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Thomas W. Chu, MD, Dermatology Resident, Post-Graduate Year 3, Wayne State University School of Medicine
Mentor: Kevin McElwee, PhD, University of British Columbia, Dermatology & Skin Sciences
Mentorship title: Dermoscopy/Trichoscopy
I would like to thank the American Hair Research Society for the Mentorship Grant that gave me an opportunity to learn from Dr. Kevin McElwee, the assistant professor in the Department of Dermatology and Skin Sciences at the University of British Columbia in Canada. Dr. McElwee's Hair Research Laboratory is dedicated to understanding the biology of the human hair follicle and the role it plays in the skin and a variety of immunologic disorders such as alopecia areata.
During this mentorship I learned how to dissect and isolate the dermal papilla from the hair follicle under 10X magnification. After carefully isolating the dermal papilla, I was introduced to the art and science of culturing the dermal papilla cells. Dr. McElwee is a pioneer in hair follicle research and has developed protocols and patents for growing dermal sheath cup cells (part of the dermal papilla). During this time, I also refined a protocol for activating platelet rich plasma for future studies. I gained valuable insights and learned techniques that are applicable to basic science hair research.
I enjoyed this learning experience because Dr. McElwee is an excellent and knowledgeable mentor. The AHRS Mentorship Grant has allowed me to gain some fundamental knowledge and skills for further basic science hair research. Dr. McElwee's dedication is an inspiration and a role model for my career. I would like to thank AHRS again for this unique opportunity to experience hair research bench-side.
Lauren Lam, BScH, MD, Dermatology Resident, Post-Graduate Year 3, University of Alberta(left)
Mentor: Carolyn Goh, MD, University of California Los Angeles, Dermatology
Mentorship title: Therapeutics for Hair Loss Disorders
I want to sincerely thank you for enabling me to have a Mentorship opportunity with Dr. Carolyn Goh at the University of California Los Angeles. As a Canadian dermatology resident, there are limited opportunities for Mentorship for hair disorders in Canada, so I was thrilled to learn one-on-one from such a distinguished a hair specialist as Dr. Goh.
Currently, there are no academic hair specialists practising in Western Canada. Hair disorders is an interest of mine that I wanted to explore and gain more exposure to through this mentorship experience. Ultimately, I hoped to sharpen my clinical acumen and strengthen my comfort with therapies beyond the first few lines of treatment. I am especially appreciative that, to my delight, my experience was much greater than simply academics.
While working with Dr. Goh, she took the time outside of clinic to personally get to know me and my career goals. We had the opportunity to participate in the Autoimmune Walk in Culver City and engage with the local community.
I also had the opportunity to attend UCLA Resident Hair Clinics and Dermatology Grand Rounds, where I had the chance to meet other dermatology residents and experience great learning and discussion of cases in a dedicated academic hair disorders clinic. In addition, I had the opportunity to see the work of JAK inhibitors in many alopecia areata patients - something I had read a great deal about, but had not had the opportunity to see in person yet, as this is not a widely accessible treatment in Canada. This was something I had hoped I would encounter during my time in the United States and was very excited to witness.
Seeing numerous diagnostically challenging & very progressed cases with Dr. Goh was invaluable. Her familiarity with third and fourth line treatments for a small pool of ethnically diverse patients and asessing the efficacy of these therapies was expertise which I could not have experienced through smaller dermatology residency programs. Currently, we are in the process of preparing a case report of an intriguing patient of hers.
What stood out most to me during my time with Dr. Goh is her appreciation for the personal impact hair disorders have on a patient. The positive inspiration and support she provided to her patients was clearly very much appreciated, and even for end-stage cicatricial alopecia patients, it was evident she was making a difference for them despite their disease course. This is something I know I will carry forward as a practising dermatologist.
So, thank you NAHRS for enabling me to have this mentorship experience. I feel grateful to have a truly invested mentor through this mentorship experience. I look forward to continuing my knowledge in hair disorders through my residency and future practise!
Michelle Oboite, MD, Dermatology Resident
Mentor: Amy McMichael, MD, Wake Forest Baptist Medical Center
Mentorship title: Hair and Scalp Disease, Medical and Procedural treatments
I spent a month working with Dr. McMichael and her team in clinics at the Wake Forest University Department of Dermatology learning about the medical management of scarring and non-scarring alopecias. It was one of the most impactful mentorship opportunities I have had in my medical career. Dr. McMichael not only taught me how to care for patients with challenging cases of alopecia, but she curated a memorable, exciting experience in a collegial, respectful environment. She introduced me to a model of developing research questions in the midst of a busy clinical practice that I hope to implement in my career (hopefully, as well as she does!) She also connected me to other outstanding physicians in the hair field.
I was able to spend time with a hair transplant surgeon in Charlotte, North Carolina learning more about protocols for platelet rich plasma and hair restoration in scarring and non-scarring alopecias. Currently, I am working with Dr. McMichael and her team to identify clinical, dermatoscopic, and/or histopathological features of central centrifugal cicatricial alopecia that could guide and optimize treatment selection for patients. I am thankful to Dr. McMichael for her continued mentorship and leadership: she motivates me and everyone around her to be better for our patients and for one another. I still don't know how she finds time to do everything she does! I am extremely grateful to the American Hair Research Society for their support with the mentorship award: I truly believe it has changed the trajectory of my career for the better.
Sarah Linn BS, Dermatology Resident
Mentor: John Sundberg DVM, PhD, DACVP, The Jackson Laboratory
Mentorship title: Mouse Modeling of Skin and Hair Disease
From September 18th to October 13th, 2017, I was able to work for Dr. John Sundberg in his lab working on dermatopathology research at The Jackson Laboratory in Bar Harbor, Maine. Dr. Sundberg is well known in the field and knowledgeable about the various laboratory mouse strains. My project was a retrospective analysis of mouse nail slides within a previously published large scale aging study from 2007. This study looked at diseases of 30 aging mice strains from The Jackson Laboratory at 12 and 20 months and also during a longitudinal study. Dr. Sundberg noticed that the NON/ShiLtJ mice had a high prevalence of dystrophic nail lesions along with some other strains but at lower rate. He hoped to characterize the lesion further and kept the slides until Allison Mustonen and I came for our externships. Analysis of the slides showed nail dystrophy, subungual inflammation, remodeling of the distal phalanx, hyperplasia of the nail matrix and nail bed, and occasionally protrusion of the distal phalanx through the hyponychium. The lesions were also seen in the C57BR/cdJ, C57BL/6J, FVB/NJ, KK/H1J, MRL/MpJ, NZO/H1LtJ, NZW/LacJ, SM/J, and SWR/J strains. We gathered samples from younger NON/ShiLtJ breeders to see if the lesion was present at earlier ages which there were some mice that were affected. Complete analysis of the slides allowed us to propose a specific pathogenesis for this lesion which was described in our article published in the Journal of Experimental Dermatology in July 2018.
During the slide analysis, Allison and I discovered that about 40% of slides were not diagnostic for us to evaluate the nails. Mouse nails are hard to section because of their small size, varying tissues within the nail unit, and difficulty orienting the feet within paraffin. Our other project was to develop a better means of sectioning mouse nails in order to evaluate strains for phenotyping. We worked with the histology technicians at The Jackson Laboratory to see what fixatives and decalcification protocols would work best for sectioning. Starting with C57BL/6J females of the same age, we developed a protocol that worked well for sectioning the tissues, orienting the nails in wax, and immunohistochemical staining of the slides. We hope to publish our results after repeating the methods for various strains and males versus females.
Aside from these projects, I attended the 16th Annual Workshop on the Pathology of Mouse Models of Human Disease. I was able to network with leaders in the field of mouse pathology and make valuable connections for my career. Allison and I also presented our work at the conference which was well received by the attendees.
Overall, I had a valuable career experience with Dr. Sundberg. He was a great mentor throughout the externship and taught me what a veterinary pathologist can achieve at an institution like The Jackson Laboratory. I truly appreciate AHRS's financial assistance for my externship and am thankful for the training I received.
Daiane Matana, MD, Dermatology Resident (left)
Paula Jacomini Sobral, MD, Dermatology Resident (right)
Mentor: Antonella Tosti, MD, University of Miami, Miller School of Medicine
Mentorship title: Dermoscopy of Hair Disorders
Thanks to the (North) American Hair Research Society, the Mentorship Program did support and offer us a great opportunity to learn with Dr. Antonella Tosti.
We had the pleasure to stay with Dr. Tosti and the residents during her daily activities at the outpatient center, see all kinds of hair and nails diseases, learn more about tricoscopy, have information about the best and new treatments available and evidence-based, attend some Grand Rounds and lectures. Above all, Dr. Tosti inspired us with her manner with patients. She educated all of her patients on their disease processes and explained the reasons behind her treatment suggestions. With her sincerity she was able to put her patients to ease and win their trust.
We spent the last 2 months (Aug. - Sept.) with Dr. Tosti and her wonderful staff at the University of Miami and we are sure that was the best academic experience, that was very important for our personal and professional career.
We thank (N)AHRS for this unique opportunity and we'll use all this knowledge for the benefit of our patients.
Marina Barletta, MD, Clinical Research
Mentor: Antonella Tosti, MD, University of Miami, Miller School of Medicine
Mentorship title: Hair and Nail Disorders and Contact Dermatitis
I would like to thank the NAHRS for this unique opportunity, to learn and work with Dr. Tosti.
In April 2017 I spent five weeks at the University of Miami with her. Since I did my residency in dermatology, when I began to be interested in hair diseases, I wanted to take this fellowship with Dr. Antonella. It was a great pleasure when I received the news from NAHRS that I won the grant for a mentorship program with her. She is an amazing researcher and so generous in sharing her knowledge with everyone who works with her. She is a worldwide-recognized scientist for her many scientific articles, and she is also a wonderful human being.
