Objective To summarize the prevention and treatment of postoperative complications after the skin soft tissue expansion for scar alopecia. Methods From January 1995 to June 2005, 57 patients with scar alopecia were admitted to our department for treatment. Of the patients, 25 were males and 32 were females with their ages ranging from 5 to 55 years. The causes were burn in 33 patients, trauma in 14, alopecia after head surgery in 8, and other causes in 2. Their disease courses ranged from 6 months to 15 years. Fortreatment, 89 therapeutic expanders were utilized in 57 patients. The retrospective analysis on the complications and their prevention and treatment were performed. Results The follow-up for 3-12 months averaged 6 monthsrevealed that 81 areas undergoing the expander insertion healed well and the hair grew well, too. Eight areas undergoing the expander insertions had complications, including expander exposure in 2 patients, infection in 2, hematoma in 1, expander rupture in 1, necrosis of the flap tip in 1, and scar necrosis at the injection port in 1. The results also revealed that there was a significantly increased rate of complications in the patients aged 5-10 years and the patients older than 50 years （Plt;0.05）. The complication rate in the patients who received 2 expanders at one time was significantly higher than that in the patients whoreceived only 1 expander（Plt;0.05）. However, there was no significant difference in the complication rate in the other kinds of patients. All the complicationswere effectively treated with a satisfactory therapeutic result. Conclusion The skin soft tissue expansion for scar alopecia can effectively prevent and treat postoperative complications. If the complications are identified early and treated properly, the therapeutic results will be satisfactory.
Objective To investigate the clinical application of skin soft-tissue expansion in repairing large-cicatricial alopecia. Methods From January 1989 to December 2003, 38 cases of large cicatricial alopecia were repaired by expanding scalp. The scalp was expanded, the cicatrix area was resected and the mode of propulsive or rotary flap was adopted. The size of alopecia ranged from 15 cm×7 cm to 23 cm×15 cm. Results The cicatricial alopecia in all the 38 cases was repaired and the hair growth was excellent during 1.2 year follow-up. Conclusion The soft tissue expansion technique is the initiative choice and an efficient method for repairing large cicatricial alopecia.
ObjectiveTo determine the expression level of Sonic hedgehog (Shh) in the passage of hair follicle stem cells (HFSCs), analyze the effect of Shh overexpression on the proliferation activity of HFSCs, and explore the survival of HFSCs after Shh overexpression and its effect on hair follicle regeneration. MethodsHair follicles from the normal area (H1 group) and alopecia area (H2 group) of the scalp donated by 20 female alopecia patients aged 40-50 years old were taken, and the middle part of the hair follicle was cut under the microscope to culture, and the primary HFSCs were obtained and passaged; the positive markers (CD29, CD71) and negative marker (CD34) on the surface of the fourth generation HFSCs were identified by flow cytometry. The two groups of HFSCs were transfected with Shh-overexpressed lentivirus. Flow cytometry and cell counting kit 8 assay were used to detect the cell cycle changes and cell proliferation of HFSCs before and after transfection, respectively. Then the HFSCs transfected with Shh lentivirus were transplanted subcutaneously into the back of nude mice as the experimental group, and the same amount of saline was injected as the control group. At 5 weeks after cell transplantation, the expression of Shh protein in the back skin tissue of nude mice was detected by Western blot. HE staining and immunofluorescence staining were used to compare the number of hair follicles and the survival of HFSCs between groups. ResultsThe isolated and cultured cells were fusiform and firmly attached to the wall; flow cytometry showed that CD29 and CD71 were highly expressed on the surface of the cells, while CD34 was lowly expressed, suggesting that the cultured cells were HFSCs. The results of real-time fluorescence quantitative PCR and Western blot showed that the expression levels of Shh protein and gene in the 4th, 7th, and 10th passages of cells in H1 and H2 groups decreased gradually with the prolongation of culture time in vitro. After overexpression of Shh, the proliferation activity of HFSCs in the two groups was significantly higher than that in the blank group (not transfected with lentivirus) and the negative control group (transfected with negative control lentivirus), and the proliferation activity of HFSCs in H1 group was significantly higher than that in H2 group before and after transfection, showing significant differences (P<0.05). At 5 weeks after cell transplantation, Shh protein was stably expressed in the dorsal skin of each experimental group; the number of hair follicles and the expression levels of HFSCs markers (CD71, cytokeratin 15) in each experimental group were significantly higher than those in the control group, and the number of hair follicles and the expression levels of HFSCs markers in H1 group were significantly higher than those in H2 group, and the differences were significant (P<0.05). ConclusionLentivirus-mediated Shh can be successfully transfected into HFSCs, the proliferation activity of HFSCs significantly increase after overexpression of Shh, which can secrete and express Shh continuously and stably, and promote hair follicle regeneration by combining the advantages of stem cells and Shh.
ObjectiveTo summarize and analyze the possible association between thyroid diseases and alopecia areata. MethodThe literatures on the relationship between thyroid disease and alopecia areata in recent years were searched and reviewed. ResultsAmong individuals with alopecia areata, the risk of thyroid disease was heightened. They were more susceptible to autoimmune thyroid conditions, often accompanied by thyroid function abnormalities. Moreover, alopecia areata patients face an increased risk of thyroid cancer. However, in patients with thyroid disease, the change of the incidence of alopecia areata was not completely clear. The risk of alopecia areata was increased in patients with autoimmune thyroid disease, and abnormal thyroid function may be one of the potential reasons for the persistence of alopecia areata. ConclusionsAutoimmune thyroid disease and alopecia areata may have a common disease basis. Patients with alopecia areata are at greater risk of autoimmune thyroid disease and thyroid dysfunction. The increased risk of alopecia areata in patients with autoimmune thyroid disease may be related to abnormal thyroid function.