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J Am Acad Dermatol 2020 Jul 1. Epub 2020 Jul 1.

Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine. Electronic address:

Background: Although topical minoxidil is an effective treatment option for hair loss, many patients are poorly compliant due to the necessity to apply the medication twice a day, undesirable hair texture, and scalp irritation.

Objective: In recent years, oral minoxidil at low dose has been proposed as a safe alternative. This study reviewed articles in which oral minoxidil was utilized to treat hair loss to determine its efficacy and safety as an alternative to topical minoxidil. Read More

Int J Dermatol 2020 Jun 9. Epub 2020 Jun 9.

Department of Dermatology, University of California, Irvine, Irvine, CA, USA.

Background: Topical minoxidil has been used for almost 40 years to treat alopecia. There is growing evidence supporting off-label use of low-dose oral minoxidil.

Objective: To conduct a systematic review evaluating the use of oral minoxidil for all types of alopecia. Read More

J Pediatr 2020 May 21. Epub 2020 May 21.

Dermatology Department, Hospital Regional Universitario de Málaga, Málaga, Spain.

Indian Dermatol Online J 2020 Jan-Feb;11(1):65-67. Epub 2020 Jan 13.

Department of Dermatology and STD, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

Monilethrix is a rare hereditary disorder affecting hair resulting in hair fragility and alopecia. We report three patients of monilethrix who presented with complaints of sparse and brittle hair from early childhood. All three patients had multiple discrete hyperkeratotic papules over the scalp. Read More

Skin Appendage Disord 2019 Feb 27;5(2):127-129. Epub 2018 Jul 27.

Dermatology Department, Habib Thameur Hospital, Tunis, Tunisia.

Am J Clin Dermatol 2019 Apr;20(2):237-250

Department of Dermatology, Northwestern University, 676 N St Clair St, Suite 1600, Chicago, IL, 60611, USA.

Topical minoxidil is a well-known and often-utilized drug in dermatological practice for the treatment of alopecia. It was approved by the United States Food and Drug Administration for the treatment of androgenetic alopecia in 1988. Since its approval, minoxidil has been used off-label for the treatment of many other types of alopecia, with minimal formal evidence of efficacy. Read More

Int J Trichology 2018 Jul-Aug;10(4):154-161

Department of Medicine, Faculty of Medicine, Mutah University, Mutah, Karak, Jordan.

Introduction: Hair loss is a common and distressing clinical complaint in the dermatology clinics. Common causes of hair loss in children include alopecia areata, tinea capitis, traction alopecia, and trichotillomania. Newly, trichoscopy allows differential diagnosis of hair loss in most cases and allows visualization of hair shafts and scalps without the need of removing hair. Read More

Dermatol Clin 2018 Oct 16;36(4):421-430. Epub 2018 Aug 16.

Department of Dermatology, Medical University of Warsaw, Pawinskiego 5, 02-106, Warszawa, Poland.

Trichoscopy allows analyzing the structure and size of growing hair shafts in their natural environment in children and adults. The method replaces light microscopy, which requires pulling of multiple hairs for investigation. In monilethrix, trichoscopy shows uniform elliptical nodosities with intermittent constrictions. Read More

CMAJ 2018 07;190(30):E912

Department of Dermatology, Affiliated Third Hospital of Hangzhou, Anhui Medical University, Hefei, Anhui province, China

Indian Dermatol Online J 2018 Jul-Aug;9(4):269-270

Department of Dermatology and Venereology, Pramukhswami Medical College, Karamsad, Gujarat, India.

J Dermatol 2018 Nov 27;45(11):e298-e300. Epub 2018 Apr 27.

Department of Dermatology, The West China Hospital, Sichuan University, Chengdu, China.

Dermatol Online J 2017 Jul 15;23(7). Epub 2017 Jul 15.

Department of Dermatology, Hôpital Nord, University of Amiens, 80000 - Amiens, France.

Monilethrix is a rare genodermatosis characterized by a hair shaft dysplasia responsible for hypotrichosis. We report the case of a child with monilethrix with no associated cases in the family. Trichoscopy facilitated the diagnosis. Read More

Australas J Dermatol 2018 Nov 5;59(4):e276-e277. Epub 2018 Feb 5.

Alopecia and Hair Disorders Section, Dermato-Oncology Clinic, Faculty of Medicine, Autonomous National University of Mexico, Mexico City, Mexico.

JAMA Pediatr 2018 Feb;172(2):193-194

Department of Pediatrics, University of Mississippi Medical Center, Jackson.