I was able to observe Dr. Tosti and the residents seeing patients with hair and nail disorders and contact dermatitis. I have discussed many cases ranging from the simplest to the most complex and interesting. I learned new approaches in the treatment of hair and scalp diseases. And I had the opportunity to learn more about tricoscopy. She inspired me to develop research protocols in Brazil to treat diseases of hair and to continue studying more and more for the benefit of my patient.
This mentorship was very important for my personal growth and for my professional career. And I recommend to all students and dermatologists who are interested in hair research to participate in this NAHRS mentorship program.
Aldo Galvez, MD, Dermatology Resident
Mentor: Leonard Sperling, MD, Uniformed Services University of the Health Sciences
Mentorship title: Comparing and Contrasting Histologic Findings in Lichen Planopilaris Versus Frontal Fibrosing Alopecia
To begin with, I would like to thank NAHRS and Dr. Sperling for giving me the opportunity of making this mentorship possible. I have been waiting for this rotation since the initial stages of my residency program, when I realized about my interest in hair diseases. In Peru, my native country, there are no dermatologists specialized in hair diseases and this encouraged me to apply for this external rotation.The mentorship was scheduled for two weeks in the Uniformed Services University of the Health Sciences, located in Bethesda - Maryland. In the first week Dr. Sperling gave me many different boxes with slides that were constantly increasing in difficulty, which I had to see by myself and then we reviewed them together. We moved from the basic to the advanced alopecia box and then to the boxes for each specific entity, which allowed me to see the spectrum of the histopathological findings in these diseases. Thanks to Dr. Sperling, this process was made simple and the learning experience was delightful. I was also able to join Dr. Sperling in the hair clinics and dermatopathology sessions at Walter Reed Hospital. After gaining significant experience in hair pathology, we dedicated the second week to our project, in which we compared and contrasted the histopathological findings in LPP and FFA.Besides being my mentor in hair diseases and pathology, Dr. Sperling also dedicated some of his time counseling me about my professional and personal life. He showed me the importance of achieving a balance between life and work.Finally, I sincerely appreciated the support given to me by NAHRS and Dr. Sperling. Thanks to them, I had a wonderful experience and achieved the objectives I expected.
Sophia Rangwala, MD, Dermatopathology Fellow
Mentor: Leonard Sperling, MD, Uniformed Services University of the Health Sciences
Mentorship title: Comparing and Contrasting Histologic Findings in Lichen Planopilaris Versus Frontal Fibrosing Alopecia Histological Diagnosis and Clinical Management of Complex Hair Disorders
In June 2017, I had the honor of completing a mentorship with Dr. Leonard Sperling at the Walter Reed Medical Center in Bethesda, MD. Although brief, the mentorship gave me a fantastic overview of Dr. Sperling's clinical and pathologic practice. During my 2016-2017 dermatopathology fellowship at Johns Hopkins University, I developed an interest in hair pathology and had become very familiar with Dr. Sperling's contribution to the field via the study of his textbook, his many research papers, and his lectures given at the ASDP annual and board review meetings. While I have been fortunate to have received excellent training in hair pathology during my fellowship, my time with Dr. Sperling significantly advanced this skill as I had the chance to learn and practice his methodology, study his extensive alopecia slide sets, and ask questions I have had regarding alopecia which were not yet answered in my training up to that point. In his resident clinic, I learned about his approach towards scarring and non-scarring alopecias, and came away with very useful tips and recommendations for management.I want to thank the American Hair Research Society for providing me the opportunity to meet and learn from the amazing Dr. Sperling. The subject of alopecia can often be challenging, but Dr. Sperling has a gift in providing clarity to even the most difficult cases. This experience has boosted my confidence in diagnosing and managing the pathologic and clinical aspects of alopecia, and encourages me to pursue care of these patients once I begin practice as a dermatologist and dermatopathologist in Golden, CO.
Leslie Castelo-Soccio MD, PhD, Dermatology Resident
Mentor: Nanette Silverberg MD, Mount Sinai Medical School
Mentorship title: Pediatric Alopecia Areata and Immunotherapy
Among contact allergens that are frequently used in the treatment of alopecia areata (AA), squaric acid dibutylester (SADBE) stands out for its good tolerability and its mild side effects. Additionally DPCP another contact sensitizer has been safely used in children but one that was not used at Children's Hospital of Philadelphia. Over a course of 6 months I was able to learn this technique from one of the United States Experts in therapy for children, Dr. Nanette Silverberg. Protocols were shared and discussions about common adverse events occurred. Other forms of contact sensitization were also learned and have been applied in the clinic setting at Children's Hospital of Philadelphia. Additionally this mentorship has led to a partnership to create a prospective registry for alopecia areata in children and to create protocols for standardizing clinic care.
Tiffany Alexander, BA, Medical Student
Mentor: Amy McMichael, MD, Wake Forest Baptist Medical Center
Mentorship title: Central Centrifugal Cicatricial Alopecia
The North American Hair Research Society Mentorship Grant program has been an invaluable experience. Through my mentor Dr. Amy McMichael, I gained extensive clinical and basic science knowledge about Central Centrifugal Cicatricial Alopecia (CCCA) and Frontal Fibrosing Alopecia (FFA). Not much is known about the pathogenesis of CCCA on the molecular level. Thus, my goal was to investigate the pathogenesis of CCCA and its relation to other scarring diseases such as FFA, scleroderma and chronic kidney disease. The analysis of scarring diseases that lead to fibrosis may help clarify the scarring mechanism of CCCA. We theorized that by examining the mechanisms for other scarring disorders that are common in African American patients can help to guide us about the mechanism of CCCA.
We reviewed the pathology literature on CCCA, FFA, scleroderma, and FKD and the mechanism of action for numerous treatments for each disease. We then analyzed the collected information to determine additional mechanisms of action to propose novel targets for medication. It was found that TGF-ß is involved in each disease pathogenesis and it induces epithelial to mesenchymal transformation. However, there are two effectors in FFA that contribute to fibrosis and thus, may also be present in CCCA. Snail1 is a marker of epithelial to mesenchymal transition and is found in increased amounts in FFA. Peroxisome proliferator-activated receptor gamma (PPAR-γ) is a counter regulatory mechanism for TGF-β signaling. There is a reduced amount in pilosebaceous units. Targeted therapy for FFA includes anti-inflammatory agents, hydroxychloroquine, pioglitazone and topical calcineurin inhibitors. More studies should be done to evaluate these effectors and whether or not they largely contribute to the pathogenesis of CCCA.
My research on CCCA and FFA has been an exciting challenge since there are many unanswered questions about them both. This mentorship program provided me with the chance to interact with CCCA patients and gave me the ability to readily identify them. I have thoroughly enjoyed this opportunity and I am grateful that the NAHRS Mentorship Grant program has equipped me with more dermatologic knowledge and experience.
Ariana Eginli, BS, Medical Student
Mentor: Amy McMichael, MD, Wake Forest Baptist Medical Center
Mentorship title: Side Effect Profile of 5 Alpha Reductase Inhibitors in Women with Female Pattern Hair Loss and Frontal Fibrosing Alopecia
I sincerely thank NAHRS for sponsoring my research. It is through their generosity and continued interest in bolstering hair research that my project was able to come into fruition.
After my third year of medical school, I pursued a research year in Dermatology. I had the honor of having Dr. Amy McMichael as my mentor. Her vast variety of publications in hair research, ranging from genetics to quality of life issues, reflect her ingenuity, innovativeness, and leadership within this niche of dermatology. My experience working with her proved no different. I was responsible for organizing and collecting data on a variety of projects, including the project that the NAHRS mentorship grant funded: understanding sexual side effects from using 5 alpha reductase inhibitors in women with androgenic alopecia or frontal fibrosing alopecia. In addition to my research responsibilities, I had the pleasure of working alongside Dr. McMichael in her hair clinic, where I gained hands-on clinical knowledge on how to counsel and treat patients with alopecia.
Ultimately, this mentorship helped me gain exposure to a field within dermatology that I previously had very little exposure to. The knowledge I have gained has significally helped me during my clinical rotations as a 4th year medical student. Additionally, I now realize my interest in working in hair loss in the future, and I am so thankful that I had the opportunity to work with an expert early on in my career.
I am certain that my experience learning how to structure and start research projects will serve me well in the future and will motivate me to continue to do research in hair loss disorders. My goal is to ultimately emulate Dr. McMichael's career by working in academics and performing clinical research in hair loss and skin of color. Thank you to NAHRS and Dr. McMichael for guiding me through this unforgettable learning experience.
Ana Lucia Ariano Junqueria, MD
Mentor: Maria Hordinsky, MD, University of Minnesota
Mentorship title: The Treatment of Frontal Fibrosing Alopecia with Platelet Rich Plasma
Dear North American Hair Research Society Mentorship Committee:
I would like to express my sincere gratitude to NAHRS for granting me this opportunity of working with Dr. Maria Hordinsky and Dr. Ronda Farah, at the University of Minnesota, in Minneapolis. During the month I spent there I was exposed to several dermatologic conditions affecting the hair and scalp, including visits in the outpatient clinic, cases presentation and discussions, lectures and meetings. My research task was primarily to write the protocol for a pilot study about treatment of frontal fibrosing alopecia with platelet rich plasma. While reviewing the literature for this project I was able to better understand the clinical aspects, the increase in prevalence of this hair condition in the past few years and the need for more research into effective treatments. I would like to specially thank Dr. Farah for her assistance with the development of the protocol, for always answering my questions and for her advices to succeed in my career. She is an extremely talented clinician and researcher, and also a wonderful person.
