J. Shapiro

J. Shapiro
University of British Columbia - Vancouver | UBC · Department of Dermatology and Skin Science

About

191
Publications
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Publications

Publications (191)
Article
Lichen planopilaris (LPP) is a cicatricial alopecia that presents with patchy or diffuse hair loss at the vertex or parietal scalp. The literature has limited evidence on treatments for this challenging disease, with most reports involving small groups of patients with varied or suboptimal clinical responses. Amongst individuals who do respond to t...
Article
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Introduction: Alopecia areata (AA) is an autoimmune disease characterized by hair loss. Patients with AA experience a range of social and emotional impacts, and the lack of effective treatments and multiple affected locations can deepen the burden of illness. The objective of the current study was to assess health-related quality of life (HRQL) am...
Article
Although alopecia areata (AA) severity is often defined by the degree of scalp hair loss, its impact on quality of life (QoL) can also be a defining measure of severity. In this cross-sectional study (AA Disease Specific Program [AA DSP™]), 259 patients were surveyed for demographics, AA illness characteristics, QoL (Skindex-16 AA), and daily impai...
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Cutaneous involvement of the scalp is a common manifestation of dermatomyositis (DM), occurring in up to 82% percent of adults with DM. Scalp DM predominantly affects women and is characterized by dermatitis, alopecia, pruritus, and/or burning. While cutaneous dermatomyositis negatively impacts quality‐of‐life, scalp symptoms in particular are ofte...
Article
While topical minoxidil has been a mainstay androgenetic alopecia (AGA) treatment, oral minoxidil has only been studied recently. Previous studies indicate low‐dose oral minoxidil (LDOM) is an efficacious, well‐tolerated AGA therapy, and our study aims to contribute to the growing LDOM literature an analysis of quantitative outcomes at multiple are...
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Background Cutaneous manifestations of COVID-19 may be useful disease markers and prognostic indicators. Recently, post-infectious telogen effluvium and trichodynia have also been reported. Objective To evaluate the presence of trichodynia and telogen effluvium in patients with COVID-19 and describe their characteristics in relation to other signs...
Article
Background The current classification for Alopecia Areata (AA) does not provide a consistent assessment of disease severity. Objective To develop an AA severity scale based on expert experience. Methods A Modified Delphi process was utilized. An advisory group of 22 US-based AA clinical experts was formed to develop this AA scale. Representatives...
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Antiandrogens have demonstrated a protective effect for COVOD-19 patients in observational and interventional studies. The goal of this study was to determine if proxalutamide, an androgen receptor antagonist, could be an effective treatment for men with COVID-19 in an outpatient setting. A randomized, double-blinded, placebo-controlled clinical tr...
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Background Although many hair disorders can be readily diagnosed based on their clinical appearance, their progression and response to treatment are often difficult to monitor, particularly in quantitative terms. We introduce an innovative technique utilizing a smartphone and computerized image analysis to expeditiously and automatically measure an...
Article
Background Frontal fibrosing alopecia (FFA) has become one of the most common causes of cicatricial alopecia worldwide, but lacks clear aetiology and robust clinical trial evidence for efficacy and safety of agents currently used for treatment. Objectives To enable data to be collected worldwide on FFA using common criteria and assessment methods....
Article
Background Minoxidil is a widely used over the counter topical treatment for hair loss. The response rate for topical minoxidil is relatively low. Minoxidil is a pro-drug, converted to its active form, minoxidil sulfate, by SULT1A1 enzymes located in the scalp. Recently, a novel topical formula that increases the activity of SULT1A1 in hair follicl...
Article
Frontal fibrosing alopecia (FFA) is a variant of lichen planopilaris (LPP) with characteristic band‐like frontotemporal hairline involvement and eyebrow loss. It most commonly occurs in post‐menopausal White women.1 In skin of color (SOC) individuals, FFA is often misdiagnosed as traction alopecia (TA),2 and little data exists regarding the present...
Article
Importance: A recent expert consensus exercise emphasized the importance of developing a global network of patient registries for alopecia areata to redress the paucity of comparable, real-world data regarding the effectiveness and safety of existing and emerging therapies for alopecia areata. Objective: To generate core domains and domain items...
