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Ntshingila S, Oputu O, Arowolo AT, Khumalo NP. Androgenetic alopecia: An update. JAAD Int 2023; 13:150-158. [PMID: 37823040 PMCID: PMC10562178 DOI: 10.1016/j.jdin.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2023] [Indexed: 10/13/2023] Open
Abstract
Androgenetic alopecia (AGA) is the most common nonscarring alopecia and is characterised by distinct gradual patterned hair loss. AGA is mediated by genetic predisposition and excessive follicular sensitivity to androgens, mainly in males, leading to the progressive conversion of scalp terminal hair into vellus hair. Although highly prevalent, it is not fatal but may have a severe psychosocial impact, especially on females and younger males. Significant advances have been made in understanding AGA's epidemiology and pathophysiology, but only 2 drugs remain approved by the FDA - finasteride and minoxidil. Prolonged use of these drugs, is a prerequisite for enhanced treatment response. However, this leads to poor medication adherence and adverse effects from extended use eg, the "postfinasteride syndrome" which persists beyond stopping the drug. Hence, there is a need for research on more effective alternative treatments for AGA, with fewer side effects. This paper reviewed recent advances in AGA pathophysiology and its treatment options. The recently characterized structure of type 2, 5-alpha reductase holds significance in comprehending present and prospective treatments of AGA.
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Affiliation(s)
- Sincengile Ntshingila
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Ogheneochuko Oputu
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Afolake T. Arowolo
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Nonhlanhla P. Khumalo
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
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Foroushani FT, Dzobo K, Khumalo NP, Mora VZ, Mezerville RD, Bayat A. Correction: Advances in surface modifications of the silicone breast implant and impact on its biocompatibility and biointegration. Biomater Res 2023; 27:95. [PMID: 37784198 PMCID: PMC10544494 DOI: 10.1186/s40824-023-00437-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023] Open
Affiliation(s)
- Fatemeh Tavakoli Foroushani
- Wound and Keloid Scarring Research Unit, Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, The South African Medical Research Council, University of Cape Town, Cape Town, South Africa
| | - Kevin Dzobo
- Wound and Keloid Scarring Research Unit, Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, The South African Medical Research Council, University of Cape Town, Cape Town, South Africa
| | - Nonhlanhla P Khumalo
- Wound and Keloid Scarring Research Unit, Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, The South African Medical Research Council, University of Cape Town, Cape Town, South Africa
| | - Vanessa Zamora Mora
- Establishment Labs Holdings, Roberto de Mezerville Establishment Labs Holdings, Alajuela, Costa Rica
| | - Roberto de Mezerville
- Establishment Labs Holdings, Roberto de Mezerville Establishment Labs Holdings, Alajuela, Costa Rica
| | - Ardeshir Bayat
- Wound and Keloid Scarring Research Unit, Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, The South African Medical Research Council, University of Cape Town, Cape Town, South Africa.
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Rhoda C, Sunda F, Kidzeru E, Khumalo NP, Arowolo A. FAM111B dysregulation promotes malignancy in fibrosarcoma and POIKTMP and a low-cost method for its mutation screening. Cancer Treat Res Commun 2023; 34:100679. [PMID: 36610347 DOI: 10.1016/j.ctarc.2022.100679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/05/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Mutations in the uncharacterised human FAM111B gene are associated with POIKTMP, a rare multi-organ fibrosing disease. Recent studies also reported the overexpression of FAM111B in specific cancers. Moreover, FAM111B mutation screening may prove expensive in under-resourced facilities. Therefore, this study investigated its cellular function and dysfunction and described an inexpensive mutation screening method. MATERIALS AND METHODS FAM111B expression was assessed in silico and validated in vitro in cell lines and primary skin fibroblasts from a South African POIKTMP-patient with the heterozygous FAM111B gene mutation: NM_198947.4: c.1861T>G (p. Tyr621Asp or Y621D) by qPCR and western blot. The cellular function of FAM111B was studied in HT1080 using various cell-based functional assays, and the Y621D mutation was genotyped by PCR-RFLP. RESULTS Expression studies showed upregulated FAM111B mRNA and protein in the cancer cells. High FAM111B expression with robust nuclear localization occurred in HT1080. Additionally, expression data and cell-based assays indicated that FAM111B led to the upregulation of cell migration, decreased cell apoptosis, and modulatory effects on cell proliferation. Y621D mutation showed similar effects on cell migration but minimal impact on cell apoptosis. FAM111B mRNA and protein expression were markedly downregulated (p ≤ 0.05) in the POIKTMP-patient's fibroblasts. The PCR-RFLP method successfully genotyped Y621D gene mutation. DISCUSSION FAM111B is a cancer-associated nuclear protein: Its modulation by mutations or overexpression may contribute to the malignancy of cancers and POIKTMP/fibrosis and poor clinical outcomes and represents a viable prognostic marker or therapeutic target. Furthermore, the PCR-RFLP method could prove a valuable tool for FAM111B mutation validation or screening in resource-constrained laboratories.
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Affiliation(s)
- Cenza Rhoda
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa
| | - Falone Sunda
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa
| | - Elvis Kidzeru
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa
| | - Nonhlanhla P Khumalo
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa
| | - Afolake Arowolo
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
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Foroushani FT, Dzobo K, Khumalo NP, Mora VZ, de Mezerville R, Bayat A. Advances in surface modifications of the silicone breast implant and impact on its biocompatibility and biointegration. Biomater Res 2022; 26:80. [PMID: 36517896 PMCID: PMC9749192 DOI: 10.1186/s40824-022-00314-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 10/31/2022] [Indexed: 12/15/2022] Open
Abstract
Silicone breast implants are commonly used for cosmetic and oncologic surgical indications owing to their inertness and being nontoxic. However, complications including capsular contracture and anaplastic large cell lymphoma have been associated with certain breast implant surfaces over time. Novel implant surfaces and modifications of existing ones can directly impact cell-surface interactions and enhance biocompatibility and integration. The extent of foreign body response induced by breast implants influence implant success and integration into the body. This review highlights recent advances in breast implant surface technologies including modifications of implant surface topography and chemistry and effects on protein adsorption, and cell adhesion. A comprehensive online literature search was performed for relevant articles using the following keywords silicone breast implants, foreign body response, cell adhesion, protein adsorption, and cell-surface interaction. Properties of silicone breast implants impacting cell-material interactions including surface roughness, wettability, and stiffness, are discussed. Recent studies highlighting both silicone implant surface activation strategies and modifications to enhance biocompatibility in order to prevent capsular contracture formation and development of anaplastic large cell lymphoma are presented. Overall, breast implant surface modifications are being extensively investigated in order to improve implant biocompatibility to cater for increased demand for both cosmetic and oncologic surgeries.
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Affiliation(s)
- Fatemeh Tavakoli Foroushani
- Wound and Keloid Scarring Research Unit, Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, The South African Medical Research Council, University of Cape Town, Cape Town, South Africa
| | - Kevin Dzobo
- Wound and Keloid Scarring Research Unit, Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, The South African Medical Research Council, University of Cape Town, Cape Town, South Africa
| | - Nonhlanhla P Khumalo
- Wound and Keloid Scarring Research Unit, Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, The South African Medical Research Council, University of Cape Town, Cape Town, South Africa
| | | | | | - Ardeshir Bayat
- Wound and Keloid Scarring Research Unit, Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, The South African Medical Research Council, University of Cape Town, Cape Town, South Africa.
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5
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Abstract
Significance: Keloid scarring is cosmetically disfiguring, psychosocially distressing, and can be physically disabling. The pathophysiology of keloid formation is poorly understood and subsequently, treatment options are ill defined, limited, and largely unsatisfactory. Therefore, in view of its unsatisfactory and recalcitrant management, keloid therapy is often seen as a financial burden affecting both patients and the health care systems. Recent Advances: Increased research on the genetic and epigenetic mechanisms in keloids has broadened our understanding of keloid pathobiology. Epigenetic mechanisms, mainly DNA methylation, histone modification, and noncoding RNAs, are currently being widely investigated. Advances in genetic sequencing technology and reduced cost have aided this endeavor. Studies on blood and patient-derived keloid tissue are being done with therapeutic agents targeting epigenetic and genetic markers with the shared goal of identifying the pathways underlying the initiation and maintenance of keloids. These advances have informed us of multiple complex molecular pathways implicated in keloids, which are yet to be fully elucidated. Critical Issues: Improved understanding of the genetic and epigenetic causes implicated in keloids will enhance our knowledge of this enigmatic disorder and likely lead to the development of therapeutic targets based on the available clinical and experimental studies. Due to the incomplete knowledge of molecular targets involved in keloid scarring pathways, therapeutics is still lagging for this clinically and scientifically important condition. Future Directions: Focused research on the identification of molecular targets and mechanistic pathways implicated in keloids is required to generate novel antifibrotic therapeutic options to decrease or eradicate recurrence of the disease as well as associated morbidity and improve the quality of life of those affected with keloids.
