Jerry Shapiro, M.D.

Central hair loss in African American women: incidence and potential risk factors
Olsen, Elise A; Callender, Valerie; McMichael, Amy; Sperling, Leonard; Anstrom, Kevin J; Shapiro, Jerry; Roberts, Janet; Durden, Faith; Whiting, David; Bergfeld, Wilma
2011 Feb;64(2):245-252, Journal of the American Academy of Dermatology
BACKGROUND: Although central scalp hair loss is a common problem in African American women, data on etiology or incidence are limited. OBJECTIVE: We sought to determine the frequency of various patterns and degree of central scalp hair loss in African American women and to correlate this with information on hair care practices, family history of hair loss, and medical history. METHODS: Five hundred twenty-nine subjects at six different workshops held at four different sites in the central and/or southeast United States participated in this study. The subjects' patterns and degree of central scalp hair loss were independently assessed by both subject and investigator using a standardized photographic scale. Subjects also completed a detailed questionnaire and had standardized photographs taken. Statistical analysis was performed evaluating answers to the questionnaire relative to pattern of central hair loss. RESULTS: Extensive central scalp hair loss was seen in 5.6% of subjects. There was no obvious association of extensive hair loss with relaxer or hot comb use, history of seborrheic dermatitis or reaction to a hair care product, bacterial infection, or male pattern hair loss in fathers of subjects; however, there was an association with a history of tinea capitis. LIMITATIONS: There was no scalp biopsy correlation with clinical pattern of hair loss and further information on specifics of hair care practices is needed. CONCLUSIONS: This central scalp photographic scale and questionnaire provide a valid template by which to further explore potential etiologic factors and relationships to central scalp hair loss in African American women
— id: 138285, year: 2011, vol: 64, page: 245, stat: Journal Article,

Alopecia areata update: part I. Clinical picture, histopathology, and pathogenesis
Alkhalifah, Abdullah; Alsantali, Adel; Wang, Eddy; McElwee, Kevin J; Shapiro, Jerry
2010 Feb;62(2):177-88, quiz 189, Journal of the American Academy of Dermatology
Alopecia areata (AA) is an autoimmune disease that presents as nonscarring hair loss, although the exact pathogenesis of the disease remains to be clarified. Disease prevalence rates from 0.1% to 0.2% have been estimated for the United States. AA can affect any hair-bearing area. It often presents as well demarcated patches of nonscarring alopecia on skin of overtly normal appearance. Recently, newer clinical variants have been described. The presence of AA is associated with a higher frequency of other autoimmune diseases. Controversially, there may also be increased psychiatric morbidity in patients with AA. Although some AA features are known poor prognostic signs, the course of the disease is unpredictable and the response to treatment can be variable. Part one of this two-part series on AA describes the clinical presentation and the associated histopathologic picture. It also proposes a hypothesis for AA development based on the most recent knowledge of disease pathogenesis. LEARNING OBJECTIVES: After completing this learning activity, participants should be familiar with the most recent advances in AA pathogenesis, recognize the rare and recently described variants of AA, and be able to distinguish between different histopathologic stages of AA
— id: 115725, year: 2010, vol: 62, page: 177, stat: Journal Article,

Alopecia areata update: part II. Treatment
Alkhalifah, Abdullah; Alsantali, Adel; Wang, Eddy; McElwee, Kevin J; Shapiro, Jerry
2010 Feb;62(2):191-202, quiz 203, Journal of the American Academy of Dermatology
Various therapeutic agents have been described for the treatment of alopecia areata (AA), but none are curative or preventive. The aim of AA treatment is to suppress the activity of the disease. The high rate of spontaneous remission and the paucity of randomized, double-blind, placebo-controlled studies make the evidence-based assessment of these therapies difficult. The second part of this two-part series on AA discusses treatment options in detail and suggests treatment plans according to specific disease presentation. It also reviews recently reported experimental treatment options and potential directions for future disease management. LEARNING OBJECTIVES: After completing this learning activity, participants should be able to compare the efficacy and safety of various treatment options, formulate a treatment plan tailored to individual patients, and recognize recently described treatments and potential therapeutic approaches
— id: 115724, year: 2010, vol: 62, page: 191, stat: Journal Article,

Hair follicles from alopecia areata patients exhibit alterations in immune privilege-associated gene expression in advance of hair loss
Kang, Hoon; Wu, Wen-Yu; Lo, Blanche K K; Yu, Mei; Leung, Gigi; Shapiro, Jerry; McElwee, Kevin J
2010 Nov;130(11):2677-2680, Journal of investigative dermatology
— id: 115723, year: 2010, vol: 130, page: 2677, stat: Journal Article,

Lichen planopilaris and pseudopelade of Brocq involve distinct disease associated gene expression patterns by microarray
Yu, Mei; Bell, Robert H; Ross, Elizabeth K; Lo, Blanche K K; Isaac-Renton, Megan; Martinka, Magda; Haegert, Anne; Shapiro, Jerry; McElwee, Kevin J
2010 Jan;57(1):27-36, Journal of dermatological science
BACKGROUND: Lichen planopilaris (LPP) and pseudopelade of Brocq (PPB) are two scarring alopecia diagnoses that exhibit similar clinical features. Some suggest LPP and PPB are not distinct diseases, but rather different clinical presentations in a spectrum derived from the same underlying pathogenic mechanism. OBJECTIVE: We explored the degree of similarity between LPP and PPB gene expression patterns and the potential for common and unique gene pathway and gene activity in LPP and PPB using microarrays. METHODS: Microarray analysis, using a 21K cDNA set, was performed on pairs of biopsies obtained from affected and unaffected scalp of untreated patients. Diagnosis was confirmed by histopathology. Significantly differentially expressed genes were identified by analysis of microarray results in various datasets and screened for signaling pathway involvement. Selected genes were validated by quantitative PCR and immunohistology. RESULTS: The global gene expression profiles in LPP and PPB versus comparative intra-control scalp tissue were distinguishable by significance analysis of microarrays (SAM). There was limited commonality in the gene expression profiles between LPP and PPB. Specific genes, such as MMP11, TNFSF13B, and APOL2, were identified with significantly differential expression in association with LPP versus PPB. CONCLUSIONS: Our findings may have important implications for understanding the pathogenesis of LPP and PPB at the molecular level. Results suggest LPP and PPB involve different mechanisms of disease development and should be regarded as biologically distinct cicatricial alopecia diagnoses. Genes that we have identified may be useful as markers of the respective diagnoses and may be potential therapeutic targets
— id: 115726, year: 2010, vol: 57, page: 27, stat: Journal Article,

Androgens and hair loss
Alsantali, Adel; Shapiro, Jerry
2009 Jun;16(3):246-253, Current opinion in endocrinology, diabetes, & obesity
PURPOSE OF REVIEW: Androgenetic alopecia (AGA) or male pattern hair loss is a very common condition that has a significant psychosocial impact for patients. Many advances in the pathogenesis and treatment of AGA have been discovered recently. We discuss the pathogenesis and treatment of AGA. RECENT FINDINGS: Wide genome analysis showed an association of AGA and chromosome 20pll in addition to androgen-receptor gene. Also, a locus on chromosome 3q26 was found to have a linkage with AGA. Dutasteride has been shown to be more effective than finasteride in the treatment of AGA but is not yet a recommended therapy. In an in-vitro study, a new topical liposomal finasteride formulation showed more than five-fold higher deposition of drug in skin than the corresponding plain drug solution. SUMMARY: These recent developments in the field of AGA hold some promise and may play a role in the future management
— id: 115732, year: 2009, vol: 16, page: 246, stat: Journal Article,