Article
Importance: A recent expert consensus exercise emphasized the importance of developing a global network of patient registries for alopecia areata to redress the paucity of comparable, real-world data regarding the effectiveness and safety of existing and emerging therapies for alopecia areata. Objective: To generate core domains and domain items fo...
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Background The entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into type II pneumocytes is dependent on a modification of viral spike proteins by transmembrane protease serine 2 (TMPRSS2) expressed on the surface of human cells. TMPRSS2 is regulated by the androgen receptor, hence, SARS-CoV-2 infectivity is indirectly dependen...
Article
Background: We previously reported The Alopecia Areata Consensus of Experts (ACE) Study: Results of an International Expert Opinion on Treatments for Alopecia Areata (AA). Objective: To report the results of the ACE international expert opinion on diagnosis and laboratory evaluation for AA. Methods: Fifty hair experts from 5 continents were in...
Article
Background Topical minoxidil is the only US FDA‐approved drug for the treatment of female pattern hair loss (FPHL). While the safety profile of topical minoxidil is excellent, the efficacy of minoxidil in hair growth is extremely low. A recent survey of 8000 people observed that only 4% of hair loss patients using an over‐the‐counter minoxidil were...
Article
Topical minoxidil has been used as a topical treatment for androgenetic alopecia (AGA) for more than 30 years. Approximately 60 to 70% of patients do not achieve hair growth. Minoxidil is a pro‐drug. In order to exert biological activity, minoxidil requires conversion to minoxidil sulfate by sulfotransferase enzymes (SULT1A1). We have reported exte...
Article
Racial disparities in COVID‐19 infection rates and disease severity are due to a multifactorial etiology that can include socioeconomic as well as other factors. Nevertheless, genetic factors in different ethnic groups often contribute to disease severity and treatment response. In particular, the frequency of genetic variations in the androgen rec...
Article
A preliminary observation of high frequency of male pattern hair loss among admitted COVID‐19 patients, and suggest that androgen expression might be a clue to COVID‐19 severity.
Article
Background A systematic review failed to identify any systemic therapy used in alopecia areata (AA) where use is supported by robust evidence from high quality randomized controlled trials (RCTs). Objective To produce an international consensus statement on the use and utility of various treatments for AA. Methods Fifty hair experts from 5 contin...
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Alopecia areata (AA) is thought to be an autoimmune process. In other autoimmune diseases, the innate immune system and Toll‐like receptors (TLRs) can play a significant role. Expression of TLR7, TLR9, and associated inducible genes were evaluated by quantitative PCR in peripheral blood mononuclear cells (PBMCs) from 10 healthy individuals and 19 A...
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Background: Approximately 40% of women experience excessive hair shedding when washing their hair. Previously, we have demonstrated that a topically applied α1 adrenergic receptor agonist can be used to contract the arrector pili muscle of the follicular unit (ie, produce "goose bumps"), increasing the force required to pluck hair by as much as 40...
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Background: The frequency of different types of alopecia is not clearly reported in recent studies. Objective: To analyze the frequency of the types of alopecia in patients consulting at specialist hair clinics (SHC) and to assess for global variations. Methods: Multicenter retrospective study including data from patients evaluated at referral...
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Topical minoxidil is the only US FDA approved OTC drug for the treatment of androgenetic alopecia (AGA). Minoxidil is a pro‐drug converted into its active form, minoxidil sulfate, by the sulfotransferase enzymes in the outer root sheath of hair follicles. Previously, we demonstrated that sulfotransferase activity in hair follicles predicts response...
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The Structure, Biology & Hair Curl, Colour, and Luster Session included two invited presentations and three selected from submitted abstracts. These presentations taken together highlight current progress in linking follicle biology to the tensile/physical properties of hair. They show progress in understanding the development of the hair fiber, an...
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Approximately 40% of women experience excessive hair shedding during styling (e.g., hair brushing). Previously, we demonstrated that topically applied phenylephrine, a potent α1 adrenergic receptor agonist, can be used to contract the arrector pili muscle of the follicular unit; thus, increasing the force required to pluck hair and reducing sheddin...