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Affiliation(s)
- Dennias Tonderai Nyika
- MRC Wound Healing Unit, Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Nonhlanhla P. Khumalo
- MRC Wound Healing Unit, Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Ardeshir Bayat
- MRC Wound Healing Unit, Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
- Plastic and Reconstructive Surgery Research, Wound Healing Unit, NIHR Manchester Biomedical Research, Centre for Dermatology Research, University of Manchester, Manchester, United Kingdom
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Panesar B, Soni D, Khan MI, Bdair F, Holek M, Tahir T, Woo J, Sanger N, Khumalo NP, Minuzzi L, Thabane L, Samaan Z. National suicide management guidelines recommending family-based prevention, intervention and postvention and their association with suicide mortality rates: systematic review. BJPsych Open 2022; 8:e54. [PMID: 35197148 PMCID: PMC8935913 DOI: 10.1192/bjo.2022.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Suicidal behaviour remains a major public health concern and countries have responded by authoring guidelines to help mitigate death by suicide. Guidelines can include family-based recommendations, but evidence for the level and category of family-based involvement that is needed to effectively prevent suicide is unclear. AIMS To explore the association between family-based recommendations in guidelines and countries' crude suicide rates. PROSPERO registration: CRD42019130195. METHOD MEDLINE, Embase, PsycInfo, Web of Science and WHO MiNDbank databases and grey literature were searched within the past 20 years (1 January 2000 to 22 June 2020) for national guidelines giving family-based recommendations in any of three categories (prevention, intervention and postvention). RESULTS We included 63 guidelines from 46 countries. All identified guidelines included at least one family-based recommendation. There were no statistically significant differences seen between mean World Health Organization crude suicide rates for countries that included only one, two or all three categories of family-based recommendations. However, a lower spread of crude suicide rates was seen when guideline recommendations included all three categories (mean crude suicide rates for one category: 11.09 (s.d. = 5.71); for two categories: 13.42 (s.d. = 7.76); for three categories: 10.68 (s.d. = 5.20); P = 0.478). CONCLUSIONS Countries should work towards a comprehensive national suicide guideline that includes all categories of family-based recommendations. Countries with previously established guidelines should work towards the inclusion of evidence-based recommendations that have clear implementation plans to potentially help lower suicide rates.
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Affiliation(s)
- Balpreet Panesar
- Neuroscience Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Divya Soni
- Faculty of Medicine, University of Toronto, Ontario, Canada
| | - Mohammed I Khan
- Biostatistics Unit, St Joseph's Healthcare, Hamilton, Ontario, Canada
| | - Faris Bdair
- Mathematical and Computational Science Undergraduate Program, Stanford University, California, USA
| | - Matthew Holek
- Health Sciences Undergraduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Talha Tahir
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Julia Woo
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Nitika Sanger
- Medical Science Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Nonhlanhla P Khumalo
- Division of Dermatology, Department of Medicine, Groote Schuur Hospital, and University of Cape Town, South Africa
| | - Luciano Minuzzi
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; and Centre for Evaluation of Medicines, Programs for Assessment of Technology in Health (PATH) Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Zainab Samaan
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada; and Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
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Sikhakhane TN, Adeola HA, Khumalo NP. An in silico approach to the identification of potential proteomic and genomic diagnostic biomarkers for primary cicatricial alopecia. Exp Dermatol 2021; 31:437-438. [PMID: 34674325 DOI: 10.1111/exd.14477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 08/26/2021] [Accepted: 10/17/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Thandeka N Sikhakhane
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Henry A Adeola
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Nonhlanhla P Khumalo
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
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8
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Madheswaran S, Mungra N, Biteghe FAN, De la Croix Ndong J, Arowolo AT, Adeola HA, Ramamurthy D, Naran K, Khumalo NP, Barth S. Antibody-Based Targeted Interventions for the Diagnosis and Treatment of Skin Cancers. Anticancer Agents Med Chem 2021; 21:162-186. [PMID: 32723261 DOI: 10.2174/1871520620666200728123006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 03/19/2020] [Accepted: 04/30/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Cutaneous malignancies most commonly arise from skin epidermal cells. These cancers may rapidly progress from benign to a metastatic phase. Surgical resection represents the gold standard therapeutic treatment of non-metastatic skin cancer while chemo- and/or radiotherapy are often used against metastatic tumors. However, these therapeutic treatments are limited by the development of resistance and toxic side effects, resulting from the passive accumulation of cytotoxic drugs within healthy cells. OBJECTIVE This review aims to elucidate how the use of monoclonal Antibodies (mAbs) targeting specific Tumor Associated Antigens (TAAs) is paving the way to improved treatment. These mAbs are used as therapeutic or diagnostic carriers that can specifically deliver cytotoxic molecules, fluorophores or radiolabels to cancer cells that overexpress specific target antigens. RESULTS mAbs raised against TAAs are widely in use for e.g. differential diagnosis, prognosis and therapy of skin cancers. Antibody-Drug Conjugates (ADCs) particularly show remarkable potential. The safest ADCs reported to date use non-toxic photo-activatable Photosensitizers (PSs), allowing targeted Photodynamic Therapy (PDT) resulting in targeted delivery of PS into cancer cells and selective killing after light activation without harming the normal cell population. The use of near-infrared-emitting PSs enables both diagnostic and therapeutic applications upon light activation at the specific wavelengths. CONCLUSION Antibody-based approaches are presenting an array of opportunities to complement and improve current methods employed for skin cancer diagnosis and treatment.
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Affiliation(s)
- Suresh Madheswaran
- Medical Biotechnology & Immunotherapy Research Unit, Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Neelakshi Mungra
- Medical Biotechnology & Immunotherapy Research Unit, Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Fleury A N Biteghe
- Department of Radiation Oncology and Biomedical Sciences, Cedars-Sinai Medical, 8700 Beverly Blvd, Los Angeles, CA, United States
| | - Jean De la Croix Ndong
- Department of Orthopedic Surgery, New York University Langone Orthopedic Hospital, 301 East 17th Street, New York, NY, United States
| | - Afolake T Arowolo
- The Hair and Skin Research Lab, Division of Dermatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - Henry A Adeola
- The Hair and Skin Research Lab, Division of Dermatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - Dharanidharan Ramamurthy
- Medical Biotechnology & Immunotherapy Research Unit, Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Krupa Naran
- Medical Biotechnology & Immunotherapy Research Unit, Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Nonhlanhla P Khumalo
- The Hair and Skin Research Lab, Division of Dermatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - Stefan Barth
- Medical Biotechnology & Immunotherapy Research Unit, Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Ngoepe MN, Cloete E, van den Berg C, Khumalo NP. The evolving mechanical response of curly hair fibres subject to fatigue testing. J Mech Behav Biomed Mater 2021; 118:104394. [PMID: 33691230 DOI: 10.1016/j.jmbbm.2021.104394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 02/05/2021] [Accepted: 02/10/2021] [Indexed: 10/22/2022]
Abstract
Cyclic testing of human hair reveals important details about the behaviour of fibres over many cycles of loading. Phenomena which are observed under static tensile tests give important clues about the form and behaviour of hair fibres, but these do not necessarily remain constant on the inevitable march to failure. In previous work, we demonstrated that curly fibres exhibited a toe-region during tensile tests. The form of curly fibres could be altered by mechanical manipulation but the curl could be recovered upon immersion in water. In this study, where straight and curly fibres are subject to cyclic loading, this characteristic toe-region was shown to be present in the first cycle of loading (for curly fibres). As the number of cycles increased (and the curly fibres progressively became straighter), the stress-strain response of curly fibres started to resemble that of straight fibres. This observation supports our previous hypothesis, which states that the toe-region can be attributed to the presence of a hydrogen bonding mechanism, which is present in curly fibres only, and can be altered by mechanical force. Interestingly, the alteration in load-bearing pattern in curly fibres did not necessarily translate to increased endurance, demonstrating that the relationship between fatigue and strength is a complex one in hair fibres.
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Affiliation(s)
- Malebogo N Ngoepe
- Department of Mechanical Engineering, University of Cape Town, Cape Town, South Africa.
| | - Elsabe Cloete
- Hair and Skin Research Lab, Division of Dermatology, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
| | - Claire van den Berg
- Hair and Skin Research Lab, Division of Dermatology, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
| | - Nonhlanhla P Khumalo
- Hair and Skin Research Lab, Division of Dermatology, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
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Halley-Stott RP, Adeola HA, Khumalo NP. Destruction of the stem cell Niche, Pathogenesis and Promising Treatment Targets for Primary Scarring Alopecias. Stem Cell Rev Rep 2020; 16:1105-1120. [PMID: 32789558 DOI: 10.1007/s12015-020-09985-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The Primary Scarring Alopecias are characterised by the irreversible destruction and fibrosis of hair follicles, leading to permanent and often disfiguring loss of hair. The pathophysiology of these diseases is not well understood. However, follicular-fibrosis and loss of the stem-cell niche appears to be a common theme. This review explores the pathogenesis of primary scarring alopecias, asking what happens to the stem cells of the hair follicle and how they may contribute to the progression of these diseases. Bulge-resident cells are lost (leading to loss of capacity for hair growth) from the follicle either by inflammatory-mediate apoptosis or through epigenetic reprogramming to assume a mesenchymal-like identity. What proportion of bulge cells is lost to which process is unknown and probably differs depending on the individual PCA and its specific inflammatory cell infiltrate. The formation of fibroblast-like cells from follicular stem cells may also mean that the cells of the bulge have a direct role in the pathogenesis. The identification of specific cells involved in the pathogenesis of these diseases could provide unique diagnostic and therapeutic opportunities to prevent disease progression by preventing EMT and specific pro-fibrotic signals.