Through this preceptorship, I also participated in Grand Rounds and worked with patients recruitment for clinical studies. During the outpatients clinic visits with Dr. Hordinsky, I was able to see and learn different clinical characteristics of several hair diseases, as well as the appropriate management. Dr.Hordinsky is not only smart and perspicacious in clinic, but also pleasant, empathetic and loveable with each of her patients. She took time to teach me and answered all of my questions about specific conditions and research development. It was a honor to work with her and she is definily an example for me to follow.
I would like to thank all of the University of Minnesota faculty and staff that helped and supported me during my stay. Thanks again to NAHRS for providing me this unique and amazing learning experience!
Heather Rosengard, MPH
Mentor: George Cotsarelis, MD, Department of Dermatology, University of Pennsylvania
Mentorship title: Analysis of the Regenerative Capacity of Cultured Keratinocytes
I would like to express my sincere gratitude for affording me the opportunity to work with Dr. George Cotsarelis at the University of Pennsylvania. My interest in hair physiology was established prior to working with Dr. Cotsarelis, when I interacted with patients suffering from hair loss. However, since working in Dr. Cotsarelis' laboratory, I have gained a deeper appreciation for the complex nature of hair research and the unique intricacies of the hair follicle niche.
Since beginning my mentorship I have spent the majority of my time bench-side, gaining proficiency in a wide variety of techniques currently utilized to investigate hair biology and cellular mechanisms. These include epidermal and dermal cell isolation, cell culture, hair follicle micro-dissection, hair follicle organ culture, histologic evaluation, immunofluorescence staining and confocal microscopy, and FACS analysis. Knowledge of, and experience with, these critical investigative tools will not only be useful in my future research endeavors, but also will enable me to better understand and interpret the research of my peers.
Of course, these skills were not learned in a vacuum, but rather in the context of planning and performing experiments under the analytical guidance of Dr. Cotsarelis and the meticulous scientists in his lab. Throughout this time, we learned a great deal about the hair follicle stem and progenitor cells and how they are influenced by various treatment modalities.
Still, learning more about the cellular dynamics in the hair follicle paled in comparison to what I learned from Dr. Cotsarelis' scientific mentorship. In weekly lab meetings Dr. Cotsarelis would help me and the other members of the lab interpret our data, always considering alternative conclusions or explanations for our findings. In planning future experiments, he would help us precisely define our core question and design protocols with strong controls and consistent reproducibility. Further, he pushed me and my colleagues to present our data succinctly and effectively, consistently emphasizing the power of communication.
I also was able to witness Dr. Cotsarelis' beside manner and clinical aptitude when accompanying him to his weekly clinic and the weekly Duhring Dermatology Grand Rounds at Upenn. It was wonderful watching him utilize his analytical mind to thoroughly evaluate a patient and translate his own nuanced understanding of hair follicle biology into clear answers to patients' questions. Having personally become interested in hair research through my patients, it was exciting to see that Dr. Cotsarelis was still inspired by his patients.
In all, his mentorship has prepared me for a career as a physician-scientist committed to hair research and I thank the NAHRS for supporting this invaluable experience.
Alexandria Marier Schauer, DVM, BA, Veterinary Medicine Student
Mentor: John P. Sundberg, DVM, PhD, DACVP, The Jackson Laboratory
Mentorship title: Characterizing Spontaneous Mutant or Created Models of Human Hair Diseases
My training at The Jackson Laboratory with Dr. John P. Sundberg would have been financially impossible without the support of the North American Hair Research Society Mentorship grant. The cost of veterinary school is debilitating as is, and having the financial support to spend two months at a world renowned institution to study hair and skin diseases has been extremely rewarding. It has been an indispensable experience to my future career as a veterinary researcher, combining lab animal pathology training with specialized methods to study hair biology. I was involved on several projects that sought to characterize hair and skin mutants, but my main project focused on characterizing a knockin mouse model created by the Sundberg lab for psoriasis and psoriatic arthritis. I learned basic laboratory techniques, including Western analyses, in situ hybridization, and immunohistochemistry that are invaluable skills that I can take with me as a part of my "tool kit" as a veterinary research candidate.
Another large part of my training was learning to identify the fundamentals of hair biology, training that I have not received as a part of the veterinary medical curriculum. I am now confident in my ability to understand the hair cycle, identify the components of the hair follicle, and have a basic understanding of a wide array of hair diseases. I also appreciate the impact and burden that hair and skin disorders have on patients including the need for scientific focus. I also spent a considerable amount of time learning the fundamentals of necropsy and slide review that has given me an advantage with the next step of my career as a resident of anatomic pathology.
I have accepted a position as an anatomic pathology resident at the Institute of Animal Pathology at the University of Bern in Switzerland, to begin in 2017 upon my graduation from veterinary school at the University of Minnesota. Their institute has a renowned dermatopathology program, which was a large part of my decision to accept their offer. Hair and skin disease research is an underserved field, and is in need of highly qualified researchers, particularly those that specialize in veterinary dermatopathology. My experience at The Jackson Laboratory that was made possible by the North American Hair Research Society Mentorship Program has given me the confidence and an invaluable skill set that will set me apart from other veterinary research candidates when I pursue a Ph.D. after completion of my anatomic pathologyresidency. The mentorship program that your society provides is greatly appreciated, and I strongly urge you to continue the program into the future. My interest in skin and hair diseases has been strengthened, and I now feel I have a focus and intent as I go through the next steps of my training. I look forward to joining the ranks of other hair and skin scientists.
Alexandria M. Schauer
Vidhi Shah, BA, Medical Student
Mentor: Amy McMichael, MD, Wake Forest Baptist Medical Center
Mentorship title: Hair Loss and Scalp Disorder with Special Consideration in Ethnic Skin
Having spent two weeks working with Dr. Amy McMichael, I now know and appreciate the value of strong clinical training and mentorship. With Dr. McMichael, I was exposed to a spectrum of hair and scalp disorders during her hair care and general dermatology clinics. I witnessed the diagnosis, treatment, and management of hair disorders including, but not limited to, central centrifugal cicatricial alopecia, lichen planopilaris, androgenetic alopecia, alopecia areata, and alopecia universalis. Dr. McMichael provided compassionate and focused treatment for these patients afflicted with hair loss. The exceptional level of care she provides is the kind I aspire to provide to my own patients as a future academic dermatologist.
My research with her focused upon writing a review article focusing upon the hair care practices in young African American women and its consequences on physical exercise. I developed a newfound awareness for not only for the nature of hair care burdens encountered by African Americans, but also its psychosocial issues and influence on an individual's overall health. In addition to research, I was also offered the exciting opportunity to give a short presentation on Janus-kinas (JAK) inhibitors for the treatment of alopecia areata to the Department of Dermatology at Wake Forest School of Medicine. I was impressed with the sense of warmth and community I experienced from the residents and other faculty members, many of whom went out of their way to speak to me and make me feel at home.
Dr. McMichael is an outstanding role model. I cannot express how much I have learned, grown, and enjoyed working with her. In addition to her clinical and academic responsibilities as Chairman of Dermatology, she took the time to get to know me on a personal level and provide me with constructive feedback regarding my application to dermatology. After working with her, I am inspired to build my own future in dermatology and contribute to the advancement in academic medicine.
I am forever grateful to the North American Hair Research Society for providing me the resources for this wonderful opportunity, without which this experience would not have been possible. I sincerely appreciated the entire Wake Forest Dermatology Department and Dr. McMichael for their teaching, guidance, and support.
Julio C. Jasso-Olivares, MD
Mentor: Antonella Tosti, MD, University of Miami
Mentorship title: Hair and scalp activity, trichoscopy and pathological correlation in patients with dermatomyositis
For the month of June I had experience working with Dr. Sundberg at The Jackson Laboratory, Bar Harbor, Maine. Thanks to the North American Hair Research Society, the Mentorship Program did support and offer me a great opportunity to participate in the research that Dr. Sundberg is working on. This gave me access to his broad knowledge of genetics and pathology in mice. The world reknown facility, The Jackson Laboratory, regularly provides seminars on site. With Dr. Sundberg's encouragement and support, I also attended several lectures which helped to broaden my research vision. This program will not only facilitate my ongoing research projects but also improve my research techniques in the future.
In April 2015 I had the opportunity to be at the University of Miami with Dr. Tosti (and her wonderful staff) that made me one my best academic experiences. In addition to examining the results of my protocol about scalp activity in patients with dermatomyositis, I had the privilege to stay with Dr. Tosti during her daily activities at the outpatient center, and see all kinds of hair diseases with pathologic correlation including the explanation from a world-wide expert like her.
Besides aim to finish my study, I also learned the way of dealing with clinical cases (even the most difficult cases), I had information about treatments (most of them evidence-based), their follow-up, attending some lectures, management grand conferences and finally recognize the health system in a country with lots of technological advances like the United States.
In conclusion, I would to thank the NAHRS for this unique opportunity because in my country we have not this kind of training that I received a lot of academic satisfaction in the form of knowledge that I will use for the benefit of my patients and intend to continue participating in hair diseases research.