Article
Background: Although alopecia areata is a common disorder, it has no FDA approved treatment and evidence-based therapeutic data is lacking. Objective: To develop guidelines for the diagnosis, evaluation, assessment, response criteria and endpoints for alopecia areata. Methods: Literature review and expert opinion of a group of dermatologists s...
Article
In recent years, dermatologists have observed an increase in the incidence of male androgenetic alopecia (AGA). In a survey of 41 dermatologists, 88% reported an increase in incidence of AGA in men younger than 30 years. This phenomenon has no apparent explanation. However, due to the strong genetic inheritance component of AGA, a social or environ...
Article
Scalp imaging techniques are necessary tools for the trichological practice and for visualization of permeation, penetration and absorption processes into and through the scalp and for the research on drug delivery and toxicology. The present letter reviews different scalp imaging techniques and discusses their utility. Moreover, two different stud...
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A subset of basal cell carcinomas (BCCs) are directly derived from hair follicles (HFs). In some respects, HFs can be defined as 'ordered' skin appendage growths, while BCCs can be regarded as 'disordered' skin appendage growths. The aim of the present study was to examine HFs and BCCs to define the expression of common and unique signaling pathway...
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Hair shedding in female patients is a frequent complaint in dermatological, endocrinological, and gynecological consults. Previously, the Sinclair Hair Shedding Scale was developed to assess normal versus excessive hair shedding in female pattern hair loss (FPHL) subjects. However, the prevalence of hair shedding in females not suffering from FPHL...
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Alopecia areata (AA) is believed to be a cell-mediated autoimmune hair loss disease. Both CD4 and cytotoxic CD8 T-cells (CTLs) are important for the onset and progression of AA. Hair follicle (HF) keratinocyte and/or melanocyte antigen epitopes are suspected potential targets of auto-reactive CTLs, but the specific epitopes have not yet been identi...
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Alopecia areata (AA) development is associated with both innate and adaptive immune cell activation, migration to peri- and intra-follicular regions, and hair follicle disruption. Both CD4+ and CD8+ lymphocytes are abundant in AA lesions; however, CD8+ cytotoxic T lymphocytes are more likely to enter inside hair follicles, circumstantially suggesti...
Article
Scarring or cicatricial alopecias represent a group of poorly understood and uncommon disorders that cause permanent hair loss. Scarring alopecias are regarded as trichologic emergencies as hair loss is irreversible, rapidly progressive, and can be disfiguring. Patients could experience tremendous anxiety, low self-esteem, and extreme psychosocial...
Article
The Journal of Investigative Dermatology publishes basic and clinical research in cutaneous biology and skin disease.
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Immunosuppressive drugs successfully prevent rejection of islet allografts in the treatment of type I diabetes. However, the drugs also suppress systemic immunity increasing the risk of opportunistic infection and cancer development in allograft recipients. In this study, we investigated a new treatment for autoimmune diabetes using naturally immun...
Chapter
The relationship between sexual maturity and hair loss was recognized for the first time by Aristotle. Since then, many steps have been undertaken to convert that observation to scientific fact. Androgens, which were found to be responsible for sexual maturity, also have a major role in normal hair growth and induction of certain hair diseases. The...
Article
The Journal of Investigative Dermatology publishes basic and clinical research in cutaneous biology and skin disease.
Article
To date, there is no standard treatment of folliculitis decalvans (FD), a rare type of cicatricial alopecia. The records of 23 patients with FD (1998-2012) were retrospectively analyzed, with added data review on the course and treatment of long-standing cases. Initial management consisted mostly of intralesional triamcinolone acetonide, clobetasol...
Article
Clinical response to 5% topical minoxidil for the treatment of androgenetic alopecia (AGA) is typically observed after 3–6 months. Approximately 40% of patients will regrow hair. Given the prolonged treatment time required to elicit a response, a diagnostic test for ruling out nonresponders would have significant clinical utility. Two studies have...
Article
Hair loss (alopecia) is a common problem and is often a major source of distress for patients. The differential diagnosis of alopecia includes both scarring and nonscarring alopecias. In addition, many hair shaft disorders can produce hair shaft fragility, resulting in different patterns of alopecia. Therefore, an organized and systematic approach...