Br J Dermatol 2017 10;177(4):e163

Department of Dermatology, Universidade de Sao Paulo Faculdade de Medicina, Av. Dr Enéas de Carvalho Aguiar, 255, 3° andar, São Paulo, 05403-900, Brazil.

Ugeskr Laeger 2017 Sep;179(37)

Monilethrix is a rare genodermatosis with high penetrance and variable expressivity. This is a case report of a Danish family with varying phenotypical presentations. The family members were diagnosed using dermatoscopy and microscopy, which were subsequently supported by gene sequence analysis. Read More

Int J Trichology 2017 Apr-Jun;9(2):90-91

Faculty of Mathematics and Natural Sciences, Institute of Biology and Environmental Protection, Pomeranian Academy, 76-200 Slupsk, Poland.

J Eur Acad Dermatol Venereol 2017 Sep 1;31(9):e409-e410. Epub 2017 Jun 1.

Department of Dermatology, Allergology and Venerology, Medical University of Gdansk, Gdansk, Poland.

J Med Genet 2017 03 13;54(3):186-189. Epub 2016 Dec 13.

Human Medical Genetics and Genomics Program, University of Colorado School of Medicine, Aurora, Colorado, USA.

Background: Progressive symmetric erythrokeratoderma (PSEK) is a rare skin disorder characterised by symmetrically distributed demarcated hyperkeratotic plaques, often with associated palmoplantar hyperkeratosis, with new plaques appearing over time. Most cases are inherited in an autosomal dominant manner, although a few cases exhibit apparent autosomal recessive inheritance.

Objective: To identify the gene underlying autosomal recessive PSEK in a large Pakistani kindred. Read More

Pediatr Rev 2016 Sep;37(9):e38-40

Departments of Dermatology and Pediatrics, University of California, San Diego and Rady Children's Hospital, San Diego, CA.

J Dermatol Sci 2016 Dec 7;84(3):232-238. Epub 2016 Aug 7.

Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan. Electronic address:

Recent advances in molecular genetics have led to the identification of many genes expressed in hair follicle (HF), while the precise roles of these genes in the HF have not completely been disclosed. Using the methods of forward genetics, we and others have recently identified a series of genes responsible for hereditary hair disorders in humans, including monilethrix, woolly hair, and various ectodermal dysplasia syndromes. Furthermore, expression and functional analyzes have gradually revealed that these genes are directly or indirectly related with each other. Read More

Pediatr Dermatol 2016 Sep 13;33(5):481-7. Epub 2016 Jun 13.

Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida.

Hair shaft disorders are characterized by congenital or acquired abnormalities of the hair shaft. The objective of this study was to review the literature regarding the prognosis and treatment options for hair shaft disorders. We used keywords in the search engines PubMed and Medline to identify all publications in English related to the prognosis and management of hair shaft disorders. Read More

Pediatr Dermatol 2016 Sep 13;33(5):473-80. Epub 2016 Jun 13.

Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida.

Hair shaft disorders are characterized by congenital or acquired abnormalities of the hair shaft. The objective was to review the literature regarding the prognosis and treatment options of hair shaft disorders. We used keywords in the search engines PubMed and Medline to identify all publications in the English language related to the prognosis and management of hair shaft disorders. Read More

JAAD Case Rep 2016 May 26;2(3):212-5. Epub 2016 May 26.

University of Melbourne, Department of Medicine, Epworth Healthcare, Melbourne, Australia.

Indian J Dermatol Venereol Leprol 2016 Jan-Feb;82(1):73-4

Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.

Curr Probl Dermatol 2015 20;47:87-96. Epub 2015 Feb 20.

Recent developments in research methods and techniques, such as whole-exome and -genome sequencing, have substantially improved our understanding of genetic conditions. Special progress has been made in the field of genotrichoses, or hereditary hair diseases, a field that has been obscure for many years. The underlying genes for many of the monogenic hair diseases are now known. Read More

Curr Probl Dermatol 2015 20;47:55-66. Epub 2015 Feb 20.

Hair diseases represent frequent complaints in dermatology clinics, and they can be caused by a number of conditions reflected by specific diagnoses. Hair loss is not uncommon in the pediatric group, but its patterns in this group are different from those seen in adults. Additionally, in children, these disorders can have psychological effects that can interfere with growth and development. Read More

Int J Dermatol 2015 Oct 14;54(10):1163-8. Epub 2015 Jul 14.

Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.

Background: Localized autosomal recessive hypotrichosis (LAH) is an inherited rare disease caused by DSG4 mutations, characterized by short, sparse, brittle hair affecting restricted areas such as the scalp, trunk, and extremities. To date, DSG4 mutations have been reported in 14 pedigrees of LAH overlapping with monilethrix.