Lauren Seale
Mentor: Amy McMichael, MD, Wake Forest School of Medicine
Mentorship title: Clinical Studies in Hair Loss
In my seven weeks with Dr. Amy McMichael at Wake Forest School of Medicine, I gained extensive exposure to dermatologic conditions affecting the hair and scalp, and deepened my commitment to pursuing a career in dermatology. My research tasks included writing a review article on the use of 5 alpha reductase inhibitors for the treatment of female pattern hair loss, as well as the completion of a protocol for a survey of symptoms related to treatment with this class of drugs. In reviewing the literature for both of these projects and through my work consenting patients for clinical studies, I became more aware of the need for more research into effective treatments for hair loss affecting women. As I consented patients for studies on frontal fibrosing alopecia and central centrifugal cicatricial alopecia, I witnessed firsthand how many women affected by this disease were immensely impacted by a lessened quality of life due to their condition.
Dr. McMichael was an excellent mentor, exceeding all my expectations for the summer by welcoming me into the clinic and being an excellent example of being both clinically astute and empathetic with each of her patients. She took time to teach me and answered all of my questions about specific conditions as well as how to best prepare for applying to residency programs in dermatology. My time with her has strengthened my desire to not only work as a dermatologist and serve individuals affected by hair loss, but to also be committed to excellence in academic medicine as well. I would like to wholeheartedly thank NAHRS, the Wake Forest Dermatology Department faculty, staff and residents, and Dr. McMichael for all of their support, wisdom, and guidance as I continue to pursue a career in dermatology.
Wendi Wohltmann, MD
Mentor: Leonard Sperling, MD, Uniformed Services University of the Health Sciences
Mentorship title: Histopathologic Diagnosis of Multifactorial Alopecia
Dear NAHRS Mentorship Committee members,
Thank you for granting me an NAHRS mentorship with Dr Leonard Sperling! I just completed my rotation in Bethesda, MD, working closely with Dr Sperling for two weeks. The mentorship absolutely exceeded my expectations. During the first few days, we used one-on-one scope sessions, his textbook, and vast collection of alopecia slides to hone my diagnostic skills. Dr Sperling's teaching format was very clear and easy to understand for such a difficult topic. The rest of my time was spent researching the histopathologic features of multifactorial alopecia, a topic not previously covered in the medical literature. We are in the final stages of writing a paper entitled "The histopathologic diagnosis of multifactorial alopecia."
Dr Sperling has the kind of career I aspire to, facing a different challenge each day. Even though he is known as an alopecia expert, he still reads general dermpath slides weekly, staffs dermatology residents in general derm clinic, sees his own patients in a hair loss clinic, participates in dermpath consensus conference, and somehow finds the time to be the Vice Chair of the military medical school admissions committee. He also reads alopecia slides at night as part of a private practice, and would bring these cases in to show me what "real alopecia" slides look like, as opposed to the "perfect" teaching slides (hint: they are much more difficult). He kindly invited me to attend dermatopathology signouts and consensus conferences, as well as his hair loss clinic, where I got to see him interact with dermatology and pathology residents as well as the dermpath fellow. This portion of the mentorship experience will specifically aid me in teaching dermatology residents at my next duty station at Wilford Hall Medical Center (WHMC) in Texas.
I was delighted to discover that Dr Sperling is not only a gifted clinician and dermatopathologist, but also a wonderful person. I saw firsthand the positive effect he has on others, with his calm and patient demeanor. He is also an exceptional listener and advisor. He gave me sound advice about future research ideas, career progression, and just life in general. As a retired Army Colonel, he was able to specifically tailor his advice to my unique situation as an active duty Air Force dermatopathologist. As a direct result of this mentorship, I plan on starting a hair loss clinic at WHMC. My ultimate career goals include academic dermatopathology, both in and after the military, with a focus on hair loss. Dr Sperling will no doubt be a valuable mentor throughout my career. This 2-week rotation cemented his approach to the histopathologic diagnosis of alopecia, helped guide future alopecia research interests, and gave me special "Sperling" teaching methods to teach future residents. Thank you again, NAHRS, for supporting this educational endeavor!
Best regards,
Wendi Wohltmann, MD
For the month of June I had experience working with Dr. Sundberg at The Jackson Laboratory, Bar Harbor, Maine. Thanks to the North American Hair Research Society, the Mentorship Program did support and offer me a great opportunity to participate in the research that Dr. Sundberg is working on. This gave me access to his broad knowledge of genetics and pathology in mice. The world reknown facility, The Jackson Laboratory, regularly provides seminars on site. With Dr. Sundberg's encouragement and support, I also attended several lectures which helped to broaden my research vision. This program will not only facilitate my ongoing research projects but also improve my research techniques in the future.
Current project I am working on deals with the Sharpin null mice (C57BL/KaLawRij-Sharpincpdm/Sharpincpdm RijSunJ; hereafter SHARPINcpdm/cpdm) which Dr. Sundberg keeps this mouse colony. Mice carrying a spontaneous mutation in the Sharpin gene develop systemic inflammation in various organs, including the signature lesion, chronic proliferative dermatitis (cpdm), affecting the skin. We reviewed the lesions that these mutant mice develop and focused on changes in the skin and hair follicles associated with changes in the vasculature. This involved immunohistochemistry as well as analysis of transcriptome changes in the skin over time as the disease progressed.
In addition to learning about project design and how the actual work was conducted, Dr. Sundberg also shared his personal experiences on career development with me. He told me that dealing with various topics simultaneous as a routine job for a principal investigator to survive in the current competitive academic world along with running a primary project. Working with specialists form various backgrounds to build connections and partnerships can always bring in new ideas and provide techniques and skill that one may lack.
I want to thank the NAHRS for giving me this great opportunity, to learn and work with Dr. Sundberg at The Jackson Laboratory. I am thankful to Dr. Sundberg for his patience, lessons, and guidance in addition to the generous financial support from the Mentorship Program of NAHRS to make this trip come true.
Figure 1. Double scoping with Dr. Sundberg in his office for our project.
I would like to express my heartfelt gratitude to the NAHRS for giving me the opportunity to work with Dr. Ken Washenik at Bosley Medical Group in Beverly Hills, CA. Through this preceptorship, I observed leading-edge techniques in hair transplantation by highly trained surgeons, Drs. Suddleson, Deutsch, and Andrews. During my time at Bosley, I observed many advanced hair transplantation techniques including trichophytic closures, follicular unit extraction, eyebrow restoration, and robotic surgery. Dr. Washenik took time out of his busy schedule to discuss novel follicular neogenesis research and advancements in cellular based hair restoration. We also discussed the process of assessing hair loss and determining the best candidates for the FUE hair transplant procedure versus other therapies such as propecia, topical minoxidil, light technology, intralesional steroid injections, biotin supplementation, and other medical therapies.
I was able to see a variety of interesting clinical cases from the first consultation for hair transplantation, to surgical techniques in difficult cases, to the post-operative visit, and long-term post-operative check. After seeing each patient, the physicians at Bosley took the time to provide valuable take home points and emphasize significant clinical findings. By the end of my rotation, I felt very comfortable assessing a patient for hair transplantation and formulating a plan for the best surgical outcome. The NAHRS mentorship program offered exposure to leaders in the field of hair transplantation which has significantly enhanced my knowledge base and skills in the management of hair loss. I also received important career advice from the faculty and have found a lifelong mentor in Dr. Washenik.
For two weeks in March 2014 I had the pleasure to work with Prof. Colin Jahoda at Durham University in the UK. I had worked with Colin previously, when I was a PhD student in his lab. However, when I was a student I was so focused on my own project, I forgot to look up and learn from my surroundings. My goal during this mentorship was to make sure I used this 'second chance' to discuss everything from hair regeneration through to changing science cultures, and benefit from Colin's wealth of expertise in hair follicle development.
During the mentorship period I had protected time to focus solely on the goals of the application. We discussed age old hair induction techniques, and evaluated how the field had changed over the past 30 years. We debated which scientific challenges relating to hair development remain to be solved, and tried to piece together recent developments, fitting them into the hair regeneration puzzle. It was a brilliant two weeks, and we were quite productive, writing a 'roadmap' style review of condensate development and hair research. The finishing touches are still outstanding, but we hope to submit this roadmap to a peer-reviewed journal in the near future.
Shortly before my mentorship, I was offered a lectureship at Imperial College, London. Hence, I partook in the mentorship program knowing I was soon to start my own research lab. This was highly beneficial, and my general discussions with Colin about hair research have certainly broadened my research horizons. He also freely dispensed his advice on running a successful team of researchers. I would like to thank the North American Hair Research Society for giving me this great opportunity, to learn and work with Dr. Jahoda, at such a crucial time in the progression of my career.
Thank you NAHRS for granting me this opportunity to work with Dr. Valerie Callender. I have always had a keen interest in hair research and hair disorders and have in the past read many of her articles. Never would I have dreamed that I would have this opportunity to not only meet her but also to work with her.
On completion of my fellowship in Hair Disorders at the University of British Columbia, I felt that I needed added exposure to patients of African descent. Though my competency in the management of hair disorders improved significantly at the UBC, my exposure to hair disorders in persons of African descent was somewhat limited due to the small percentage of this racial demographic in the total population of British Columbia. This 2-week experience was just what I needed as I was able to see the management of these disorders in persons of African descent, quite necessary for someone who is from a country that is 98% of African ancestry.
Dr. Callender has proven to be an excellent teacher, mentor and motivator. I learnt so much from her with respect to not only the management of patients but also how to run a successful practice. We discussed in detail all aspects of her management of patients with such disorders as Traction Alopecia, Frontal Fibrosing Alopecia, and Central Centrifugal Cicatricial Alopecia. This bolstered my confidence in treating hair disorders unique to this group. From this we are proposing a review article on the effects of hair care practices on hair disorders presenting in women of African descent.
Thanks again to NAHRS and Dr. Callender for allowing me this opportunity. I look forward to utilizing the practical tips I learnt in this preceptorship.