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Affiliation(s)
- Richard P Halley-Stott
- Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, South Africa.
| | - Henry A Adeola
- Hair and Skin Research Laboratory, Groote Schuur Hospital, Cape Town, South Africa
| | - Nonhlanhla P Khumalo
- Hair and Skin Research Laboratory, Groote Schuur Hospital, Cape Town, South Africa
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Adeola HA, Khumalo NP, Arowolo AT, Mehlala N. No difference in the proteome of racially and geometrically classified scalp hair sample from a South African cohort: Preliminary findings. J Proteomics 2020; 226:103892. [DOI: 10.1016/j.jprot.2020.103892] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 06/25/2020] [Accepted: 06/26/2020] [Indexed: 02/07/2023]
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12
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Sharma JR, Lebeko M, Kidzeru EB, Khumalo NP, Bayat A. In Vitro and Ex Vivo Models for Functional Testing of Therapeutic Anti-scarring Drug Targets in Keloids. Adv Wound Care (New Rochelle) 2019; 8:655-670. [PMID: 31827980 PMCID: PMC6904937 DOI: 10.1089/wound.2019.1040] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 09/09/2019] [Indexed: 01/08/2023] Open
Abstract
Significance: Keloids are benign fibro-proliferative raised dermal lesions that spread beyond the original borders of the wound, continue to grow, rarely regress, and are the most common in pigmented individuals after an abnormal wound healing response. The current treatment failure and respective challenges involved highlighting the underlying issue that the etiopathogenesis of keloids is still not well understood. Disease models are required to better understand the disease pathogenesis. It is not possible to establish keloids in animals because of the uniqueness of this disease to human skin. To address this challenge, along these lines, non-animal reproducible models are vital in investigating molecular mechanisms of keloid pathogenesis and therapeutics development. Recent Advances: Various non-animal models have been developed to better understand the molecular mechanisms involved in keloid scarring and aid in identifying and evaluating the therapeutic potential of novel drug candidates. In this scenario, the current review aims at describing in vitro monocultures, co-cultures, organotypic cultures, and ex vivo whole skin keloid tissue organ culture models. Critical Issues and Future Directions: Current treatment options for keloids are far from securing a cure or preventing disease recurrence. Identifying universally accepted effective therapy for keloids has been hampered by the absence of appropriate disease model systems. Animal models do not accurately mimic the disease, thus non-animal model systems are pivotal in keloid research. The use of these models is essential not only for a better understanding of disease biology but also for identifying and evaluating novel drug targets.
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Affiliation(s)
- Jyoti R. Sharma
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Maribanyana Lebeko
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Elvis B. Kidzeru
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
- Centre for Medical Research, Institute of Medical Research and Medical Plant Studies, Ministry of Scientific Research and Innovation, Yaoundé, Cameroon
| | - Nonhlanhla P. Khumalo
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Ardeshir Bayat
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
- Plastic and Reconstructive Surgery Research, Division of Musculoskeletal & Dermatological Sciences, NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
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Ngwanya RM, Adeola HA, Beach RA, Gantsho N, Walker CL, Pillay K, Prokopetz R, Gumedze F, Khumalo NP. Reliability of Histopathology for the Early Recognition of Fibrosis in Traction Alopecia: Correlation with Clinical Severity. Dermatopathology (Basel) 2019; 6:170-181. [PMID: 31700859 PMCID: PMC6827454 DOI: 10.1159/000500509] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 04/18/2019] [Indexed: 11/30/2022] Open
Abstract
Traction alopecia (TA) is hair loss caused by prolonged pulling or repetitive tension on scalp hair; it belongs to the biphasic group of primary alopecia. It is non-scarring, typically with preservation of follicular stem cells and the potential for regrowth of early lesions especially if traction hairstyles are stopped. However, the alopecia may become permanent (scarring) and fail to respond to treatment if the traction is excessive and prolonged. Hence, the ability to detect fibrosis early in these lesions could predict patients who respond to treatment. Histopathological diagnosis based on scalp biopsies has been used as a gold standard to delineate various forms of non-scarring alopecia and to differentiate them from scarring ones. However, due to potential discrepant reporting as a result of the type of biopsy, method of sectioning, and site of biopsy, histopathology often tends to be unreliable for the early recognition of fibrosis in TA. In this study, 45 patients were assessed using the marginal TA severity scoring system, and their biopsies (both longitudinal and transverse sections) were systematically assessed by three dermatopathologists, the aim being to correlate histopathological findings with clinical staging. Intraclass correlation coefficients were used to determine the level of agreement between the assessors. We found poor agreement of the identification and grading of perifollicular and interfollicular fibrosis (0.55 [0.23–0.75] and 0.01 [2.20–0.41], respectively), and no correlation could be drawn with the clinical severity score. Better methods of diagnosis are needed for grading and for recognition of early fibrosis in TA.
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Affiliation(s)
| | - Henry Ademola Adeola
- Division of Dermatology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Renée A Beach
- Division of Dermatology and Pathology, University of Ottawa, Ottawa, Ontario, Canada
| | - Nomphelo Gantsho
- Division of Dermatology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Christopher L Walker
- Department of Anatomical Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Komala Pillay
- Department of Anatomical Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Robert Prokopetz
- Division of Dermatology and Pathology, University of Ottawa, Ottawa, Ontario, Canada
| | - Freedom Gumedze
- Department of Statistical Sciences, University of Cape Town, Cape Town, South Africa
| | - Nonhlanhla P Khumalo
- Division of Dermatology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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14
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Abstract
An attempt to understand and explain a peculiarity that was observed for curly fibres during experimentation revealed disparate literature reporting on several key issues. The phenotypical nature of curly fibres is only accurately understood within the larger scope of hair fibres, which are highly complex biological structures. A brief literature search produced thousands of research items. Besides the large amount of information on the topic, there was also great variability in research focus. From our review, it appeared that the complexity of hair biology, combined with the variety of research subtopics, often results in uncertainty when relating different aspects of investigation. During the literature investigation, we systematically categorized elements of curly hair research into three basic topics: essentially asking why fibres curl, what the curly fibre looks like and how the curly fibre behaves. These categories were subsequently formalized into a curvature fibre model that is composed of successive but distinctive tiers comprising the elements in curly hair research. The purpose of this paper is twofold: namely to present (i) a literature review that explores the different aspects of curly human scalp hair and (ii) the curvature fibre model as a systemized approach to investigating curly hair.
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Affiliation(s)
- Elsabe Cloete
- Hair and Skin Research Lab, Division of Dermatology, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
| | - Nonhlanhla P. Khumalo
- Hair and Skin Research Lab, Division of Dermatology, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
| | - Malebogo N. Ngoepe
- Department of Mechanical Engineering, University of Cape Town, Cape Town, South Africa
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15
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Cloete E, Khumalo NP, Ngoepe MN. Understanding Curly Hair Mechanics: Fiber Strength. J Invest Dermatol 2019; 140:113-120. [PMID: 31330147 DOI: 10.1016/j.jid.2019.06.141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 06/20/2019] [Accepted: 06/24/2019] [Indexed: 11/30/2022]
Abstract
The relationship between the geometric and mechanical profiles of hair fibers has been studied, with special focus on curly samples. Incidental observations pointed to a significantly different viscoelastic character with varying curliness. Further investigations confirmed initial observations, showing an initial distinct toe region behavior for curly fibers on the stress-strain plot, which is absent for straight fibers. This behavior suggested a difference in the viscoelastic nature of the curly fiber that is linked to mechanical energy stored in the fiber. Results also suggest that the strength of hair depends on two main components, and further pointed out that de facto methods of tensile testing may erode curly fiber strength during preparation. The main outcome of this study is that the tensile strength (σT) of hair fibers is composed of two (rather than one main) components, namely the toe region (σt) and the elastic region (σε), so that: σT=σt+σε. For noncurly fibers, the greatest part of fiber strength is derived from σε, while σt ≈ 0. For curly fibers, σt (i.e., springiness) adds significantly to the overall strength, even though σε remains the major contributor. Although these results require validation in larger studies, they are significant in the current understanding of curly hair. Also, they may represent a fundamental shift from the current understanding of tensile testing of human hair in general.
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Affiliation(s)
- Elsabe Cloete
- Hair and Skin Research Lab, Division of Dermatology, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
| | - Nonhlanhla P Khumalo
- Hair and Skin Research Lab, Division of Dermatology, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
| | - Malebogo N Ngoepe
- Department of Mechanical Engineering, University of Cape Town, Cape Town, South Africa.
