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Cognitive-behavioural psychotherapy and alopecia areata

100%

Kuty-Pachecka M.

Psychiatria i Psychologia Kliniczna

2017

vol. 17

issue 2

129-136

Alopecia areata (also known as spot baldness) is a disease with multifactorial aetiology, including genetic, hormonal, autoimmune and psychological factors as well as nervous system disorders. This disorder belongs to the group of dermatological conditions modified by psychological factors. Clinical experience indicates that stress and psychological aspects contribute significantly to the onset and/or exacerbation of alopecia areata. Pharmacological treatment of this dermatosis is often ineffective or insufficient. Therefore, a holistic approach to the disease, including both medical and psychological aspects, is crucial. It is emphasised in the subject literature that some forms of psychotherapy and pharmacotherapy used in patients with alopecia areata improve their psychophysical condition, and, consequently, stimulate the regrowth of their hair. Research has shown that cognitive-behavioural therapy complements dermatological treatment of alopecia areata, improving the quality of life of patients. The aim of cognitive and behavioural techniques is, on the one hand, to change the maladaptive negative convictions about oneself, the world, and the disease, and, on the other hand, to acquire the ability to cope with negative emotional states and difficult situations, such as a disease. The aim of the paper is to present the results of a literature review on the efficiency of pharmacotherapy and the role of cognitive-behavioural therapy in alopecia areata.

Łysienie plackowate (alopecia areata) jest chorobą o wieloczynnikowej etiologii, w której uwzględnia się czynniki genetyczne, hormonalne, autoimmunologiczne i psychiczne oraz zaburzenia w zakresie układu nerwowego. Schorzenie to zalicza się do grupy chorób dermatologicznych modyfikowanych przez czynniki psychologiczne. Doświadczenie kliniczne wskazuje, że stres i aspekty psychologiczne mają znaczący udział w wystąpieniu i/lub zaostrzeniu łysienia plackowatego. Leczenie farmakologiczne tej dermatozy nierzadko okazuje się nieskuteczne albo niewystarczające. Istotne jest zatem holistyczne podejście do choroby, obejmujące zarówno aspekt medyczny, jak i psychologiczny. W literaturze przedmiotu podaje się, że niektóre formy psychoterapeutyczne i farmakoterapia stosowane u pacjentów z łysieniem plackowatym poprawiają ich stan psychofizyczny, a w konsekwencji wpływają także na odrost włosów. Badania wskazują, że terapia poznawczo- -behawioralna to istotne uzupełnienie dermatologicznego leczenia łysienia plackowatego, przyczyniające się do poprawy jakości życia pacjentów. Celem technik poznawczych i behawioralnych jest z jednej strony zmiana nieadaptacyjnych negatywnych przekonań (zarówno na temat samego siebie czy świata, jak i choroby), a z drugiej nabycie umiejętności radzenia sobie z negatywnymi stanami emocjonalnymi i trudnymi sytuacjami (np. z chorobą). W pracy zaprezentowano wyniki przeglądu literatury dotyczącej efektywności farmakoterapii stosowanej w łysieniu plackowatym oraz techniki terapii poznawczo-behawioralnej, które można wykorzystać w leczeniu tej dermatozy, z uwzględnieniem istotnych problemów charakterystycznych dla pacjentów z chorobami przewlekłymi.

Capillaroscopic patterns in patients with systemic sclerosis, psoriasis and alopecia and their correlations with serum concentrations of several angiogenic markers

63%

Chodorowska G., Michalska-Jakubus M., Bartosińska J., Gerkowicz A., Adamczyk M., Krasowska D.

issue 1

49-54

Introduction. Capillaroscopy is a non-invasive imaging method that allows cutaneous microcirculation to be analyzed. During the last decades, a diagnostic and prognostic potential of nailfold capillaroscopy (NVC) has been gaining increasing appreciation. The main indications include Raynaud phenomenon and scleroderma spectrum diseases, however the usefulness of this technique is also suggested in a variety of non-rheumatic diseases. Aim. To assess capillaroscopic patterns in systemic scleroderma (SSc), psoriasis (PV), psoriatic arthritis (PsA), alopecia areata (AA) and androgenetic alopecia. To evaluate serum levels of several endothelial and angiogenic markers, and their relation to capillaroscopic pattern. Material and methods. There were evaluated 295 patients with systemic scleroderma (SSc), psoriasis (PV), psoriatic arthritis (PsA), alopecia areata (AA) and androgenetic alopecia, as well as age- and sex-matched controls, were examined. In each subject, NVC was performed and serum concentration levels of several angiogenic markers. Results. In SSc three NVC patterns: early, active and late were distinguished. Angiopoietin-2 concentrations were higher and andothelial microparticles were lower in patients with late NVC pattern. We found several differences between the NVC pattern in PV and PsA. No correlations between NVC pattern and serum levels of angiogenic markers were revealed. In AA, we distinguished both normal and abnormal NVC patterns, although the normal patterns were more frequent. Branching capillaries and features of neoformation were often present in patients with the abnormal pattern. In androgenetic alopecia, the normal NVC pattern was most frequently present, however, we found several statistically significant capillarosopic alterations, like branching capillaries, features of neoformation and altered distribution of capillaries. Discussion and Conclusions. Serum levels of Ang-2 and EMPs may reflect capillary damage in SSc. NVC pattern varies between PV and PsA patients. The presence of abnormal NVC patterns in alopecia patients might show the role of disturbances in microcirculation in the diseases. Further studies are required to confirm the hypothesis.

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1 Polish Journal of Public Health

1 Psychiatria i Psychologia Kliniczna

1 2017

1 2015

1 Adamczyk M.

1 Bartosińska J.

1 Chodorowska G.

1 Gerkowicz A.

1 Krasowska D.

1 Kuty-Pachecka M.

1 Michalska-Jakubus M.

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Cognitive-behavioural psychotherapy and alopecia areata

Capillaroscopic patterns in patients with systemic sclerosis, psoriasis and alopecia and their correlations with serum concentrations of several angiogenic markers