Dear North American Hair Research Society Mentorship Committee:
I spent an enriching two weeks in Bethesda, MD, in late April 2014 with Dr. Leonard Sperling at Uniformed Health Sciences University studying hair pathology. I was very fortunate to have this opportunity because the experience had numerous defining moments. My goal in completing the mentorship was to better understand the various facets of hair disorders related to clinical presentation, histopathological characteristics, and how these features may guide and impact management. Through a combination of alopecia histology slide self-study, literature review, multiple daily collaborative slide review and teaching sessions with Dr. Sperling, and consensus conferences, I feel that my goal was accomplished.
The most critical lessons learned were in the histopathologic evaluation of alopecia, a topic in which Dr. Sperling has significant expertise. Through self-study and teaching by Dr. Sperling, I began to understand alopecia as representative of a spectrum of disorders and less as static disease states in which a patient's clinical presentation correlated specifically to one histologic finding. I observed numerous histologic examples of telogen effluvium in the setting of androgenetic alopecia. In addition, I observed examples of patients with not only folliculitis decalvans histologically but also with features of central centrifugal cicatricial alopecia (CCCA). This knowledge debunked the rudimentary algorithms I had created in my approach to alopecia. I realized that specific alopecias, whether scarring or non-scarring, may have distinct pathological etiologies but also may share overlapping features with other alopecia processes that we have yet to fully understand. Ultimately, I realized that more study and research is needed to determine the pathogenesis of these disorders and the corresponding histological findings.
A form of alopecia that I was previously unfamiliar with was psoriatic alopecia. While I have an interest in psoriasis and have treated numerous patients with variable skin and joint involvement, I had not associated alopecia with this chronic disease. I was able to learn about its characteristic histologic findings and how treatment could impact the prognosis of this hair loss.
In addition to histopathology study, I had the opportunity to learn from patients who I encountered. In the clinic setting with Dr. Sperling, I observed approaches to the treatment of lichen planopilaris and CCCA unique from my home institution at the University of Minnesota. Specifically with CCCA, the use of oral antibiotics, such as doxycycline to help treat inflammation appeared to be the standard of care, coupled with high potency topical or intralesional steroids.
Furthermore, I learned about alternative therapies for alopecia areata. Dyphencyprone is somewhat popular in Europe for the treatment of alopecia areata. I learned about topical immunotherapy with dyphencyprone and was also able to observe Dr. Sperling's use of this therapy on a patient. It was fascinating to see how the use of an allergen could "redirect" an altered immune system so that hair may grow as it focuses its efforts on the allergic contact dermatitis response. This also led me to read and learn more about squaric acid dibutyl ester and its potential role in treating alopecia areata recalcitrant to more common therapies.
To the NAHRS Mentorship Committee: thank you for the professional and financial support that enabled me to participate in this mentorship experience. I learned a tremendous amount about hair dermatopathology and continue to share a passion for these disorders. I have now graduated from residency and look forward to incorporating all that I have learned into the care of patients and potential future research endeavors.
Margareth Pierre-Louis, MD, MBA
I am a dermatologist and fellow in trichology in Brazil and I had the privilege to stay a month (November 2014) in contact with Dr. Tosti during her activities at the outpatient center of University of Miami. I was able to observe Dr. Tosti and the residents attending patients with hair and nail disorders and contact dermatitis, which are her areas of expertise. I learned a lot discussing simple and complex cases in all aspects: history, clinical exam including dermoscopy, dermatopathology, current and emerging treatments and follow up. Also, I was inspired by the way she deals with her patients, being always kind, attentive and in a good mood. She is a worldwide-recognized scientist but above all she is an amazing human being.
In addition, I attended some lectures and Grand rounds once a week and had the opportunity to write case reports and a project in dermoscopy of cicatricial alopecia that will interchange ideas between Miami and Sao Paulo.
Besides consolidating my scientific knowledge in diagnosis and treatment of hair diseases, it was very interesting to see how the health system works in United States and analyse the cultural differences between US and Brazil regarding doctor–patient relationship.
I want to thank the NAHRS for this unique opportunity, to learn and work with Dr. Tosti. She is a great researcher, a very experienced dermatologist and a leader and I thank her very much for being so generous in sharing her knowledge. This mentorship enhanced my personal growth and strengthens my academic pursuits and I am sure this contact is the beginning of a prosperous partnership.
I would like to thank NAHRS for giving me this unique opportunity to work with Dr Sperling in Bethesda, Maryland. I would also like to express my heartfelt gratitude to Dr Sperling for his world class expertise in hair pathology and his hospitality.
I am new to the field of hair pathology and this experience has certainly broadened my horizons and improved my knowledge. The mentorship was 2 week long. On the first day, I was given the chance to take self-assessment tests in hair pathology which I found challenging. However, the self-assessment tests were useful as I had time to think over cases. Dr Sperling took time out of his busy schedule to discuss the cases and I was given opportunities to ask questions. During my first week, I spent time at the microscope reviewing Dr Sperling's collection of hair specimens followed by a discussion at the microscope on daily basis. These sessions were particularly useful and I expended my knowledge on the assessment of horizontal sections. I spent the second week working on a project on hair pathology.
Other than spending time at the microscope, Dr Sperling also showed me the importance of achieving work-life balance as we went for nice afternoon walks between microscope sessions.
I thoroughly enjoyed my experience through the generosity of this mentorship award and I would like to thank everyone at NAHRS who made this very valuable learning experience possible. Dr Sperling is truly an excellent mentor who shares his knowledge and experiences, provides guidance and inspires.
I would like to thank the NAHRS, grant contributors and sponsors, and the grant selection committee for making possible the excellent experience and mentorship I gained as a result of their generosity. I would of course also like to thank Dr. Sundberg for his world class expertise and his hospitality, both professionally and personally.
As part of the grant I spent two weeks in the Sundberg lab at the Jackson Laboratory in Bar Harbor, ME, in July and August. This provided unmatched experience for hair research from several vantage points. I was able to work with Dr. Sundberg's excellent technicians, Kathleen Silva and Victoria Kennedy, to see firsthand how hair and skin samples are collected and prepared for analysis. Dr. Sundberg has a well-annotated and extensive collection of hair and skin slides from many of the mutant mice maintained at the Jackson Laboratory. I was able to review these slides individually and then together with Dr. Sundberg at a two headed microscope (see attached photo). This provided not only an opportunity to see a wide variety of phenotypes, but to ask questions about differences and similarities between phenotypes. On a number of occasions I was able to sit in on meetings with co-investigators at different stages in the evaluation of new skin and hair phenotypes. I had ample opportunity during lunches, walks, or at his house in the evenings for dinner to pick his brain, itself a valuable experience, regarding skin and hair phenotypes I had encountered and was in the process of working up. Even in my free time I was able to avail myself to his library to review appropriate textbooks, some of which are out of print or difficult to find. This provided me with the quality specialized references that I can use later.
Looking forward, I am presently immunostaining hair follicles with Dr. Sundberg to characterize cell populations involved in catagen regression. If successful, this would be a valuable scientific manuscript. Finally, Dr. Sundberg included me as a co-author on an invited review detailing the systematic evaluation of skin phenotypes in mutant mice for the journal Experimental Dermatology. This is in addition to several other papers on which we anticipate collaborating.
Again, I would like to thank everyone at NAHRS who made this very valuable learning experience possible. Dr. Sundberg is an excellent mentor, for hair and skin in particular as well as career (and life) in general, and I am happy to have benefitted from this opportunity.
As a recent graduate from residency who had chosen to remain in academics, I was faced with the somewhat daunting task of choosing an area of interest or "expertise." When I reminisced on factors that initially attracted me to medicine, the theme of serving underserved communities, and my passion for teaching were constant. As a result, one of my interests is skin of color, as I believe that as the demographic of the United States continues to change, there will be a greater need for dermatologists interested in treating this patient population. Since common complaints of darker skinned patients include hair disorders, such as alopecia and hirsutism, cultivating my interest in hair disorders seemed like a natural extension of this interest. Dr. McMichael is the quintessential academic dermatologist, and as some of my interests mirror hers, I felt that she would serve as the perfect mentor. Thanks to the generosity of NAHRS, I was able to pursue this career changing and invaluable mentoring experience.
In addition to the expected practical gems regarding the diagnosis and treatment of hair disease, I also received unexpected lessons regarding the art of practicing medicine and being a mentor. Once out of residency, it is rare to be able to observe, without expectation or duty, a talented, experienced physician practice medicine. How much more worthwhile is this experience after one has formed his/her own practices, and can better understand the subtleties that distinguish between good and great physicians? The nuances of skilled history taking and the physical exam necessary for diagnosis of hair disorders, (for example, I learned that I have NEVER properly completed a hair pull test), and even the subtleties of dealing with the "difficult" patient are some of the lessons that I learned from Dr. McMichael and will incorporate into my future practice. Dr. McMichael was also interested in my personal goals and expectations for the mentoring experience, ensuring that my time spent would be as enriching and fulfilling as possible. As a result, I was able to begin collaborations on a few projects with her that will extend past the boundaries of my seemingly short 2 week experience.
Furthermore, the warmth of Dr. McMichael, the faculty and staff were unparalleled, as I received my first tastes of "southern hospitality." Even as a staunch Northeasterner, I instantly felt at home, adding to the richness of my experience. Dr. McMichael embodies the essence of a mentor, taking time not only to educate and guide, but to also cultivate a more personal relationship. I thoroughly enjoyed my experience made possible through the generosity of this mentorship award, and will be forever grateful to the NAHRS and Dr. McMichael. I look forward to enacting the practical lessons I have learned clinically, as well as hopefully passing similar experiences forward as an educator and mentor.