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16
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Lebeko M, Khumalo NP, Bayat A. Multi-dimensional models for functional testing of keloid scars: In silico, in vitro, organoid, organotypic, ex vivo organ culture, and in vivo models. Wound Repair Regen 2019; 27:298-308. [PMID: 30761660 DOI: 10.1111/wrr.12705] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 01/14/2019] [Accepted: 01/23/2019] [Indexed: 01/20/2023]
Abstract
Keloid scars are described as benign fibro-proliferative dermal outgrowths that commonly occur in pigmented skin post cutaneous injury, and continue to grow beyond the boundary of the original wound margin. There is a lack of thorough understanding of keloid pathogenesis and thus keloid therapeutic options remain ill-defined. In view of the poor response to current therapy and high recurrence rates, there is an unmet need in improving our knowledge and therefore in identifying targeted and effective treatment strategies in management of keloids. Keloid research however, is hampered by a lack of relevant animal models as keloids do not spontaneously occur in animals and are unique to human skin. Therefore, developing novel animal models and nonanimal models for functional evaluation of keloid cells and tissue for better understanding their pathobiology and response to putative candidate therapies are essential. Here, we present the key concepts and relevant emerging research on two-dimensional and three-dimensional cell and tissue models for functional testing of keloid scars. We will describe in detail current models including in vitro mono- and co-cultures, multi-cellular spheroids (organoids) and organotyopic cultures, ex vivo whole skin keloid tissue organ culture models as well as in vivo human patient models. Finally, we discuss the role played by time as the fourth dimension in a novel model that involves sequential temporal biopsies of human patients with keloids (a so called 4D in vivo human model). The use of these unique models will no doubt prove pivotal in identification of new drug targets as well as biomarkers, in functional testing of emerging novel therapeutics, and in enhancing our understanding of keloid disease biology.
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Affiliation(s)
- Maribanyana Lebeko
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Nonhlanhla P Khumalo
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Ardeshir Bayat
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
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17
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Cloete E, Khumalo NP, Van Wyk JC, Ngoepe MN. Systems Approach to Human Hair Fibers: Interdependence Between Physical, Mechanical, Biochemical and Geometric Properties of Natural Healthy Hair. Front Physiol 2019; 10:112. [PMID: 30846943 PMCID: PMC6393780 DOI: 10.3389/fphys.2019.00112] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 01/30/2019] [Indexed: 11/13/2022] Open
Abstract
Contextual interpretation of hair fiber data is often blind to the effects of the dynamic complexity between different fiber properties. This intrinsic complexity requires systems thinking to decipher hair fiber accurately. Hair research, studied by various disciplines, follows a reductionist research approach, where elements of interest are studied from a local context with a certain amount of detachment from other elements or contexts. Following a systems approach, the authors are currently developing a cross-disciplinary taxonomy to provide a holistic view of fiber constituents and their interactions within large-scale dynamics. Based on the development process, this paper presents a review that explores the associated features, interrelationships and interactive complexities between physical, mechanical, biochemical and geometric features of natural, healthy hair fibers. Through the review, the importance of an appropriate taxonomy for interpreting hair fiber data across different disciplines is revealed. The review also demonstrates how seemingly unrelated fiber constituents are indeed interdependent and that these interdependencies may affect the behavior of the fiber. Finally, the review highlights how a non-integrative approach may have a negative impact on the reliability of hair data interpretation.
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Affiliation(s)
- Elsabe Cloete
- Hair and Skin Research Lab, Division of Dermatology, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
| | - Nonhlanhla P Khumalo
- Hair and Skin Research Lab, Division of Dermatology, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
| | - Jennifer C Van Wyk
- Hair and Skin Research Lab, Division of Dermatology, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
| | - Malebogo N Ngoepe
- Department of Mechanical Engineering, University of Cape Town, Cape Town, South Africa
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18
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Dhana A, Yen H, Okhovat JP, Cho E, Keum N, Khumalo NP. Ivermectin versus permethrin in the treatment of scabies: A systematic review and meta-analysis of randomized controlled trials. J Am Acad Dermatol 2018; 78:194-198. [DOI: 10.1016/j.jaad.2017.09.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 08/29/2017] [Accepted: 09/05/2017] [Indexed: 11/16/2022]
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19
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Arowolo AT, Adeola HA, Khumalo NP. "Next generation sequencing identifies mutations in GNPTG gene as a cause of familial form of scleroderma-like disease". Pediatr Rheumatol Online J 2017; 15:88. [PMID: 29287597 PMCID: PMC5747945 DOI: 10.1186/s12969-017-0215-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 12/14/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Afolake T. Arowolo
- 0000 0004 1937 1151grid.7836.aHair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Henry A. Adeola
- 0000 0004 1937 1151grid.7836.aHair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Nonhlanhla P. Khumalo
- 0000 0004 1937 1151grid.7836.aHair and Skin Research Laboratory, Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
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20
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Hlela C, Khumalo NP. Comment on "Prevention of flares in children with atopic dermatitis with regular use of an emollient containing glycerol and paraffin: A randomised controlled study". Pediatr Dermatol 2017; 34:743. [PMID: 29144052 DOI: 10.1111/pde.13264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Carol Hlela
- Division of Dermatology, Red Cross Children's Hospital, Rondenbosch, Cape Town, South Africa
| | - Nonhlanhla P Khumalo
- Groote Schuur Hospital, University of Cape Town, Rondenbosch, Cape Town, South Africa
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21
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Adeola HA, Van Wyk JC, Arowolo A, Ngwanya RM, Mkentane K, Khumalo NP. Emerging Diagnostic and Therapeutic Potentials of Human Hair Proteomics. Proteomics Clin Appl 2017; 12. [PMID: 28960873 DOI: 10.1002/prca.201700048] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 06/09/2017] [Indexed: 01/22/2023]
Abstract
The use of noninvasive human substrates to interrogate pathophysiological conditions has become essential in the post- Human Genome Project era. Due to its high turnover rate, and its long term capability to incorporate exogenous and endogenous substances from the circulation, hair testing is emerging as a key player in monitoring long term drug compliance, chronic alcohol abuse, forensic toxicology, and biomarker discovery, among other things. Novel high-throughput 'omics based approaches like proteomics have been underutilized globally in comprehending human hair morphology and its evolving use as a diagnostic testing substrate in the era of precision medicine. There is paucity of scientific evidence that evaluates the difference in drug incorporation into hair based on lipid content, and very few studies have addressed hair growth rates, hair forms, and the biological consequences of hair grooming or bleaching. It is apparent that protein-based identification using the human hair proteome would play a major role in understanding these parameters akin to DNA single nucleotide polymorphism profiling, up to single amino acid polymorphism resolution. Hence, this work seeks to identify and discuss the progress made thus far in the field of molecular hair testing using proteomic approaches, and identify ways in which proteomics would improve the field of hair research, considering that the human hair is mostly composed of proteins. Gaps in hair proteomics research are identified and the potential of hair proteomics in establishing a historic medical repository of normal and disease-specific proteome is also discussed.
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Affiliation(s)
- Henry A Adeola
- Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.,Hair and Skin Research Laboratory, Groote Schuur Hospital, Cape Town, South Africa
| | - Jennifer C Van Wyk
- Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.,Hair and Skin Research Laboratory, Groote Schuur Hospital, Cape Town, South Africa
| | - Afolake Arowolo
- Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.,Hair and Skin Research Laboratory, Groote Schuur Hospital, Cape Town, South Africa
| | - Reginald M Ngwanya
- Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Khwezikazi Mkentane
- Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.,Hair and Skin Research Laboratory, Groote Schuur Hospital, Cape Town, South Africa
| | - Nonhlanhla P Khumalo
- Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.,Hair and Skin Research Laboratory, Groote Schuur Hospital, Cape Town, South Africa
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22
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van den Worm L, Khumalo NP. Skin manifestations are common and associated with a higher prevalence of congenital abnormalities in Zika virus infection. Int J Dermatol 2017; 56:1470-1473. [DOI: 10.1111/ijd.13700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 05/16/2017] [Accepted: 06/09/2017] [Indexed: 12/28/2022]
Affiliation(s)
- Lerinza van den Worm
- Division of Dermatology; University of Cape Town; Groote Schuur Hospital; Cape Town South Africa
| | - Nonhlanhla P. Khumalo
- Division of Dermatology; University of Cape Town; Groote Schuur Hospital; Cape Town South Africa
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23
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Ngwanya MR, Gray NA, Gumedze F, Ndyenga A, Khumalo NP. Higher concentrations of dithranol appear to induce hair growth even in severe alopecia areata. Dermatol Ther 2017; 30. [PMID: 28598005 DOI: 10.1111/dth.12500] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 04/17/2017] [Indexed: 11/26/2022]
Abstract
Alopecia areata (AA) is the commonest autoimmune cause of non-scarring alopecia. Topical treatments including corticosteroids and irritants maybe beneficial. Studies report variable hair regrowth with dithranol (anthralin) but all used low concentrations (0.1-1.25%) and inconsistent measurements of AA severity. We report retrospective data (2005-2014) of 102 patients who had failed ultra-potent topical steroids and were referred to a specialist hair clinic for treatment with dithranol up to 3%. The severity of alopecia areata tool was used and participants graded as mild (<25%), moderate (>25 to 75%), and severe (>75%) hair loss. Compared with baseline any and at-least 50% hair regrowth [72%, 68%, 50% and 61.5%, 48.4%, 37.5%, in mild, moderate and severe AA respectively] occurred in all groups (median treatment duration 12 months). Twenty-nine patients (28.4%) were discharged with complete regrowth; with no difference in proportions in severity groups (33.3%, 29%, and 21.9%) but in the period to discharge [7.9, 6.3, and 29.4 months (p-values <.05)] for mild, moderate, and severe AA. Treatment trials of 12 months with dithranol at higher concentrations may be an option in patients who failed potent topical or intra-lesional steroids) regardless of AA severity. Randomized trials (of less staining formulations) of dithranol are warranted.