European Consensus on the evaluation of women presenting with excessive hair growth
Blume-Peytavi, Ulrike; Atkin, Stephen; Shapiro, Jerry; Lavery, Stuart; Grimalt, Ramon; Hoffmann, Rolf; Gieler, Uwe; Messenger, Andrew
2009 Nov-Dec;19(6):597-602, European journal of dermatology. EJD
Our objective was to develop clinical practice guidance for the evaluation of hirsutism in premenopausal women. The Skin Academy is led by an international interdisciplinary team of experts, and aims to use the latest scientific and clinical data in selected dermatological diseases, to promote awareness, education and best clinical practice, thus improving patient care. The Skin Academy is an international platform designed to drive and develop education and awareness programmes, and to transfer scientific knowledge in dermatology across Europe and wider geographical areas. Consensus was guided by systematic review and discussion of current clinical practice across Europe during several group meetings of The Skin Academy, supported by conference calls, and e-mail communications. The outcome of the discussions was an evaluation form to be used by the clinician to help evaluate a patient presenting with excessive hair growth. This round-table expert opinion consensus paper, and the Diagnostic Evaluation Form it contains, is presented for discussion by the wider dermatology community
— id: 115727, year: 2009, vol: 19, page: 597, stat: Journal Article,

Uncombable hair syndrome
Calderon, Pamela; Otberg, Nina; Shapiro, Jerry
2009 Sep;61(3):512-515, Journal of the American Academy of Dermatology
Uncombable hair syndrome is a relatively rare anomaly of the hair shaft, with less than 100 cases reported to date, that results in a disorganized, unruly hair pattern that is impossible to comb flat. The characteristic longitudinal grooves along the hair shaft, along with the triangular or kidney-shaped cross section allows this condition to be diagnosed microscopically. The majority of cases are inherited in an autosomal-dominant manner with either complete or incomplete penetrance. There is no definitive treatment, and most cases improve with the onset of puberty
— id: 115728, year: 2009, vol: 61, page: 512, stat: Journal Article,

Successful hair re-growth with multimodal treatment of early cicatricial alopecia in discoid lupus erythematosus
Hamilton, Tatyana; Otberg, Nina; Wu, Wen-Yu; Martinka, Magdalena; Shapiro, Jerry
2009 ;89(4):417-418, Acta dermato-venereologica
— id: 115730, year: 2009, vol: 89, page: 417, stat: Journal Article,

Discoid lupus erythematosus presenting with cysts, comedones, and cicatricial alopecia on the scalp
Hemmati, Iman; Otberg, Nina; Martinka, Magdalena; Alzolibani, Abdullateef; Restrepo, Isabel; Shapiro, Jerry
2009 Jun;60(6):1070-1072, Journal of the American Academy of Dermatology
— id: 115733, year: 2009, vol: 60, page: 1070, stat: Journal Article,

Folliculitis decalvans developing 20 years after hair restoration surgery in punch grafts: case report
Otberg, Nina; Wu, Wen-Yu; Kang, Hoon; Martinka, Magdalena; Alzolibani, Abdullateef A; Restrepo, Isabel; Shapiro, Jerry
2009 Nov;35(11):1852-1856, Dermatologic surgery
— id: 115729, year: 2009, vol: 35, page: 1852, stat: Journal Article,

Alefacept for severe alopecia areata: a randomized, double-blind, placebo-controlled study
Strober, Bruce E; Menon, Kavita; McMichael, Amy; Hordinsky, Maria; Krueger, Gerald; Panko, Jackie; Siu, Kimberly; Lustgarten, Jonathan L; Ross, Elizabeth K; Shapiro, Jerry
2009 Nov;145(11):1262-1266, Archives of dermatology
OBJECTIVE: To assess the efficacy of alefacept for the treatment of severe alopecia areata (AA). DESIGN: Multicenter, double-blind, randomized, placebo-controlled clinical trial. SETTING: Academic departments of dermatology in the United States. PARTICIPANTS: Forty-five individuals with chronic and severe AA affecting 50% to 95% of the scalp hair and resistant to previous therapies. Intervention Alefacept, a US Food and Drug Administration-approved T-cell biologic inhibitor for the treatment of moderate to severe plaque psoriasis. Main Outcome Measure Improved Severity of Alopecia Tool (SALT) score over 24 weeks. RESULTS: Participants receiving alefacept for 12 consecutive weeks demonstrated no statistically significant improvement in AA when compared with a well-matched placebo-receiving group (P = .70). Conclusion Alefacept is ineffective for the treatment of severe AA
— id: 105347, year: 2009, vol: 145, page: 1262, stat: Journal Article,

Successful treatment of temporal triangular alopecia by hair restoration surgery using follicular unit transplantation
Wu, Wen-Yu; Otberg, Nina; Kang, Hoon; Zanet, Lucianna; Shapiro, Jerry
2009 Aug;35(8):1307-1310, Dermatologic surgery
— id: 115731, year: 2009, vol: 35, page: 1307, stat: Journal Article,

Development of alopecia areata is associated with higher central and peripheral hypothalamic-pituitary-adrenal tone in the skin graft induced C3H/HeJ mouse model
Zhang, Xingqi; Yu, Mei; Yu, Wayne; Weinberg, Joanne; Shapiro, Jerry; McElwee, Kevin J
2009 Jun;129(6):1527-1538, Journal of investigative dermatology
The relationship of the stress response to the pathogenesis of alopecia areata (AA) was investigated by subjecting normal and skin graft-induced, AA-affected C3H/HeJ mice to light ether anesthesia or restraint stress. Plasma corticosterone (CORT), adrenocorticotropic hormone (ACTH), and estradiol (E2) levels were determined by RIA, whereas gene expression in brains, lymphoid organs, and skin was measured by quantitative RT-PCR for corticotropin-releasing hormone (Crh), arginine vasopressin (Avp), proopiomelanocortin (Pomc), glucocorticoid receptor (Nr3c1), mineralocorticoid receptor (Nr3c2), corticotropin-releasing hormone receptor types 1 and 2 (Crhr1, Crhr2), interleukin-12 (Il12), tumor necrosis factor-alpha (Tnf alpha), and estrogen receptors type-1 (Esr1) and type-2 (Esr2). AA mice had a marked increase in hypothalamic-pituitary-adrenal (HPA) tone and activity centrally, and peripherally in the skin and lymph nodes. There was also altered interaction between the adrenal and gonadal axes compared with that in normal mice. Stress further exacerbated changes in AA mouse HPA activity both centrally and peripherally. AA mice had significantly blunted CORT and ACTH responses to acute ether stress (physiological stressor) and a deficit in habituation to repeated restraint stress (psychological stressor). The positive correlation of HPA hormone levels with skin Th1 cytokines suggests that altered HPA activity may occur as a consequence of the immune response associated with AA
— id: 115734, year: 2009, vol: 129, page: 1527, stat: Journal Article,

Pseudopelade of Brocq
Alzolibani, Abdullateef A; Kang, Hoon; Otberg, Nina; Shapiro, Jerry
2008 Jul-Aug;21(4):257-263, Dermatologic therapy
Pseudopelade of Brocq (PPB) is a rare, idiopathic, slowly progressive hair disorder, resulting in cicatricial alopecia. It typically presents in Caucasian adult patients as small, smooth, flesh-toned and slightly depressed alopecic patches with irregular outlines. It primarily involves the parietal and vertex portions of the scalp with a chronic prolonged course. Controversial opinions still exist as to whether PPB is a single entity or an end stage of several cicatricial alopecic disorders. A practical approach to diagnosis of PPB and therapeutic update are discussed in this review
— id: 115737, year: 2008, vol: 21, page: 257, stat: Journal Article,

