Elise A. Olsen's research while affiliated with Duke University Medical Center and other places

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...

Background: There are currently no universally effective or FDA-approved treatments for alopecia areata (AA). Oral ruxolitinib has shown efficacy in extensive AA. Ruxolitinib cream would potentially avoid systemic side effects. Objective: To assess the efficacy and safety of 1.5% ruxolitinib cream in patients with AA who had ≥25% hair loss by Se...

Natural killer (NK)/T-cell lymphomas are a rare and distinct subtype of non-Hodgkin's lymphomas. NK/T-cell lymphomas are predominantly extranodal and most of these are nasal type, often localized to the upper aerodigestive tract. Because extranodal NK/T-cell lymphomas (ENKL) are rare malignancies, randomized trials comparing different regimens have...

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...

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...

Background: Focal atrichia is a common clinical finding in female pattern hair loss whose specificity and histologic findings need further clarification. Objective: To determine the frequency of focal atrichia in various types of hair loss and its histologic characteristics in female pattern hair loss. Methods: Part 1: Review of 250 consecutiv...

Primary cutaneous CD8-positive aggressive epidermotropic T-cell lymphoma is a rare and poorly characterized variant of cutaneous lymphoma still considered a provisional entity in the latest 2016 World Health Organization Classification of Cutaneous lymphomas. We sought to better characterize and provide diagnostic and therapeutic guidance of this r...

In 2014, Medicare expenditures increased 12%, the largest increase reported since 2002, resulting in major concerns by both patients and physicians. Although costs are rising for both specialty drugs and generic medications,out-of-pocket costs, restrictive formularies,and health plan bureaucracies are limiting patients' access to necessary medicati...

Background: Ultraviolet light (UVL) is a long established treatment for mycosis fungoides (MF) and Sézary syndrome (SS), subtypes of cutaneous T-cell lymphoma (CTCL). Treatments have traditionally included broadband, narrowband ultraviolet B light (UVB) and psoralen plus ultraviolet A light photochemotherapy (PUVA), but more recently, treatment op...

Primary cutaneous lymphomas (PCLs) are an extremely heterogeneous group of non-Hodgkin lymphomas that manifest in the skin. Their diagnosis is complex and based on clinical lesion type and evaluation of findings on light microscopic examination, immunohistochemistry and molecular analysis of representative skin biopsies. The evaluation, classificat...

This case report describes the occurrence of disseminated cutaneous cytomegalovirus infection in an immunocompromised patient following total body electron beam irradiation for mycosis fungoides. Cutaneous cytomegalovirus (CMV) infections are rare and are often associated with poor prognosis from an underlying malignant condition or immunosuppress...

Background: Forodesine is a potent inhibitor of purine nucleoside phosphorylase (PNP) that leads to intracellular accumulation of deoxyguanosine triphosphate (dGTP) in T and B cells, resulting in apoptosis. Forodesine has demonstrated impressive antitumor activity in early phase clinical trials in cutaneous T-cell lymphoma (CTCL). Patients and me...

Central centrifugal cicatricial alopecia is an inflammatory type of central scalp hair loss seen primarily in women of African descent. The prevalence is unknown, but may vary from 2.7% to 5.7% and increases with age. This review outlines the history and current beliefs and identifies clues for future research for this enigmatic condition. Despite...

This chapter reviews the types and amounts of hair loss seen with various anticancer agents. It discusses newer methods of tracking and defining the amount of hair loss and the severity of the psychosocial impact. The chapter focuses on potential measures to prevent or hasten the regrowth seen with CIA. There are three main types of hair abnormalit...

BACKGROUND: Frontal fibrosing alopecia (FFA) is a type of scarring hair loss primarily observed in postmenopausal women and characterized by fronto-tempero-parietal hairline recession, perifollicular erythema, and loss of eyebrows. The incidence is unknown, but the number of women presenting with this condition has significantly increased in recent...

We reviewed our multicenter experience with gamma-delta (γδ) T-cell lymphomas first presenting in the skin. Fifty-three subjects with a median age of 61 years (range, 25 to 91 y) were diagnosed with this disorder. The median duration of the skin lesions at presentation was 1.25 years (range, 1 mo to 20 y). The most common presentation was deep plaq...