Methods: To clarify the etiology of hair defects for a 2-year-old Chinese girl, peripheral blood, skin, and hair samples were collected, and skin immunohistochemistry, electron microscopy (scanning and transmission types), Vivascope confocal microscopy, and DSG4 sequencing were investigated. Read More

Int J Trichology 2015 Jan-Mar;7(1):33-5

Department of Dermatology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India.

Congenital hypotrichosis may be due to a number of causes and may have multiple systemic associations. A child born of second-degree consanguineous marriage was found to have monilethrix as the cause of congenital hypotrichosis. A detailed systemic evaluation in the child revealed atrial septal defect and a hypoplastic right thumb leading to a diagnosis of coexisting Holt-Oram syndrome. Read More

Clin Exp Dermatol 2015 Oct 21;40(7):781-5. Epub 2015 Mar 21.

Institute of Human Genetics, University of Bonn, Bonn, Germany.

Background: Monilethrix is a rare monogenic dystrophic hair loss disorder with high levels of intrafamilial and interfamilial variability. It is characterized by diffuse occipital or temporal alopecia, hair fragility and follicular hyperkeratosis of the occipital region. Mutations in the keratin genes KRT81, KRT83 and KRT86 lead to autosomal dominant monilethrix, whereas mutations in the desmoglein 4 gene (DSG4) cause an autosomal recessive form. Read More

An Bras Dermatol 2015 Jan-Feb;90(1):126-7

Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.

Monilethrix is a rare hereditary condition generally considered to be an autosomal dominant disorder with variable penetrance. A case of a 6-year-old girl without a familial background for this disease is reported. The diagnosis was made by optic microscopy and dermoscopy. Read More

Exp Dermatol 2015 Jun 25;24(6):416-7. Epub 2015 Mar 25.

Department of Dermatology, Hadassah - Hebrew University Medical Center, Jerusalem, Israel.

J Invest Dermatol 2015 May 23;135(5):1253-1260. Epub 2015 Jan 23.

Department of Dermatology, Gunma University Graduate School of Medicine, Gunma, Japan.

Monilethrix is a hair shaft anomaly characterized by beaded hair with periodic changes in hair thickness. Mutations in the desmoglein 4 (DSG4) gene reportedly underlie the autosomal recessive form of the disease. However, the pathogenesis and cellular basis for the DSG4 mutation-induced monilethrix remained largely unknown. Read More

Exp Dermatol 2015 Mar;24(3):222-4

Department of Dermatology, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands; GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands; Institute of Medical Biology, Immunos, Singapore.

Monilethrix is an autosomal dominant hair disorder caused by mutations in the hard keratins KRT81, KRT83 and KRT86. The affected hairs are fragile and break easily, leading to scarring alopecia. Follicular hyperkeratosis in the neck and on extensor sides of extremities is a frequently associated finding. Read More

Clin Exp Dermatol 2015 Jan 23;40(1):78-84. Epub 2014 Sep 23.

Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan.

Background: Autosomal recessive hypotrichosis is a rare human hereditary disorder presenting as sparse scalp hair or as woolly hair occurring on various parts of the body. Various forms of isolated hypotrichosis have been reported to date. Mutations in at least 11 genes have been reported to cause hypotrichosis. Read More

Indian Dermatol Online J 2014 Jul;5(3):339-40

Department of Skin and Venereal Diseases, Pramukh Swami Medical College, Karamsad, Gujarat, India.

Hautarzt 2014 Jun;65(6):520-6

Institut für Humangenetik, Biomedizinisches Zentrum (BMZ), Universität Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Deutschland,

The monogenic inherited isolated alopecias comprise a group of clinically and genetically heterogeneous disorders with decreased or absent hair. Clinical classification of the isolated alopecias is based upon the onset of the disorder, the regions affected, and the structure of the hair shaft. Men and women are equally affected, and the mode of inheritance is autosomal dominant or autosomal recessive. Read More

Int J Trichology 2013 Oct;5(4):224-5

Department of Dermatology, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India.

G Ital Dermatol Venereol 2014 Feb;149(1):1-13

Department of Internal Medicine and Medical Specialties, Unit of Dermatology Sapienza University, Rome, Italy -

Congenital abnormalities of the hair shaft are conditions in most cases linked to chemical, biochemical, and morphological alterations, genetically determined. These alterations may be associated with a larger array of symptoms, as mentioned above, or may occur isolated. The number of genes involved and their penetration are responsible for the mode of transmission, severity, and phenotypic expression of the disease. Read More

Pan Afr Med J 2013 12;15:53. Epub 2013 Jun 12.