Calcipotriol plus betamethasone dipropionate scalp formulation is effective and well tolerated in the treatment of scalp psoriasis: a phase II study
Buckley, Colin; Hoffmann, Vibeke; Shapiro, Jerry; Saari, Seppo; Cambazard, Frederic; Milsgaard, Mette
2008 ;217(2):107-113, Dermatology
BACKGROUND: There is a need for more effective therapy for scalp psoriasis. OBJECTIVE: To assess the efficacy and safety of a 2-compound scalp formulation including calcipotriol and betamethasone dipropionate in the treatment of scalp psoriasis. METHODS: Patients (n = 218) with scalp psoriasis were randomized to treatment with the 2-compound scalp formulation (n = 108) or betamethasone dipropionate in the same vehicle (n = 110). The treatments were applied once daily on the scalp for up to 8 weeks. RESULTS: The 2-compound scalp formulation showed a significantly higher efficacy than betamethasone dipropionate on the total sign score at the end of treatment (p = 0.042) and after 2 weeks (p = 0.005). CONCLUSION: The calcipotriol plus betamethasone dipropionate scalp formulation was superior to betamethasone dipropionate in the same vehicle when used once daily for up to 8 weeks in the treatment of scalp psoriasis
— id: 115741, year: 2008, vol: 217, page: 107, stat: Journal Article,

Secondary cicatricial and other permanent alopecias
Finner, Andreas M; Otberg, Nina; Shapiro, Jerry
2008 Jul-Aug;21(4):279-294, Dermatologic therapy
Various nonfollicular scalp conditions can cause secondary scarring or permanent alopecia. Possible causes are congenital defects, trauma, inflammatory conditions, infections, and neoplasms (rarely drugs). Associated signs and symptoms and other diagnostic procedures such as histopathology may aid in the diagnosis. Detection of the underlying disorder may be difficult in end-stage lesions. Treatment is specific for active conditions. Surgery and hair transplantation are options for localized scars
— id: 115736, year: 2008, vol: 21, page: 279, stat: Journal Article,

Lichen planopilaris
Kang, Hoon; Alzolibani, Abdullateef A; Otberg, Nina; Shapiro, Jerry
2008 Jul-Aug;21(4):249-256, Dermatologic therapy
Lichen planopilaris is a chronic scarring alopecia characterized by follicular hyperkeratosis, perifollicular erythema, and loss of follicular orifices. The scalp lesions may be single or multiple and commonly involve the vertex and parietal area. The hair follicles at the margin of the alopecic patches reveal perifollicular erythema. Anagen hairs can be pulled out easily in active lesions. Associated cutaneous, nail, and mucous membrane lichen planus may be present. Commonly encountered symptoms and signs are increased hair shedding, itching, scaling, burning, and tenderness. Differentiation from other cicatricial alopecia can be performed through meticulous evaluation of the clinical, histopathologic, and immunohistopathologic findings. Treatment strategies depend on the disease activity and physician expertise. Although there are no definitive curative modalities, some new discoveries and conceptual advances continue to broaden our treatment options of this complex condition
— id: 115739, year: 2008, vol: 21, page: 249, stat: Journal Article,

Folliculitis decalvans
Otberg, Nina; Kang, Hoon; Alzolibani, Abdullateef A; Shapiro, Jerry
2008 Jul-Aug;21(4):238-244, Dermatologic therapy
Folliculitis decalvans is a rare inflammatory scalp disorder. The present paper gives a practical approach to diagnosis and patient management and reviews possible pathogenetic factors and treatment options. Folliculitis decalvans is classified as primary neutrophilic cicatricial alopecia and predominantly occurs in middle-aged adults. Staphylococcus aureus and a deficient host immune response seem to play an important role in the development of this disfiguring scalp disease. Lesions occur mainly in the vertex and occipital area. Clinically, the lesions present with follicular pustules, lack of ostia, diffuse and perifollicular erythema, follicular tufting, and, oftentimes, hemorrhagic crusts and erosions. Histology displays a mainly neutrophilic inflammatory infiltrate in early lesions and additionally lymphocytes and plasma cells in advanced lesions. Treatment is focused on the eradication of S. aureus anti-inflammatory agents
— id: 115738, year: 2008, vol: 21, page: 238, stat: Journal Article,

Diagnosis and management of primary cicatricial alopecia: part I
Otberg, Nina; Wu, Wen-Yu; McElwee, Kevin John; Shapiro, Jerry
2008 Jan-Feb;7(1):19-26, Skinmed
In this 2-part article, the authors review the primary cicatricial alopecias. Primary cicatricial alopecia can be defined as predominantly lymphocytic, neutrophilic, or mixed based on the nature of the follicular infiltrate that is present around affected hair follicles. Lymphocytic primary cicatricial alopecias include chronic cutaneous lupus erythematosus (discoid lupus erythematosus), lichen planopilaris, classic pseudopelade of Brocq, central centrifugal cicatricial alopecia, alopecia mucinosa, and keratosis follicularis spinulosa decalvans. In this first part, the authors summarize the classification, epidemiology, diagnostic approach, and patient management of lymphocytic cicatricial alopecias. In part II, the authors will focus on neutrophilic cicatricial alopecias and mixed cicatricial alopecias
— id: 115744, year: 2008, vol: 7, page: 19, stat: Journal Article,

Cicatricial alopecias
Shapiro, Jerry
2008 Jul-Aug;21(4):211-211, Dermatologic therapy
— id: 115740, year: 2008, vol: 21, page: 211, stat: Journal Article,

Diagnosis and management of primary cicatricial alopecia: part II
Wu, Wen-Yu; Otberg, Nina; McElwee, Kevin John; Shapiro, Jerry
2008 Mar-Apr;7(2):78-83, Skinmed
The second part of this 2-part article reviews clinical features, histology, management, and treatment of neutrophilic primary cicatricial alopecias (folliculitis decalvans and dissecting folliculitis) and mixed primary cicatricial alopecias (acne keloidalis, acne necrotica, and erosive pustular dermatosis)
— id: 115742, year: 2008, vol: 7, page: 78, stat: Journal Article,

Interleukin-6 cytokine family member oncostatin M is a hair-follicle-expressed factor with hair growth inhibitory properties
Yu, Mei; Kissling, Sabine; Freyschmidt-Paul, Pia; Hoffmann, Rolf; Shapiro, Jerry; McElwee, Kevin J
2008 Jan;17(1):12-19, Experimental dermatology
The activation of receptor complexes containing glycoprotein 130 (gp130) identifies the interleukin (IL)-6 cytokine family. We examined members of this family for their expression and activity in hair follicles. Quantitative polymerase chain reaction using mRNA derived from microdissected, anagen-stage human hair follicles and comparison to non-follicular skin epithelium revealed higher levels of IL-6 (15.5-fold) and oncostatin M (OSM, 3.4-fold) in hair follicles. In contrast, expression of all mRNAs coding for IL-6 cytokine family receptors was reduced. Immunohistology suggested expression of OSM, gp130, leukaemia inhibitory factor receptor (LIFr) and IL-11r in the hair follicle root sheaths and dermal papilla, while IL-11, IL-6r and OSMr were expressed in root sheaths alone. IL-6 was expressed in the dermal papilla while cardiotrophin-1 (CT-1) and LIF were not observed. OSM and to a lesser extent CT-1 exhibited a dose-dependent growth inhibition capacity on human hair follicles in vitro. OSM and CT-1 incubated with agarose beads and injected subcutaneously at 1 mug per mouse into telogen skin of 65-day-old mice revealed no capacity to induce anagen hair growth. In contrast, injection of 65-day-old mice in which anagen had been induced by hair plucking revealed a moderate hair growth inhibitory capacity for OSM, but no significant effect for CT-1. The data identify OSM as a modulator of hair follicle growth and suggest other family members may also have some degree of hair growth inhibitory effect. In principle, increased expression of some IL-6 cytokine family members in cutaneous inflammation might contribute to the promotion of hair loss
— id: 115745, year: 2008, vol: 17, page: 12, stat: Journal Article,