Objective To evaluate the efficacy and safety of a novel mechlorethamine hydrochloride, 0.02%, gel in mycosis fungoides. Design Randomized, controlled, observer-blinded, multicenter trial comparing mechlorethamine, 0.02%, gel with mechlorethamine, 0.02%, compounded ointment. Mechlorethamine was applied once daily for up to 12 months. Tumor response...

This open-label phase III trial, a companion to an earlier placebo-controlled trial, evaluated safety and efficacy of denileukin diftitox (DD) in patients with cutaneous T-cell lymphoma (CTCL) who relapsed after responding to DD primary treatment in the earlier trial. Twenty relapsed patients (stages IA-III) received DD 18 μg/kg/day intravenously o...

In a placebo-controlled study, denileukin diftitox (DD) was effective against cutaneous T-cell lymphoma (CTCL) expressing CD25. An open-label companion study examined the efficacy and safety of DD in 36 patients with skin biopsies containing < 20% CD25 cells by immunohistochemistry staining (CD25 low expression). Patients received DD 18 µg/kg/day f...

Herein we report a case of recalcitrant cutaneous pseudolymphoma (CPL) treated with subcutaneous interferon.Correspondence: Elise Olsen, MD, Department of Dermatology, Duke University Medical Center, PO Box 3294, Durham, NC 27710 (olsen001@mc.duke.edu).Accepted for Publication: August 21, 2011.Author Contributions: All authors had full access to al...

Dermatologic adverse events to cancer therapies have become more prevalent and may to lead to dose modifications or discontinuation of life-saving or prolonging treatments. This has resulted in a new collaboration between oncologists and dermatologists, which requires accurate cataloging and grading of side effects. The Common Terminology Criteria...

Finasteride (1 mg) has been shown to increase vertex hair growth in men aged 18 to 60 years with male pattern hair loss and to increase frontal scalp hair growth in subjects aged 18 to 41 years. A secondary efficacy analysis was conducted to determine effects of finasteride (1 mg) on scalp hair growth in the 4 distinct scalp regions affected by mal...

Primary cutaneous CD30(+) lymphoproliferative disorders (CD30(+) LPDs) are the second most common form of cutaneous T-cell lymphomas and include lymphomatoid papulosis and primary cutaneous anaplastic large-cell lymphoma. Despite the anaplastic cytomorphology of tumor cells that suggest an aggressive course, CD30(+) LPDs are characterized by an exc...

Chemotherapy-induced alopecia has been well documented as a cause of distress to patients undergoing cancer treatment. Despite the importance of hair loss to patients, however, patients often receive little more counseling than the advice to purchase a wig or other head covering for the duration of their treatment. Research into non-camouflage (wig...

The clinical course of cutaneous T-cell lymphoma (CTCL) is typically chronic, often progressive, and variably response to existing therapeutic interventions. To date, few controlled clinical trials demonstrate durable complete responses (CR) in advanced-stage patients. Denileukin diftitox (DD) is a recombinant fusion protein targeting the interleuk...

Mycosis fungoides (MF) and Sézary syndrome (SS), the major forms of cutaneous T-cell lymphoma, have unique characteristics that distinguish them from other types of non-Hodgkin's lymphomas. Clinical trials in MF/SS have suffered from a lack of standardization in evaluation, staging, assessment, end points, and response criteria. Recently defined cr...

To quantify pruritus and assess its impact on the quality of life of patients with mycosis fungoides (MF) and Sézary syndrome (SS), investigators at 2 centers conducted in-depth interviews of MF/SS patients aged ≥18 years who experienced pruritus associated with their disease. The relevance of a dermatologic-specific health-related quality-of-life...

The reported efficacy of various treatments for alopecia is difficult to compare based on a general lack of consideration in case reports/series and clinical trials of the spontaneous regrowth or baseline prognostic factors seen in alopecia areata and a general lack of quantification of hair growth. This report will give both the investigator and c...

Sézary syndrome (SS) has a poor prognosis and few guidelines for optimizing therapy. The US Cutaneous Lymphoma Consortium, to improve clinical care of patients with SS and encourage controlled clinical trials of promising treatments, undertook a review of the published literature on therapeutic options for SS. An overview of the immunopathogenesis...

