Cicatricial alopecia is hair loss resulting from a condition that damages the scalp and hair follicle 7 ( Figure 5 ) . In addition to a bald spot, the scalp usually has an abnormal appearance. Plaques of erythema with or without scaling or pustules may be present. Conditions that can be associated with cicatricial alopecia include infections (., syphilis, tuberculosis, acquired immunodeficiency syndrome, herpes zoster), autoimmune disease (discoid lupus erythematosus), sarcoidosis, scalp trauma (., injuries, burns), and radiation therapy. 7
Many men with Peyronie’s disease are anxious about the appearance of their penis, for obvious reasons. Some might feel worried about not being able to satisfy their partner or even fathering a child, due to difficulties having intercourse. The loss of intimacy and the relationship problems due to Peyronie’s disease can strongly affect one’s psychological well-being. [ 1,2 ] That is why it is important to be open about these feelings, however difficult it might be. Here are some tips/guidelines for talking to your partner about Peyronie’s disease.
Mechanism of action: Topical immunotherapy acts by varied mechanisms of action. The most important mechanism is a decrease in CD4 to CD8 lymphocyte ratio which changes from 4:1 to 1:1 after contact immunotherapy. A decrease in the intra-bulbar CD6 lymphocytes and Langerhan cells is also noted. Happle et al, proposed the concept of ‘antigenic competition’, where an allergic reaction generates suppressor T cells that non-specifically inhibit the autoimmune reaction against a hair follicle constituent. Expression of class I and III MHC molecules, which are normally increased in areas affected by alopecia areata disappear after topical immunotherapy treatment 34 .A ‘cytokine inhibitor’ theory has also been postulated 34 .