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Affiliation(s)
- M R Ngwanya
- Division of Dermatology, Groote Schuur Hospital, University of Cape Town, South Africa
| | - N A Gray
- Division of Dermatology, Groote Schuur Hospital, University of Cape Town, South Africa
| | - F Gumedze
- Department of Statistical Sciences, University of Cape Town, South Africa
| | - A Ndyenga
- Division of Dermatology, Groote Schuur Hospital, University of Cape Town, South Africa
| | - N P Khumalo
- Division of Dermatology, Groote Schuur Hospital, University of Cape Town, South Africa
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24
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Abstract
Abstract
Chemicals capable of lightening the skin – variously known as skin-bleaching, skin-lightening, depigmenting, skin-evening and skin-brightening agents – are among the most commonly used skin preparations in the world. Globally, Africa reportedly exhibits a high prevalence of skin lightener use. In this review, we provide both clinical and social perspectives on skin lightener use in Africa, with particular emphasis on South Africa. We narratively explore the timeline associated with skin lightener use in South Africa and attempt to interweave the social rhetoric of this specific paradigm. Despite the risks associated with exposing the skin to known constituents of these formulations, such as hydroquinone and mercury, chronic use continues. In spite of legislation banning hydroquinone and mercury in cosmetics in South Africa, these ingredients are present in widely available products. We recommend better implementation of policies and greater ethical responsibility of multinational cosmetic companies in addition to the initiation of a system of random product testing and penalties that could improve industry compliance.
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25
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Abstract
There is a sense that many patients seen at referral centers could be managed at a primary health care level. The objective of the current study was to examine the range of diagnoses among consultations at the Red Cross Children's Hospital in Cape Town, South Africa, to help develop a strategy for targeted education of primary health care personnel. This was a retrospective review of data for children seen at a pediatric dermatology clinic from 2005 to 2010, recorded according to International Classification of Diseases coding and compared with published data from similar clinical settings. There were 13,253 clinic visits, with 4,789 patients seen (median age 4.8 yrs, range 2 days to 18.6 yrs). The top 10 diagnoses accounted for 88.5% of consultations (59.5% atopic eczema [AE], 7.1% seborrheic dermatitis [SD], 4.2% superficial mycoses, 3.1% molluscum contagiosum, 2.8% vitiligo, 2.7% viral warts, 2.4% prurigo or scabies, 2.3% psoriasis, 2.3% hemangioma, 2.1% impetigo). Disease prevalence was somewhat different during the first year of life (AE 43.7%, SD 18.6%, hemangiomas 13.4%). Inflammatory dermatoses (76.6%) were more prevalent than infections and infestations (14.5%). The disease spectrum was similar to that in developed countries, although AE prevalence was higher in this study (followed by London 36%, Greece 35%, and Hong Kong 33%) than in 19 published studies. The top 10 diagnoses accounted for more than 70% of diagnoses in 12 studies. The retrospective nature and setting at a specialist clinic increased bias and limited generalizability. Focused education on the optimal care of common diseases, especially AE, could reduce referrals, improve access, and allow specialists at tertiary centers more time to manage complex and uncommon dermatoses.
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Affiliation(s)
- Betty Kakande
- Division of Dermatology, Red Cross Children's Hospital, Cape Town, South Africa.,Division of Dermatology, Groote Schuur Hospital, Cape Town, South Africa
| | - Freedom Gumedze
- Department of Statistical Sciences, University of Cape Town, Cape Town, South Africa
| | - Carol Hlela
- Division of Dermatology, Red Cross Children's Hospital, Cape Town, South Africa.,Division of Dermatology, Groote Schuur Hospital, Cape Town, South Africa
| | - Nonhlanhla P Khumalo
- Division of Dermatology, Red Cross Children's Hospital, Cape Town, South Africa.,Division of Dermatology, Groote Schuur Hospital, Cape Town, South Africa
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26
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Khumalo NP, Shaboodien G, Hemmings SM, Moolman-Smook JC, Stein DJ. Pathologic grooming (acne excoriee, trichotillomania, and nail biting) in 4 generations of a single family. JAAD Case Rep 2016; 2:51-3. [PMID: 27051827 PMCID: PMC4809443 DOI: 10.1016/j.jdcr.2015.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Nonhlanhla P. Khumalo
- Division of Dermatology, Hatter Institute for Cardiovascular Research in Africa, University of Cape Town, Cape Town, Tygerberg, South Africa
| | - Gasnat Shaboodien
- Division of Cardiovascular Genetics Laboratory, Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Cape Town, Tygerberg, South Africa
| | - Sian M.J. Hemmings
- MRC Unit on Anxiety and Stress Disorders, University of Stellenbosch, Tygerberg Hospital, South Africa
| | - Johanna C. Moolman-Smook
- MRC Unit on Anxiety and Stress Disorders, University of Stellenbosch, Tygerberg Hospital, South Africa
| | - Dan J. Stein
- Division of Psychiatry, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
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27
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Mercier S, Küry S, Salort-Campana E, Magot A, Agbim U, Besnard T, Bodak N, Bou-Hanna C, Bréhéret F, Brunelle P, Caillon F, Chabrol B, Cormier-Daire V, David A, Eymard B, Faivre L, Figarella-Branger D, Fleurence E, Ganapathi M, Gherardi R, Goldenberg A, Hamel A, Igual J, Irvine AD, Israël-Biet D, Kannengiesser C, Laboisse C, Le Caignec C, Mahé JY, Mallet S, MacGowan S, McAleer MA, McLean I, Méni C, Munnich A, Mussini JM, Nagy PL, Odel J, O'Regan GM, Péréon Y, Perrier J, Piard J, Puzenat E, Sampson JB, Smith F, Soufir N, Tanji K, Thauvin C, Ulane C, Watson RM, Khumalo NP, Mayosi BM, Barbarot S, Bézieau S. Expanding the clinical spectrum of hereditary fibrosing poikiloderma with tendon contractures, myopathy and pulmonary fibrosis due to FAM111B mutations. Orphanet J Rare Dis 2015; 10:135. [PMID: 26471370 PMCID: PMC4608180 DOI: 10.1186/s13023-015-0352-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 10/05/2015] [Indexed: 12/05/2022] Open
Abstract
Background Hereditary Fibrosing Poikiloderma (HFP) with tendon contractures, myopathy and pulmonary fibrosis (POIKTMP [MIM 615704]) is a very recently described entity of syndromic inherited poikiloderma. Previously by using whole exome sequencing in five families, we identified the causative gene, FAM111B (NM_198947.3), the function of which is still unknown. Our objective in this study was to better define the specific features of POIKTMP through a larger series of patients. Methods Clinical and molecular data of two families and eight independent sporadic cases, including six new cases, were collected. Results Key features consist of: (i) early-onset poikiloderma, hypotrichosis and hypohidrosis; (ii) multiple contractures, in particular triceps surae muscle contractures; (iii) diffuse progressive muscular weakness; (iv) pulmonary fibrosis in adulthood and (v) other features including exocrine pancreatic insufficiency, liver impairment and growth retardation. Muscle magnetic resonance imaging was informative and showed muscle atrophy and fatty infiltration. Histological examination of skeletal muscle revealed extensive fibroadipose tissue infiltration. Microscopy of the skin showed a scleroderma-like aspect with fibrosis and alterations of the elastic network. FAM111B gene analysis identified five different missense variants (two recurrent mutations were found respectively in three and four independent families). All the mutations were predicted to localize in the trypsin-like cysteine/serine peptidase domain of the protein. We suggest gain-of-function or dominant-negative mutations resulting in FAM111B enzymatic activity changes. Conclusions HFP with tendon contractures, myopathy and pulmonary fibrosis, is a multisystemic disorder due to autosomal dominant FAM111B mutations. Future functional studies will help in understanding the specific pathological process of this fibrosing disorder.
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Affiliation(s)
- Sandra Mercier
- CHU de Nantes, Service de Génétique Médicale, Unité de Génétique Clinique, Centre de Référence Anomalies de Développement et Syndromes Malformatifs de l'interrégion Grand-Ouest, 9 quai Moncousu, 44093, Nantes CEDEX 1, France. .,INSERM UMR1089, Atlantic Gene Therapy Institute, University of Nantes, Nantes, France. .,Centre de Référence des Maladies Neuromusculaires Rares de l'Enfant et de l'Adulte Nantes-Angers, Nantes, F-44000, France.
| | - Sébastien Küry
- CHU Nantes, Service de Génétique Médicale, Unité de Génétique Moléculaire, 9 quai Moncousu, 44093, Nantes CEDEX 1, France.
| | - Emmanuelle Salort-Campana
- Hôpital de la Timone, Service de Neurologie, Centre de Référence des maladies Neuromusculaires et Sclérose Latérale Amyotrophique, Marseille, France.
| | - Armelle Magot
- Centre de Référence des Maladies Neuromusculaires Rares de l'Enfant et de l'Adulte Nantes-Angers, Nantes, F-44000, France. .,CHU de Nantes, Laboratoire d'Explorations Fonctionnelles, Nantes, F-44000, France.
| | - Uchenna Agbim
- Department of Medicine, Columbia University Medical Center, New York, NY, USA.
| | - Thomas Besnard
- CHU Nantes, Service de Génétique Médicale, Unité de Génétique Moléculaire, 9 quai Moncousu, 44093, Nantes CEDEX 1, France.