Article
The use of trichoscopy for evaluating a number of hair and scalp disorders is gaining popularity. It is a simple and noninvasive in vivo tool for visualizing hair shafts and the scalp. Recently, alopecias have been classified according to their trichoscopic findings. The second part of this 2-part continuing medical education article reviews recent...
Article
Background Frontal fibrosing alopecia is a distinctive form of scarring alopecia presenting with frontal and temporoparietal recession of the hairline. Its etiology remains unknown, and there are no universal treatment guidelines. We conducted a retrospective cohort study to define the clinical findings and treatment outcomes of 62 patients with fr...
Article
Female pattern hair loss (FPHL) is the most common cause of hair loss in women. It has a greater psychosocial morbidity than that of male pattern hair loss. The clinical presentation of FPHL is distinctive with hair thinning usually confined to the crown region of the scalp. The frontal hair line is usually spared; however, it can be affected in so...
Article
The immune privilege (IP) of hair follicles has been well established in previous studies. However whether cultured hair follicle cells still exhibit IP properties, the individual factors involved in this process, and the detailed mechanisms that drive and maintain IP, are largely unidentified. We found preferential expression of IP associated gene...
Article
Hair loss is a widespread complaint that carries a significant psychosocial burden for affected individuals. Androgenetic alopecia (AGA) is the predominant cause of hair loss seen in the dermatology clinic. Although a range of therapies are available, minoxidil remains the only approved topical treatment for AGA. Promising new topical agents are un...
Article
Full-text available
Alopecia areata (AA) is a chronic autoimmune hair loss disease that affects several million men, women and children worldwide. Previous studies have suggested a link between autoimmunity, stress hormones, and increased cardiovascular disease risk. In the current study, histology, immunohistology, quantitative PCR (qPCR) and ELISAs were used to asse...
Data
Preliminary qPCR gene screening of chronic AA mice compared to the healthy controls. In both the skin (a) and heart (b), there was a significant increase of Il18 and significant decrease of Cti in the AA mice (n = 6) compared to the healthy sham-grafted controls (n = 6). There was an over 1,000 fold increase in granzyme B (Gzmb) activity in the ski...
Data
Primer sequences used for qPCR analysis. (DOC)
Article
Androgenetic alopecia is a common cause of hair loss in both men and women. The exact pathogenesis of androgenetic alopecia is not well understood. As the name implies, the role of androgens and genetic susceptibility predisposes to pattern hair loss due to gradual conversion of terminal hair into vellus hair. Male and female pattern hair loss are...
Article
The advances in hair transplantation, particularly the advent of follicular unit transplantation, have greatly elevated the outcome of this procedure. Various modifications to the basic technique as well as innovations focused on the different aspects of the hair transplantation procedure have further enhanced this type of hair restoration surgery....
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Background: Emotional stress has been associated with the development of alopecia areata (AA) and androgenetic alopecia (AGA). Emotional intelligence (EI), a component of general intelligence, is thought to govern the recognition, expression, and control of stress and other emotions. People with low EI are unable to adequately control stress in ev...
Article
Immune privilege (IP) is believed to exist in the anagen hair follicle (HF). Studies have shown down-regulation of MHC Class I occurs and immunosuppressive factors are expressed in the HF bulb and bulge. However, demonstration and quantitation of functional IP in HF cells is required. We examined the middle (sheath) and lower (bulb) portions of the...
Article
African governments, donors and the private sector have stepped up their efforts to revitalise the agricultural sector with additional resources and support for new business initiatives. In NEPAD’s 2003 Comprehensive Africa Agriculture Development Programme (CAADP), the continent’s leaders acknowledged their responsibility for providing technical a...
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Androgenetic alopecia (AGA) may affect up to 70% of men and 40% of women at some point in their lifetime. While men typically present with a distinctive alopecia pattern involving hairline recession and vertex balding, women normally exhibit a diffuse hair thinning over the top of their scalps. The treatment standard in dermatology clinics continue...
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We conducted a microarray study to discover gene expression patterns associated with a lack of melanogenesis in non-pigmented hair follicles (HF) by microarray. Pigmented and non-pigmented HFs were collected and micro-dissected into the hair bulb (HB) and the upper hair sheaths (HS) including the bulge region. In comparison to pigmented HS and HBs,...