The Alopecias: Diagnosis and Treatments 1st Edition

The Alopecias: Diagnosis and Treatments 1st EditionThe Alopecias: Diagnosis and Treatments provides a practical answer to most diagnostic and therapeutic matters related to the different types of alopecia physicians may encounter in daily practice. It also presents a clear classification of all the types of alopecia.

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Among the topics covered are diffuse alopecia, traumatic alopecia, the male patient with androgenetic alopecia, the female patient with androgenetic alopecia, cicatricial alopecia, alopecia areata, congenital alopecia, and specific problems posed by alopecia in patients of African and Asian origin.

The book’s chapters are divided into four major categories. The first one reviews biology and hair investigations. The second is dedicated to clinical pathology: describes various hair diseases including all major pathological conditions of the scalp affecting hair growth. The third emphasizes the role of aesthetic and reconstructive hair transplantation or scalp surgery. And the fourth covers cosmetic treatment, new medical innovations, and the latest procedures in aesthetic surgery.

This book will help you understand the basic pathophysiology, clinical presentation, and the most effective treatment options for patients with hair-growth disorders.

The Alopecias: Diagnosis and Treatments 1st Edition
by Pierre Bouhanna (Editor), Eric Bouhanna (Editor)
ISBN-13: 978-1482212754
ISBN-10: 1482212757

The Alopecias: Diagnosis and Treatments 1st Edition – Content

Preface vii
Contributors ix
1 Biology of the hair follicle 1
Ulrike Blume-Peytavi, Varvara Kanti, and Annika Vogt
2 Hair and scalp investigations 11
Pierre Bouhanna
3 Trichoscopy 27
Lidia Rudnicka
4 Hair dysplasias 33
Juan Ferrando, L. Alheli Niebla, and Gerardo A. Moreno-Arias
5 Alopecia classifications 51
Pierre Bouhanna
6 Management of male androgenetic alopecia 59
Ralph M. Trüeb
7 Management of female androgenetic alopecia 67
Bianca Maria Piraccini and Aurora Alessandrini
8 Management of diffuse alopecia 71
Pierre Bouhanna
9 Management of noncicatricial circumscribed alopecia 79
Ralph M. Trüeb
10 Traumatic alopecia 91
Pierre Bouhanna
11 Management of acquired primary cicatricial alopecia 99
Salvador Villablanca and Juan Ferrando
12 Management of definitive alopecia in African Americans 119
Pierre Bouhanna
13 Management of definitive hair alopecia in Asians 131
Damkerng Pathomvanich
14 Hair transplantation in the reconstruction of the face and scalp 151
Alfonso Barrera
cont ent s
15 Hair Transplantaion for aesthetic surgery of the scalp and body hair 163
Pierre Bouhanna and Eric Bouhanna
16 Follicular cell implantation: Research update on “hair cloning” 189
Jerry E. Cooley
17 Platelet-rich plasma and stem cells 195
Gilbert Amgar, Joseph Greco, and Fabio Rinaldi
18 Adjuvant therapy for alopecia: Synthetic hair implant, dermopigmentation,
hair prosthesis, and hair camouflage 211
Pierre Bouhanna and Sophie Casadio
19 Hair cosmetology 225
Claude Bouillon and Michèle Verschoore

The Alopecias: Diagnosis and Treatments 1st Edition


Biology of the hair follicle
Ulrike Blume-Peytavi, Varvara Kanti, and Annika Vogt


The spectrum of physiological functions of hair ranges from protection, e.g., from ultraviolet (UV) radiation,
insulation against cold, and mechanical protection, to sensory and tactile as well as decorative and gender
defining functions. Hair growth plays an important role in social and sexual communication, and hair loss may
have a detrimental impact on quality of life, with significant impairment of life perceived by the affected patients.
Understanding the biology of the hair follicle, its growth activity, including hair cycle regulation, is key for hair
loss counseling and management.

Despite the development of new treatments, hair cycle regulation and its dysregulation leading to alopecia are
not yet fully understood and controllable. A greater understanding of hair biology and pathogenetic mechanisms of hair disorders could lead to new therapeutic approaches for the management of hair disorders. The majority of clinically relevant hair diseases are caused by disturbances of hair cycle regulation, differentiation and
keratinization, pigmentation, and immunology of the hair follicle. Generally, the complex mechanisms of hair
follicle biology are only rudimentarily understood; our current knowledge is predominantly based on structural
and morphological investigations as well as on functional characterization of single cell populations. The identification of mediators and elucidation of the complex cell– cell interactions in hair cycle regulation could open up new diagnostic and therapeutic possibilities.

The aim of this chapter is to present current aspects of hair follicle biology and pathophysiology and carve out their clinical relevance.


The hair follicle is composed of epidermal and dermal components; the latter includes the dermal papilla and the
dermal fibrous sheath that are derived from an aggregate of mesenchymal cells that forms directly beneath the epithelial hair germ at the onset of follicular development. The epidermal hair germ grows downward and forms the
hair peg as a result of complex epidermal–dermal interactions, which involve many pathways known from embryonic development, e.g., Hedgehog (Hh) and Wingless (Wnt) signaling. The full development of the hair follicle
further requires a complex sequence of autocrine, paracrine, and endocrine signals both within and between the
epidermis and the dermis. The development and differentiation of hair follicles during embryogenesis are classically divided into eight stages, characterized by distinct morphologies (Figure 1.1).


More than 20 different cell populations are involved in the structure of the pilosebaceous unit, which includes
the hair follicle, together with the sebaceous gland and the arrector pili muscle as well as the adjacent vascular supply of the hair follicle (Figure 1.2)…….

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