| | - Nathalie Bodak
- Hôpital Necker Enfants Malades, AP-HP, Service de Dermatologie, Paris, France.
| | | | - Flora Bréhéret
- CHU Nantes, Service de Génétique Médicale, Unité de Génétique Moléculaire, 9 quai Moncousu, 44093, Nantes CEDEX 1, France.
| | - Perrine Brunelle
- CHU Nantes, Service de Génétique Médicale, Unité de Génétique Moléculaire, 9 quai Moncousu, 44093, Nantes CEDEX 1, France.
| | - Florence Caillon
- CHU Nantes, Service de Radiologie, CHU Nantes, Nantes, F-44000, France.
| | - Brigitte Chabrol
- Service de neuropédiatrie, Hôpital Timone, Aix-Marseille Université, Marseille, France.
| | - Valérie Cormier-Daire
- Hôpital Necker-Enfants malades, AP-HP, U781, Fondation Imagine, Paris Descartes-Sorbonne Paris Cité, Service de Génétique, Paris, 75015, France.
| | - Albert David
- CHU de Nantes, Service de Génétique Médicale, Unité de Génétique Clinique, Centre de Référence Anomalies de Développement et Syndromes Malformatifs de l'interrégion Grand-Ouest, 9 quai Moncousu, 44093, Nantes CEDEX 1, France.
| | - Bruno Eymard
- Centre de référence de Pathologie Neuromusculaire Paris-Est, Institut de Myologie, GHU La Pitié-Salpétrière, AP-HP, Paris, France.
| | - Laurence Faivre
- Equipe d'accueil EA 4271 GAD "Génétique des Anomalies du Développement", IFR Santé STIC, Université de Bourgogne, Dijon, France. .,Centre de Référence Anomalies de Développement et Syndromes Malformatifs de l'interrégion Grand-Est et Centre de Génétique, Hôpital d'Enfants, CHU, Dijon, France.
| | | | - Emmanuelle Fleurence
- Centre de Référence des Maladies Neuromusculaires Rares de l'Enfant et de l'Adulte Nantes-Angers, Nantes, F-44000, France. .,Etablissement de Santé pour Enfants et Adolescents de la région Nantaise, Nantes, France.
| | - Mythily Ganapathi
- Department of Neurology, Columbia University Medical Center, New York, NY, USA.
| | - Romain Gherardi
- APHP, Service d'Histologie, INSERM U841, CHU Mondor, Créteil, France.
| | - Alice Goldenberg
- CHU de Rouen, Hôpital Charles Nicolles, Service de Génétique, Rouen, France.
| | - Antoine Hamel
- CHU de Nantes, Service de Chirurgie Infantile, Nantes, France.
| | - Jeanine Igual
- CH de Marne la Vallée, Service de Pneumologie, Jossigny, France.
| | - Alan D Irvine
- Department of Paediatric Dermatology, Our Lady's Children's Hospital Crumlin, Dublin, Ireland. .,National Children's Research Centre, Our Lady's Children's Hospital, Dublin, Ireland. .,Clinical Medicine, Trinity College Dublin, Dublin, Ireland.
| | | | | | - Christian Laboisse
- Equipe d'accueil Biometadys, Université de Nantes, Nantes, France. .,Laboratoire d'Anatomopathologie A, Faculté de Médecine, Université de Nantes, 1, rue Gaston Veil, Nantes Cedex, 44035, France.
| | - Cédric Le Caignec
- CHU Nantes, Service de Génétique Médicale, Unité de Cytogénétique, 9 quai Moncousu, 44093, Nantes CEDEX 1, France.
| | - Jean-Yves Mahé
- Centre de Référence des Maladies Neuromusculaires Rares de l'Enfant et de l'Adulte Nantes-Angers, Nantes, F-44000, France. .,Etablissement de Santé pour Enfants et Adolescents de la région Nantaise, Nantes, France.
| | - Stéphanie Mallet
- Service de Dermatologie, Hôpital La Timone, Aix Marseille Université, Provence, France.
| | - Stuart MacGowan
- Centre for Dermatology and Genetic Medicine, Colleges of Life Sciences and Medicine, Dentistry & Nursing, University of Dundee, Dundee, UK. .,Division of Computational Biology, College of Life Sciences, University of Dundee, Dundee, UK.
| | - Maeve A McAleer
- Department of Paediatric Dermatology, Our Lady's Children's Hospital Crumlin, Dublin, Ireland. .,National Children's Research Centre, Our Lady's Children's Hospital, Dublin, Ireland.
| | - Irwin McLean
- Centre for Dermatology and Genetic Medicine, Colleges of Life Sciences and Medicine, Dentistry & Nursing, University of Dundee, Dundee, UK.
| | - Cécile Méni
- Hôpital Necker Enfants Malades, AP-HP, Service de Dermatologie, Paris, France.
| | - Arnold Munnich
- Hôpital Necker-Enfants malades, AP-HP, U781, Fondation Imagine, Paris Descartes-Sorbonne Paris Cité, Service de Génétique, Paris, 75015, France.
| | - Jean-Marie Mussini
- Laboratoire d'Anatomopathologie A, Faculté de Médecine, Université de Nantes, 1, rue Gaston Veil, Nantes Cedex, 44035, France.
| | - Peter L Nagy
- Department of Pathology and Cell Biology, Personalized Genomic Medicine, Columbia University Medical Center, New York, NY, USA.
| | - Jeffrey Odel
- Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA.
| | - Grainne M O'Regan
- Department of Paediatric Dermatology, Our Lady's Children's Hospital Crumlin, Dublin, Ireland.
| | - Yann Péréon
- Centre de Référence des Maladies Neuromusculaires Rares de l'Enfant et de l'Adulte Nantes-Angers, Nantes, F-44000, France. .,CHU de Nantes, Laboratoire d'Explorations Fonctionnelles, Nantes, F-44000, France.
| | - Julie Perrier
- Centre de Référence des Maladies Neuromusculaires Rares de l'Enfant et de l'Adulte Nantes-Angers, Nantes, F-44000, France.
| | - Juliette Piard
- CHU de Besançon, Service de Génétique Médicale, Besançon, France.
| | - Eve Puzenat
- CHU de Besançon, Service de Dermatologie, Besançon, France.
| | - Jacinda B Sampson
- Department of Neurology, Columbia University Medical Center, New York, NY, USA.
| | - Frances Smith
- Dermatology and Genetic Medicine, University of Dundee, Dundee, UK.
| | - Nadem Soufir
- AP-HP, Hôpital Bichat, Service de Génétique, INSERM U976, Paris, France.
| | - Kurenai Tanji
- Division of Neuropathology, Columbia University Medical Center, New York, NY, USA.
| | - Christel Thauvin
- Equipe d'accueil EA 4271 GAD "Génétique des Anomalies du Développement", IFR Santé STIC, Université de Bourgogne, Dijon, France. .,Centre de Référence Anomalies de Développement et Syndromes Malformatifs de l'interrégion Grand-Est et Centre de Génétique, Hôpital d'Enfants, CHU, Dijon, France.
| | - Christina Ulane
- Department of Neurology, Columbia University Medical Center, New York, NY, USA.
| | - Rosemarie M Watson
- Department of Paediatric Dermatology, Our Lady's Children's Hospital Crumlin, Dublin, Ireland.
| | - Nonhlanhla P Khumalo
- Division of Dermatology, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa.
| | - Bongani M Mayosi
- Cardiovascular Genetics Laboratory, Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa.
| | - Sébastien Barbarot
- CHU Nantes, Clinique dermatologique, Hôtel Dieu, Place Alexis Ricordeau, 44000, Nantes, France.
| | - Stéphane Bézieau
- CHU Nantes, Service de Génétique Médicale, Unité de Génétique Moléculaire, 9 quai Moncousu, 44093, Nantes CEDEX 1, France. .,Equipe d'accueil Biometadys, Université de Nantes, Nantes, France.
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Maneli MH, Wiesner L, Tinguely C, Davids LM, Spengane Z, Smith P, van Wyk JC, Jardine A, Khumalo NP. Combinations of potent topical steroids, mercury and hydroquinone are common in internationally manufactured skin-lightening products: a spectroscopic study. Clin Exp Dermatol 2015. [PMID: 26211494 DOI: 10.1111/ced.12720] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The topical steroids betamethasone (BM) and clobetasol propionate (CP) are illegal in cosmetics. Hydroquinone (HQ) and mercury (Hg) are either illegal or allowed only in limited concentrations (2% and 1 ppm, respectively). AIM To investigate active ingredients and countries of origin of popular skin-lightening products available in Cape Town, South Africa. METHODS In total, 29 products were examined; of these, 22 products were purchased from informal vendors, and 2 products (out of a total of 29) were purchased over the counter. HQ, Hg(2+) and steroids were quantified by high-performance liquid chromatography-ultraviolet spectrophotometry, inductively coupled plasma-mass spectrometry and liquid chromatography-mass spectrometry, respectively. RESULTS Of the 29 products, 22 (75.9%), all imported and bought from informal vendors, contained illegal or banned ingredients: 13 (44.8%) contained steroids (9 CP, 4 BM), 12 (41.4%) contained Hg (30-2300 ppm), and 11 (37.9%) contained HQ. Sequentially, the products originated from Italy (27.3%, n = 6), India (22.7%, n = 5), the Democratic Republic of Congo (DRC) (22.7%, n = 5), Cote d'Ivoire (9.1%, n = 2), USA (9.1%, n = 2), UK (4.5%, n = 1) and France (4.5%, n = 1). Two products, one from India and one from the DRC, contained all four ingredients (HQ, Hg, BM, CP). Of the 12 products containing Hg, 10 also contained HQ and/or a steroid, yet none listed Hg as an ingredient. A significant proportion of the steroid-containing products (76.9%) also contained at least one other skin-lightening agent. Not all internationally available products were tested, which is a limitation of the study. CONCLUSION In spite of a European Union ban on skin lighteners, a third of the products tested were from Europe. Combinations of Hg and ultrapotent steroids were prominent. International law enforcement and random testing is needed to encourage industry compliance and help protect consumers.
