Practice and Educational Gaps in Dermatology

June 2016 in “ Dermatologic Clinics ”

Maria Colavincenzo

hair disorders body dysmorphic disorder scarring alopecias frontal fibrosing alopecia central centrifugal cicatricial alopecia dermoscopy scalp hair evidence-based treatment hair loss disorders hair loss BDD FFA CCCA

Studysummary This article reviews clinical practice gaps in dermatology regarding the care of patients with hair disorders, including attitude, knowledge, and skill deficiencies, and reports no new results. Our plain-language summary of this paper — not a Tressless recommendation.

The 2016 document highlighted that dermatologists often displayed a lack of interest in treating hair disorders, which might stem from the perception that these cases are complex and emotionally taxing with no clear-cut treatments. This attitude overlooks the significant impact hair disorders have on patients' lives and the potential presence of body dysmorphic disorder (BDD) among these patients. There were identified knowledge gaps in the prevalence and presentation of hair loss disorders, particularly scarring alopecias like frontal fibrosing alopecia (FFA) and central centrifugal cicatricial alopecia (CCCA), which can lead to delayed diagnosis and treatment. Additionally, skill gaps, such as discomfort with dermoscopy of the scalp and hair, were noted to affect patient care. The lack of evidence-based treatment options for hair disorders poses a challenge, leaving many questions unanswered. These clinical practice gaps are reflected in dermatology residency programs, where residents may not receive adequate training or develop confidence in treating hair disorders. The document suggests that fostering awareness and enthusiasm for recent advancements in hair disorder treatments could help bridge these gaps.

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Research cited in this study

17 / 17 results

research Frequency of Body Dysmorphic Disorder Among Patients With Complaints of Hair Loss

13 citations , June 2015 in “International Journal of Dermatology”

This study found that body dysmorphic disorder is about 10 times more prevalent among patients with hair loss complaints compared to general dermatology patients, with a higher incidence in males.

research Reversal of Alopecia Areata Following Treatment With the JAK1/2 Inhibitor Baricitinib

184 citations , February 2015 in “EBioMedicine”

This study observed that baricitinib treatment led to significant improvement in a patient's alopecia areata symptoms and suggests further clinical trials to explore its potential as a treatment.

research Trichoscopic Features of Frontal Fibrosing Alopecia: Results in 249 Patients

46 citations , January 2015 in “Journal of The American Academy of Dermatology”

This study suggests that trichoscopic features, such as perifollicular erythema and cicatricial white patches, are independently associated with pruritus and the severity of frontal fibrosing alopecia.

research Platelet-Rich Plasma as a Potential Treatment for Noncicatricial Alopecias

58 citations , January 2015 in “International Journal of Trichology”

This review evaluates the therapeutic potential of platelet-rich plasma for treating non-cicatricial alopecias and suggests it may be effective, though further research is needed to confirm its efficacy.

research Alopecia Areata Is Driven by Cytotoxic T Lymphocytes and Is Reversed by JAK Inhibition

701 citations , August 2014 in “Nature medicine”

This study found that JAK inhibitors promote hair regrowth in both mice and human alopecia areata cases by blocking key immune pathways involved in disease development.

research Evaluation and Diagnosis of the Hair Loss Patient

69 citations , August 2014 in “Journal of The American Academy of Dermatology”

This review discusses recent advances in trichoscopy for differentiating types of alopecia and presents a systematic approach for using its diagnostic findings, but reports no new clinical results.

research Platelet-Rich Plasma for Androgenetic Alopecia

107 citations , August 2014 in “Dermatologic Surgery”

This pilot study suggests injecting platelet-derived growth factors into the scalp may offer some clinical benefits for androgenetic alopecia, though further randomized trials are needed for confirmation.

research Does Prostaglandin D2 Hold the Cure to Male Pattern Baldness?

57 citations , February 2014 in “Experimental Dermatology”

This review discusses the role of Prostaglandin D2 and its synthase in androgenetic alopecia but reports no new clinical findings, suggesting pathways for future therapeutic development.

research Frontal Fibrosing Alopecia: A Multicenter Review of 355 Patients

339 citations , February 2014 in “Journal of The American Academy of Dermatology”

This study found that eyelash loss, facial papules, and body hair involvement were linked to severe frontal fibrosing alopecia, and antiandrogens were the most effective treatment.

research The Difficult Hair Loss Patient: A Particular Challenge

14 citations , January 2013 in “International Journal of Trichology”

This review discusses physician-patient dynamics in managing hair loss and highlights the emotional impacts, emphasizing the need for effective communication and patient education, but it reports no new clinical findings.

research Hair Breakage as a Presenting Sign of Early or Occult Central Centrifugal Cicatricial Alopecia

44 citations , September 2012 in “Archives of Dermatology”

This study observed that hair breakage may indicate early central centrifugal cicatricial alopecia in African American women, suggesting that it should be considered in their differential diagnosis.

research Frontal Fibrosing Alopecia: A Review of 60 Cases

166 citations , April 2012 in “Journal of The American Academy of Dermatology”

This study reviewed clinical data from 60 patients with frontal fibrosing alopecia and found increasing prevalence and generally poor response to treatment, with the cause remaining unclear.

research Prostaglandin D2 Inhibits Hair Growth and Is Elevated in Bald Scalp of Men with Androgenetic Alopecia

205 citations , March 2012 in “Science Translational Medicine”

PGD2 stops hair growth and is higher in bald men with AGA.

research Hair and Scalp Dermatoscopy

245 citations , March 2012 in “Journal of The American Academy of Dermatology”

This review discusses the dermoscopic features of common hair and scalp disorders and reports no new clinical results, aiming to assist dermatologists in diagnosing conditions like tinea capitis and alopecia areata.

research Central Centrifugal Cicatricial Alopecia: An Approach to Diagnosis and Management

32 citations , November 2011 in “International Journal of Dermatology”

This article reviews central centrifugal cicatricial alopecia, focusing on its multifactorial etiology and challenges in clinical diagnosis, and calls for more research and better treatment options.

research Clinical Severity Does Not Reliably Predict Quality of Life in Women With Alopecia Areata, Telogen Effluvium, or Androgenic Alopecia

86 citations , May 2011 in “Journal of The American Academy of Dermatology”

This study found that patients with alopecia perceive their hair loss as more severe than dermatologists do, and their own ratings of hair loss severity better reflect their quality of life impacts.

research Postmenopausal Frontal Fibrosing Alopecia

325 citations , June 1994 in “Archives of Dermatology”

This study observed that progressive frontal recession in postmenopausal women may exhibit features of fibrosing alopecia, suggesting a distinct reaction pattern from typical lichen planopilaris.