Department of Dermatology, Jundishapur University of Medical Sciences, Ahvaz, Iran.

Chin Med J (Engl) 2013 Aug;126(16):3103-6

Department of Dermatology, Peking University Third Hospital, Beijing, China.

Background: Monilethrix is an autosomal dominant hair disorder characterized clinically by alopecia and follicular papules. In this study, we collected a Han monilethrix family to detect the mutations in patients and investigated the correlation between the genotype and phenotype of monilethrix.

Methods: In this study, we identified a Chinese family with monilethrix through light microscopic and scanning electron microscopic (SEM) examination. Read More

Int J Trichology 2013 Jan;5(1):53-5

Department of Dermatology, Pariyaram Medical College, Kannur, Kerala, India.

Monilethrix is a rare autosomal dominant hair shaft disorder with variable expressivity. It usually presents with short broken scalp hairs and follicular hyperkeratosis. Light microscopy of hair reveals a beaded appearance. Read More

Pediatr Dermatol 2013 Sep-Oct;30(5):633-5. Epub 2013 Jul 9.

Department of Dermatology, University Hospitals Bristol NHS Foundation Trust, Bristol, UK; Department of Dermatology, Dudley Group of Hospitals NHS Foundation Trust, Dudley, UK.

A 4-year-old girl presented with sparse, brittle hair on her entire scalp and keratosis pilaris on the nape of her neck. Subtle microscopic and macroscopic diagnostic features presented a challenge for physicians. Only repeated, optimized light microscopy revealed the diagnosis of monilethrix, a rare genetic hair shaft disorder with a variable phenotypic expression and inheritance pattern. Read More

Indian J Dermatol 2013 May;58(3):243

Department of Dermatology, Venereology and Leprosy, Pondicherry Institute of Medical Sciences, Pondicherry, India.

Monilethrix is a rare hereditary condition generally considered to be an autosomal-dominant disorder with variable penetrance. Here, we report a case of monilethrix in a 13-year-old boy with an affected sibling. A therapeutic trial with oral N-acetyl cysteine was attempted. Read More

Am J Med Genet A 2013 May;161A(5):1058-63

Division of Medical Genetics, A. I. duPont Hospital for Children, Wilmington, DE 19803, USA.

Exome analysis has had a dramatic impact on genetic research. We present the application of such newly generated information to patient care. The patient was a female, born with normal growth parameters to nonconsanguineous parents after an uneventful pregnancy. Read More

Pediatr Dermatol 2013 Mar-Apr;30(2):163-71. Epub 2013 Feb 14.

Memorial Sloan Kettering Cancer Center, Hauppauge, New York 11788, USA.

The dermoscope allows physicians to examine the macroscopic and microscopic primary morphology of skin lesions, identify subtle clinical clues, confirm naked-eye clinical diagnoses, and monitor treatment progress while posing little threat to the young patient. This review summarizes important dermoscopic structures seen in infectious and inflammatory skin conditions and hair disorders in children. Scabies, pediculosis, phthiriasis, molluscum contagiosum, tinea nigra, and verrucae are well characterized dermoscopically by delta-shaped structures, ovoid-shaped nits, the crab louse, red corona, brown strands or spicules, and multiple densely packed papilla with a central black dot surrounded by a whitish halo, respectively. Read More

J Pediatr 2012 Dec 9;161(6):1176. Epub 2012 Aug 9.

Dermatology Service, Hospital de Santo António dos Capuchos, Centro Hospitalar de Lisboa Central, Lisbon, Portugal.

Br J Dermatol 2012 Jun;166 Suppl 2:27-32

University of Melbourne and Epworth Hospital, Melbourne, Vic., Australia.

Background: Monilethrix is a congenital hair shaft disorder with associated fragility. Many of the changes seen in monilethrix hair on light microscopy and scanning electron microscopy are also seen in hair weathering and cosmetic damage to hair.

Objectives: We used monilethrix as a model to investigate the relationship between hair protein structure and hair strength and resistance to cosmetic insult. Read More

Br J Dermatol 2012 Jun;166 Suppl 2:20-6

Department of Dermatology, St Vincent's Hospital Melbourne, PO Box 2900, Fitzroy, Vic. 3065, Australia.

Background: Monilethrix is a genetic hair shaft disorder that causes a dystrophic alopecia. Mutations causing autosomal dominant monilethrix have been found in the helix initiation and helix termination motifs of the type II hair keratins KRT81, KRT83 and KRT86. Mutations in DSG4 are linked to recessive transmission. Read More