Superficial, nodular, and morpheiform basal-cell carcinomas exhibit distinct gene expression profiles
Yu, Mei; Zloty, David; Cowan, Bryce; Shapiro, Jerry; Haegert, Anne; Bell, Robert H; Warshawski, Larry; Carr, Nicholas; McElwee, Kevin J
2008 Jul;128(7):1797-1805, Journal of investigative dermatology
Basal-cell carcinoma (BCC), the most common neoplasm in humans, occurs in a variety of morphological presentations. The mechanisms of BCC development downstream of the initial genetic mutations are not well understood, and different BCC morphological presentations might exhibit distinct gene expression patterns. We investigated superficial (n=8), nodular (n=8), and morpheiform (n=7) BCCs using 21K cDNA microarrays. Global gene expression profiles between respective BCC subtypes, and as compared with normal skin (n=8), were statistically defined by significance analysis of microarrays (SAM). Thirty-seven genes were subsequently validated by quantitative reverse transcriptase-PCR analysis using an expanded set of 31 BCCs. Gene ontology analysis indicated that gene expression patterns of BCC subtypes in multiple biological processes showed significant variation, particularly in genes associated with the mitogen-activated protein kinase (MAPK) pathway. Notably, genes involved in response to DNA-damage stimulus were uniquely upregulated in morpheiform BCCs. Our results indicate a relative similarity in gene expression between nodular and superficial BCC subtypes. In contrast, morpheiform BCCs are more diverse, with gene expression patterns consistent with their more 'invasive' phenotype. These data may help us understand the complex behavior of BCC subtypes and may eventually lead to new therapeutic strategies
— id: 115743, year: 2008, vol: 128, page: 1797, stat: Journal Article,

Efficacy of a day-care program in the treatment of psoriasis
Zhang, Junling; Adam, David N; Stebbing, Elaine; Gerbrandt, Judith; Lui, Harvey; Shapiro, Jerry; Zhou, Youwen
2008 Sep-Oct;12(5):211-216, Journal of cutaneous medicine & surgery
BACKGROUND: Few data exist documenting the effectiveness of psoriasis day-care treatment programs (PDTPs) using standardized efficacy measurements. OBJECTIVES: We sought to analyze the efficacy of a PDTP using the Psoriasis Area and Severity Index (PASI). METHODS: A retrospective review was performed on 132 patients treated at our PDTP. Sufficient data existed to permit PASI analysis using a simplified method for a representative subgroup of 64 patients, who formed the study population. Patients received phototherapy and topical treatments over 2 weeks. The outcome measures included a baseline and day 11 PASI, a physician global assessment (PGA), and adverse events reported by the patients. RESULTS: Mean baseline PASI was 13.6 (N = 64), with a 59.6% reduction by day 11. A PASI reduction of > or = 50% was seen in 75% of patients, with 30% of patients achieving > or = 75% reduction of PASI. Day 11 PGA demonstrated a 69.9% improvement. CONCLUSION: With a reduction in PASI of 59.6% at 11 days, our PDTP, with phototherapy and topical agents, seems to be a rapid and effective therapy for psoriasis
— id: 115735, year: 2008, vol: 12, page: 211, stat: Journal Article,

A randomized bilateral vehicle-controlled study of eflornithine cream combined with laser treatment versus laser treatment alone for facial hirsutism in women
Hamzavi, Iltefat; Tan, Eileen; Shapiro, Jerry; Lui, Harvey
2007 Jul;57(1):54-59, Journal of the American Academy of Dermatology
BACKGROUND AND OBJECTIVE: Although there are a multitude of therapeutic modalities for removing unwanted facial hair in women, there is very little information on using the newer medical treatment approaches in combination. This study was designed to determine whether topical eflornithine can enhance the efficacy of laser hair removal. DESIGN: This was a randomized, double-blind, placebo-controlled, right-left comparison study of eflornithine cream combined with laser treatment versus laser alone for treating unwanted hair on the upper lip in women. All subjects underwent treatment to the entire upper lip with a long pulse alexandrite laser (10-40 ms pulse duration) at fluences of 7 to 40 J/cm(2). Laser treatments were performed every 4 weeks for up to 6 sessions. Each patient also applied either eflornithine or placebo cream twice daily to each side of the upper lip in a double-blinded manner. Subjects were evaluated for safety by recording adverse events and for efficacy via (1) investigator global scoring, (2) patient self assessment, and (3) hair count analysis. RESULTS: Both treatment modalities were well tolerated by the 31 evaluable patients. All 3 outcome measures showed significantly better results in favor of eflornithine plus laser versus laser treatment alone. At the end of the study, complete or almost complete hair removal was achieved in 29 of 31 (93.5%) of the eflornithine-laser-treated sites versus 21 of 31 (67.9%) for the placebo cream-laser-treated sites (P = .021, McNemar test). Statistically significant differences in favor of eflornithine were likewise demonstrated at the final assessment through blinded patient grading (13/31 patients [41.9%] thought that the eflornithine was superior to placebo, P = .029, Poisson regression) and hair count analysis (P < .01, paired t test). LIMITATIONS: This is a single-center study that did not determine whether the differences noted above last beyond 6 months. CONCLUSIONS: On the basis of both investigator and patient assessments and hair count analysis, we have demonstrated that the addition of eflornithine to laser hair removal results in a more rapid and complete reduction of unwanted facial hair in women when the combination is used for up to 6 months
— id: 115748, year: 2007, vol: 57, page: 54, stat: Journal Article,

Androgenetic alopecia
Otberg, Nina; Finner, Andreas M; Shapiro, Jerry
2007 Jun;36(2):379-398, Endocrinology & metabolism clinics of North America
Androgenetic alopecia (AGA), or male pattern hair loss, affects approximately 50% of the male population. AGA is an androgen-related condition in genetically predisposed individuals. There is no treatment to completely reverse AGA in advanced stages, but with medical treatment (eg, finasteride, minoxidil, or a combination of both), the progression can be arrested and partly reversed in the majority of patients who have mild to moderate AGA. Combination with hair restoration surgery leads to best results in suitable candidates. Physicians who specialize in male health issues should be familiar with this common condition and all the available approved treatment options
— id: 115747, year: 2007, vol: 36, page: 379, stat: Journal Article,

Clinical practice. Hair loss in women
Shapiro, Jerry
2007 Oct 18;357(16):1620-1630, New England journal of medicine
— id: 115746, year: 2007, vol: 357, page: 1620, stat: Journal Article,

Alopecia areata: pathogenesis and potential for therapy
Lu, Wei; Shapiro, Jerry; Yu, Mei; Barekatain, Armin; Lo, Blanche; Finner, Andreas; McElwee, Kevin
2006 ;8(14):1-19, Expert reviews in molecular medicine
Although the complete picture for alopecia areata (AA) pathogenesis has yet to be determined, recent research has made much progress in our understanding of the disease mechanism. Numerous circumstantial evidence supports the notion that AA is fundamentally a disease mediated by inflammatory cells and may be autoimmune in nature. Recent research has shown the hair-loss phenotype is precipitated predominantly by CD8+ lymphocytes, but the disease mechanism is driven by CD4+ lymphocytes. Although genetic susceptibility is a key contributor to disease development, disease onset and phenotypic presentation are probably modified by complex environmental interplay. On the basis of our current understanding of AA disease pathogenesis, several experimental and theoretical therapeutic approaches might be possible. However, the pathogenetic disease mechanism is particularly robust and the development of a cure for AA will be a significant challenge
— id: 115749, year: 2006, vol: 8, page: 1, stat: Journal Article,