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Affiliation(s)
- M H Maneli
- Division of Dermatology, Groote Schuur Hospital, Cape Town, South Africa
| | - L Wiesner
- Division of Clinical Pharmacology, Groote Schuur Hospital, Cape Town, South Africa
| | - C Tinguely
- Department of Geological Sciences, University of Cape Town, Cape Town, South Africa
| | - L M Davids
- Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Z Spengane
- Division of Dermatology, Groote Schuur Hospital, Cape Town, South Africa
| | - P Smith
- Division of Clinical Pharmacology, Groote Schuur Hospital, Cape Town, South Africa
| | - J C van Wyk
- Division of Dermatology, Groote Schuur Hospital, Cape Town, South Africa
| | - A Jardine
- Department of Chemistry, University of Cape Town, Cape Town, South Africa
| | - N P Khumalo
- Division of Dermatology, Groote Schuur Hospital, Cape Town, South Africa
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Van Wyk JC, Mkentane K, Gumedze F, Khumalo NP. No-lye not better than lye relaxers. J Cosmet Sci 2014; 65:403-405. [PMID: 25898766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Gray CL, Levin ME, Zar HJ, Potter PC, Khumalo NP, Volkwyn L, Fenemore B, du Toit G. Food allergy in South African children with atopic dermatitis. Pediatr Allergy Immunol 2014; 25:572-9. [PMID: 25201137 DOI: 10.1111/pai.12270] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/22/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND The prevalence of food allergy in South Africa is unknown, but previously thought to be rare in black South Africans. This study aimed to determine the prevalence of, and risk factors for, IgE-mediated food allergy in South African children with atopic dermatitis (AD). METHODOLOGY This was a prospective, observational study in a paediatric university hospital in Cape Town. Children with AD, aged 6 months to 10 yrs, were randomly recruited from the dermatology clinic. They were assessed for sensitization and allergy by questionnaire, skin prick tests, Immuno Solid Phase Allergen Chip (ISAC) test and incremental food challenges. RESULTS 100 participants (59 black Africans and 41 of mixed race) were enrolled, median age 42 months. There were high overall rates of food sensitization (66%) and food allergy (40%). Egg (25%) and peanut (24%) were the most common allergies. Black participants had comparable sensitization (69% vs. 61%) but lower allergy rates (34% vs. 46%) than mixed race participants. This was especially evident for peanut allergy (15% Blacks vs. 37% mixed race allergic to peanut, p = 0.01). Early-onset AD (<6 months), severe eczema, and young age <2 yrs were significant risk factors for food allergy. CONCLUSION The prevalence of food allergy is unexpectedly high in South African children with AD, and comparable with food allergy rates in patients with AD in developed countries. There are ethnic differences, with significantly lower peanut allergy rates in Blacks compared to mixed race patients. These results are not generalizable to an unselected South African population, which requires further study.
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Affiliation(s)
- Claudia L Gray
- Division of Allergology, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
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Affiliation(s)
- Kwezikazi Mkentane
- Division of Dermatology; Groote Schuur Hospital; University of Cape Town; Cape Town South Africa
- Department of Human Biology; University of Cape Town; Cape Town South Africa
| | - Mbulelo Maneli
- Division of Dermatology; Groote Schuur Hospital; University of Cape Town; Cape Town South Africa
| | | | - Gumedze Freedom
- Department of Statistics; University of Cape Town; Cape Town South Africa
| | - Nonhlanhla P. Khumalo
- Division of Dermatology; Groote Schuur Hospital; University of Cape Town; Cape Town South Africa
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Maneli MH, Smith P, Khumalo NP. Elevated formaldehyde concentration in “Brazilian keratin type” hair-straightening products: A cross-sectional study. J Am Acad Dermatol 2014; 70:276-80. [DOI: 10.1016/j.jaad.2013.10.023] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2013] [Revised: 10/10/2013] [Accepted: 10/11/2013] [Indexed: 11/16/2022]
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Abstract
Traction alopecia (TA) affects up to 32% of women and 22% of high school girls with Afro-textured hair but can start in the preschool years. Traction induces inflammation and follicle damage. The risk of TA increases with symptomatic traction and combined hairstyles. To influence the practice of hairdressers and at risk individuals and help narrow the knowledge, attitudes, and practices (KAP) gap, scientific data should be translated into simple messages like "tolerate pain from a hairstyle and risk hair loss" and "no braids or weaves on relaxed hair". With appropriate education and public awareness, TA could potentially be eradicated.
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Affiliation(s)
- Paradi Mirmirani
- Department of Dermatology, The Permanente Medical Group, Vallejo, CA, USA; Department of Dermatology, University of California, San Francisco, CA, USA; Department of Dermatology, Case Western Reserve University, Cleveland, OH, USA
| | - Nonhlanhla P Khumalo
- Division of Dermatology Ward G23, Groote Schuur Hospital Main Road Observatory and the University of Cape Town, Western Province 7925, South Africa.
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Maneli M, Mkentane K, Khumalo NP. Acquired silky African hair, malnutrition, and chronic diseases. Int J Dermatol 2013; 53:e158-9. [PMID: 24320928 DOI: 10.1111/ijd.12284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Mbulelo Maneli
- Division of Dermatology, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
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Mercier S, Küry S, Shaboodien G, Houniet DT, Khumalo NP, Bou-Hanna C, Bodak N, Cormier-Daire V, David A, Faivre L, Figarella-Branger D, Gherardi RK, Glen E, Hamel A, Laboisse C, Le Caignec C, Lindenbaum P, Magot A, Munnich A, Mussini JM, Pillay K, Rahman T, Redon R, Salort-Campana E, Santibanez-Koref M, Thauvin C, Barbarot S, Keavney B, Bézieau S, Mayosi BM. Mutations in FAM111B cause hereditary fibrosing poikiloderma with tendon contracture, myopathy, and pulmonary fibrosis. Am J Hum Genet 2013; 93:1100-7. [PMID: 24268661 DOI: 10.1016/j.ajhg.2013.10.013] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 09/10/2013] [Accepted: 10/15/2013] [Indexed: 11/19/2022] Open
Abstract
Congenital poikiloderma is characterized by a combination of mottled pigmentation, telangiectasia, and epidermal atrophy in the first few months of life. We have previously described a South African European-descent family affected by a rare autosomal-dominant form of hereditary fibrosing poikiloderma accompanied by tendon contracture, myopathy, and pulmonary fibrosis. Here, we report the identification of causative mutations in FAM111B by whole-exome sequencing. In total, three FAM111B missense mutations were identified in five kindreds of different ethnic backgrounds. The mutation segregated with the disease in one large pedigree, and mutations were de novo in two other pedigrees. All three mutations were absent from public databases and were not observed on Sanger sequencing of 388 ethnically matched control subjects. The three single-nucleotide mutations code for amino acid changes that are clustered within a putative trypsin-like cysteine/serine peptidase domain of FAM111B. These findings provide evidence of the involvement of FAM111B in congenital poikiloderma and multisystem fibrosis.
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Affiliation(s)
- Sandra Mercier
- Unité de Génétique Clinique, Service de Génétique Médicale, Centre de Référence Anomalies de Développement et Syndromes Malformatifs de l'Interrégion Grand-Ouest, Centre Hospitalier Universitaire Nantes, 9 Quai Moncousu, 44093 Nantes Cedex 1, France; Institut National de la Santé et de la Recherche Médicale UMR 1089, Atlantic Gene Therapy Institute, University of Nantes, 44007 Nantes, France
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Hlela C, Graham N, Bhigjee AI, Taylor GP, Khumalo NP, Mosam A. Human T cell lymphotropic virus type 1- associated infective dermatitis in KwaZulu Natal, South Africa. BMC Dermatol 2013; 13:11. [PMID: 24152710 PMCID: PMC4015614 DOI: 10.1186/1471-5945-13-11] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Accepted: 10/11/2013] [Indexed: 11/30/2022]
Abstract
Background The Human T cell lymphotropic virus type 1 (HTLV-1)-associated infective dermatitis (IDH), is a chronic relapsing dermatitis which usually presents in children older than 2 years. A total of 300 cases have been reported worldwide (Latin America, the Caribbean and only 5 from Senegal). Neither IDH, nor its complications have been reported from the rest of Africa. We aimed to examine the clinical and aetiological characteristics of IDH in a cohort of South African children. Methods Attendees at the dermatology clinic at King Edward VIII Hospital, Durban underwent clinical examination. After obtaining consent those suspected of IDH had specimens taken for blood counts, immunoglobulins, serum protein electrophoresis, viral studies (including genotyping), skin swabs and stool examinations. Results Nineteen of 60 suspected cases recruited over 3 years met the diagnostic criteria for IDH. The male-to-female ratio was 1:2; mean age 8 years (range 0.7 to 15). Dermatitis mostly affected the scalp (78.9%) and axilla (73.7%); fewer children had nasal crusting (47.4%). Mean Ig A, IgG and IgM were raised, at 3.52 g/l, 22.6 g/l and 1.38 g/l, respectively. The median CD4 cell count was 1958 cells/mm3. Viral genotyping of all tested samples were positive for the Cosmopolitan, Subtype A (HTLV-1a). Conclusions IDH is a distinct entity which also affects South Africans. Our patients were older at presentation and the majority did not present with nasal crusting as has been described in other countries.
