP in the left orbitofrontal cortex and parahippocampal gyrus. Baseline BP was significantly negatively correlated with experimental pain sensitivity and tolerance in both FM and CON subjects, although spatial patterns of these associations differed between groups. The data suggest that abnormal DA function may be associated with differential processing of pain perception in FM. Further studies are needed to explore the functional significance of DA in nociception and cognitive processing in chronic pain. PMID:26497890

  20. Follicular density and ratios in scarring and nonscarring alopecia.

    PubMed

    Horenstein, Marcelo G; Bacheler, Christian J

    2013-12-01

    Follicular counts from transverse sectioning of scalp biopsies have not been statistically scrutinized across disease entities in a standardized fashion. We applied uniform histological criteria and strict statistical measures to compare nonscarring and scarring alopecia. We studied 700 consecutive cases including 355 nonscarring alopecia [136 telogen effluvium, 115 alopecia areata (AA), 95 androgenetic alopecia, and 9 trichotillosis] and 345 scarring alopecia [238 central centrifugal cicatricial alopecia, 29 traction alopecia, 26 lichen planopilaris, 21 end-stage alopecia, 20 lupus erythematosus, 11 folliculitis decalvans]. We counted follicular units, anagen, catagen/telogen, and vellus-like follicles at the central follicular unit level. We calculated follicular density per square centimeter, anagen percentage, telogen percentage, anagen to telogen ratio, and terminal to vellus ratio (TVR). The following achieved statistical significance (P < 0.05): follicular density was 249.4 ± 4.6 in nonscarring alopecia versus 120.1 ± 3.8 in scarring alopecia, follicular density of telogen effluvium was 273.5 ± 7.0 (36.5 ± 12.5 above nonscarring alopecia mean), TVR of androgenetic alopecia was 1.6 ± 0.1 (3.6 ± 0.5 below nonscarring alopecia mean), TVR of AA was 3.2 ± 0.4 (1.5 ± 0.6 below nonscarring alopecia mean), anagen percentage of AA was 26.8 ± 1.8 (26.3 ± 3.0 below nonscarring alopecia mean), anagen to telogen ratio of AA was 1.6 ± 0.4 (3.9 ± 0.7 below nonscarring alopecia mean), and telogen percentage of AA was 59.0 ± 2.3 (31.0 ± 3.5 above nonscarring alopecia mean). There exists a great overlap of densities and ratios across the various disorders due to the limited nature of the punch biopsy sample, variations in scalp anatomy, disease biology and duration, patient gender, and age, etc. Our data provide a bell curve distribution that helps analyze hair counts in the clinicopathologic context. PMID:23435361

  1. Focusing on Fibromyalgia : A Puzzling and Painful Condition

    MedlinePlus

    ... on Fibromyalgia Health Capsules Infertility Treatments and Children’s Development Help for Rare and Undiagnosed Conditions Featured Website: NIH Office of Dietary Supplements Past Issues Most ...

  2. Triangular temporal alopecia: a rare case in adulthood.

    PubMed

    Jutla, Simran; Patel, Vikas; Rajpara, Anand

    2016-01-01

    Triangular temporal alopecia (TTA) is an asymptomatic, circumscribed, non-scarring form of alopecia that affects the temporal scalp. Although TTA is most often seen between ages two and nine, the condition has rarely been described in adults. If unrecognized, adulthood TTA can be misdiagnosed, leading to unnecessary steroid treatment. This case report describes TTA in an adult woman who had no prior history of alopecia. It also reviews the existing TTA literature, describing the diagnosis and management of this condition. PMID:27136639

  3. Psoriatic alopecia/alopecia areata-like reactions secondary to anti-tumor necrosis factor-α therapy: a novel cause of noncicatricial alopecia.

    PubMed

    Doyle, Leona A; Sperling, Leonard C; Baksh, Shashi; Lackey, Jeffrey; Thomas, Brian; Vleugels, Ruth Ann; Qureshi, Abrar A; Velazquez, Elsa F

    2011-04-01

    With the increasing use of anti-tumor necrosis factor α (anti-TNF) biologic drugs to treat autoimmune diseases, an expanding array of adverse reactions is emerging. Anti-TNF drug-induced alopecia is a less well-known side effect of this class of drugs. The aim of this study was to define the clinical and histopathological features of alopecia arising in the setting of anti-TNF therapy. Clinical and histopathological features of 3 patients who developed scalp alopecia during anti-TNF treatment were examined. Two of the 3 patients also developed psoriasiform lesions outside the scalp, and biopsies from both scalp and nonscalp sites were reviewed. Clinically, each patient had large scaly patches associated with the scalp alopecia. All scalp biopsies revealed psoriasiform epidermal features and alopecia areata-like dermal changes. Epidermal changes included acanthosis and confluent parakeratosis with neutrophils and frank pustules. Dermal changes included markedly increased catagen/telogen and miniaturized hairs and peribulbar lymphocytic inflammation. Numerous plasma cells and eosinophils were present in all cases. Biopsies from the nonscalp lesions showed psoriasiform changes and prominent eosinophils and plasma cells. Two patients showed significant improvement of the alopecia with topical treatment only. In conclusion, anti-TNF therapy-related alopecia may closely mimic psoriatic alopecia and alopecia areata but can be histologically distinguished from alopecia areata by epidermal psoriasiform changes and dermal plasma cells and from primary psoriasis by the presence of plasma cells and eosinophils. A correct diagnosis can enable effective treatment and, in some cases, allow anti-TNF therapy to continue. PMID:21317611

  4. Alopecia in three macaque species housed in a laboratory environment

    PubMed Central

    Kroeker, R.; Bellanca, R. U.; Lee, G. H.; Thom, J. P.; Worlein, J. M.

    2014-01-01

    Alopecia is a persistent problem in captive macaque populations and despite recent interest, no factors have been identified that can unequivocally explain the presence of alopecia in a majority of cases. Seasonal, demographic and environmental factors have been identified as affecting alopecia presentation in rhesus macaques, the most widely studied macaque species. However, few studies have investigated alopecia rates in other macaque species. We report alopecia scores over a period of 12 months for three macaque species (Macaca nemestrina, M. mulatta, and M. fascicularis) housed at three indoor facilities within the Washington National Primate Research Center (WaNPRC) in Seattle. Clear species differences emerged with cynomolgus (M. fascicularis) showing the lowest alopecia rates and pigtails (M. nemestrina) the highest rates. Further analysis of pigtail and rhesus (M. mulatta) macaques revealed that sex effects were apparent for rhesus but not pigtails. Age and seasonal effects were evident for both species. In contrast to previous reports, we found that older animals (over 10 years of age) had improved alopecia scores in comparison to younger adults. This is the first report on alopecia rates in pigtail macaques and the first comparison of alopecia scores in pigtail, cynomolgus, and rhesus macaques housed under similar conditions. PMID:24243351

  5. Diphenylcyclopropenone-Induced Vitiligo in a Patient with Alopecia Universalis

    PubMed Central

    Riad, Hassan; Mannai, Haya Al; Mansour, Khalid; Qaatri, Khalifa Al; Dosari, Sharifa Al; Obaidaly, Amina Al; Sultan, Emad

    2013-01-01

    Alopecia areata and vitiligo are autoimmune diseases, both associated with multiple autoimmune comorbidities. Many studies show colocalization of these diseases at the same anatomical site. Here, we have a case where both disorders were reported to present in the same patient. Diphenylcyclopropenone (diphencyprone, DCP) is used in the treatment of alopecia areata and may induce vitiligo in some patients. We report on one case of vitiligo that was induced by DCP during therapy for alopecia universalis. Alopecia areata and vitiligo share many susceptibility genes. Follicular melanocyte destruction may represent the link between the two diseases. PMID:24019775

  6. Diphenylcyclopropenone-induced vitiligo in a patient with alopecia universalis.

    PubMed

    Riad, Hassan; Mannai, Haya Al; Mansour, Khalid; Qaatri, Khalifa Al; Dosari, Sharifa Al; Obaidaly, Amina Al; Sultan, Emad

    2013-01-01

    Alopecia areata and vitiligo are autoimmune diseases, both associated with multiple autoimmune comorbidities. Many studies show colocalization of these diseases at the same anatomical site. Here, we have a case where both disorders were reported to present in the same patient. Diphenylcyclopropenone (diphencyprone, DCP) is used in the treatment of alopecia areata and may induce vitiligo in some patients. We report on one case of vitiligo that was induced by DCP during therapy for alopecia universalis. Alopecia areata and vitiligo share many susceptibility genes. Follicular melanocyte destruction may represent the link between the two diseases. PMID:24019775

  7. Three-Quarters of Persons in the US Population Reporting a Clinical Diagnosis of Fibromyalgia Do Not Satisfy Fibromyalgia Criteria: The 2012 National Health Interview Survey

    PubMed Central

    Walitt, Brian; Katz, Robert S.; Bergman, Martin J.; Wolfe, Frederick

    2016-01-01

    Objectives Although fibromyalgia criteria have been in effect for decades, little is known about how the fibromyalgia diagnosis is applied and understood by clinicians and patients. We used the National Health Interview Survey (NHIS) to determine the prevalence of self-reported clinician diagnosed fibromyalgia and then compared demographics, symptoms, disability and medical utilization measures of persons with a clinical diagnosis of fibromyalgia that did not meet diagnostic criteria (false-positive or prior [F/P] fibromyalgia) to persons with and without criteria-positive fibromyalgia. Methods The National Health Interview Survey (NHIS) collected information about both clinical diagnosis and symptoms of fibromyalgia that was appropriately weighted to represent 225,726,257 US adults. Surrogate NHIS diagnostic criteria for fibromyalgia were developed based on the level of polysymptomatic distress (PSD) as characterized in the 2011 modified American College of Rheumatology criteria (ACR) for fibromyalgia. Persons with F/P fibromyalgia were compared with persons who do not have fibromyalgia and those meeting surrogate NHIS fibromyalgia criteria. Results Of the 1.78% of persons reporting a clinical diagnosis, 73.5% did not meet NHIS fibromyalgia criteria. The prevalence of F/P fibromyalgia is 1.3%. F/P fibromyalgia is associated with a mild degree of polysymptomatic distress (NHIS PSD score 6.2) and characterized by frequent but not widespread pain and insomnia. Measures of work disability and medical utilization in F/P fibromyalgia were equal to that seen with NHIS criteria positive fibromyalgia and were 6-7x greater in F/P fibromyalgia than in non-fibromyalgia persons. F/P fibromyalgia was best predicted by being female (Odds Ratio [OR] 8.81), married (OR 3.27), and white (OR 1.96). In contrast, being a white, married woman was only modestly predictive of NHIS (criteria positive) fibromyalgia (OR 2.1). Conclusions The majority of clinically diagnosed fibromyalgia

  8. Color-dilution alopecia in dogs.

    PubMed

    Kim, Jae Hoon; Kang, Kyung Il; Sohn, Hyun Joo; Woo, Gye Hyeong; Jean, Young Hwa; Hwang, Eui Kyung

    2005-09-01

    Color-dilution alopecia is a relatively uncommon hereditary skin disease seen in "Blue" and other color-diluted dogs. This syndrome is associated with a color-dilution gene. The initial clinical signs are the gradual onset of a dry, dull and poor hair coat quality. Hair shafts and hair regrowth are poor, and follicular papules may develop and progress to frank comedones. Hair loss and comedo formation are usually most severe on the trunk, especially color-diluted area on the skin. Six cases of color-dilution alopecia are reported in 3 months to 10 years old dogs. The breeds of dogs are blue Doberman Pinscher, Miniature Pinscher, Dachshund, and Schnauzer. Grossly, extensive partial hair loss was seen on the skin. Histopathologically, the epidermis is relatively normal but may be hyperplastic. Hair follicles are characterized by atrophy and distortion. Heavily clumped melanin is present in the epidermis, dermis and hair follicles. PMID:16131833