Paradoxical hypertrichosis after laser epilation
Alajlan, Abdulmajeed; Shapiro, Jerry; Rivers, Jason K; MacDonald, Nina; Wiggin, Judy; Lui, Harvey
2005 Jul;53(1):85-88, Journal of the American Academy of Dermatology
OBJECTIVE: Hair removal using lasers or broadband intense pulsed light has become one of the most ubiquitous medical procedures. At our center a small proportion of patients have spontaneously reported what they believed to be increased hair growth at sites of previous laser epilation. We sought to retrospectively review the prevalence and features of this paradoxical effect. METHODS: This was a single center, retrospective study that included all patients who underwent laser hair removal during a 4-year period with a long-pulsed alexandrite laser. All cases of laser-induced hypertrichosis were assessed clinically by history, examination, and laboratory tests, and confirmed by review of serial clinical photographs taken during the course of the laser treatments. The clinical features of patients with postlaser hypertrichosis were compared with 50 patients randomly selected from among all those who had undergone laser hair removal at our center (n = 489). RESULTS: Of 489 patients, 3 (0.6%, 95% confidence interval: 0.01-1.9%) treated with the long-pulsed alexandrite laser (755 nm) reported increased hair after laser hair epilation. There was a trend for this adverse effect to occur in darker skin phototypes (IV) and with black hair as compared with the unaffected comparison group (n = 50). However, the small number of cases (n = 3) did not provide sufficient power to adequately test factors such as age, sex, treatment settings, and number of treatments statistically. CONCLUSION: Postlaser hair removal hypertrichosis is a real but rare occurrence in our experience
— id: 115753, year: 2005, vol: 53, page: 85, stat: Journal Article,

What can we learn from animal models of Alopecia areata?
McElwee, Kevin J; Yu, Mei; Park, Sung-Wook; Ross, Elizabeth K; Finner, Andreas; Shapiro, Jerry
2005 ;211(1):47-53, Dermatology
Alopecia areata (AA) is a hair loss disease marked by a focal inflammatory infiltrate of dystrophic anagen stage hair follicles by CD4+ and CD8+ lymphocytes. Although AA is thought to be an autoimmune disorder, definitive proof is lacking. Moreover, characterization of the primary pathogenic mechanisms by which hair loss is induced in AA is limited. In this context, animal models may provide a vital contribution to understanding AA. Recent research using animal models of AA has focused on providing evidence in support of a lymphocyte-mediated pathogenic mechanism consistent with AA as an autoimmune disease. In the future, research with both humans and animal models shall likely concentrate on identifying the primary antigenic epitopes involved in AA and the genetics of AA susceptibility. With a comprehensive understanding of the key elements in AA pathogenesis, new avenues for therapeutic research and intervention will be defined
— id: 115752, year: 2005, vol: 211, page: 47, stat: Journal Article,

Evaluation and treatment of male and female pattern hair loss
Olsen, Elise A; Messenger, Andrew G; Shapiro, Jerry; Bergfeld, Wilma F; Hordinsky, Maria K; Roberts, Janet L; Stough, Dow; Washenik, Ken; Whiting, David A
2005 Feb;52(2):301-311, Journal of the American Academy of Dermatology
— id: 67509, year: 2005, vol: 52, page: 301, stat: Journal Article,

Rapp-Hodgkin syndrome: a review of the aspects of hair and hair color
Park, Sung-Wook; Yong, Siu Li; Martinka, Magdalena; Shapiro, Jerry
2005 Oct;53(4):729-735, Journal of the American Academy of Dermatology
— id: 115751, year: 2005, vol: 53, page: 729, stat: Journal Article,

Lack of efficacy of topical latanoprost in the treatment of eyebrow alopecia areata
Ross, Elizabeth K; Bolduc, Chantal; Lui, Harvey; Shapiro, Jerry
2005 Dec;53(6):1095-1096, Journal of the American Academy of Dermatology
— id: 115750, year: 2005, vol: 53, page: 1095, stat: Journal Article,

Management of hair loss
Ross, Elizabeth K; Shapiro, Jerry
2005 Apr;23(2):227-243, Dermatologic clinics
The management of patients with hair loss requires a customized plan. Diagnosis, prognosis, psychosocial impact, treatment options, and patient preference are key determinants. This article discusses current agents for the treatment of three commonly encountered nonscarring alopecias: male- and female-pattern hair loss, telogen effluvium, and alopecia areata. Algorithmic approaches to management are provided
— id: 115755, year: 2005, vol: 23, page: 227, stat: Journal Article,

Update on primary cicatricial alopecias
Ross, Elizabeth K; Tan, Eileen; Shapiro, Jerry
2005 Jul;53(1):1-37, Journal of the American Academy of Dermatology
The cicatricial alopecias encompass a diverse group of disorders characterized by permanent destruction of the hair follicle and irreversible hair loss. Destruction of the hair follicle can result from primary, folliculocentric disease or as a secondary result. This article focuses on the former, or primary cicatricial alopecias. The cause and pathogenesis of many of these disorders are largely unknown. Although unique clinicopathologic features allow for accurate diagnosis in some cases, diagnostic certainty is often elusive and reflects the limits of present understanding. Classification of the primary cicatricial alopecias on the basis of pathology provides a diagnostic and investigational framework and, it is hoped, will facilitate future enlightenment. Details of classification, etiopathogenesis, clinicopathologic features, differential diagnosis, and practical management of the primary cicatricial alopecias will be discussed. LEARNING OBJECTIVES: Upon completion of this learning activity, participants should be familiar with the following aspects of the primary cicatricial alopecias: (1) the new, consensus-issued classification scheme, (2) current understanding about etiopathogenesis, (3) salient clinicopathologic features, (4) differential diagnosis, and (5) therapeutic management
— id: 115754, year: 2005, vol: 53, page: 1, stat: Journal Article,

Parametric modeling of narrowband UV-B phototherapy for vitiligo using a novel quantitative tool: the Vitiligo Area Scoring Index
Hamzavi, Iltefat; Jain, Hem; McLean, David; Shapiro, Jerry; Zeng, Haishan; Lui, Harvey
2004 Jun;140(6):677-683, Archives of dermatology
BACKGROUND: There is currently no quantitative tool for evaluating vitiligo treatment response using parametric methods. OBJECTIVE: To develop and apply a simple clinical tool, the Vitiligo Area Scoring Index (VASI), to model the response of vitiligo to narrowband UV-B (NB-UV-B) phototherapy using parametric tests. DESIGN: Prospective, randomized, controlled, bilateral left-right comparison trial. SETTING: North American tertiary care, university-affiliated phototherapy center. PATIENTS: Patients older than 18 years with stable vitiligo involving at least 5% of their total body surface in a symmetric distribution. INTERVENTION: Treatment with NB-UV-B was given 3 times a week to half of the body on all patients for either 60 treatments or 6 months. The contralateral side served as a no-treatment control. MAIN OUTCOME MEASURE: Repigmentation was assessed using the VASI, which was based on a composite estimate of the overall area of vitiligo patches at baseline and the degree of macular repigmentation within these patches over time. The VASI was validated separately against physician and patient global assessments. The overall reductions in VASI for NB-UV-B and control groups were modeled by multilevel regression with random effects and compared parametrically. RESULTS: The VASI scoring correlated well with both patient and physician global assessments (P =.05 and P<.001, respectively, using ordinal logistic regression). The extent of repigmentation after 6 months on the treated side was 42.9% (95% confidence interval, 26.7%-59.0%) vs 3.3% (95% confidence interval -19.3% to 30.0%) on the untreated side (P<.001). A significant difference between control and NB-UV-B groups was apparent within the first 2 months of therapy. The legs, trunk, and arms were much more likely to repigment than the feet and hands. CONCLUSIONS: The VASI is a quantitative clinical tool that can be used to evaluate vitiligo parametrically. Patients treated with NB-UV-B can be expected to achieve approximately 42.9% repigmentation of their vitiligo after 6 months of treatment, with the greatest response being achieved over the trunk and nonacral portions of the extremities
— id: 115756, year: 2004, vol: 140, page: 677, stat: Journal Article,

