Vera Price

University of California, San Francisco, San Francisco, CA, United States

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Publications (8)3.53 Total impact

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    ABSTRACT: Primary cicatricial alopecia (PCA) is a group of inflammatory hair disorders that cause scarring and permanent hair loss. Previous studies have implicated PPARγ, a transcription factor that integrates lipogenic and inflammatory signals, in the pathogenesis of PCA. However, it is unknown what triggers the inflammatory response in these disorders, whether the inflammation is a primary or secondary event in disease pathogenesis, and whether the inflammatory reaction reflects an autoimmune process. In this paper, we show that the cholesterol biosynthetic pathway is impaired in the skin and hair follicles of PCA patients. Treatment of hair follicle cells with BM15766, a cholesterol biosynthesis inhibitor, or 7-dehydrocholesterol (7-DHC), a sterol precursor, stimulates the expression of pro-inflammatory chemokine genes. Painting of mouse skin with 7-DHC or BM15766 inhibits hair growth, causes follicular plugging and induces the infiltration of inflammatory cells into the interfollicular dermis. Our results demonstrate that cholesterologenic changes within hair follicle cells trigger an innate immune response that is associated with the induction of toll-like receptor (TLR) and interferon (IFN) gene expression, and the recruitment of macrophages that surround the hair follicles and initiate their destruction. These findings reveal a previously unsuspected role for cholesterol precursors in PCA pathogenesis and identify a novel link between sterols and inflammation that may prove transformative in the diagnosis and treatment of these disorders.
    PLoS ONE 01/2012; 7(6):e38449. · 3.53 Impact Factor
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    Vera Price, Paradi Mirmirani
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    ABSTRACT: The patient with hair loss invariably complains “I am losing my hair,” which can mean vastly different things in different patients. Every patient with hair loss should have the following baseline lab studies: CBC, TSH, ferritin, and vitamin D 25OH because you do not want to miss other possible contributing factors of hair loss. KeywordsOstia-Scalp biopsy-Patient evaluation-Hair Card-Anagen hairs-Tug Test
    03/2011: pages 7-13;
  • Vera Price, Paradi Mirmirani
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    ABSTRACT: A 45-year-old man presents with extensive asymptomatic hair loss affecting most of the top of his scalp. Ten years earlier, he was seen by a dermatologist for patchy hair loss and he remembers having much pain and itching. Scalp biopsy at that time showed lichen planopilaris. His treatment included hydroxychloroquine 200 mg twice daily and intralesional triamcinolone acetonide. He was lost to follow up until his current visit. Scalp examination at the present time shows complete, confluent hair loss over the entire top of his scalp with absence of follicular markings and absence of any clinical inflammation (Fig. 9.1). Currently, there is no clinical clue regarding the diagnosis of his original patchy hair loss. A scalp biopsy is taken.
    01/2011;
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    ABSTRACT: We discuss a patient with central centrifugal cicatricial alopecia (CCCA) who developed severe scalp pruritus that was initially attributed to the cicatricial alopecia and ultimately diagnosed as tinea capitis. The rarity of severe pruritus in CCCA should prompt a search for a fungal infection in these patients.
    Dermatology online journal 02/2008; 14(11):3.
  • Vera Price, Paradi Mirmirani
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    ABSTRACT: Until recently, primary cicatricial alopecias had received little attention in the clinical and research realm. With the dramatic increases in our knowledge of basic hair biology, new and powerful tools have become available to study these rare disorders in ways that were previously not possible. As we have moved from traditional clinical studies and histopathology to molecular biology, new paradigms regarding the pathophysiology of cicatricial alopecia have been developed. However, after clarifying many previously unanswered questions, we are faced with a series of new and unanswered ones. By the time this publication is completed, new information will be available, and we encourage the reader to stay tuned and engaged as research in cicatricial alopecia continues to unfold. KeywordsSebotrophic hypothesis-Research in cicatricial alopecia-Animal models (in research)-Hair follicle stem cells-Epidermal stem cells-Immunology-Peroxisomes-Lipid metabolic pathways-PPAR-gamma
    01/1970: pages 31-34;
  • Article: Mixed Group
    Vera Price, Paradi Mirmirani
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    ABSTRACT: The inflammation in dissecting cellulitis and ­folliculitis keloidalis is secondary to follicular rupture and the release of sebaceous and keratinous material and hair keratin fragments. The latter incite an intense inflammatory response. The inflammation is initially neutrophilic and later mixed with lymphocytes, plasma cells, and foreign body giant cells; granulomas may form around the hair keratin fragments. Sinus tract formation is prominent in dissecting cellulitis and rarely found in folliculitis keloidalis. Unlike folliculitis decalvans and tufted folliculitis in which Staphylococcus aureus is usually cultured, in the mixed group, bacterial pathogens are not usually found. Dissecting cellulitis is considered part of the follicular occlusion triad, which includes acne conglobata and hidradenitis suppurativa. The pathogenesis of folliculitis keloidalis is not well understood.
  • Vera Price, Paradi Mirmirani
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    ABSTRACT: In this chapter, lichen planopilaris, Graham Little syndrome, frontal fibrosing alopecia (FFA), pseudopelade (Brocq), and central centrifugal cicatricial alopecia are described. Two additional entities that are not primary cicatricial alopecias are included, namely chronic cutaneous lupus erythematosus (CCLE) and keratosis follicularis spinulosa decalvans (KFSD) because they are important to recognize and differentiate.
  • Vera Price, Paradi Mirmirani
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    ABSTRACT: The predominantly neutrophilic group of primary cicatricial alopecias includes folliculitis decalvans and tufted folliculitis. Clinically, the affected areas are much more inflamed than the lymphocytic cicatricial alopecias with crusting, pustules, draining, and erythema. There is usually considerable pain, tenderness, and itching. Histologically in the early stages, the inflammatory infiltrate consists predominantly of neutrophils. However, the infiltrate does not remain neutrophilic but rather becomes plasma-cell rich. What other histologic features can be used as clues to a neutrophilic cicatricial alopecia that is no longer predominantly neutrophilic? Scan the scalp biopsy with low-power light microscopy: the presence of four or more fused follicles, and dense interfollicular inflammation and fibrosis are diagnostically useful (see Chap. 3)

Publication Stats

5 Citations
3.53 Total Impact Points

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Institutions

  • 1970–2011
    • University of California, San Francisco
      • Department of Dermatology
      San Francisco, CA, United States