  9. Cytokines and Other Mediators in Alopecia Areata

    PubMed Central

    Gregoriou, Stamatis; Papafragkaki, Dafni; Kontochristopoulos, George; Rallis, Eustathios; Kalogeromitros, Dimitrios; Rigopoulos, Dimitris

    2010-01-01

    Alopecia areata, a disease of the hair follicles with multifactorial etiology and a strong component of autoimmune origin, has been extensively studied as far as the role of several cytokines is concerned. So far, IFN-γ, interleukins, TNF-α, are cytokines that are well known to play a major role in the pathogenesis of the disease, while several studies have shown that many more pathways exist. Among them, MIG, IP-10, BAFF, HLA antigens, MIG, as well as stress hormones are implicated in disease onset and activity. Within the scope of this paper, the authors attempt to shed light upon the complexity of alopecia areata underlying mechanisms and indicate pathways that may suggest future treatments. PMID:20300578

  10. Fibromyalgia: poorly understood; treatments are disappointing.

    PubMed

    2009-08-01

    (1) Fibromyalgia is characterised by a range of symptoms that include muscle pain, fatigue and sleep disorders. Anxiety and depression are often also present. The cause is unknown. More women than men are affected; (2) The following review focuses on differential diagnoses and available treatments for fibromyalgia, based on a review of the literature using the standard Prescrire methodology; (3) Fibromyalgia is mainly diagnosed by excluding other possibilities. The principal differential diagnoses are rheumatic involvement of the spine, systemic inflammatory disorders, and hypothyroidism. Unlike these other conditions, fibromyalgia is not associated with radiological or laboratory abnormalities; (4) Paracetamol has not been compared with other treatments in fibromyalgia. Nonsteroidal antiinflammatory drugs have no specific effect; (5) The only two trials assessing tramadol showed little effect; in one study the average pain score was 53 mm in the tramadol group versus 65 mm in the placebo group, on a scale ranging from 0 to 100 mm. The adverse effects of tramadol are those of opiates in general, mainly nausea and dependence. Tramadol interacts with numerous other drugs; (6) The efficacy of tricyclic antidepressants is also difficult to quantify. Their limited superiority over placebo lasts no more than a few months. The efficacy of selective serotonin reuptake inhibitor antidepressants (fluoxetine, paroxetine and citalopram), serotonin and nonadrenaline reuptake inhibitors (duloxetine and milnacipran) is even less well established. Duloxetine has been tested in four placebo-controlled trials with unconvincing results; (7) Pregabalin and gabapentin, two antiepileptic drugs, appear to be more effective than placebo but have only been tested in short-term trials. In one trial 44% of patients in the pregabalin group said they felt better after 13 weeks versus 35% of patients in the placebo group. However, adverse effects are frequent and sometimes troublesome

  11. Evidence for supplemental treatments in androgenetic alopecia.

    PubMed

    Famenini, Shannon; Goh, Carolyn

    2014-07-01

    Currently, topical minoxidil and finasteride are the only treatments that have been FDA approved for the treatment of female pattern hair loss and androgenetic alopecia. Given the incomplete efficacy and sife effect profile of these medications, some patients utilize alternative treatments to help improve this condition. In this review, we illustrate the scientific evidence underlying the efficacy of these alternative approaches, including biotin, caffeine, melatonin, a marine extract, and zinc. PMID:25007363

  12. Annular Alopecia Areata: Report of Two Cases

    PubMed Central

    Bansal, Manish; Manchanda, Kajal; Pandey, SS

    2013-01-01

    Alopecia areata (AA) is an auto-immune disorder characterized by the appearance of non-scarring bald patches affecting the hair bearing areas of the body. Scalp is the most common site of involvement. AA can affect any age group. The usual pattern of the hair loss is oval or round. We hereby, report two cases of annular and circinate pattern of AA due to its unusual morphology. PMID:24403774

  13. Development of a self-reporting tool to obtain a Combined Index of Severity of Fibromyalgia (ICAF*)

    PubMed Central

    2010-01-01

    Background Fibromyalgia is a syndrome with heterogeneous symptoms. The evaluation in the clinical setting usually fails to cover the complexity of the syndrome. This study aims to determine how different aspects of fibromyalgia are inter-related when measured by means of a self-reporting tool. The objective is to develop a more complete evaluation model adjusted to the complexity and multi-dimensional nature of the syndrome. Methods Application was made of the Fibromyalgia Impact Questionnaire, the Hospital Anxiety and Depression Scale, the Brief Pain Inventory, the Fatigue Assessment Scale, the Health Assessment Questionnaire, the General Health Questionnaire (GHQ-28), the Chronic Pain Coping Inventory, the Arthritis Self-efficacy Scale and the Sleep Quality Scale. An assessment was made, on the basis of clinical interviews, case histories and specific tests, of the patient sociodemographic data, comorbidity, physical exploration and other clinical indexes. An exploratory factor analysis was made, with comparisons of the clinical index scores in extreme groups of patients. Results The ICAF composed of 59 items was obtained, offering four factors that explain 64% of the variance, and referred to as Emotional Factor (33.7%), Physical-Activity (15%), Active Coping (9%) and Passive Coping (6.3%). A t-test between the extreme scores of these factors in the 301 patients revealed statistically significant differences in occupational status, medically unexplained syndromes, number of tender points, the six-minutes walk test, comorbidity and health care costs. Conclusions This study offers a tool allowing more complete and rapid evaluation of patients with fibromyalgia. The test intrinsically evaluates the emotional aspects: anxiety and depression, and their impact upon social aspects. It also evaluates patient functional capacity, fatigue, sleep quality, pain, and the way in which the patient copes with the disease. This is achieved by means of a self

  14. Grammatical Arthritis.

    ERIC Educational Resources Information Center

    Bush, Don

    1994-01-01

    Discusses grammatical arthritis (an internal buildup of rules that hinders writing flexibility); four new "rules" (concerning "data is,""none are,""hopefully," and the restrictive "which"); attitudes toward English grammar; how to be a helpful editor; and where to learn about grammar. (SR)

  15. Fibromyalgia, Spirituality, Coping and Quality of Life.

    PubMed

    Biccheri, Eliane; Roussiau, Nicolas; Mambet-Doué, Constance

    2016-08-01

    The aim of this study is to identify the impact of spirituality on coping strategies and on the quality of life of fibromyalgia patients. The study was carried out on 590 people suffering from fibromyalgia. The data were collected with the French version of the WCC-R (The Ways of Coping Checklist: Cousson et al. 1996), the questionnaire of spirituality (Evaluation de La Spiritualité: Renard and Roussiau, 2016) and Diener's Satisfaction with Life Scale questionnaire, translated into French (Blais et al. 1989). An analysis carried out with the software SPSS and Hayes' models showed that both problem-focused coping and coping through social support seeking are mediating variables that enable an indirect link between spirituality and quality of life. PMID:26922751

  16. Patient-Reported Outcomes and Fibromyalgia.

    PubMed

    Williams, David A; Kratz, Anna L

    2016-05-01

    Fibromyalgia (FM) is classified as a chronic pain condition accompanied by symptoms of fatigue, sleep problems, problems with cognition, negative mood, limited functional status, and the presence of other chronic overlapping pain conditions. Comprehensive assessment of all of these components can be challenging. This paper provides an overview of patient-reported approaches that can be taken to assess FM in the contexts of diagnosis, symptom monitoring, phenotyping/characterization, and for purposes of clinical trials. PMID:27133492

  17. [Fibromyalgia and psychiatry: 35 years later… what's new?].

    PubMed

    Geoffroy, Pierre A; Amad, Ali; Gangloff, Christine; Thomas, Pierre

    2012-05-01

    Fibromyalgia (FM) is a complex disorder that affects 2 to 5% of the general population worldwide at any age and any sex, but more frequently in adult women. The variability of symptoms and the frequency of comorbidities among patients with fibromyalgia make this a difficult disorder to diagnose and treat. New diagnostic criteria are available to improve the diagnosis and care of patients. We propose the first French translation of the new diagnostic criteria proposed by the American College of Rheumatology (ACR) 2010. Although the etiology of fibromyalgia remains unclear, evidences suggest that biologic, genetic and environmental factors are involved. This chronic psychophysical suffering state of fibromyalgia adversely affects the patient's quality of life, performance and mood. Studies report a higher prevalence of psychiatric disorders in patients with fibromyalgia that requires careful history and evaluation for the presence of primary or secondary mood disturbances and psychological stress. Despite the absence of strong evidence of the fibromyalgia pathogenesis, evidence base medecine lead us to consider a biopsychosocial model and a multidisciplinary treatment. Treatment of fibromyalgia requires a comprehensive and multidimensional approach with patient education, cognitive behavior therapy, exercise, physical therapy and pharmacological therapy. Today, the serotonin noradrenaline reuptake inhibitors (milnacipran and duloxetine) and the antiepileptic (pregabalin) are the most effective drugs available for the treatment for fibromyalgia. Therapeutic and pathophysiologic researches seem necessary in this disease and should establish an exemplary model for integrative disease where somatic and psychic form a continuum. PMID:21993145

  18. Duloxetine for the treatment of fibromyalgia.

    PubMed

    Acuna, Carmen

    2008-10-01

    The underlying cause of fibromyalgia is not known, although dysfunction of serotoninergic and noradrenergic neurotransmitters appears to play an important role in the condition. Duloxetine is a newer and better tolerated dual antidepressant that does not induce muscarinic, histaminergic or adrenergic adverse reactions, and at the same time modulates and enhances the endogenous descending system that inhibits nociception. Duloxetine reduces pain symptoms in depression and other diseases and conditions, including fibromyalgia. Over 90% of the observed effect on pain is due to a direct analgesic effect rather than an indirect antidepressant effect. In clinical trials, pain reduction with duloxetine was not associated with its antidepressant and anxiolytic effects in patients with fybromialgia. A meta-analysis of four randomized, double-blind, placebo-controlled studies of duloxetine in the treatment of fibromyalgia showed it to be significantly superior to placebo in providing pain relief, reducing fatigue and improving physical and mental performance. The results of safety studies indicate that duloxetine is safe and well tolerated. Adverse effects tend to be mild, appearing more often at the start of therapy and decreasing or disappearing over the course of continued treatment. PMID:19137126

  19. Halo naevi, vitiligo and diffuse alopecia areata associated with tocilizumab therapy

    PubMed Central

    Nadesalingam, Kavitha; Goodfield, Mark; Emery, Paul

    2016-01-01

    We present a follow-up case report of a 33-year-old lady with juvenile onset arthritis who developed halo naevi while on treatment with tocilizumab. This case report describes the development of halo naevi, vitiligo and diffuse alopecia areata associated with tocilizumab therapy following infection with Methicillin-resistant Staphylococcus aureus (MRSA) and Panton–Valentine leukocidin positivity. This is the first case that describes these events and supports previous theories on cellular and humoral immunity as causative factors. The regression of melanocytes during treatment with tocilizumab could also implicate IL-6 and sIL-6R as future targets in the treatment of melanoma through its direct effect of melanocytic cytotoxicity, which supports previous studies. PMID:27516894

  20. Arthritis of the Wrist

    MedlinePlus

    ... is caused by just two types: osteoarthritis and rheumatoid arthritis. Osteoarthritis Osteoarthritis (OA) is a progressive condition that ... other, it results in pain, stiffness, and weakness. Rheumatoid Arthritis Rheumatoid arthritis (RA) is a chronic disease that ...