Alopecia areata investigational assessment guidelines--Part II. National Alopecia Areata Foundation
Olsen, Elise A; Hordinsky, Maria K; Price, Vera H; Roberts, Janet L; Shapiro, Jerry; Canfield, Doug; Duvic, Madeleine; King, Lloyd E Jr; McMichael, Amy J; Randall, Valerie A; Turner, Maria L; Sperling, Leonard; Whiting, David A; Norris, David
2004 Sep;51(3):440-447, Journal of the American Academy of Dermatology
— id: 67510, year: 2004, vol: 51, page: 440, stat: Journal Article,

Primary cicatricial alopecias: clinicopathology of 112 cases
Tan, Eileen; Martinka, Magdalena; Ball, Nigel; Shapiro, Jerry
2004 Jan;50(1):25-32, Journal of the American Academy of Dermatology
BACKGROUND: Cicatricial alopecias represent a diverse group of diseases characterized by a lack of follicular ostia and irreversible alopecia. There is limited literature on the epidemiology and therapeutics of cicatricial alopecias. OBJECTIVE: The aim of this study was to review the epidemiology, clinical characteristics, and treatment of inflammatory cicatricial alopecias in a mixed ethnic population referred to a university hair clinic. METHODS: The study population consisted of 112 patients seen during a 5-year period with acquired primary cicatricial alopecias. This represented 3.2% of the total number of trichologic consultations seen at the University of British Columbia Hair Clinic, Vancouver, British Columbia, Canada. RESULTS: The ratio of lymphocytic to neutrophilic cicatricial alopecias was 4:1. Lymphocytic cicatricial alopecias had a tendency to affect middle-aged women, whereas neutrophilic cicatricial alopecias had a predilection for middle-aged men. CONCLUSIONS: An accurate diagnosis of cicatricial alopecia is achieved through careful clinicopathologic evaluation. We suggest that a scalp biopsy is mandatory in all cases. Multiple biopsies may be necessary for some affected individuals to achieve a definitive diagnosis as a result of a highly variable clinical course. An aggressive multiple modality therapeutic approach is often necessary to prevent further irreversible follicular destruction, implying cicatrical alopecia should be considered a trichologic emergency. Current therapeutic options for lymphocytic cicatricial alopecia include corticosteroids, antimalarials, and isotretinoin versus antibiotics, corticosteroids, and isotretinoin for neutrophilic cicatricial alopecias
— id: 115758, year: 2004, vol: 50, page: 25, stat: Journal Article,

Topical nitrogen mustard in the treatment of alopecia areata: a bilateral comparison study
Bernardo, Olga; Tang, Liren; Lui, Harvey; Shapiro, Jerry
2003 Aug;49(2):291-294, Journal of the American Academy of Dermatology
Topical nitrogen mustard is an alkylating agent. Its efficacy in treating alopecia areata was reported in an uncontrolled study. We present a preliminary, half-head, controlled 16-week study showing that topical nitrogen mustard was of benefit in 1 of 6 patients treated with 50% to 100% scalp involvement. Another 4 patients did not complete the trial
— id: 115763, year: 2003, vol: 49, page: 291, stat: Journal Article,

Update on cicatricial alopecia
Olsen, E; Stenn, K; Bergfeld, W; Cotsarelis, G; Price, V; Shapiro, J; Sinclair, R; Solomon, A; Sperling, L; Whiting, D
2003 Jun;8(1):18-19, Journal of investigative dermatology symposium proceedings
Cicatricial alopecia is an enigmatic group of hair disorders linked by the potential permanent loss of scalp hair follicles in involved areas. Progress in our understanding and treatment of these disorders has been stymied by the lack of clear diagnostic criteria for the current terms used to describe the various hair loss entities. Since all of these conditions evolve as the hair is destroyed or replaced, diagnosis is further made difficult by a lack of clinical and pathologic 'snapshots' over the evolution of each disorder. Without some acceptance of general clinical and histological presentations in the early, mid and late stage of these disorders, one cannot begin to explore ways to make the diagnosis at a very early stage before significant follicular destraction has occurred (making the clinical diagnosis obvious) and when the damage is potentially repairable or progression preventable
— id: 67511, year: 2003, vol: 8, page: 18, stat: Journal Article,

Summary of North American Hair Research Society (NAHRS)-sponsored Workshop on Cicatricial Alopecia, Duke University Medical Center, February 10 and 11, 2001
Olsen, Elise A; Bergfeld, Wilma F; Cotsarelis, George; Price, Vera H; Shapiro, Jerry; Sinclair, Rodney; Solomon, Alvin; Sperling, Leonard; Stenn, Kurt; Whiting, David A; Bernardo, O; Bettencourt, M; Bolduc, C; Callendar, V; Elston, D; Hickman, J; Ioffreda, M; King, L; Linzon, C; McMichael, A; Miller, J; Mulinari, F; Trancik, R
2003 Jan;48(1):103-110, Journal of the American Academy of Dermatology
— id: 67512, year: 2003, vol: 48, page: 103, stat: Journal Article,

Safety of topical minoxidil solution: a one-year, prospective, observational study
Shapiro, Jerry
2003 Jul-Aug;7(4):322-329, Journal of cutaneous medicine & surgery
BACKGROUND: Topical minoxidil solution (TMS) is widely used for androgenetic alopecia (AGA), and this is the first report of a large safety trial. OBJECTIVES: The aim of the study was to evaluate the safety profile of TMS by comparing hospitalization and death rates among subjects using TMS with controls. Cardiovascular safety and pregnancy outcomes were evaluated, and usage patterns were described. METHODS: All subjects were followed at baseline, 3, 6, 9, and 12 months. Usage patterns, pregnancy status, overnight hospital stays, and cardiovascular risk factors were evaluated. Subjects rated effectiveness of TMS in the treatment of AGA. Statistical analyses were conducted to determine if TMS was associated with an increased risk of death or hospitalization. RESULTS: TMS is a safe and effective treatment for AGA. There were no increases in cardiovascular events and no apparent increased risk for adverse pregnancy outcomes. CONCLUSIONS: This large, prospective study demonstrated the overall safety of TMS in the treatment of AGA
— id: 115757, year: 2003, vol: 7, page: 322, stat: Journal Article,