2863 Introduction Cutaneous T-cell lymphoma (CTCL) is a heterogeneous group of non-Hodgkin's lymphomas typically characterized by skin patches, plaques, and tumors. Although CTCL primarily develops in the skin, it may progress to involve lymph nodes, blood, and visceral organs. Denileukin diftitox (DD) is a recombinant fusion protein that targets...

Although central scalp hair loss is a common problem in African American women, data on etiology or incidence are limited. We sought to determine the frequency of various patterns and degree of central scalp hair loss in African American women and to correlate this with information on hair care practices, family history of hair loss, and medical hi...

The literature suggests that iron deficiency (ID) may play a role in female pattern hair loss (FPHL) or in chronic telogen effluvium (CTE). We sought to determine if ID is more common in women with FPHL and/or CTE than in control subjects without hair loss. This was a controlled study of 381 Caucasian women aged 18 years or older with FPHL or CTE s...

Chemotherapy-induced alopecia is very common, but the amount and type of hair loss and regrowth are dependent on the drug, combination of agents, and/or dose. These differences are discussed along with new methods for tracking and quantifying the hair loss.

Accurate grading of dermatologic adverse events (AE) due to epidermal growth factor receptor (EGFR) inhibitors (EGFRIs) is necessary for drug toxicity determinations, interagent comparisons, and supportive care trials. The most widely used severity grading scale, the National Cancer Institute's Common Terminology Criteria for Adverse Events version...

Vorinostat, an orally active histone deacetylase inhibitor, was approved in October 2006 by the US Food and Drug Administration for the treatment of cutaneous manifestations of cutaneous T-cell lymphoma (CTCL) in patients with progressive, persistent, or recurrent disease during or after treatment with 2 systemic therapies. A multicenter, open-labe...

1709 Poster Board I-735 Background Vorinostat (Zolinza®) is an oral histone deacetylase inhibitor licensed by the United States Food and Drug Administration for the treatment of cutaneous manifestations of CTCL in pts with progressive and persistent disease on or following two prior systemic therapies. In a pivotal Phase IIB, open-label, multicent...

3745 Poster Board III-681 Cutaneous T-cell lymphoma (CTCL) is a disorder of CD4+ helper T-cells with manifestations in the skin, nodes, and, in advanced stages, blood and visceral sites. For many patients, the clinical course of the disease is chronic and progressive, despite multiple therapeutic interventions. To date, are few controlled clinical...

Central centrifugal cicatricial alopecia (CCCA) is a common but poorly understood cause of hair loss in African American women. A photographic scale was developed that captures the pattern and severity of the central hair loss seen with CCCA in order to help identify this problem in the general community and to potentially correlate clinical data w...

A progressive scarring alopecia of the central scalp is commonly seen in young to middle-aged females of African descent. It usually starts at the vertex or mid top of the scalp and gradually spreads centrifugally, hence, the unifying term of central centrifugal cicatricial alopecia. The clinical pattern is suggestive of female pattern alopecia, bu...

The NCCN Clinical Practice Guidelines in Oncology: Non-Hodgkin's Disease were recently revised to include recommendations for treating mycosis fungoides and Sézary syndrome. These uncommon lymphomas require a specialized evaluation and use a unique TNMB staging system. Unlike the other forms of non-Hodgkin's lymphomas, stage overwhelmingly determin...

Alopecia areata (AA) is a T-cell-mediated autoimmune disease. Efalizumab is a T-cell-targeted therapy approved for the treatment of psoriasis. To assess the efficacy and safety of efalizumab in the treatment of moderate-to-severe AA. Sixty-two patients were enrolled into this phase II, placebo-controlled trial. The trial consisted of three 12-week...

Keratosis follicularis spinulosa decalvans (KFSD) is a rare condition characterized by diffuse keratosis pilaris with a scarring alopecia of the scalp and associated photophobia, facial erythema, and palmoplantar keratoderma. Although initially described as a sex-linked disorder, several different inheritance patterns have been observed. We describ...