  1. What Is Rheumatoid Arthritis?

    MedlinePlus

    ... Information Arthritis Find a Clinical Trial Journal Articles Rheumatoid Arthritis PDF Version Size: 57 KB Audio Version Time: ... Size: 9.7 MB November 2014 What Is Rheumatoid Arthritis? Fast Facts: An Easy-to-Read Series of ...

  2. Forms of Arthritis

    MedlinePlus

    ... stiffness, inflammation, swelling and, sometimes, destruction of joints. Gout — a form of arthritis that occurs when uric ... the joints. Some 2.1 million Americans have gout. Lupus — a form of arthritis, like rheumatoid arthritis, ...

  3. A symptom-based approach to pharmacologic management of fibromyalgia.

    PubMed

    Boomershine, Chad S; Crofford, Leslie J

    2009-04-01

    Fibromyalgia is a prevalent disorder that is characterized by widespread pain along with numerous other symptoms, including fatigue, poor sleep, mood disorders, and stiffness. Previous guidelines for the management of fibromyalgia recommended an approach that integrates pharmacologic and nonpharmacologic therapies selected according to the symptoms experienced by individual patients. However, they offered no recommendations for a system of patient assessment that would provide a basis for individualized treatment selection. We present a simple, rapid and easily remembered system for symptom quantitation and pharmacologic management of fibromyalgia that combines visual analogue scale symptom scores from a modified form of the disease-neutral Fibromyalgia Impact Questionnaire, with a review of medications that can be used to treat the individual symptoms. This symptom-based approach is amenable to caring for patients with fibromyalgia in a busy clinical practice. PMID:19337283

  4. Color dilution alopecia in a blue Doberman pinscher crossbreed.

    PubMed

    Perego, Roberta; Proverbio, Daniela; Roccabianca, Paola; Spada, Eva

    2009-05-01

    A 6-year-old male, blue Doberman pinscher crossbreed was presented with coat abnormalities; in particular, flank alopecia and pruritus. Based on medical the history, clinical evidence, and histopathological examination, color dilution alopecia was diagnosed. The dog was with oral melatonin treated for 3 months without success. PMID:19436637

  5. Color dilution alopecia in a blue Doberman pinscher crossbreed

    PubMed Central

    Perego, Roberta; Proverbio, Daniela; Roccabianca, Paola; Spada, Eva

    2009-01-01

    A 6-year-old male, blue Doberman pinscher crossbreed was presented with coat abnormalities; in particular, flank alopecia and pruritus. Based on medical the history, clinical evidence, and histopathological examination, color dilution alopecia was diagnosed. The dog was with oral melatonin treated for 3 months without success. PMID:19436637

  6. Cicatricial alopecia as a manifestation of different dermatoses.

    PubMed

    Oremović, Lenka; Lugović, Liborija; Vucić, Majda; Buljan, Marija; Ozanić-Bulić, Suzana

    2006-01-01

    There are numerous dermatoses which may cause cicatricial alopecia when localized on the scalp, such as chronic discoid lupus erythematosus (DLE), lichen planus, graft-versus-host disease, dermatomyositis, scleroderma, cicatricial pemphigoid, porphyria cutanea tarda, follicular mucinosis, perifolliculitis capitis abscedens, lichen sclerosus et atrophicus, necrobiosis lipoidica, sarcoidosis, etc. Histologically, cicatricial alopecia is characterized by dermal scarring, along with absent or reduced hair follicles and reduced number of erector pili muscles. According to working classification of cicatricial alopecia by the North American Hair Society, primary cicatricial alopecia may be divided into the following categories: lymphocytic group (e.g., DLE, lichen planopilaris, classic pseudopelade (Brocq), central centrifugal cicatricial alopecia); neutrophilic group (e.g., folliculitis decalvans, dissecting cellulitis); and mixed group (e.g., folliculitis keloidalis). Over a 5-year period, 36 patients with cicatricial alopecia were hospitalized at our Department: DLE (n = 27), pseudopelade Brocq (n = 3), mucinosis follicularis (n = 2), and lichen planopilaris, folliculitis decalvans, folliculitis abscedens and folliculitis keloidalis (one patient each). Clinical evaluation was compared with histopathologic analysis of follicular architecture, as well as with the type, localization and extent of inflammatory infiltrate. Scalp biopsy was considered mandatory in all cases. Our experience indicates the need of more complex research to extend the knowledge about the etiopathogenesis and treatment options for cicatricial alopecia. We hope that this type of alopecia may attract more attention and research in the future. PMID:17311739

  7. Emotional modulation of pain and spinal nociception in fibromyalgia.

    PubMed

    Rhudy, Jamie L; DelVentura, Jennifer L; Terry, Ellen L; Bartley, Emily J; Olech, Ewa; Palit, Shreela; Kerr, Kara L

    2013-07-01

    Fibromyalgia (FM) is characterized by widespread pain, as well as affective disturbance (eg, depression). Given that emotional processes are known to modulate pain, a disruption of emotion and emotional modulation of pain and nociception may contribute to FM. The present study used a well-validated affective picture-viewing paradigm to study emotional processing and emotional modulation of pain and spinal nociception. Participants were 18 individuals with FM, 18 individuals with rheumatoid arthritis (RA), and 19 healthy pain-free controls (HC). Mutilation, neutral, and erotic pictures were presented in 4 blocks; 2 blocks assessed only physiological-emotional reactions (ie, pleasure/arousal ratings, corrugator electromyography, startle modulation, skin conductance) in the absence of pain, and 2 blocks assessed emotional reactivity and emotional modulation of pain and the nociceptive flexion reflex (NFR, a physiological measure of spinal nociception) evoked by suprathreshold electric stimulations over the sural nerve. In general, mutilation pictures elicited displeasure, corrugator activity, subjective arousal, and sympathetic activation, whereas erotic pictures elicited pleasure, subjective arousal, and sympathetic activation. However, FM was associated with deficits in appetitive activation (eg, reduced pleasure/arousal to erotica). Moreover, emotional modulation of pain was observed in HC and RA, but not FM, even though all 3 groups evidenced modulation of NFR. Additionally, NFR thresholds were not lower in the FM group, indicating a lack of spinal sensitization. Together, these results suggest that FM is associated with a disruption of supraspinal processes associated with positive affect and emotional modulation of pain, but not brain-to-spinal cord circuitry that modulates spinal nociceptive processes. PMID:23622762

  8. Emotional modulation of pain and spinal nociception in fibromyalgia

    PubMed Central

    Rhudy, Jamie L.; DelVentura, Jennifer L.; Terry, Ellen L.; Bartley, Emily J.; Olech, Ewa; Palit, Shreela; Kerr, Kara L.

    2013-01-01

    Fibromyalgia (FM) is characterized by widespread pain, as well as affective disturbance (e.g., depression). Given that emotional processes are known to modulate pain, a disruption of emotion and emotional modulation of pain and nociception may contribute to FM. The present study used a well-validated affective picture-viewing paradigm to study emotional processing and emotional modulation of pain and spinal nociception. Participants were 18 individuals with FM, 18 individuals with rheumatoid arthritis (RA), and 19 healthy pain-free controls (HC). Mutilation, neutral, and erotic pictures were presented in four blocks; two blocks assessed only physiological-emotional reactions (i.e., pleasure/arousal ratings, corrugator EMG, startle modulation, skin conductance) in the absence of pain and two blocks assessed emotional reactivity and emotional modulation of pain and the nociceptive flexion reflex (NFR, a physiological measure of spinal nociception) evoked by suprathreshold electric stimulations over the sural nerve. In general, mutilation pictures elicited displeasure, corrugator activity, subjective arousal, and sympathetic activation, whereas erotic pictures elicited pleasure, subjective arousal, and sympathetic activation. However, FM was associated with deficits in appetitive activation (e.g., reduced pleasure/arousal to erotica). Moreover, emotional modulation of pain was observed in HC and RA, but not FM, even though all three groups evidenced modulation of NFR. Additionally, NFR thresholds were not lower in the FM group, indicating a lack of spinal sensitization. Together, these results suggest that FM is associated with a disruption of supraspinal processes associated with positive affect and emotional modulation of pain, but not brain-to-spinal cord circuitry that modulates spinal nociceptive processes. PMID:23622762

  9. Music as a sleep aid in fibromyalgia

    PubMed Central

    Picard, Larry M; Bartel, Lee R; Gordon, Allan S; Cepo, Davor; Wu, Qi; Pink, Leah R

    2014-01-01

    BACKGROUND: Interventions to improve sleep in fibromyalgia may generalize to improvements in multiple symptom domains. Delta-embedded music, pulsating regularly within the 0.25 Hz to 4 Hz frequency band of brain wave activity, has the potential to induce sleep. OBJECTIVES: To assess the effects of a delta-embedded music program over four weeks for sleep induction in patients with fibromyalgia. METHODS: The present unblinded, investigator-led pilot study used a within-subject design. Analysis was based on 20 individuals with fibromyalgia who completed the study, of the 24 recruited into the study. The primary outcome variables were the change from baseline in Fibromyalgia Impact Questionnaire (FIQ) and Jenkins Sleep Scale scores. A patient global impression of change was measured on a seven-point Likert scale. Secondary outcome measures, comprised of items 5, 6 and 7 of the FIQ, were used as indicators of pain, tiredness and being tired on awakening. RESULTS: The FIQ median score of 76.4 (95% CI 61.3 to 82.1) at baseline improved to 60.3 (95% CI 53.1 to 72.0; P=0.004). The Jenkins Sleep Scale median value of 17.5 (95% CI 15.5 to 18.5) at baseline fell to 12.5 (95% CI 8.5 to 14.5; P=0.001) at study completion. The outcomes of the patient global impression of change ratings were mostly positive (P=0.001). Being tired on awakening declined significantly from a median of 9.0 (95% CI 8.0 to 10.0) to 8.0 (95% CI 5.5 to 9.0; P=0.021). However, there was no significant improvement in pain level (baseline median 7.5 [95% CI 7.0 to 8.5] versus study completion median 7.0 [95% CI 6.5 to 8.0]; P=0.335) or tiredness (baseline median 9.0 [95% CI 8.0 to 9.5] versus study completion median 8.0 [95% CI 6.0 to 8.5]; P=0.061). There were no serious adverse events. CONCLUSIONS: Delta-embedded music is a potential alternative therapy for fibromyalgia. PMID:24555178

  10. Reactive Arthritis Diagnosis

    MedlinePlus

    ... Of Spondylitis The Heart In Spondyloarthritis Inflammatory vs. Mechanical Back ... Arthritis Symptoms Because there is no specific laboratory test for reactive arthritis, doctors sometimes find it difficult ...