Use of finasteride in the treatment of men with androgenetic alopecia (male pattern hair loss)
Shapiro, Jerry; Kaufman, Keith D
2003 Jun;8(1):20-23, Journal of investigative dermatology symposium proceedings
Finasteride, a type 2-selective 5alpha-reductase inhibitor, was approved in 1997 as the first oral pharmacologic therapy for the treatment of men with androgenetic alopecia (AGA; male pattern hair loss). Originally developed for the treatment of men with benign prostatic hyperplasia (BPH) at a dose of 5 mg/day, finasteride has a well-established, excellent safety profile. Subsequent studies demonstrated that finasteride was an effective treatment for men with AGA at an optimal dose of 1 mg/day. This report summarizes the published peer-reviewed literature on the use of finasteride in the treatment of men with AGA, including the data on long-term (5 years) use of finasteride in a placebo-controlled clinical trial environment
— id: 115762, year: 2003, vol: 8, page: 20, stat: Journal Article,

The expression of insulin-like growth factor 1 in follicular dermal papillae correlates with therapeutic efficacy of finasteride in androgenetic alopecia
Tang, Liren; Bernardo, Olga; Bolduc, Chantal; Lui, Harvey; Madani, Shabnam; Shapiro, Jerry
2003 Aug;49(2):229-233, Journal of the American Academy of Dermatology
BACKGROUND: It is generally believed that dihydrotestosterone is one of the pivotal mediators of hair loss in androgenetic alopecia (AGA). Finasteride, which blocks the conversion of testosterone to dihydrotestosterone, has now become an integral part of the current treatment approaches for male AGA. Several lines of evidence support the notion that dermal papilla (DP) cells represent the androgen target within the hair follicle. The specific molecular regulators modulated by androgens within hair follicles in the balding scalp are unknown. OBJECTIVE: The purpose of this study was to identify and quantify changes in expression of specific molecular hair growth regulators in DP of men with AGA treated with finasteride and correlate these findings to clinical efficacy. METHODS: Biopsy specimens were collected from 9 male patients from both the balding area and nonbalding occipital area before and after 4 months of finasteride therapy. DP were microdissected and total RNA was extracted from an equal number of DP from each biopsy specimen. The expression of various cytokines, including insulin-like growth factor (IGF)-1, was determined by reverse transcription polymerase chain reaction. The signals were detected by autoradiography. All 9 patients were given finasteride for 1 year and evaluated for efficacy at month 12. Efficacy was graded on a 7-point scale on the basis of comparison with initial baseline photography. RESULTS: IGF-1 was up-regulated by finasteride treatment in 4 of 9 patients. Among the patients with increased IGF-1 expression, 3 of them showed moderate clinical improvement after 12 months of treatment and another patient remained unchanged. In contrast, 3 patients with decreased IGF-1 expression in the balding scalp showed clinical worsening after 12 months. The other 2 patients without noticeable change in IGF-1 expression showed either slight improvement or no change in their hair condition. CONCLUSION: In a small uncontrolled study of 9 patients with AGA, an increased expression of IGF-1 messenger RNA levels in the DP was associated with patient response to finasteride
— id: 115764, year: 2003, vol: 49, page: 229, stat: Journal Article,

Topical mechlorethamine restores autoimmune-arrested follicular activity in mice with an alopecia areata-like disease by targeting infiltrated lymphocytes
Tang, Liren; Cao, Liping; Bernardo, Olga; Chen, Yongliang; Sundberg, John P; Lui, Harvey; Chung, Stephen; Shapiro, Jerry
2003 Mar;120(3):400-406, Journal of investigative dermatology
Alopecia areata is an autoimmune disease targeted at hair follicles with infiltrated T lymphocytes probably playing an important role in the pathogenesis. It was reported in 1985 that mechlorethamine was effective on alopecia areata patients. This has never been confirmed since. The aims of the study were to investigate the effects of mechlorethamine on balding C3H/HeJ mice affected with an alopecia-areata-like disease and to study the underlying mechanisms. Mice were treated on half of the dorsal skin with mechlorethamine and the contralateral side was treated with the vehicle ointment. After 10 wk of mechlorethamine therapy, a full pelage of hair covered the treated side in all the mice and was maintained during the study, whereas the vehicle-treated sides showed either no change or continued hair loss. Immunohistochemistry revealed that infiltrated CD4+ and CD8+ lymphocytes were eliminated from the treated side. In vitro cell viability assay showed that lymphocytes were much more sensitive to the cytotoxic effects of mechlorethamine than skin and hair follicular cells. RNase protection assay and real-time reverse transcription polymerase chain reaction showed that tumor necrosis factor alpha/beta, interleukin-12, and interferon-gamma were inhibited by mechlorethamine upon successful treatment. Our findings support that mechlorethamine restores follicular activity by selectively targeting infiltrated lymphocytes in vivo in alopecia-areata-affected mice
— id: 115765, year: 2003, vol: 120, page: 400, stat: Journal Article,

Cytokines and signal transduction pathways mediated by anthralin in alopecia areata-affected Dundee experimental balding rats
Tang, Liren; Cao, Liping; Pelech, Steven; Lui, Harvey; Shapiro, Jerry
2003 Jun;8(1):87-90, Journal of investigative dermatology symposium proceedings
Although many therapeutic modalities have been tested on alopecia areata, patient outcomes have been disappointing. Use of animal models would help to develop more efficient therapies as well as understanding therapeutic mechanisms. We have demonstrated that 0.1% topical anthralin ointment is 100% effective in restoring follicular activity in Dundee experimental balding rats. This is the most promising topical treatment for Dundee experimental balding rats among the therapeutic agents tested on this model. Various cytokines have been shown to be associated with the pathogenesis of alopecia areata. To test whether any of these cytokines might be modulated by anthralin, an RNase protection assay and the real-time polymerase chain reaction were performed to compare their expression between anthralin-treated and control skins. These experiments showed that expression of tumor necrosis factor-alpha and interferon-gamma was inhibited by anthralin, whereas expression of interleukin-1alpha/beta and their receptor antagonist, interleukin-1Ra, and interleukin-10 was stimulated by anthralin. In addition, using an antibody-based multi-immunoblotting technique, we found that certain signaling regulatory proteins were modulated by anthralin. Their potential roles in reversing the autoimmune-arrested follicular activity in Dundee experimental balding rats are discussed
— id: 115761, year: 2003, vol: 8, page: 87, stat: Journal Article,

Restoration of hair growth with topical diphencyprone in mouse and rat models of alopecia areata
Tang, Liren; Lui, Harvey; Sundberg, John P; Bissonnette, Robert; McLean, David I; Shapiro, Jerry
2003 Dec;49(6):1013-1019, Journal of the American Academy of Dermatology
BACKGROUND: The contact sensitizer, diphencyprone (DPCP), is one of the most effective therapies for the more severe forms of alopecia areata (AA). OBJECTIVE: The purpose of this study was to determine the efficacy of topical DPCP on the 2 available rodent models for AA, and to determine the underlying therapeutic mechanisms. METHODS: AA-affected mice and rats were treated unilaterally with topical DPCP on the ventral and dorsal surface, respectively. The opposite sides were treated with vehicle alone. Skin biopsy specimens were collected from both sides for histologic analysis. RESULTS: Hair regrowth was observed on the treated sides in the majority of the animals of both species. Immunohistochemical analyses revealed reduction of intrafollicular CD8(+) lymphocyte infiltrates after successful treatment in mice. CONCLUSION: The AA-like hair disorder of these 2 rodent models can be used as a tool for furthering our understanding of human AA and the therapeutic actions of DPCP
— id: 115759, year: 2003, vol: 49, page: 1013, stat: Journal Article,