An alternative to currently marketed topical minoxidil solutions is desirable. To assess the efficacy and safety of a new 5% minoxidil topical formulation in a propylene glycol-free foam vehicle in men with androgenetic alopecia (AGA). This was a 16-week, double-blind, placebo-controlled trial of 5% minoxidil topical foam (MTF) in 352 men, 18 to 49...

Background: Forodesine is a rationally designed, potent inhibitor of purine nucleoside phosphorylase (PNP) that leads to intracellular accumulation of dGTP and then apoptosis. Intravenous forodesine has demonstrated activity in treatment of cutaneous T-cell lymphoma (CTCL) and served as the basis for the design of an oral forodesine Phase I/II tria...

The ISCL/EORTC recommends revisions to the Mycosis Fungoides Cooperative Group classification and staging system for cutaneous T-cell lymphoma (CTCL). These revisions are made to incorporate advances related to tumor cell biology and diagnostic techniques as pertains to mycosis fungoides (MF) and Sézary syndrome (SS) since the 1979 publication of t...

To evaluate the activity and safety of the histone deacetylase inhibitor vorinostat (suberoylanilide hydroxamic acid) in persistent, progressive, or recurrent mycosis fungoides or Sézary syndrome (MF/SS) cutaneous t-cell lymphoma (CTCL) subtypes. Patients with stage IB-IVA MF/SS were treated with 400 mg of oral vorinostat daily until disease progre...

Currently availabel staging systems for non-Hodgkin lymphomas are not useful for clinical staging classification of most primary cutaneous lymphomas. The tumor, node, metastases (TNM) system used for mycosis fungoides (MF) and Sézary syndrome (SS) is not appropriate for other primary cutaneous lymphomas. A usable, unified staging system would impro...

A double-blind, parallel comparison was made of the short-term efficacy and safety of three times daily regimens of 0.05% clobetasol propionate cream and 0.05% fluocinonide cream in 114 adolescent and adult patients with psoriasis and 113 with eczema. After 2 weeks of topical applications, patients were assessed according to (1) investigators' over...

Male pattern hair loss (MPHL) is a potentially reversible condition in which dihydrotestosterone is an important etiologic factor. Our aim was to evaluate the efficacy of the type 1 and 2 5alpha-reductase inhibitor dutasteride in men with MPHL. Four hundred sixteen men, 21 to 45 years old, were randomized to receive dutasteride 0.05, 0.1, 0.5 or 2....

Interleukin-12 (IL-12) increases Th(1) cytokines, natural killer (NK) cells, and cytotoxic T-cell activities. Progression of mycosis fungoides is associated with Th(2) cytokines produced by a clonal proliferation of epidermotropic T-helper cells. To determine the safety and efficacy of subcutaneous recombinant human IL-12 (rhIL-12) in early mycosis...

Female pattern hair loss (FPHL) is a common hair disorder of the central scalp. The clinical change in hair density, related to a change in the hair cycle and miniaturization of the hair follicle, is generally considered to be potentially reversible. However, there is now evidence of a permanent hair loss that develops in a subset of women with FPH...

This editorial review summarizes the results of 5 meetings sponsored by the International Society for Cutaneous Lymphoma at which the clinicopathologic and ancillary features of early mycosis fungoides were critically examined. Based on this analysis, an algorithm was developed for the diagnosis of early mycosis fungoides involving a holistic integ...

Short anagen syndrome is an uncommon, probably underreported, condition whose clinical characteristics are poorly recognized and whose incidence is poorly documented in the medical literature. We describe the clinicopathologic features of a child with short anagen syndrome and propose methods for diagnosing this entity by clinical examination, tric...

no Alopecia areata is an immunologically mediated disease characterized by extreme variability not only in the time of initial onset of hair loss but in the duration, extent and pattern of hair loss during any given episode of active loss. These variables, as well as the unpredictable nature of spontaneous regrowth and lack of a uniform response to...

We report the results of a pilot study of topical 5% 5-fluorouracil (FU) cream for the treatment of alopecia areata, an immunologically modulated disorder of hair growth. Patients with extensive (>50% scalp surface area involvement) alopecia areata that was refractory to previous treatments applied 5-FU to one side of their scalp twice daily for 3...