  11. Etiology of cicatricial alopecias: a basic science point of view.

    PubMed

    McElwee, Kevin J

    2008-01-01

    This article presents a short summary of our current knowledge of cicatricial alopecia disease pathogenesis and the hypothetical disease mechanisms that may be involved in scarring alopecia development. Several forms of scarring alopecia likely involve targeted cytotoxic action against hair follicle cells mediated by a folliculocentric inflammation. However, the specific nature of the inflammatory interference in hair follicle growth is open to question. A popular hypothesis of lymphocyte-mediated scarring alopecia development involves autoimmune targeting of hair follicle-specific self-antigens, although there is no direct evidence in support of such a view. Alternative hypotheses focus on defects in sebaceous gland function, destruction of hair follicle stem cells, and interference in the communication between hair follicle mesenchyme and epithelium. Many questions arise from these hypotheses, and addressing them with a systematic research approach may enable significant advances in understanding cicatricial alopecia etiology. PMID:18715290

  12. Alopecia areata and narcolepsy: a tale of obscure autoimmunity.

    PubMed

    Nigam, Gaurav; Pathak, Charu; Riaz, Muhammad

    2016-01-01

    Alopecia areata is an autoimmune dermatological disorder characterised by loss of hair in one or more discrete patches over the scalp. It has been linked to multiple disorders having an autoimmune origin. Like many autoimmune disorders it tends to be more common in females. To date, only five cases have been reported where alopecia has been associated with narcolepsy. Male gender is less commonly affected by alopecia areata. No case of alopecia areata in males has been associated with narcolepsy to the best of our knowledge. The current case represents the first ever-reported case of alopecia areata in a male patient with narcolepsy type 1. This coexistence is most likely the manifestation of a common underlying pathoimmunological mechanism that has not been completely understood, rather than a random association. PMID:27060069

  13. Midfoot arthritis.

    PubMed

    Patel, Amar; Rao, Smita; Nawoczenski, Deborah; Flemister, Adolf S; DiGiovanni, Benedict; Baumhauer, Judith F

    2010-07-01

    Midfoot arthritis is a common cause of significant pain and disability. Although the medial tarsometatarsal (TMT) joints provide < 7 degrees of sagittal plane motion, the more mobile lateral fourth and fifth TMT joints provide balance and accommodation on uneven ground. These small constrained TMT joints also provide stability and translate the forward propulsion motion of the hindfoot and ankle joint to the forefoot metatarsophalangeal joints from heel rise to toe-off. Posttraumatic degeneration is the primary cause of midfoot arthritis, although primary degeneration and inflammatory conditions can also affect this area. The result is a painful midfoot that can no longer effectively transmit load from the hindfoot to the forefoot. Shoe modifications and orthotic inserts are the mainstay of nonsurgical management. Successful management of midfoot arthritis with orthoses is predicated on achieving adequate joint stabilization while still allowing function. Surgical intervention typically involves arthrodesis of the medial midfoot, although the best treatment of the more mobile lateral column is a subject of debate. PMID:20595134

  14. UTILITY OF DERMOSCOPY IN ALOPECIA AREATA

    PubMed Central

    Mane, Mandar; Nath, Amiya Kumar; Thappa, Devinder Mohan

    2011-01-01

    Background: Alopecia areata (AA) shows several well-defined dermoscopic features which may help in confirming diagnosis in AA. Aims: We carried out a study to examine the dermoscopic features of AA and develop a protocol for diagnosis of AA by dermoscopy. Materials and Methods: Dermoscopy was performed in 66 patients with AA. Hanse HVS-500NP dermoscope (magnification of ×32 and ×140) was used. Results: The mean age of the patients (46 males and 20 females) was 26.85 years. The mean age of onset was 25.15 years. The mean duration of alopecia was 10.3 months. Most common AA in our study was patchy type (57/66, 87.7%). Single patch was seen in 24 patients and multiple patches in 33 patients. Diffuse AA was seen in five patients. Ophiasis and alopecia universalis were seen in two patients each. Nail changes were fine pitting (4), ridging (2), thinning of nail plate (2). Twenty nail dystrophy, distal onycholysis, striate leukonychia and coarse pitting were seen in one patient each. Intralesional triamcinolone acetonide was the most common therapy offered. Others were oral betamethasone minipulse therapy, dexamethasone pulse, minoxidil, anthralin and corticosteroids. The most common dermoscopic finding was yellow dots seen in 54 patients (81.8%), followed by black dots (44 patients, 66.6%), broken hairs (36 patients, 55.4%), short vellus hair (27 patients, 40.9%) and tapering hairs (8 patients, 12.1%). Conclusions: The most common dermoscopic finding of AA in our study was yellow dots, followed by black dots, broken hairs, short vellus hair and tapering hairs. Dermoscopic findings were not affected by the type of AA or the severity of the disease. PMID:21965849

  15. Characteristics of Androgenetic Alopecia in Asian

    PubMed Central

    Lee, Hae-Jin

    2012-01-01

    Androgenetic alopecia (AGA), or pattern hair loss, is a common disorder in Asian men and women, with a reported incidence of up to 73% among general population. There are several descriptions regarding the characteristics of AGA in patients of European descent. Asian patients with AGA have different types of hair loss and family histories from Europeans, which may affect treatment response. Therefore, in this review, prevalence, hair loss patterns, familial factors, androgen receptor gene polymorphisms of Asian AGA patients, and management based on algorithmic guidelines for AGA are discussed. This review may be useful for dermatologists in clinical practice for diagnosing and designing management approaches for Asian patients with AGA. PMID:22879706

  16. Alopecia areata: a new treatment plan

    PubMed Central

    Alsantali, Adel

    2011-01-01

    Many therapeutic modalities have been used to treat alopecia areata, with variable efficacy and safety profiles. Unfortunately, none of these agents is curative or preventive. Also, many of these therapeutic agents have not been subjected to randomized, controlled trials, and, except for topical immunotherapy, there are few published studies on long-term outcomes. The treatment plan is designed according to the patient’s age and extent of disease. In this paper, the therapeutic agents are organized according to their efficacy and safety profiles into first-line, second-line, and third-line options. PMID:21833161

  17. Review of overlap between thermoregulation and pain modulation in fibromyalgia

    PubMed Central

    Larson, Alice A.; Pardo, José V.; Pasley, Jeffrey D.

    2013-01-01

    Fibromyalgia syndrome is characterized by widespread pain that is exacerbated by cold and stress but relieved by warmth. We review the points along thermal and pain pathways where temperature may influence pain. We also present evidence addressing the possibility that brown adipose tissue activity is linked to the pain of fibromyalgia given that cold initiates thermogenesis in brown adipose tissue via adrenergic activity, while warmth suspends thermogenesis. Although females have a higher incidence of fibromyalgia as well as more resting thermogenesis, they are less able to recruit brown adipose tissue in response to chronic stress than males. In addition, conditions that are frequently comorbid with fibromyalgia compromise brown adipose activity making it less responsive to sympathetic stimulation. This results in lower body temperatures, lower metabolic rates, and lower circulating cortisol/corticosterone in response to stress - characteristics of fibromyalgia. In the periphery, sympathetic nerves to brown adipose also project to surrounding tissues, including tender points characterizing fibromyalgia. As a result, the musculoskeletal hyperalgesia associated with conditions like fibromyalgia may result from referred pain in the adjacent muscle and skin. PMID:23887348

  18. Medical and surgical therapies for alopecias in black women.

    PubMed

    Callender, Valerie D; McMichael, Amy J; Cohen, George F

    2004-01-01

    Hair loss is a common problem that challenges the patient and clinician with a host of cosmetic, psychological and medical issues. Alopecia occurs in both men and women, and in all racial and ethnic populations, but the etiology varies considerably from group to group. In black women, many forms of alopecia are associated with hair-care practices (e.g., traction alopecia, trichorrhexis nodosa, and central centrifugal cicatricial alopecia). The use of thermal or chemical hair straightening, and hair braiding or weaving are examples of styling techniques that place African American women at high risk for various "traumatic" alopecias. Although the exact cause of these alopecias is unknown, a multifactorial etiology including both genetic and environmental factors is suspected. A careful history and physical examination, together with an acute sensitivity to the patient's perceptions (e.g., self-esteem and social problems), are critical in determining the best therapy course. Therapeutic options for these patients range from alteration of current hair grooming practices or products, to use of specific medical treatments, to hair replacement surgery. Since early intervention is often a key to preventing irreversible alopecia, the purpose of the present article is to educate the dermatologist on all aspects of therapy for hair loss in black women--including not only a discussion of the main medical and surgical therapies but also an overview of ethnic hair cosmetics, specific suggestions for alterations of hair-care practices, and recommendations for patient education and compliance. PMID:15113284

  19. Central centrifugal cicatricial alopecia: challenges and solutions.

    PubMed

    Herskovitz, Ingrid; Miteva, Mariya

    2016-01-01

    Central centrifugal cicatricial alopecia (CCCA) is the most common scarring alopecia among African American women. Data about epidemiology, etiology, genetic inheritance, and management are scarce and come from individual reports or small series. CCCA has been associated with hot combing and traumatic hair styling for years; however, studies fail to confirm it as the sole etiologic factor. It has been shown in a small series that CCCA can be inherited in an autosomal dominant fashion, with a partial penetrance and a strong modifying effect of hairstyling and sex. CCCA presents clinically as a central area of progressive irreversible hair loss that expands to the periphery. A patchy form has also been described. Dermoscopy is helpful to identify the optimal site for the biopsy, which establishes the diagnosis. Well-designed randomized controlled trials are needed to discover the optimal management. At this point, patients are advised to avoid traction and chemical treatments; topical and intralesional steroids, calcineurin inhibitors, and minoxidil can be helpful in halting the progression. PMID:27574457

  20. Central centrifugal cicatricial alopecia: challenges and solutions

    PubMed Central

    Herskovitz, Ingrid; Miteva, Mariya

    2016-01-01

    Central centrifugal cicatricial alopecia (CCCA) is the most common scarring alopecia among African American women. Data about epidemiology, etiology, genetic inheritance, and management are scarce and come from individual reports or small series. CCCA has been associated with hot combing and traumatic hair styling for years; however, studies fail to confirm it as the sole etiologic factor. It has been shown in a small series that CCCA can be inherited in an autosomal dominant fashion, with a partial penetrance and a strong modifying effect of hairstyling and sex. CCCA presents clinically as a central area of progressive irreversible hair loss that expands to the periphery. A patchy form has also been described. Dermoscopy is helpful to identify the optimal site for the biopsy, which establishes the diagnosis. Well-designed randomized controlled trials are needed to discover the optimal management. At this point, patients are advised to avoid traction and chemical treatments; topical and intralesional steroids, calcineurin inhibitors, and minoxidil can be helpful in halting the progression. PMID:27574457

  1. ILK Index and Regrowth in Alopecia Areata.

    PubMed

    Stallings, Alicia M; Velez, Mara Weinstein; Fiessinger, Lori A; Piliang, Melissa P; Mesinkovska, Natasha A; Kyei, Angela; Bergfeld, Wilma F

    2015-11-01

    There is insufficient data in the literature concerning optimal intralesional kenalog (ILK) dosing for the treatment of alopecia areata (AA). The purpose of this pilot study was to evaluate the utility of using the ratio of ILK received to initial Severity of Alopecia Tool (SALT) score to guide ILK dosing in patients with AA. Using photographic data from patients at baseline and 4-months follow-up, hair loss in 15 patients treated with AA was retrospectively graded using the SALT scores. The ILK received/initial SALT score (ILK index) was calculated for each patient, and the mean ILK index for patients who experienced significant (≥50%) and suboptimal (<50%) hair regrowth at 4 months follow-up were compared. Patients who experienced suboptimal hair regrowth had a lower ILK index on average than patients who experienced significant improvement. Although the difference did not meet significance (<0.1), the trend suggests that the ILK index, a novel calculation, may be a useful tool for guiding ILK dosing in the treatment of AA. PMID:26551947