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Affiliation(s)
- Carol Hlela
- Division of Dermatology; Red Cross Children's Hospital, University of Cape Town, Cape Town, South Africa.
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Khumalo NP, Mkentane K, Muthukarapan C, Hardie D, Korsman S, Hu N, Mthebe T, Davids LM, Rousseau J. Invisible bleeding from clean-shave haircuts: detection with blood specific RNA markers. Dermatology 2013; 227:197-201. [PMID: 24135308 DOI: 10.1159/000353529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 06/04/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND 'Haircut-associated bleeding' is a newly recognized entity that affects at least a quarter of African men who wear shiny clean-shave ('chiskop') haircuts. AIM This pilot study aimed to elucidate whether invisible haircut-associated bleeding was detectable using blood specific RNA markers (16 participants, 5 with unknown HIV status) and whether surface virus could be detected using PCR from scalp swabs (of 11 known HIV-positive participants). METHODS Haircuts were performed professionally and scalps examined by a dermatologist to exclude injury. Serum samples for viral loads were also collected at the same time. RESULTS In all, 6/16 (37%) samples tested positive (>100 relative fluorescent units) for hemoglobin beta and albumin, confirming evidence of blood; of these, only 1/11 was HIV-positive but had an undetectable serum viral load. No surface HIV was detected from any scalp samples. CONCLUSIONS This study confirms the entity of haircut-associated bleeding but goes further to show for the first time that invisible bleeding from clean-shave haircuts is also common. Both a high serum viral load and evidence of bleeding should ideally be present prior to surface HIV detection. Future investigations for potential HIV (and hepatitis B) transmission through clean-shave haircuts are warranted but should not delay public education for disease prevention.
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Affiliation(s)
- N P Khumalo
- Division of Dermatology, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
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Affiliation(s)
- M H Maneli
- Division of Dermatology, Ward G23 Schuur Hospital, Observatory 7925, Cape Town, South Africa; Division of Dermatology, University of Cape Town, Cape Town, South Africa
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Affiliation(s)
- Nonhlanhla P Khumalo
- Division of Dermatology, Groote Schuur and Red Cross Children's Hospital Cape Town, South Africa.
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Khumalo NP, Gumedze F. The adapted classification of male pattern hair loss improves reliability. Dermatology 2012; 225:110-4. [PMID: 23038020 DOI: 10.1159/000341542] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Accepted: 06/29/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The Hamilton-Norwood classification (HNC) is used to assess the severity of pattern hair loss (PHL). Conflicting associations between PHL and cardiovascular disease (CVD) have been reported from studies that used different methods to assess alopecia severity. No classification including the HNC has been validated for population studies. We aimed to simplify the HNC, produce the adapted HNC and test its reliability for use in population studies. METHODS Identifying vertex alopecia as distinct allowed for a simpler alignment of alopecia figures where scores 4V and 5V in the adapted HNC replace IV and V in the original HNC. The two classifications were to be used by twelve of our staff (secretaries, nurses, dermatology trainees and dermatologists) to evaluate 16 men with PHL. Observer agreement was estimated using intraclass correlation coefficient (ICC) and a percentage method duplicated from the recent basic and specific (BASP) classification. RESULTS The ICC improved with the adapted HNC when assessed by both the nurses/secretaries (from 0.47 to 0.61) and dermatology residents/consultants (from 0.68 to 0.76). Agreement using the BASP percentage method for dermatologists was 62-69% for the original and 93-100% for the adapted HNC. CONCLUSIONS The adapted HNC increased reliability at various staff levels, making it suitable for epidemiological studies; its use in future studies could help elucidate the association between PHL and CVD.
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Affiliation(s)
- N P Khumalo
- Division of Dermatology, Groote Schuur and Red Cross Children's Hospitals, Cape Town, South Africa.
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Khumalo NP. The "fringe sign" for public education on traction alopecia. Dermatol Online J 2012; 18:16. [PMID: 23031383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
The "fringe sign" introduced by Samrao and co-authors is a phenomenally descriptive catch phrase for translating study data for public education in the prevention of traction alopecia.
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Beach RA, Wilkinson KA, Gumedze F, Khumalo NP. Baseline sebum IL-1α is higher than expected in afro-textured hair: a risk factor for hair loss?*. J Cosmet Dermatol 2012; 11:9-16. [DOI: 10.1111/j.1473-2165.2011.00603.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Khumalo NP. Hair fashion trends and formaldehyde health risks. S Afr Med J 2011; 101:872. [PMID: 22273026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2011] [Accepted: 10/03/2011] [Indexed: 05/31/2023] Open
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Khumalo NP. Hair care practices and scalp/hair disease in African American girls. J Am Acad Dermatol 2011; 64:1181-2; author reply 1182-3. [DOI: 10.1016/j.jaad.2010.11.059] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Revised: 10/26/2010] [Accepted: 11/01/2010] [Indexed: 11/15/2022]
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Abstract
BACKGROUND Bullous pemphigoid (BP) is the most common autoimmune blistering disease in the West. Oral steroids are the standard treatment.This is an update of the review published in 2005. OBJECTIVES To assess treatments for bullous pemphigoid. SEARCH STRATEGY In August 2010 we updated our searches of the Cochrane Skin Group Specialised Register, the Cochrane Central Register of Controlled Trials (Clinical Trials), MEDLINE, EMBASE, and the Ongoing Trials registers. SELECTION CRITERIA Randomised controlled trials of treatments for participants with immunofluorescence-confirmed bullous pemphigoid. DATA COLLECTION AND ANALYSIS At least two authors evaluated the studies for the inclusion criteria, and extracted data independently. MAIN RESULTS We included 10 randomised controlled trials (with a total of 1049 participants) of moderate to high risk of bias. All studies involved different comparisons, none had a placebo group. In 1 trial plasma exchange plus prednisone gave significantly better disease control at 1 month (0.3 mg/kg: RR 18.78, 95% CI 1.20 to 293.70) than prednisone alone (1.0 mg/kg: RR 1.79, 95% CI 1.11 to 2.90), while another trial showed no difference in disease control at 6 months.No differences in disease control were seen for different doses or formulations of prednisolone (one trial each), for azathioprine plus prednisone compared with prednisone alone (one trial), for prednisolone plus azathioprine compared with prednisolone plus plasma exchange (one trial), for prednisolone plus mycophenolate mofetil or plus azathioprine (one trial), for tetracycline plus nicotinamide compared with prednisolone (one trial). Chinese traditional medicine plus prednisone was not effective in one trial.There were no significant differences in healing in a comparison of a standard regimen of topical steroids (clobetasol) with a milder regimen (RR 1.00, 95% 0.97 to 1.03) in one trial. In another trial, clobetasol showed significantly more disease control than oral prednisolone in people with extensive and moderate disease (RR 1.09, 95% CI 1.02 to 1.17), with significantly reduced mortality and adverse events (RR 1.06, 95% CI 1.00 to 1.12). AUTHORS' CONCLUSIONS Very potent topical steroids are effective and safe treatments for BP, but their use in extensive disease may be limited by side-effects and practical factors. Milder regimens (using lower doses of steroids) are safe and effective in moderate BP. Starting doses of prednisolone greater than 0.75 mg/kg/day do not give additional benefit, lower doses may be adequate to control disease and reduce the incidence and severity of adverse reactions. The effectiveness of adding plasma exchange, azathioprine or mycophenolate mofetil to corticosteroids, and combination treatment with tetracycline and nicotinamide needs further investigation.
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Affiliation(s)
- Gudula Kirtschig
- University of TübingenInstitute of General Medicine and Interprofessional CareTübingenGermany
- Nottingham University Hospitals NHS TrustCentre of Evidence Based DermatologyNottinghamUK
| | - Philippa Middleton
- Healthy Mothers, Babies and Children, South Australian Health and Medical Research InstituteWomen's and Children's Hospital72 King William RoadAdelaideSouth AustraliaAustralia5006
| | - Cathy Bennett
- Coventry UniversityCentre for Technology Enabled Health Research (CTEHR)Priory StreetCoventryUKCV1 5FB
| | - Dedee F Murrell
- St George Hospital & University of New South WalesDepartment of DermatologyBelgrave StKogarahSydneyNSWAustralia2217
| | | | - Nonhlanhla P Khumalo
- Groote Schuur HospitalDepartment of DermatologyAnzio RoadObservatoryCape TownWestern CapeSouth Africa7925
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