Owing to the NAHRS Mentorship grant I was able to visit Dr. John Sundberg at The Jackson Laboratory in Bar Harbor in June. During this visit and after, I have gained tremendous amount of insight to mouse skin and hair pathology, but also to genetic mouse models, in general. Establishing personal contact with Dr. Sundberg and his great laboratory has been instrumental in taking my research forward. I would like to express my deep gratitude to NAHRS for awarding this mentorship grant.
During my visit to Bar Harbor I became acquainted with the research activities at Jackson Laboratory. For example, I had the opportunity to follow their standardized procedures for mouse necropsies and tissue sample preparation, attend seminars and follow individual researchers in their work in specific projects related to the cutaneous histopathology of the Sharpin null mouse models.
Most importantly, Dr. Sundberg trained me in how to investigate histological skin samples by light microscopy. I learnt to detect and recognize the basic structures as well as many pathological features of the mammalian skin. In the process, I became familiar with samples from different mutant mouse models exhibiting abnormal skin and hair, which gave me valuable perspective to understanding the scaly skin phenotype of the Sharpin null mouse.
Since the visit, we have been in close contact by email and skype, and our research collaboration has continued. I have received histological and whole mount samples from conditional Sharpin knockout animals, and I am currently working on their immunohistochemical analysis.
Not only did this mentorship give me specific knowhow on mouse skin and hair pathology, but I also had the privilege to discuss with Dr. Sundberg broader themes from scientific nomenclature and research funding to lifelong career as a scientist. I felt most welcome and inspired while visiting Dr. Sundberg at Bar Harbor and I thank him for this opportunity.
Natalie Yin, BS, Medical Student, Amy McMichael, MD, Wake Forest University, Department of Dermatology, Clinical approach to hair disorders
I would like to express my heartfelt gratitude to the NAHRS for giving me the opportunity to work with Dr. Amy McMichael at Wake Forest this summer. Through the program, not only did I gain significant knowledge regarding clinical hair disorders, but more importantly, I returned home with a new field of interest.
During my two week mentorship, Dr. McMichael went out of her way to schedule several of her hair patient clinics. As a result, I was able to see a variety of interesting clinical cases, ranging from alopecia universalis to LPP to CCCA. After seeing each patient, Dr. McMichael took the time to provide valuable take home points and emphasize significant clinical findings. By the end of my rotation, I felt very comfortable formulating differential diagnoses and identifying treatment options for the various presentations of hair disease. The NAHRS mentorship program confirmed my desire to specialize in hair disease as a future dermatologist.
As Dr. McMichael cares for a very diverse patient population and is a leading expert in skin of color, I had the opportunity to learn the distinct presentations as well as management options for the various dermatologic diseases in pigmented skin. In addition to the clinic work, I was able to co-author a review with Dr. McMichael on acne treatments for patients with skin of color during my rotation, which further enriched my learning in the field.
On the days when Dr. McMichael did not have clinic, I had the pleasure of working with many of the other dermatology faculty members at Wake Forest, including Drs. Fleischer, Jorizzo, Huang, Pichardo-Geisinger, and Taylor. I greatly benefited from working with these mentors, as they were all very generous in sharing with me their knowledge and expertise.
Above all, Dr. McMichael inspired me most with her impressive bedside manner. She educated all of her patients on their disease processes and explained the reasons behind her treatment suggestions. With her genuine warmth, sincerity, openness and great sense of humor, she was able to quickly put her patients at ease and win their trust. I hope to one day emulate Dr. McMichael's doctoring skills and cannot thank the NAHRS enough for this exceptionally rewarding experience.
I am writing to inform you about my experience during the two week rotation I took at the University of Pennsylvania from October 1-12 2012 with Dr. George Cotsarelis.
During the time I spent in UPenn, I was able to join the Department of Dermatology in scientific and clinical conferences, shadow Dr. Cotsarelis in the hair clinic and spend time in his laboratory where I performed immunofluorescence staining on human and mouse tissue to look at the expression of prostaglandin synthases and receptors.
I was welcomed by the people in Dr. Cotsarelis laboratory and got started with a set of experiments in samples that the lab had previously prepared for this purpose. The results of these experiments are part of a greater project that the lab will publish in the future. I felt very confident with the technique I used and with the project I undertook because of my background in skin research in the University of Miami. I was also very happy to meet such a friendly and knowledgeable group of researchers to help me settle into the lab and accomplish my tasks.
In spite of the responsibilities of Dr. Cotsarelis as Chairman of Dermatology in UPenn, he made time to get to know my particular interests and opinions in research, clinical practice and Dermatology and give me feedback. I believe we accomplished the purpose of the Mentorship Program which is to establish a relationship between a senior researcher and a trainee and I believe this rotation has opened opportunities of collaboration between our institutions.
I am thankful for the opportunity that the NAHRS gave me and the support of the Cancer Biology Graduate Program and the Department of Dermatology of the University of Miami, and for the hospitality of the University of Pennsylvania. This experience has truly confirmed my vocation as a researcher and dermatologist and motivated me to pursue a career in academia.
Mentee: Qiaoli Li, PhD, Thomas Jefferson University
Mentor: John P. Sundberg, DVM, PhD, The Jackson Laboratory
Period of support: March 2012 – February 2013
As a junior faculty member (Assistant Professor) in the Department of Dermatology and Cutaneous Biology at Thomas Jefferson University in Philadelphia, I work with Dr. Jouni Uitto on pseudoxanthoma elasticum (PXE), a prototype of heritable connective tissue diseases manifesting with ectopic mineralization, using the targeted Abcc6tm1Jfk mouse as a model system.
In September 2011, I attended a basic mouse genetics course at The Jackson Laboratory where I met Dr. John Sundberg. This led me to apply for and receive a Mentorship Grant from the North American Hair Research Society to return to work with Dr. Sundberg in March 2012 for two weeks. Dr. Sundberg provided me with access to his data on a large scale, high throughput, pathological phenotyping study of 31 strains of inbred mice that had been aged. This study identified several strains that had lesions consistent with PXE associated with spontaneous mutations in their Abcc6 gene. Working with Dr. Sundberg was an extremely rewarding experience. Besides the time and hands-on experience that he dedicated to me at the microscope, I was also welcomed to his lab and lab meetings. He trained me not only in the basics of mouse skin and hair pathology, but also the wide diversity mouse genetic tools that I can use, both technical and biological, for studying mouse models of human diseases. The mentorship and collaborative efforts have resulted in two publications in high impact journals, one accepted pending revision, and two in preparation (see below). Sufficient preliminary data were generated which enabled me to a submission of a NIH K01 grant application in October 2012.
Dr. Sundberg's enthusiasm, commitment, guidance, and inspiration will always be a role model in my career. I am very grateful to NAHRS for supporting this amazing mentorship experience. I believe the mentorship had opened opportunities of collaboration with Dr. Sundberg, but also with his colleague and another mentee, Dr. Annerose Berndt, at the University of Pittsburgh, on multiple on-going projects. Dr. Berndt was also a recipient of the North American Hair Research Society Mentorship Award for 2012 working with Dr. Sundberg.
This past year has certainly been a wonderful experience for me at Cleveland Clinic. As a resident in the research track, it has been helpful working with Dr. Bergfeld as she is passionate about research and has many contacts in the field of hair disorders. At national meetings she has taken the time to introduce me to others in hair research and dermatopathology. Currently we are working on a project looking at the use of intralesional kenalog in folliculitis decalvans. For my upcoming research year, we will be conducting a study on the use of botulinum toxin in androgenic alopecia. I am very excited to continue my work in hair research during residency and hope to continue this in my academic career.
Over the course of my residency, I have found I also have a strong interest in dermatopathology. As a dermatopathologist herself, Dr. Bergfeld has agreed to be my departmental mentor and has been extremely supportive in my pursuit of this subspecialty field. In fact, I have been awarded a 2012-2013 Mentorship Award from the American Society of Dermatopathology (ASDP) and my mentor for this award, Dr. Joan Guitart, is a former fellow of Dr. Bergfeld's. He was more than happy to serve as my mentor upon her recommendation. I will be working with him for two weeks at Northwestern University on a project entitled, "Rationale for Reporting PAS for Onychomycosis." This past October, I also presented a poster at the ASDP's 48th Annual Meeting in Seattle, Washington entitled, "Eosinophils in the Dermal Infiltrate: Does This Rule Out Secondary Syphilis?" I will be working on a number of projects in the Department of Dermatopathology and in hair disorders here at Cleveland Clinic, and I must give credit to Dr. Bergfeld for helping me facilitate these opportunities. I have also applied for a 2012 NAHRS Mentorship because my previous experience has been so valuable.
Lastly, over the past year I have become more involved in leadership at Cleveland Clinic and in the Cleveland community as a whole. I am currently in the process of being matched for a little sister in the Big Brothers/Big Sisters program here. I am also the resident representative on the Cleveland Clinic Policy Committee. In efforts to recruit minorities to Cleveland Clinic, I will represent our many residency programs at the Student National Medical Association's Annual Education Conference in Atlanta, Georgia in April. Upon the recommendation of Dr. Bergfeld, I have been asked to join the Editorial Board for the Women's Dermatologic Society, and I hope to be approved for this appointment during the AAD meeting in March. While I have made progress in research in the field of hair disorders, I have also made strides in leadership and service, which will certainly help me be well-rounded in my career. I am so grateful for this experience and hope to continue to work with NAHRS throughout my career.