  2. Extensive Alopecia Areata: Not Necessarily Recalcitrant to Therapy!

    PubMed Central

    Deshpande, Deepal; Dhurat, Rachita; Saraogi, Punit; Mishra, Sunil; Nayak, Chitra

    2011-01-01

    Background: Extensive alopecia areata includes alopecia universalis, alopecia totalis, ophiasis and patients having more than 50% scalp involvement. Alopecia universalis (AU) and totalis (AT) are considered to be resistant to single modalities of treatment. Our study highlights the efficacy and safety of combination therapy in extensive alopecia areata. Aim: To evaluate the efficacy and safety of a combination treatment with oral bethametasone mini-pulse, topical minoxidil and short contact anthralin in long-standing, treatment-resistant, extensive alopecia areata. Materials and Methods: Fifteen patients aged 7 to 45 years with extensive, treatment-resistant alopecia areata (AU: 7; AT: 1; ophiasis: 4; patients with more than 50% scalp involvement: 3) were treated with betamethasone oral mini-pulse (0.1 mg per kg body weight per dose on two consecutive days per week) along with short contact anthralin (1.15%) and 2-5% minoxidil lotion daily, till response. The response was assessed by the severity of alopecia tool (SALT) score. Cosmetic response was defined as regrowth obviating the need of a wig. Failure of treatment was defined as no growth or vellus hair on the scalp. Results: Out of eight patients with AU/AT, two attained cosmetic response as early as three months, two at six months and one had partial response. Cosmetic response was attained in all four patients with ophiasis and all three patients with more than 50% scalp involvement at six months. All responders maintained their response without systemic steroids beyond 12 months. Among a total of twelve responders (80%), two with AU showed a mild relapse and were effectively treated with intralesional steroids. Side effects to therapy were mild and reversible. Conclusion: A combination therapy of oral steroid minipulse with topical anthralin and minoxidil acts synergistically, being effective as well as safe in treatment-resistant, extensive, long-standing alopecia areata. PMID:22223966

  3. A review of hormonal therapy for female pattern (androgenic) alopecia.

    PubMed

    Scheinfeld, Noah

    2008-01-01

    Female pattern hair loss (female androgenetic alopecia) is a common, but puzzling, condition in women. Approximately 10 percent of pre-menopausal women show evidence of androgenetic alopecia. Age increases the incidence and 50-75 percent of women 65 years or older suffer from this condition. Only 2 percent topical mindoxidil is approved for treating female androgenetic alopecia. Reviews suggest that anti-hormonal therapy (e.g. cyproterone acetate, spironolactone) is helpful in treating female pattern alopecia in some women who have normal hormone levels. The use of hormonal therapies is most extensively studied in post-menopausal women. Several studies have suggested that cyproterone acetate with or without ethinyl estradiol and spironolactone can ameliorate female androgenetic alopecia in women with normal hormone levels, but larger controlled studies need to be done. Flutamide was found to be more effective than spironolactone or cyproterone in one study. Testosterone conversion inhibitors have been tried in post-menopausual women with normal hormone levels to treat alopecia. No study has shown that 1 mg of finasteride effectively treats female androgenetic alopecia but doses of 2.5 and 5 mg finasteride have helped some women in a few open studies. One case report notes the utility of dutasteride after finasteride failed. The role and place of anti-androgentic agents in female androgenetic alopecia in both pre and post-menopausal women remains to be fully defined. The need for effective agents is highlighted by the paucity of effective treatments and the substantial psychosocial impact of alopecia on women. PMID:18627703

  4. Tramadol for the treatment of fibromyalgia.

    PubMed

    MacLean, Ashley J B; Schwartz, Thomas L

    2015-05-01

    Tramadol is a novel, synthetic opioid receptor agonist with serotonin-norepinephrine reuptake inhibitor properties that is often prescribed acutely for painful conditions. Fibromyalgia (FM) is a chronic painful condition that is difficult to treat and until more recently has had no approved medical treatments. Currently, the only US FDA-approved medications for FM include duloxetine, milnacipran and pregabalin. No opioid is approved for use in the treatment of FM. This paper specifically reviews the literature on tramadol use in FM and concludes that there is a fair evidence base to support its use as a second-line treatment for more resistant cases. PMID:25896486

  5. Social influences on the concept of fibromyalgia.

    PubMed

    Merskey, Harold

    2008-03-01

    Despite relevant evidence of physical illness promoting fibromyalgia syndrome (FMS), some authors claim that it is a psychological illness, or due to "psychological amplification." Good evidence for such views is lacking. Selection processes lead to increased rates of psychological illness in general practice and in specialist practice. The physical distress of FMS can increase both anxiety and depression. Questionable research supported by the insurance industry has tended to provide negative and disparaging views of pain. Current imaging studies support the view that central effects connected with FMS relate to the processing of noxious stimulation more than affective disorder. PMID:18323769

  6. [Female androgenetic alopecia, a survey of causes and therapeutic options].

    PubMed

    Duchková, Hana; Hašková, Marta

    2015-01-01

    Mesotherapy is one of the options for the treatment of androgenetic alopecia. Testing 24 women with androgenetic alopecia has demonstrated a positive effect of mesotherapy on the hair growth, hair thickness, with only insignificant increase of hair density. It is known that androgenetic alopecia represents a localized aging of hair follicles. We therefore decided to examine the different effects of mesotherapy on hair density in younger and in elderly women. In younger women mesotherapy significantly increased hair density compared with older women. For mesotherapy we used a combination of micronutrients and antioxidants. Mesotherapy achievements were evident for 6-12 months. Treatment requires a long-term care. PMID:25994911

  7. Lymphocytes, neuropeptides, and genes involved in alopecia areata

    PubMed Central

    Gilhar, Amos; Paus, Ralf; Kalish, Richard S.

    2007-01-01

    Many lessons in autoimmunity — particularly relating to the role of immune privilege and the interplay between genetics and neuroimmunology — can be learned from the study of alopecia areata, the most common cause of inflammation-induced hair loss. Alopecia areata is now understood to represent an organ-restricted, T cell–mediated autoimmune disease of hair follicles. Disease induction is associated with collapse of hair follicle immune privilege in both humans and in animal models. Here, the role of HLA associations, other immunogenetic factors, and neuroendocrine parameters in alopecia areata pathogenesis are reviewed. This instructive and clinically significant model disease deserves more widespread interest in the immunology community. PMID:17671634

  8. Clinical Characteristics and Prognostic Factors in Early-Onset Alopecia Totalis and Alopecia Universalis

    PubMed Central

    Cho, Hyun Hee; Jo, Seong Jin; Paik, Seung Hwan; Jeon, Hye Chan; Kim, Kyu Han; Eun, Hee Chul

    2012-01-01

    Alopecia totalis (AT) and alopecia universalis (AU), severe forms of alopecia areata (AA), show distinguishable clinical characteristics from those of patch AA. In this study, we investigated the clinical characteristics of AT/AU according to the onset age. Based on the onset age around adolescence (< or ≥ 13 yr), 108 patients were classified in an early-onset group and the other 179 patients in a late-onset group. We found that more patients in the early-onset group had a family history of AA, nail dystrophy, and history of atopic dermatitis than those in the late-onset group. These clinical differences were more prominent in patients with AU than in those with AT. In addition, significantly more patients with concomitant medical disorders, especially allergic diseases were found in the early-onset group (45.8%) than in the late-onset group (31.2%). All treatment modalities failed to show any association with the present hair condition of patients. In the early-onset group, patients with AU or a family history of AA showed worse prognosis, whereas this trend was not observed in the late-onset group. Systemic evaluations might be needed in early-onset patients due to the higher incidence of comorbid diseases. It is suggested that patients with AU or family history of AA make worse progress in the early-onset group than in the late-onset group. PMID:22787378

  9. Mind and Body Practices for Fibromyalgia: What the Science Says

    MedlinePlus

    ... Mind and Body Practices for Fibromyalgia: What the Science Says Share: June 2014 Clinical Guidelines, Scientific Literature, ... products and practices in the context of rigorous science, training complementary health researchers, and disseminating authoritative information ...

  10. Facing Fibromyalgia | NIH MedlinePlus the Magazine

    MedlinePlus

    ... with NIH MedlinePlus magazine about her conditions. When did you start having symptoms of fibromyalgia? I actually ... with my right wrist since the third grade. Did your problems become more severe over time? Yes, ...

  11. Anticonvulsant Drugs for Nerve Pain, Bipolar Disorder and Fibromyalgia

    MedlinePlus

    Anticonvulsant Drugs for Nerve Pain, Bipolar Disorder &Fibromyalgia: Choosing What’sRight for You What are anticonvulsant drugs? Anticonvulsants are drugs used to treat seizures. They are also used ...

  12. Living with Fibromyalgia, Drugs Approved to Manage Pain

    MedlinePlus

    ... with fibromyalgia may find relief of symptoms with pain relievers, sleep medicines, antidepressants, muscle relaxants, and anti-seizure medications. But medication is just one part of the treatment approach. What helped Matallana was a combination of ...

  13. Immunologic profile of patients with fibromyalgia.

    PubMed

    Smart, P A; Waylonis, G W; Hackshaw, K V

    1997-01-01

    Fibromyalgia is a musculoskeletal disorder characterized by generalized myalgias, arthralgias widespread tender points in discreet areas on examination. It is frequently accompanied by fatigue, stiffness, and a nonrestorative sleep pattern. These patients generally have a normal blood count and chemistry profile. There is a subset of people with fibromyalgia (FM) who test positive for the antinuclear antibody (ANA) and have constitutional symptoms that resemble those of patients with early lupus. We studied the immunologic profile of patients with FM who are ANA-positive (+). A retrospective review of patient records in a university-based rheumatology practice was conducted. In a group of 66 FM patients, 30% (20) were ANA+, with a 75% preponderance of the speckled pattern and 20% diffuse pattern. The remaining 5% were equally split between diffuse-speckled and speckled-nucleolar patterns. All had negative staining for extractable nuclear antibodies. The Smart Index (SI), a ratio of the sedimentation rate to one-half the patient's age, was developed to characterize each patient's inflammatory response. The FM patients who were ANA negative (-) had a mean SI of 0.55, whereas the FM patient's who were ANA+ had a SI of 1.07. These ANA+ patients represent a subgroup of patients who have FM with an inflammatory response profile larger than that of the ANA-patients. PMID:9207710

  14. Opioid Use in Fibromyalgia: A Cautionary Tale.

    PubMed

    Goldenberg, Don L; Clauw, Daniel J; Palmer, Roy E; Clair, Andrew G

    2016-05-01

    Multiple pharmacotherapies are available for the treatment of fibromyalgia (FM), including opioid analgesics. We postulate that the mechanism of action of traditional opioids predicts their lack of efficacy in FM. Literature searches of the MEDLINE and Cochrane Library databases were conducted using the search term opioid AND fibromyalgia to identify relevant articles, with no date limitations set. Citation lists in returned articles and personal archives of references were also examined for additional relevant items, and articles were selected based on the expert opinions of the authors. We found no evidence from clinical trials that opioids are effective for the treatment of FM. Observational studies have found that patients with FM receiving opioids have poorer outcomes than patients receiving nonopioids, and FM guidelines recommend against the use of opioid analgesics. Despite this, and despite the availability of alternative Food and Drug Administration-approved pharmacotherapies and the efficacy of nonpharmacologic therapies, opioids are commonly used in the treatment of FM. Factors associated with opioid use include female sex; geographic variation; psychological factors; a history of opioid use, misuse, or abuse; and patient or physician preference. The long-term use of opioid analgesics is of particular concern in the United States given the ongoing public health emergency relating to excess prescription opioid consumption. The continued use of opioids to treat FM despite a proven lack of efficacy, lack of support from treatment guidelines, and the availability of approved pharmacotherapy options provides a cautionary tale for their use in other chronic pain conditions. PMID:26975749

  15. VIEWPOINT – Vitiligo and alopecia areata: Apples and oranges?

    PubMed Central

    Harris, John E.