It is well accepted that cutaneous T-cell lymphomas (CTCL), including mycosis fungoides and Sézary syndrome, represent lymphomas that are highly responsive to immune modifying agents. Furthermore, the recent emphasis on the use of cytokine-related therapeutics is based upon the exceedingly important role of the host immune response in effecting pro...

Interferons are polypeptides with a broad range of in vivo effects that have shown efficacy in cutaneous T-cell lymphoma (CTCL). Particularly useful is alfa interferon (IFN) which, as a single agent, has shown partial remission rates of > 50% and complete responses of > 20%. Side-effects are predictable, generally well tolerated and dose-related. T...

Cicatricial alopecia is an enigmatic group of hair disorders linked by the potential permanent loss of scalp hair follicles in involved areas. Progress in our understanding and treatment of these disorders has been stymied by the lack of clear diagnostic criteria for the current terms used to describe the various hair loss entities. Since all of th...

A 24-month double-blind, randomized, placebo-controlled, parallel-group, multicenter study of 424 men was conducted to determine the efficacy and tolerability of finasteride 1 mg on hair growth/loss in men aged 41 to 60 years with mild-to-moderate, predominantly vertex male pattern hair loss. Efficacy was evaluated by review of global photographs o...

J Am Acad Dermatol 2003;48:103-10

J Am Acad Dermatol 2002;47:795.

Topical minoxidil solution 2% stimulates new hair growth and helps stop the loss of hair in individuals with androgenetic alopecia (AGA). Results can be variable, and historical experience suggests that higher concentrations of topical minoxidil may enhance efficacy. The purpose of this 48-week, double-blind, placebo-controlled, randomized, multice...

Cutaneous T-cell lymphoma (CTCL) can be associated with painful, pruritic, disfiguring lesions. As part of a multicenter, randomized phase III trial in patients with heavily pretreated advanced and/or recurrent CTCL, the effects of an interleukin-2 receptor-targeted fusion protein, denileukin diftitox (DAB389IL-2, ONTAK), on patient-rated overall q...

Two conferences were sponsored by the International Society for Cutaneous Lymphomas (ISCL) to gain consensus on definitions and terminology for clinical use in erythrodermic cutaneous T-cell lymphoma (E-CTCL). Three subsets of E-CTCL were defined: Sézary syndrome ("leukemic phase" E-CTCL), erythrodermic mycosis fungoides (secondary E-CTCL that deve...

Recent phase I and phase II trials using recombinant human interleukin-12 (rhIL-12) for cutaneous T cell lymphoma (CTCL) have been completed. Observations on 32 evaluable patients revealed an overall response rate approaching 50 percent. Biopsy of regressing lesions revealed an increase in numbers of CD8+ and/or TIA-1+ T cells. These results sugges...

• Decrease in hair density in the central (vertex, mid and frontal) scalp, bitemporal and parietal regions in women. • Miniaturization of affected hairs. • Two ages of onset: early (post-puberty to third decade) and late (age 40+ years). • Signs of hyperandrogenism (hirsutism, irregular periods) or hyperandrogenemia occur in a subset of women with...

J Am Acad Dermatol 2001;45:S69.

The purine nucleoside phosphorylase inhibitor peldesine is a new agent being evaluated as a T-cell inhibitor. We attempted to determine the efficacy of peldesine (BCX-34) in a 1% dermal cream formulation as a treatment for cutaneous T-cell lymphoma (CTCL). Ninety patients with patch and plaque phase CTCL, histologically confirmed by a referee derma...

To determine the safety and efficacy of oral bexarotene (Targretin capsules; Ligand Pharmaceuticals Incorporated, San Diego, Calif). The effects of 2 randomized doses of 6.5 mg/m(2) per day (with crossover for progression) vs 650 mg/m(2) per day (later modified to 300 mg/m(2) per day) were evaluated in an open-label, multicenter, phase 2 and 3 stud...

The objective of this phase III study was to determine the efficacy, safety, and pharmacokinetics of denileukin diftitox (DAB389IL-2, Ontak [Ligand Pharmaceuticals Inc, San Diego, CA]) in patients with stage Ib to IVa cutaneous T-cell lymphoma (CTCL) who have previously received other therapeutic interventions. Patients with biopsy-proven CTCL that...