Old wine in new bottles: reviving old therapies for alopecia areata using rodent models
Tang, Liren; Sundberg, John P; Lui, Harvey; Shapiro, Jerry
2003 Oct;8(2):212-216, Journal of investigative dermatology symposium proceedings
Alopecia areata is regarded as a tissue-restricted autoimmune disease of hair follicles in which follicular activity is arrested because of the continued activity of lymphocytic infiltrates. Actual loss of hair follicles does not occur, even in hairless lesions. A variety of immunomodulating therapies, including contact sensitizers and immunomodulators, are part of the usual armamentarium for this disorder. None of these treatments have been consistent in their efficacy, and many have untoward side effects. Nevertheless, their uses in valid animal models provide a tool to dissect out molecular mechanisms of therapeutic effects. For several decades, both mechlorethamine (for the treatment of cutaneous T cell lymphoma) and anthralin (for the treatment of psoriasis) have been used successfully. When these therapies were tested in rat and mouse alopecia areata models, we found anthralin and mechlorethamine to be the most effective topical modalities, respectively. The underlying cellular mechanisms may act through targeting infiltrative lymphocytes, and the molecular mechanisms may involve specific cytokine expression changes. These visible, accessible, and unilaterally treated animal model systems are ideal for studying novel alopecia areata therapies, particularly in terms of their in vivo molecular mechanisms of action
— id: 115760, year: 2003, vol: 8, page: 212, stat: Journal Article,

Reduced inositol content in lymphocyte-derived cell lines from bipolar patients
Belmaker, R H; Shapiro, J; Vainer, E; Nemanov, L; Ebstein, R P; Agam, G
2002 Feb;4(1):67-69, Bipolar disorders
OBJECTIVES: The study aimed to determine whether low inositol content and uptake previously reported in brain and peripheral tissue of bipolar patients are also reflected in lymphocyte-derived cell lines from these patients. METHODS: Inositol content and uptake were studied in lymphocyte-derived cell lines grown in vitro for at least five generations to eliminate influences of drug treatment. Inositol content was studied gas chromatographically and inositol uptake by following 3H-inositol incorporation at various concentrations. RESULTS: Inositol levels of cell lines derived from bipolar patients were significantly lower than those of cell lines from controls. CONCLUSIONS: Low inositol content in lymphocyte-derived cell lines from bipolar patients corroborates previous findings in frontal cortex and in lymphoblastoid cell lines and are consistent with the notion that the phosphatidylinositol signaling system is involved in the pathophysiology of this disorder
— id: 149600, year: 2002, vol: 4, page: 67, stat: Journal Article,

Using the internet to assess and teach medical students in dermatology
Hong, Chih-Ho; McLean, David; Shapiro, Jerry; Lui, Harvey
2002 Jul-Aug;6(4):315-319, Journal of cutaneous medicine & surgery
BACKGROUND AND OBJECTIVES: We wish to develop and evaluate a user-friendly online interactive teaching and examination model as an adjunct to traditional bedside teaching of medical students during a clinical rotation in dermatology. METHODS: Following completion of an online examination, senior medical students at the University of British Columbia (n = 178) were asked to complete an online survey to evaluate their acceptance of this new method. The online examination model was evaluated through students' responses to the questionnaire-based evaluation they were asked to complete following their examination. Responses were evaluated on a standardized 5-point scale. RESULTS: A high response rate was achieved (98.9%). Overall, 93% of senior medical students felt that the Internet was a useful and effective way to administer a dermatology examination. Most (90%) preferred the online examination to a traditional paper-and-pencil examination and the majority (88%) felt that the quality of digital images presented was sufficient to make an accurate diagnosis. In addition, students strongly supported the further development of teaching resources on the web and would use these resources in learning dermatology (93%). CONCLUSIONS: The development of an online interactive examination tool for dermatology is technically feasible with current technology. Senior medical students are not only accepting of this new technology but also prefer it to more traditional formats and indicate enthusiasm for the development of further online teaching resources in dermatology
— id: 115767, year: 2002, vol: 6, page: 315, stat: Journal Article,

Regeneration of a new hair follicle from the upper half of a human hair follicle in a nude mouse
Tang, Liren; Madani, Shabnam; Lui, Harvey; Shapiro, Jerry
2002 Oct;119(4):983-984, Journal of investigative dermatology
— id: 115766, year: 2002, vol: 119, page: 983, stat: Journal Article,

Occupational alopecia or alopecia areata?
Tosti, Antonella; Piraccini, Bianca Maria; Bergfeld, Wilma F; Camacho, Francisco; Dawber, Rodney P r; Happle, Rudolf; Olsen, Elise A; Price, Vera H; Rebora, Alfredo; Shapiro, Jerry; Sinclair, Rod; Vanneste, Dominique; Whiting, David A
2002 Oct;47(4):636-637, Journal of the American Academy of Dermatology
— id: 67513, year: 2002, vol: 47, page: 636, stat: Journal Article,

Alopecia areata investigational assessment guidelines. National Alopecia Areata Foundation
Olsen, E; Hordinsky, M; McDonald-Hull, S; Price, V; Roberts, J; Shapiro, J; Stenn, K
1999 Feb;40(2 Pt 1):242-246, Journal of the American Academy of Dermatology
— id: 67514, year: 1999, vol: 40, page: 242, stat: Journal Article,

Finasteride in the treatment of men with androgenetic alopecia. Finasteride Male Pattern Hair Loss Study Group
Kaufman, K D; Olsen, E A; Whiting, D; Savin, R; DeVillez, R; Bergfeld, W; Price, V H; Van Neste, D; Roberts, J L; Hordinsky, M; Shapiro, J; Binkowitz, B; Gormley, G J
1998 Oct;39(4 Pt 1):578-589, Journal of the American Academy of Dermatology
BACKGROUND: Androgenetic alopecia (male pattern hair loss) is caused by androgen-dependent miniaturization of scalp hair follicles, with scalp dihydrotestosterone (DHT) implicated as a contributing cause. Finasteride, an inhibitor of type II 5alpha-reductase, decreases serum and scalp DHT by inhibiting conversion of testosterone to DHT. OBJECTIVE: Our purpose was to determine whether finasteride treatment leads to clinical improvement in men with male pattern hair loss. METHODS: In two 1-year trials, 1553 men (18 to 41 years of age) with male pattern hair loss received oral finasteride 1 mg/d or placebo, and 1215 men continued in blinded extension studies for a second year. Efficacy was evaluated by scalp hair counts, patient and investigator assessments, and review of photographs by an expert panel. RESULTS: Finasteride treatment improved scalp hair by all evaluation techniques at 1 and 2 years (P < .001 vs placebo, all comparisons). Clinically significant increases in hair count (baseline = 876 hairs), measured in a 1-inch diameter circular area (5.1 cm2) of balding vertex scalp, were observed with finasteride treatment (107 and 138 hairs vs placebo at 1 and 2 years, respectively; P < .001). Treatment with placebo resulted in progressive hair loss. Patients' self-assessment demonstrated that finasteride treatment slowed hair loss, increased hair growth, and improved appearance of hair. These improvements were corroborated by investigator assessments and assessments of photographs. Adverse effects were minimal. CONCLUSION: In men with male pattern hair loss, finasteride 1 mg/d slowed the progression of hair loss and increased hair growth in clinical trials over 2 years
— id: 67515, year: 1998, vol: 39, page: 578, stat: Journal Article,

Spontaneous communication between a pancreatic pseudocyst and the colon: unusual clinical and radiographic presentation
Rosen, R J; Teplick, S K; Shapiro, J H
1980 Nov 15;5(4):353-355, Gastrointestinal radiology
A huge pancreatic pseudocyst which nearly filled the entire abdomen ruptured into the sigmoid colon, and caused perplexing clinical and radiographic findings. Because of the thickness of its wall, the pseudocyst did not collapse but became filled with intestinal gas. The more common features of pseudocysts that rupture are discussed
— id: 126538, year: 1980, vol: 5, page: 353, stat: Journal Article,