    2013-01-01

    Vitiligo and alopecia areata are common autoimmune diseases of the skin. Vitiligo is caused by the destruction of melanocytes and results in the appearance of white patches on any part of the body, while alopecia areata is characterized by patchy hair loss primarily on the scalp, but may also involve other areas as well. At first glance, the two diseases appear to be quite different, targeting different cell types and managed using different treatment approaches. However, the immune cell populations and cytokines that drive each disease are similar, they are closely associated within patients and their family members, and vitiligo and alopecia areata have common genetic risk factors, suggesting that they share a similar pathogenesis. Like apples and oranges, vitiligo and alopecia areata have some obvious differences, but similarities abound. Recognizing both similarities and differences will promote research into the pathogenesis of each disease, as well as the development of new treatments. PMID:24131336

  16. Transient Efficacy of Tofacitinib in Alopecia Areata Universalis

    PubMed Central

    Anzengruber, Florian; Maul, Julia-Tatjana; Kamarachev, Jivko; Trüeb, Ralph M.; French, Lars E.; Navarini, Alexander A.

    2016-01-01

    Alopecia areata is a common autoimmune disorder that targets hair follicles. Swarms of lymphocytes surround the basis of the follicles, inducing loss of pigmented terminal hair and subsequently inhibit further hair growth. Depending on the extent of involvement, alopecia areata can be associated with a dramatic reduction of quality of life. Currently, no targeted treatment option is available, and topical immune therapies or immunosuppressive drugs are typically used with mixed success. Recently, several cases of alopecia areata responding to Janus kinase inhibitors were published. Here, we report on a businessman with alopecia areata universalis who was treated with tofacitinib. We observed initial signs of hair regrowth in the same timeframe as previously reported, but efficacy quickly waned again, leading to renewed effluvium. Thus, even though tofacitinib and ruxolitinib are a promising new treatment option, we have yet to learn more about their potential role in each particular patient's individual treatment strategy. PMID:27194979

  17. Transient Efficacy of Tofacitinib in Alopecia Areata Universalis.

    PubMed

    Anzengruber, Florian; Maul, Julia-Tatjana; Kamarachev, Jivko; Trüeb, Ralph M; French, Lars E; Navarini, Alexander A

    2016-01-01

    Alopecia areata is a common autoimmune disorder that targets hair follicles. Swarms of lymphocytes surround the basis of the follicles, inducing loss of pigmented terminal hair and subsequently inhibit further hair growth. Depending on the extent of involvement, alopecia areata can be associated with a dramatic reduction of quality of life. Currently, no targeted treatment option is available, and topical immune therapies or immunosuppressive drugs are typically used with mixed success. Recently, several cases of alopecia areata responding to Janus kinase inhibitors were published. Here, we report on a businessman with alopecia areata universalis who was treated with tofacitinib. We observed initial signs of hair regrowth in the same timeframe as previously reported, but efficacy quickly waned again, leading to renewed effluvium. Thus, even though tofacitinib and ruxolitinib are a promising new treatment option, we have yet to learn more about their potential role in each particular patient's individual treatment strategy. PMID:27194979

  18. Frontal Fibrosing Alopecia in a Male Presenting with Sideburn Loss.

    PubMed

    AlGaadi, Salim; Miteva, Mariya; Tosti, Antonella

    2015-01-01

    Frontal fibrosing alopecia (FFA) is a cicatricial alopecia that affects mainly postmenopausal women. It is typically characterized by recession of frontotemporal hairline. Hair loss of eyebrows, eyelashes, axillae, limbs, and pubic area may be observed. Here, we describe a case of FFA in a male patient presenting with only localized loss of sideburns. Skin biopsy findings were consistent with lichen planopilaris. To our knowledge, this is the only reported case of FFA patient with only localized loss of sideburns. PMID:26180452

  19. Frontal Fibrosing Alopecia in a Male Presenting with Sideburn Loss

    PubMed Central

    AlGaadi, Salim; Miteva, Mariya; Tosti, Antonella

    2015-01-01

    Frontal fibrosing alopecia (FFA) is a cicatricial alopecia that affects mainly postmenopausal women. It is typically characterized by recession of frontotemporal hairline. Hair loss of eyebrows, eyelashes, axillae, limbs, and pubic area may be observed. Here, we describe a case of FFA in a male patient presenting with only localized loss of sideburns. Skin biopsy findings were consistent with lichen planopilaris. To our knowledge, this is the only reported case of FFA patient with only localized loss of sideburns. PMID:26180452

  20. Menstrual arthritis.

    PubMed Central

    McDonagh, J E; Singh, M M; Griffiths, I D

    1993-01-01

    The menstrual cycle is characterised by variations in the absolute and relative concentrations of the hormones of the hypothalamic pituitary ovarian axis, which in turn affect cell function and cytokine and heat shock protein production. Menstruation involves the shedding of the secretory endometrium, which is part of the mucosal associated lymphoid tissue and hence is rich in immunologically competent cells such as CD8 T cells and macrophages. The case is reported here of a patient presenting with a recurrent but transient symmetrical inflammatory polyarthritis which only occurred at menstruation with no residual damage. The disease was suppressed by danazol. Endometrial degradation products are suggested as the trigger of this 'menstrual arthritis'. PMID:8427519

  1. Beyond pain in fibromyalgia: insights into the symptom of fatigue

    PubMed Central

    2013-01-01

    Fatigue is a disabling, multifaceted symptom that is highly prevalent and stubbornly persistent. Although fatigue is a frequent complaint among patients with fibromyalgia, it has not received the same attention as pain. Reasons for this include lack of standardized nomenclature to communicate about fatigue, lack of evidence-based guidelines for fatigue assessment, and a deficiency in effective treatment strategies. Fatigue does not occur in isolation; rather, it is present concurrently in varying severity with other fibromyalgia symptoms such as chronic widespread pain, unrefreshing sleep, anxiety, depression, cognitive difficulties, and so on. Survey-based and preliminary mechanistic studies indicate that multiple symptoms feed into fatigue and it may be associated with a variety of physiological mechanisms. Therefore, fatigue assessment in clinical and research settings must consider this multi-dimensionality. While no clinical trial to date has specifically targeted fatigue, randomized controlled trials, systematic reviews, and meta-analyses indicate that treatment modalities studied in the context of other fibromyalgia symptoms could also improve fatigue. The Outcome Measures in Rheumatology (OMERACT) Fibromyalgia Working Group and the Patient Reported Outcomes Measurement Information System (PROMIS) have been instrumental in propelling the study of fatigue in fibromyalgia to the forefront. The ongoing efforts by PROMIS to develop a brief fibromyalgia-specific fatigue measure for use in clinical and research settings will help define fatigue, allow for better assessment, and advance our understanding of fatigue. PMID:24289848

  2. Fibromyalgia patients have reduced hippocampal volume compared with healthy controls

    PubMed Central

    McCrae, Christina S; O’Shea, Andrew M; Boissoneault, Jeff; Vatthauer, Karlyn E; Robinson, Michael E; Staud, Roland; Perlstein, William M; Craggs, Jason G

    2015-01-01

    Objective Fibromyalgia patients frequently report cognitive abnormalities. As the hippocampus plays an important role in learning and memory, we determined whether individuals with fibromyalgia had smaller hippocampal volume compared with healthy control participants. Methods T1-weighted structural magnetic resonance imaging (MRI) scans were acquired from 40 female participants with fibromyalgia and 22 female healthy controls. The volume of the hippocampus was estimated using the software FreeSurfer. An analysis of covariance model controlling for potentially confounding factors of age, whole brain size, MRI signal quality, and Beck Depression Inventory scores were used to determine significant group differences. Results Fibromyalgia participants had significantly smaller hippocampi in both left (F[1,56]=4.55, P=0.037, η2p=0.08) and right hemispheres (F[1,56]=5.89, P=0.019, η2p=0.10). No significant effect of depression was observed in either left or right hemisphere hippocampal volume (P=0.813 and P=0.811, respectively). Discussion Potential mechanisms for reduced hippocampal volume in fibromyalgia include abnormal glutamate excitatory neurotransmission and glucocorticoid dysfunction; these factors can lead to neuronal atrophy, through excitotoxicity, and disrupt neurogenesis in the hippocampus. Hippocampal atrophy may play a role in memory and cognitive complaints among fibromyalgia patients. PMID:25674013

  3. Cognitive dysfunction in fibromyalgia: slow access to the mental lexicon.

    PubMed

    Leavitt, Frank; Katz, Robert S

    2014-12-01

    Lexical access speed, the time needed for the brain to access the catalogue of words in long-term memory, is assumed to provide a foundation for a broad array of cognitive operations. It was hypothesized that deficits in lexical speed are likely to play a central role in deficiencies in cognitive performance of patients with fibromyalgia, who as a group show deficits in lexical speed. This was tested in a sample of 209 patients with fibromyalgia and in 72 control patients with memory deficits. Participants completed the Stroop word-naming measure of lexical access speed and 12 neurocognitive measures. Deficit in lexical access speed occurred at approximately twice the frequency (48.3% vs 25.0%) in fibromyalgia. The average delay in speed of lexical access was 171 msec. in fibromyalgia and 163 msec. in controls. Those with deficits in lexical access speed displayed deficiencies on 10 of 12 cognitive measures in the fibromyalgia group, and on 8 of 12 cognitive measures in the control group. The premise that lexical access speed is disproportionately present in fibromyalgia and serves as a foundation for a wide array of cognitive operations is supported. PMID:25539171

  4. Androgenic alopecia in women: an Indian perspective.

    PubMed

    Sehgal, Virendra N; Srivastava, Govind; Aggarwal, Ashok K; Midha, Reshmi

    2013-01-01

    The authors sought to investigate androgenic alopecia (AA) utilizing clinical and investigative procedures to establish the pattern of AA in the Indian subcontinent. A total of 35 consecutive women presenting with AA were included. After obtaining informed consent, a detailed history/examination, hair pull test, trichogram, and a scalp biopsy were performed in patients. AA classification was attempted across Ludwig and Norwood guidelines. Of 35 women, 16 had grade I, 10 had grade II, and 1 had grade III Ludwig classification. In addition, 6 other women had Christmas tree baldness: 1 each of fronto-parietal and male pattern baldness. Several investigations including hormonal profile were inconclusive; however, hair pull test and trichogram may be helpful in understanding the sequence in AA in women. AA has infrequently been reported, particularly India and in Asia in general. PMID:24517037

  5. [Treatment of androgenic alopecia with topical minoxidil].