Ghada Abdulaziz Binsaif, MD, Dermatologist; Mentor: Amy McMichael, MD & Gil Yosipovitch, MD, Wake Forest University School of Medicine, Central Centrifugal Cicatricial Alopecia
I would like to thank you for involving me in the NAHRS Mentorship Program. It was an amazing, useful and very productive experience. Words are not enough to describe how much skills and knowledge I gained from working with Drs. McMichael and Yosipovitch. We started with our project of assessing pain, thermal thresholds and neurogenic inflammation in CCCA patients. The unexpected results pushed us to extend our work to study the scalp of healthy subjects from various ethnic groups.
We presented part of our work in the Cicatricial Alopecia Symposium, Bethesda, Maryland, USA, Oct 2011. Under the title "Bin saif G, Mcmichael A, Yosipovitch G. Assessment of Itch, Thermal and Pain Thresholds, and Neurogenic Inflammation in Central Centrifugal Cicatricial Alopecia." We also submitted the following abstract "Healthy scalp has reduced sensory thresholds to temperature, pain, itch and neurogenic inflammation response" to the Society of Investigative Dermatology annual meeting (2012). We are working now on writing two manuscripts that represent the results of our work, and they will be sent for publication soon.
This experience provides me with skills in conducting simple basic science research in the field of hair, as well as skills in writing papers and presenting in conferences. I get very interested in the hair and scalp field, so I wrote (with Dr. Yosipovitch) a review article entitled "Itchy scalp, Scratching for an explanation" that was published in Exp Dermatology, Dec 2011. In addition, I am still working on a review article with Dr. McMichael on Neoxidil.
During the academic year 2010-11, I joined the international fellowship program in Wake Forest University under Drs. McMichael and Yosipovitch, and I was lucky to get the NAHRS mentorship award. During which I believes that my hair clinical approach and research skills get polished. Now, I went back home to King Saud University, Riyadh, KSA. I opened a hair clinic and I am planning to be specialized in hair and scalp disorders in the clinical and the research sides. I am planning now for many hair researches and wishing to be able to participate with international hair research groups in future. Hope we could contribute to improve our understanding and our management skills of various hair disorders.
Sabina Anna Cieszynski, Medical Student; Mentor: Kimberly Salkey, MD, Eastern Virginia Medical School, Synthetic Hair is Associated with CCCA in Southeastern Virginia
The purpose of our study was to investigate whether there was an association between certain types of hair practices and central centrifugal cicatricial alopecia and whether the condition had a significant impact on patients' lives. Two types of surveys were distributed to patients with CCCA, including the Hair Grooming Assessment Survey and the Dermatology Quality of Life Index, and results were analyzed.
We found that CCCA did have a moderate impact on the quality of life in these patients, comparable to other chronic skin conditions such as psoriasis and vitiligo. In addition, we found that there was an association between CCCA and glued in and sewn in weaves; however there was no clear indication that the use of this hair care practice preceded the onset of the condition. Currently we are in the process of submitting our results for publication and hope that these results will place us one step closer to finding the potential cause of this condition. Our results are similar to ones from various publications on this topic, indicating that weaves seem to be one of the main practices associated with CCCA.
Working with Dr. Kimberly Salkey was an extremely rewarding experience. As this was my first clinical study, I needed assistance in learning the steps of this process and she guided me through each of these steps with immense patience and encouragement. Prior to this experience, the process of running my own research project was somewhat foreign to me, however with Dr. Salkey's enthusiasm, commitment, and guidance I am now much more comfortable with pursuing something like this on my own in the future.
Alde Carlo Patdu Gavino, MD, Resident, Mentor: David Whiting, MD, Baylor University Medical Center, Histopathology with clinical correlation
I spent 2 weeks (July 25 to August 5, 2011) with Dr. David Whiting at his Hair and Skin Research and Treatment Center in Dallas, TX. My experience was priceless, and I could not be more grateful to the North American Hair and Research Society for supporting my mentorship.
Dr. Whiting has a very busy Hair Clinic. I saw hair patients with him --- it was a good mix of follow-up and new patients --- and learned how he evaluated and managed alopecias. Dr. Whiting biopsied all of his new patients, and read those biopsies himself. This was a fantastic opportunity for me, especially because before dermatology residency, I completed a residency in anatomic and clinical pathology followed by a fellowship in dermatopathology. I had the opportunity to review all of the biopsies we did, do follicular counts on them, and formulate a diagnosis based on those counts. Dr. Whiting went over the biopsies with me after I had previewed them. The clinico-pathologic correlation was extremely educational. In addition to all that, Dr. Whiting was so generous with his time in that he sat down with me everyday and gave me a lecture using talks he had given at various local, national, and international meetings. What a privilege I had!
Incidentally, during my stay there, Dr. Whiting was working on a paper on Frontal Fibrosing Alopecia. I helped Dr. Whiting gather and organize some of the data needed to complete that paper. It was a great learning experience for me as well. Dr. Whiting had seen and continues to see a lot of patients with FFA, and I learned a lot about that disease during my time with him.
Lastly, I had the wonderful opportunity, pleasure, and honor to meet Dr. Whiting's wife. Like Dr. Whiting, Mrs. Whiting was unbelievably kind and generous. The same is true for Dr. Whiting's office staff.
In summary, I had the most pleasant and most valuable learning experience with Dr. Whiting. My time with him solidified my desire and plan to carve a niche in hair diseases and alopecias. Dr. Whiting will always be an inspiration and role model to me, and I thank him and the North American Hair and Research Society for helping me find my niche in dermatology and dermatopathology.
Natasha Atanaskova Mesinkovska, MD, PhD, Resident, Mentor: Wilma Bergfeld, MD, Cleveland Clinic, Lichen Plano Pilaris: Therapy with Pioglitazone
Where do I begin to tell you about the amazing and prolific year that I had working with Dr. Bergfeld? For all of you who know her, you are well aware that she is an exemplary mentor, smart, fair and imaginative. Dr. Bergfeld possesses an amazing gift to teach her mentees while making them feel that they are the ones who are changing the future, as she only gently points the way. In these times full of limitations, with Dr. Bergfeld I discovered the world where hard work still obtains unlimited possibilities.
Here is what may seem like an uncreative task list, but one completed with tremendous effort and love on my part:
We were jovially discussing with Dr. Bergfeld, that I have too much work to send this NAHRS summary back on time. That is her gentle way of nudging me to get it done.
With immense gratitude to the NAHRS for making all of this possible: the $500 grant has supported my inkling to grow into a strong interest and possible career path. For this alone, I will be eternally indebted.
I look forward to returning this favor to future generations of residents.
Mariya Miteva, Associate Scientist, Mentor: Leonard Sperling, MD, Uniformed Services University, Hair pathology
I consider my visit with Dr. Sperling as one of my best academic experiences. My area of interest is hair pathology and therefore for me to be able sit at microscope with Dr. Sperling who is a leading expert in this field was a terrific opportunity.
I combined my mentorship visit in Bethesda with attending the Cicatricial Alopecia Symposium which was held there in October. My visit with Dr. Sperling consisted of 4 days. At the beginning I had the chance to take several self-assessment tests in hair pathology which I liked very much. I found that particularly useful as I had time to think over the cases, then we discussed the answers and I was able to ask questions. Every day I spent time at the microscope reviewing Dr. Sperling's collection of hair specimens which we discussed afterwards during our sessions at the microscope. In these sessions I extended significantly my knowledge on hair pathology, particularly the assessment of horizontal sections and we exchanged ideas about future common projects. In fact, we are currently working on two scientific publications on hair pathology which will appear in the near future.
Dr. Sperling included me also in the routine evaluation of hair biopsies which I found very exciting part of the mentorship. I also attended the dermatopathology sign out of the most difficult cases of the week where I was able to meet and interact with other nice colleagues.
Besides all the time that he dedicated to me at the microscope, Dr. Sperling also gave me great hospitality as we went for nice afternoon walks between the microscope sessions and dinners at the end of the day. In this time we were able to talk about future projects and exchange ideas in an informal way.
In conclusion, I would to thank the NAHRS for this unique opportunity.
I am sure this mentorship established the basis of new productive future collaboration with big impact on hair pathology.
Peggy Suejin Myung, MD, PhD, Resident, Mentor: Mayumi Ito, PhD, New York University School of Medicine, The regulation of Wnt signaling in hair follicle melanocyte stem cells by epithelial and dermal cells
During my mentorship training under Dr. Mayumi Ito at New York University, we examined hair follicle regeneration in adult mouse skin using two models: 1) the adult hair cycle and 2) wound-induced hair follicle neogenesis.
We approached an important question: How do hair follicles activate Wnt/β-catenin signaling to initiate adult hair follicle regeneration? Virtually all hair biologists recognize that Wnt/β-catenin signaling is critical for hair follicle regeneration, but the cellular source of Wnt ligands that activate Wnt/β-catenin signaling during hair regeneration is unknown. Several Wnt ligands are expressed redundantly in the hair follicle epithelium and dermal papilla, making it difficult to experimentally address this question in vivo. We took advantage of the recently characterized Wntless protein that is required for secretion of Wnt ligands by Wnt-producing cells. We generated mice that allowed us to genetically delete the Wntless gene specifically in hair follicle stem cells during telogen phase. We discovered that Wnt ligand secretion by the follicular epithelium is absolutely required for anagen and that Wntless-depleted hair follicles show a profound hair cycle arrest at telogen or early anagen. Furthermore, we show that epithelial Wnts are necessary for the dual activation of Wnt/β-catenin signaling in hair follicle stem cells and dermal papilla cells, and epithelial Wnt ligands are required for hair follicle stem cell proliferation but not their maintenance. Finally, epidermal Wnt ligands are critical for de novo hair follicle regeneration following wound healing in adult mice.
This study demonstrated the requirement for epithelial Wnt ligand secretion in directing early events in hair regeneration. This study also highlights Wntless as an effective tool to inhibit Wnt signaling in the hair follicle independently of downstream Wnt signaling transducers, which have both Wnt-dependent and Wnt-independent functions. We predict that this study will provide new insight into the cell-cell interactions that promote the coordinated growth of different cell types during adult hair/tissue regeneration and will be signifcant to hair biologists, clinical dermatologists and tissue engineers. This work has been submitted recently to the Journal of Investigative Dermatology for publication and will be presented orally at the 2012 annual Society of Investigational Dermatology meeting.
More importantly, this hands-on experience with Dr. Ito and her lab gave me a new appreciation and excitement for studying hair follicle biology and the experimental approaches available to address questions, including their limitations. Dr. Ito's astute and prolific expertise in hair biology, as well as her sincere and contagious enthusiasm for teaching and engaging students, gave me the unique opportunity to learn hair morphology throughout the hair cycle as well as during adult hair neogenesis. As a future dermatopathologist, this experience gave me a new appreciation of the histological and biochemical changes that occur throughout the hair cycle and how this relates to human hair diseases. I am eager to incorporate basic science research with my upcoming dermatopathology fellowship training at Yale and hope to continue my interests in hair regeneration there. I am looking forward to continuing scientific collaborations with Dr. Ito during my fellowship and know that we will maintain a friendship throughout my career. Put simply, she is one of the best mentors I have ever met and has the unique ability to give a sense of ownership, dedication, and discovery to her trainees.
Sophia Rangwala, Researcher, Mentor: Madeleine Duvic, MD, University of Texas M.D. Anderson Cancer Center, Alopecial areata, T cell disease
In January 2011, I was awarded a NAHRS grant to support my mentorship with Dr. Madeleine Duvic at the University of Texas M.D. Anderson Cancer Center. I participated in her cutaneous lymphoma clinic twice weekly and helped manage many patients who had debilitating diseases associated with hair loss, such as folliculotropic mycosis fungoides and cutaneous B cell lymphoma of the scalp. Outside of clinic, I was involved in translational research that determined the biologic mechanisms of response of various therapeutics found to be effective in cutaneous T-cell lymphoma patients, including histone deacetylase inhibitors, pralatrexate, and bexarotene. The findings of this research have implications for hair loss associated with T cell lymphomas of the scalp. While at MD Anderson, I also helped prepare a case series entitled "Antinuclear antibody seropositivity in male patients with cutaneous B-cell lymphoma of the scalp" and a review entitled "Alopecia: a review of laser and light approaches." Both manuscripts are currently submitted for publication.
In addition to these projects, I helped obtain buccal DNA samples for the National Alopecia Areata Registry from patients who had declined phlebotomy and determined the best protocol to extract the buccal DNA. Buccal samples gathered from clinic and the 2011 National Alopecia Areata Conference will be used for a future genome-wide association study on alopecia areata.
During my experience, I observed how debilitating hair disease can be, read over the current literature, and finally, participated in research that has the potential to reverse hair-affecting conditions. This mentorship has reinforced my interest in serving and improving the lives of those with hair disease as a future medical dermatologist.
Patricia Ting, Resident, Mentor: Vera Price, MD, University of California San Francisco, Hair disorders
I completed a 2 week mentorship in March 2010 with Dr. Vera Price in San Francisco. This mentorship experience was generously supported by the NAHRS.
The experience was both delightful and memorable. On the first day, I arrived at the UCSF Dermatology Department bright and early at 7:15am. The walk to the clinic was a little shorter than I had anticipated. I was greeted by welcoming support staff. When I returned from Starbucks, I was greeted by a smiling Dr. Price. I was fortunate to have had the opportunity to meet her in New Orleans just one month earlier since she graciously invited me to her UCSF Hair Fellow's breakfast at the American Academy Meeting. Dr. Price immediately began to get me organized by directing me to a bookshelf of reference books, website resources, patient information handouts and a clinic schedule. As I began to peruse through some of her books, I quickly realized how vast hair disorders can actually be, clearly not reflected in the 25 pages dedicated to hair in our beloved Bolognia textbook.
During the time I spent with Dr. Price, I learned how to take a proper history and perform through hair examinations. The clinics were filled with patients with androgenetic alopecia as well as uncommon and rare forms of cicatricial alopecias, alopecia areata, etc. I can recall a number of teary eyed patients, upset from the cosmetic disfigurement caused from their hair loss. The patience, understanding and reassurance Dr. Price demonstrated to these patients was very special to observe. Dr. Price also provided these patients with useful resources and support groups to help them cope with their hair disorders.
Furthermore, Dr. Price also taught me how to make and interpret hair mounts. This was something I had never done before! She gave me access to her collection of hair samples collected over the years of rare hair disorders such as trichorexhis nodosa, spun glass hair, monilethrix, pili bifurcate, etc. It was immensely educational to look through seemingly endless envelopes of hair samples and practice making hair mounts of them.
In sum, I accumulated a lot of knowledge and practical skills in the two short weeks I spent with Dr. Price in San Francisco. She is a very skilled and knowledgeable clinician and researcher, a wonderful mentor and a lovely person to work with. I certainly wish I could have had the opportunity to work with her longer! This mentorship experience has certainly made me more interested in possibly pursuing a hair fellowship. I am very thankful to NAHRS for supporting this amazing mentorship experience.
Vasanop Vachiramon, Dermatologist, Mentor: Amy McMichael, MD, Wake Forest University School of Medicine, Hair and pigmentary disorders, laser hair removal
I would like to express my sincere gratitude to both North American Hair Research Society and to Dr. McMichael for an exceptional mentorship experience at the Department of Dermatology, Wake Forest University School of Medicine. Dr. McMichael and the entire Department of Dermatology at Wake Forest University were very gracious hosts and incredibly welcoming.
I spent time in Dr. McMichael's hair clinic, general dermatology clinics, and laser clinic. One of the reasons I was so interested in spending time in her hair clinics was her interest in patients with hair and scalp disorders. Dr. McMicahel is the quintessential academic dermatologist and such a great teacher. Every case provided an interesting teaching point. The patients in Dr. McMichael's hair clinic provided me unique opportunities to hone my clinical skills in this field. I had a chance to see many patients who had hair and scalp disorders in her clinic. These include central centrifugal cicatricial alopecia, lichen planopilaris, folliculitis decalvans, androgenetic alopecia, alopecia areata, and alopecia universalis. Seeing a high volume of these patients helped me recognize patterns of presentation for these disorders as well as subtle variations in disease manifestations. These patients provided even further teaching opportunities for Dr. McMichael who seems to truly enjoy teaching. I didn't just benefit, though, from learning about patients' conditions, it was also Dr. McMichael's approach to patient education that was also very beneficial. All patients walk out the door with a handout about hair and skin care and usually one about their specific diagnosis, which is something I definitely plan to bring back to my home institution.
Another clinical interest of Dr. McMichael is laser hair removal and I had a chance to see many patients who had unwanted hair in her laser clinic. We also conducted two clinical researches and published during my visit. The first one is entitled "Patient knowledge and attitudes on laser hair removal: a survey in people of color" and was published in Journal of Cosmetic Dermatology and the second one is entitled "Patient satisfaction and complications following laser hair removal in ethnic skin" and was accepted for publication in Journal of Drugs in Dermatology.
During my visit at the Department of Dermatology, Wake Forest University School of Medicine, I was also able to attend the clinico-pathological conferences, grand rounds, and many lecture series for resident education. They were all of high quality and informative. Many of the faculty members are recognized experts in the topics they presented, and it was an enormous privilege to hear them speak. When Dr. McMichael wasn't in her clinic, she graciously had talked with other attendings to ensure if it was okay for me to spend time with them and so I got to spend time with Dr. Yosipovitch and Dr. Jorizzo in their clinic. Both of them were also an excellent teacher.
Again, I want to thank everyone at the NAHRS for giving me this amazing opportunity to spend time with Dr. McMichael and the rest of the dermatologists at the Department of Dermatology, Wake Forest University School of Medicine. I will take whatever I have learned and bring it back to my home institution in Thailand to teach medical students and residents. I would highly recommend this experience to others interested in hair and scalp disorders. Thank you again to both the NAHRS and Dr. McMichael for making all of this possible.


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The number of children diagnosed with autism continues to grow dramatically in the United States according to a new report by the Centers for Disease Control and Prevention (CDC), reports CNN. The latest estimate is that 1 in 88 children have some form of autism spectrum disorder. This is a 78 percent increase in comparison to a decade ago, when the autism estimate was 1 in 150 children.
Plus: Educate Yourself during Autism Awareness Month
The CDC based these figures on surveillance reports from its Autism and Developmental Disabilities Monitoring Network, which counts the number of 8-year-olds with autism in approximately a dozen communities across the country every two years. Mark Roithmayr, president of the advocacy group Autism Speaks, tells CNN that the steady rise of autism could be because of "better diagnosis, broader diagnosis, better awareness, and roughly 50% of 'We don't know.'"
Plus: Definition of Autism May Be Changing
Early recognition of the signs of autism is vital, as research shows that children benefit greatly from early intervention, such as medications, behavioral therapy, or additional help in school. However, the CDC report shows that most children were only diagnosed with autism between the ages of four and five—a time when a child's brain is already more developed and harder to change. The CDC is working with the Academy of American Pediatrics to recommend that children get screened for autism between 18 months and 24 months.
Do you have a child with autism? How do you feel about these new numbers?

subset: commoncrawl


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