    PubMed

    Brenner, S; Tamir, A

    1991-11-01

    Minoxidil, a vasodilator, was first marketed in 1979 as an oral antihypertensive. Since hypertrichosis occurred as an adverse effect in most patients treated, a 2% topical solution was developed for use in men with androgenic alopecia. It was approved by the American Food and Drug Administration and by the Israel Ministry of Health. A follow-up of 30 cases treated with the preparation is presented. Efficacy of treatment was assessed by hair counts in a marked area on the balding scalp, as well as by subjective evaluations of patients and physicians. The treatment was beneficial in 63%: balding was slowed in most, while in a minority hair density actually increased. However, in only 6.6% was dramatic cosmetic improvement achieved. PMID:1800277

  6. Sarcoidosis presenting as non-scarring non-scalp alopecia.

    PubMed

    Dan, Luke; Relic, John

    2016-08-01

    In this article we describe a 39-year-old man who presented with non-scarring non-scalp alopecia of his limbs as the initial presentation of sarcoidosis. Alopecia is a rare cutaneous manifestation of sarcoidosis. A literature review has found only one other example of sarcoidosis presenting as non-scarring non-scalp alopecia in an area other than the scalp in a patient who was otherwise asymptomatic. Several reported cases have described scarring alopecia of the scalp, which is the area of skin most commonly affected by sarcoidosis. There has been one documented case of sarcoidosis manifesting as total body non-scarring alopecia in a patient who had systemic symptoms of sarcoidosis. Other cases have presented rare cutaneous manifestations of sarcoidosis but in all these cases several other organ systems have been involved, and the patient has had systemic symptoms on presentation or the cutaneous presentation did not include non-scalp non-scarring alopecia. PMID:25823524

  7. Alopecia: Possible Causes and Treatments, Particularly in Captive Nonhuman Primates

    PubMed Central

    Novak, Melinda A; Meyer, Jerrold S

    2009-01-01

    Alopecia (hair loss) occurs in some nonhuman primates housed in captivity and is of concern to colony managers and veterinarians. Here we review the characteristics, potential causes, and treatments for this condition. Although we focus on nonhuman primates, relevant research on other mammalian species is discussed also, due to the relative paucity of studies on alopecia in the primate literature. We first discuss the cycle of hair growth and explain how this cycle can be disrupted to produce alopecia. Numerous factors may be related to hair loss and range from naturally occurring processes (for example, seasonality, aging) to various biologic dysfunctions, including vitamin and mineral imbalances, endocrine disorders, immunologic diseases, and genetic mutations. We also address bacterial and fungal infections, infestation by parasites, and atopic dermatitis as possible causes of alopecia. Finally, we examine the role of psychogenic factors, such as stress. Depending on the presumed cause of the hair loss, various treatment strategies can be pursued. Alopecia in nonhuman primates is a multifaceted disorder with many potential sources. For this reason, appropriate testing for various disease conditions should be completed before alopecia is considered to be related to stress. PMID:19295051

  8. Selective serotonin reuptake inhibitors for fibromyalgia syndrome

    PubMed Central

    Walitt, Brian; Urrútia, Gerard; Nishishinya, María Betina; Cantrell, Sarah E; Häuser, Winfried

    2016-01-01

    Background Fibromyalgia is a clinically well-defined chronic condition with a biopsychosocial aetiology. Fibromyalgia is characterized by chronic widespread musculoskeletal pain, sleep problems, cognitive dysfunction, and fatigue. Patients often report high disability levels and poor quality of life. Since there is no specific treatment that alters the pathogenesis of fibromyalgia, drug therapy focuses on pain reduction and improvement of other aversive symptoms. Objectives The objective was to assess the benefits and harms of selective serotonin reuptake inhibitors (SSRIs) in the treatment of fibromyalgia. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2014, Issue 5), MEDLINE (1966 to June 2014), EMBASE (1946 to June 2014), and the reference lists of reviewed articles. Selection criteria We selected all randomized, double-blind trials of SSRIs used for the treatment of fibromyalgia symptoms in adult participants. We considered the following SSRIs in this review: citalopram, fluoxetine, escitalopram, fluvoxamine, paroxetine, and sertraline. Data collection and analysis Three authors extracted the data of all included studies and assessed the risks of bias of the studies. We resolved discrepancies by discussion. Main results The quality of evidence was very low for each outcome. We downgraded the quality of evidence to very low due to concerns about risk of bias and studies with few participants. We included seven placebo-controlled studies, two with citalopram, three with fluoxetine and two with paroxetine, with a median study duration of eight weeks (4 to 16 weeks) and 383 participants, who were pooled together. All studies had one or more sources of potential major bias. There was a small (10%) difference in patients who reported a 30% pain reduction between SSRIs (56/172 (32.6%)) and placebo (39/171 (22.8%)) risk difference (RD) 0.10, 95% confidence interval (CI) 0.01 to 0.20; number needed to treat for an additional

  9. Juvenile idiopathic arthritis

    MedlinePlus

    Juvenile rheumatoid arthritis (JRA); Juvenile chronic polyarthritis; Still disease; Juvenile spondyloarthritis ... The cause of juvenile idiopathic arthritis (JIA) is not known. It ... illness . This means the body attacks and destroys healthy body ...

  10. Forms of Arthritis

    MedlinePlus

    ... this page please turn Javascript on. Forms of Arthritis Past Issues / Fall 2006 Table of Contents Today, ... of Linda Saisselin Osteoarthritis (OA) — the form of arthritis typically occurring during middle or old age, this ...

  11. Rheumatoid arthritis (image)

    MedlinePlus

    Rheumatoid arthritis is an autoimmune disease in which the body's immune system attacks itself. The pattern of joints ... other joints and is worse in the morning. Rheumatoid arthritis is also a systemic disease, involving other body ...

  12. Juvenile rheumatoid arthritis

    MedlinePlus

    ... joints. This form of JIA may turn into rheumatoid arthritis. It may involve five or more large and ... no known prevention for JIA. Alternative Names Juvenile rheumatoid arthritis (JRA); Juvenile chronic polyarthritis; Still disease; Juvenile spondyloarthritis ...

  13. Treating Psoriatic Arthritis

    MedlinePlus

    ... Psoriatic Arthritis Info Kit Resources Community icon: Link text: Post your questions in our online community and ... psoriasis and psoriatic arthritis. Talk Psoriasis icon: Link text: Contact our Patient Navigators for free and confidential ...

  14. Classification of Psoriatic Arthritis

    MedlinePlus

    ... Psoriatic Arthritis Info Kit Resources Community icon: Link text: Post your questions in our online community and ... psoriasis and psoriatic arthritis. Talk Psoriasis icon: Link text: Contact our Patient Navigators for free and confidential ...

  15. Diagnosing Psoriatic Arthritis

    MedlinePlus

    ... Psoriatic Arthritis Info Kit Resources Community icon: Link text: Post your questions in our online community and ... psoriasis and psoriatic arthritis. Talk Psoriasis icon: Link text: Contact our Patient Navigators for free and confidential ...

  16. Heart Rate Variability for Quantification of Autonomic Dysfunction in Fibromyalgia

    PubMed Central

    Kang, Jin Ho; Hong, Seok Hyun; Lee, Chang Hyun; Choi, Byoong Yong

    2016-01-01

    Objective To quantify autonomic dysfunction in fibromyalgia patients compared to healthy controls using heart rate variability (HRV). Methods Sixteen patients with fibromyalgia and 16 healthy controls were recruited in this case control study. HRV was measured using the time-domain method incorporating the following parameters: total heartbeats, the mean of intervals between consecutive heartbeats (R-R intervals), the standard deviation of normal to normal R-R intervals (SDNN), the square root of the mean squared differences of successive R-R intervals (RMSSD), ratio of SDNN to RMSSD (SDNN/RMSSD), and difference between the longest and shortest R-R interval under different three conditions including normal quiet breathing, rate controlled breathing, and Valsalva maneuver. The severity of autonomic symptoms in the group of patients with fibromyalgia was measured by Composite Autonomic Symptom Scale 31 (COMPASS 31). Then we analyzed the difference between the fibromyalgia and control groups and the correlation between the COMPASS 31 and aforementioned HRV parameters in the study groups. Results Patients with fibromyalgia had significantly higher SDNN/RMSSD values under both normal quiet breathing and rate controlled breathing compared to controls. Differences between the longest and shortest R-R interval under Valsalva maneuver were also significantly lower in patients with fibromyalgia than in controls. COMPASS 31 score was negatively correlated with SDNN/RMSSD values under rate controlled breathing. Conclusion SDNN/RMSSD is a valuable parameter for autonomic nervous system function and can be used to quantify subjective autonomic symptoms in patients with fibromyalgia. PMID:27152281

  17. What Is Juvenile Arthritis?

    MedlinePlus

    ... children with arthritis Preventing anemia in children with chronic inflammatory diseases such as arthritis Whether daily calcium supplements ... density in children with arthritis The impact of chronic and recurrent pain on ... role of an inflammatory chemical called interleukin-15 (IL-15). For More ...

  18. Prevalence of Comorbid Conditions and Sun-Induced Skin Cancers in Patients with Alopecia Areata.

    PubMed

    Miller, Rose; Conic, Ruzica Z; Bergfeld, Wilma; Mesinkovska, Natasha Atanaskova

    2015-11-01

    Alopecia areata is a multifactorial autoimmune disease causing non-scarring hair loss. Recent genome-wide association studies have pointed to connections between alopecia areata and other autoimmune disorders. Research of clinical conditions positively and negatively associated with alopecia areata is crucial for discovering the pathological mechanisms of disease and further treatment options. PMID:26551951

  19. Pain Information Brochure

    MedlinePlus

    ... of Arthritis and Musculoskeletal and Skin Diseases Top Fibromyalgia Fibromyalgia National Center for Complementary and Alternative Medicine What is Fibromyalgia? National Institute of Arthritis and Musculoskeletal and Skin ...

  20. [The aetiology of generalized alopecia in young calves].

    PubMed

    Lorenz, I; Mayr, S; Rademacher, G; Klee, W

    2007-06-01

    The objective of this study was to test for correlations between alopecia and ruminal drinking in young calves. 331 calves up to an age of 31 days were tested for evidence of generalized hair loss daily during their stay in the clinic. Incidence of diarrhoea and the results of ruminal fluid and blood analysis were compared between the groups with and without alopecia. Calves with alopecia showed a significantly higher incidence of diarrhoea and of ruminal acidosis persisting for at least 24 hours. Blood analysis revealed significant differences in degree of acidosis, in concentrations of D-lactate, urea, and creatinine in serum as well as in the activities of glutathione peroxidase, aspartate amino transferase, and creatine kinase. Alopecia in calves is correlated to longer periods of diseases, which are known to be accompanied by the production of D-lactate in the gastrointestinal tract, such as diarrhoea and ruminal drinking. The question, whether alopecia is due to formation of toxic substances or to deficiency of essential substances can not be answered. PMID:17642324

  1. The Occupational Profile of Women with Fibromyalgia Syndrome.

    PubMed

    Pérez-de-Heredia-Torres, Marta; Huertas Hoyas, Elisabet; Sánchez-Camarero, Carlos; Pérez-Corrales, Jorge; Fernández de-Las-Peñas, César

    2016-06-01

    The aims of this study were to assess the functional level of women with fibromyalgia; to investigate the differences in the occupational activities between women with fibromyalgia and healthy women; and to analyse the perceived importance of occupational performance during self-care, productivity and leisure activities. A cross-sectional case control study was performed. Twenty women with fibromyalgia and 20 healthy women completed the Functional Independence Measure (FIM), the Canadian Occupational Performance Measure (COPM), a Numerical Pain Rating Scale, the Fibromyalgia Impact Questionnaire and the SF-36 health survey. The Chi-square test (χ2), the Student's t test and the Spearman's test were used on the data. The FIM revealed significant differences regarding several activities: personal hygiene, bathing and memory (p < 0.01). The COPM scores did not reveal significant differences between groups (p > 0.10). Women with fibromyalgia had higher disability and reduced quality of life and required greater assistance to perform specific activities of daily living, i.e. hygiene, than healthy women. This highlights the specific occupational therapy needs these women have for performing many basic activities and for improving their quality of life. Limitations of the study include the small sample size, the exclusion of male participants and the possible influence of the women's psychological status on the assessments performed. Findings should be generalized with caution. Copyright © 2015 John Wiley & Sons, Ltd. PMID:26679109

  2. Current status of atypical antipsychotics for the treatment of fibromyalgia.

    PubMed

    Rico-Villademoros, F; Calandre, E P; Slim, M

    2014-06-01

    The treatment of fibromyalgia requires pharmacological and nonpharmacological therapies. The pharmacological treatment of fibromyalgia is limited to a few drugs that have been demonstrated to be moderately effective in some but not all dimensions of the disease. Therefore, the search for new drugs to treat this condition is warranted. Atypical antipsychotics offered an attractive alternative because they had been shown to be active against several key symptoms of fibromyalgia. The results of open-label studies, however, appear to indicate that atypical antipsychotics are poorly tolerated in patients with fibromyalgia, and only quetiapine XR has been studied in randomized controlled trials. Quetiapine XR has demonstrated effectiveness in treating comorbid major depression, anxiety and sleep disturbance. However, in two randomized controlled trials, quetiapine XR was not differentiated from placebo and failed to demonstrate noninferiority to amitriptyline in terms of improving overall symptomatology. The effect of quetiapine XR on pain and its usefulness as part of a combination pharmacological regimen should be further evaluated. Overall, the use of quetiapine (initiated at a low dose and slowly titrated) in fibromyalgia should be limited to patients with comorbid major depression or patients who are currently receiving other treatments and have unresolved and disabling depressive and/or anxiety symptoms. PMID:24983591

  3. Involvement of Mechanical Stress in Androgenetic Alopecia

    PubMed Central

    Tellez-Segura, Rafael

    2015-01-01

    Context: Androgenetic alopecia (AGA) is a frequent disorder characterized by progressive hair miniaturization in a very similar pattern among all affected men. The pathogenesis is related to androgen-inducible overexpression of transforming growth factor β-1 from balding dermal papilla cells, which is involved in epithelial inhibition and perifollicular fibrosis. Recent research shows that hair follicle androgen sensitivity is regulated by Hic-5, an androgen receptor co-activator which may be activated by the mechanical stimulation. Moreover, the dermis of scalp susceptible to be affected by AGA is firmly bounded to the galea aponeurotica, so the physical force exerted by the occipitofrontalis muscle is transmitted to the scalp skin. Aims: To know whether mechanical stress supported by hair follicles is involved in AGA phenomenon. Materials and Methods: It is performed with a finite element analysis of a galea model and a schematic representation of AGA progression according to Hamilton–Norwood scale in order to establish the correlation between elastic deformation in scalp and clinical progression of male pattern baldness. Results: The result was a highly significant correlation (r: −0.885, P < 0.001) that clearly identifies a mechanical factor in AGA development. Conclusions: All these data suggest that mechanical stress determines AGA patterning and a stretch-induced and androgen-mediated mechanotransduction in dermal papilla cells could be the primary mechanism in AGA pathogenesis. PMID:26622151

  4. Angiotensin Converting Enzyme Activity in Alopecia Areata

    PubMed Central

    Namazi, Mohammad Reza; Handjani, Farhad; Eftekhar, Ebrahim; Kalafi, Amir

    2014-01-01

    Background. Alopecia areata (AA) is a chronic inflammatory disease of the hair follicle. The exact pathogenesis of AA remains unknown, although recent studies support a T-cell mediated autoimmune process. On the other hand, some studies have proposed that the renin-angiotensin-aldosterone system (RAAS) may play a role in autoimmunity. Therefore, we assessed serum activity of angiotensin converting enzyme (ACE), a component of this system, in AA. Methods. ACE activity was measured in the sera of 19 patients with AA and 16 healthy control subjects. In addition, the relationship between severity and duration of the disease and ACE activity was evaluated. Results. Serum ACE activity was higher in the patient group (55.81 U/L) compared to the control group (46.41 U/L), but the difference was not statistically significant (P = 0.085). Also, there was no correlation between ACE activity and severity (P = 0.13) and duration of disease (P = 0.25) in the patient group. Conclusion. The increased serum ACE activity found in this study may demonstrate local involvement of the RAAS in the pathogenesis of AA. Assessment of ACE in a study with a larger sample size as well as in tissue samples is recommended in order to further evaluate the possible role of RAAS in AA. PMID:25349723

  5. Perifollicular fibrosis: pathogenetic role in androgenetic alopecia.

    PubMed

    Yoo, Hyeon Gyeong; Kim, Jin Sook; Lee, Se Rah; Pyo, Hyun Keol; Moon, Hyung In; Lee, Jong Hee; Kwon, Oh Sang; Chung, Jin Ho; Kim, Kyu Han; Eun, Hee Chul; Cho, Kwang Hyun

    2006-06-01

    Androgenetic alopecia (AGA) is a dihydrotestosterone (DHT)-mediated process, characterized by continuous miniaturization of androgen reactive hair follicles and accompanied by perifollicular fibrosis of follicular units in histological examination. Testosterone (T: 10(-9)-10(-7) M) treatment increased the expression of type I procollagen at mRNA and protein level. Pretreatment of finasteride (10(-8) M) inhibited the T-induced type I procollagen expression at mRNA (40.2%) and protein levels (24.9%). T treatment increased the expression of transforming growth factor-beta 1 (TGF-beta1) at protein levels by 81.9% in the human scalp dermal fibroblasts (DFs). Pretreatment of finasteride decreased the expression of TGF-beta1 protein induced by an average of T (30.4%). The type I procollagen expression after pretreatment of neutralizing TGF-beta1 antibody (10 microg/ml) was inhibited by an average of 54.3%. Our findings suggest that T-induced TGF-beta1 and type I procollagen expression may contribute to the development of perifollicular fibrosis in the AGA, and the inhibitory effects on T-induced procollagen and TGF-beta1 expression may explain another possible mechanism how finasteride works in AGA. PMID:16755026

  6. Alopecia areata associated with abacavir therapy.

    PubMed

    Kim, Hee-Sung; Shin, Hyoung-Shik

    2014-06-01

    Abacavir is a nucleoside reverse-transcriptase inhibitor that has been approved for use in combination with other retroviral agents in the treatment of HIV infection. Common adverse reactions include headache, fatigue, nausea, and rash. A fatal hypersensitivity reaction may occur in 5% of patients receiving abacavir; therefore, screening for HLA-B5701 should be performed before starting abacavir. Alopecia areata (AA) is infrequently reported in HIV-infected patients. Certain underlying conditions have been associated with AA, including a decreased CD4:CD8 ratio related to the progression of HIV infection, some opportunistic infections, and syphilis. Several antiretroviral drugs, such as zidovudine, indinavir, indinavir/ritonavir, lopinavir/ritonavir, and atazanavir/ritonavir have been implicated in the development of AA. At present, the occurrence of AA has not been associated with abacavir use. We cannot exclude that the use of abacavir and the development of AA could be coincidental. Nevertheless, patients given abacavir should be monitored for hair loss and the drug discontinued promptly if such signs appear. PMID:25024872

  7. Exercise reduces depressive symptoms in adults with arthritis: Evidential value

    PubMed Central

    Kelley, George A; Kelley, Kristi S

    2016-01-01

    AIM To determine whether evidential value exists that exercise reduces depression in adults with arthritis and other rheumatic conditions. METHODS Utilizing data derived from a prior meta-analysis of 29 randomized controlled trials comprising 2449 participants (1470 exercise, 979 control) with fibromyalgia, osteoarthritis, rheumatoid arthritis or systemic lupus erythematosus, a new method, P-curve, was utilized to assess for evidentiary worth as well as dismiss the possibility of discriminating reporting of statistically significant results regarding exercise and depression in adults with arthritis and other rheumatic conditions. Using the method of Stouffer, Z-scores were calculated to examine selective-reporting bias. An alpha (P) value < 0.05 was deemed statistically significant. In addition, average power of the tests included in P-curve, adjusted for publication bias, was calculated. RESULTS Fifteen of 29 studies (51.7%) with exercise and depression results were statistically significant (P < 0.05) while none of the results were statistically significant with respect to exercise increasing depression in adults with arthritis and other rheumatic conditions. Right-skew to dismiss selective reporting was identified (Z = −5.28, P < 0.0001). In addition, the included studies did not lack evidential value (Z = 2.39, P = 0.99), nor did they lack evidential value and were P-hacked (Z = 5.28, P > 0.99). The relative frequencies of P-values were 66.7% at 0.01, 6.7% each at 0.02 and 0.03, 13.3% at 0.04 and 6.7% at 0.05. The average power of the tests included in P-curve, corrected for publication bias, was 69%. Diagnostic plot results revealed that the observed power estimate was a better fit than the alternatives. CONCLUSION Evidential value results provide additional support that exercise reduces depression in adults with arthritis and other rheumatic conditions. PMID:27489782

  8. Alopecia areata treated with phenolisation and intravenous dexamethasone pulses.

    PubMed

    Kar, Sumit; Singh, Neha

    2013-01-01

    Phenol is an aromatic hydrocarbon derived from coal tar or manufactured from monochlorobenzene. Alopecia areata is a common non scarring autoimmune condition characterised by patchy loss of hair without atrophy. Various treatment modalities have been proposed and used for the treatment of alopecia areata, which is indeed a difficult condition to treat. Variable results have been documented using intralesional corticosteroid injections, topical minoxidil, topical anthralin ointment, topical contact sensitizers like diphencyprone, dinitrochlorobenzene or squaric acid dibutyl ester, and oral mini pulse with betamethasone. The use of 88% phenol for the treatment of alopecia areata has been documented in literature, but it has failed to secure a place in the priority list. Herein we have reported a case of a young girl who was treated with short-time aggressive therapy using 88% phenol and dexamethasone pulse therapy and who responded well to the treatment with no recurrence in the last 6 months of follow-up. PMID:23960401

  9. Alopecia Areata Treated with Phenolisation and Intravenous Dexamethasone Pulses

    PubMed Central

    Kar, Sumit; Singh, Neha

    2013-01-01

    Phenol is an aromatic hydrocarbon derived from coal tar or manufactured from monochlorobenzene. Alopecia areata is a common non scarring autoimmune condition characterised by patchy loss of hair without atrophy. Various treatment modalities have been proposed and used for the treatment of alopecia areata, which is indeed a difficult condition to treat. Variable results have been documented using intralesional corticosteroid injections, topical minoxidil, topical anthralin ointment, topical contact sensitizers like diphencyprone, dinitrochlorobenzene or squaric acid dibutyl ester, and oral mini pulse with betamethasone. The use of 88% phenol for the treatment of alopecia areata has been documented in literature, but it has failed to secure a place in the priority list. Herein we have reported a case of a young girl who was treated with short-time aggressive therapy using 88% phenol and dexamethasone pulse therapy and who responded well to the treatment with no recurrence in the last 6 months of follow-up. PMID:23960401

  10. Alopecia universalis with remission during pregnancy and prednisolone therapy.

    PubMed

    Asanuma, N; Sakurai, A; Aizawa, T; Hashizume, K

    1997-01-01

    In a 32-year-old woman, alopecia universalis went into unequivocal remission during pregnancy and prednisolone therapy. A skin biopsy specimen showed intense infiltration of the lymphocyte around the hair follicle without immunoglobulin and complement deposition. Autoantibody test results were negative except for the antithyroid and anti-nuclear antibodies. Human leukocyte antigen haplotypes common in Japanese patients with insulin-dependent diabetes were found in this patient. However, thyroid function and glucose tolerance were normal, and other clinical evidence of collagen vascular disorders was not found. In this patient, alopecia was considered to have been caused by autoimmune abnormalities. This is the first documentation of remission of autoimmune alopecia universalis during pregnancy. PMID:9001169