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MENTEE EXPERIENCES - 2013 Mentorship Awards Minimize
Timothy K. Cooper DVM, PhD., Dipl. ACVP, Summary of Experience with the Sundberg Lab

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.


Temitayo A. Ogunleye, MD, Dermatologist, Amy McMichael, MD, Wake Forest University, Department of Dermatology, Ethnic skin and hair management

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.


Emilia Peuhu, PhD
Mentor: John Sundberg, MD
Mentorship title: Hair and Skin pathology of the Sharpin null mouse models

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.

  

MENTEE EXPERIENCES - 2012 Mentorship Awards Minimize
Julia Escandon, MD, Dual MD-PhD Student; Mentor: George Cotsarelis, MD, University of Pennsylvania, Immunostaining in protein expression of various stem cell markers in mouse and human skin

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.

  

MENTEE EXPERIENCES - 2011 Mentorship Awards Minimize
Rayna M. Dyck, MD, Resident; Mentor: Wilma Bergfeld, MD, Cleveland Clinic, The use of intralesional steroids in folliculitis decalvans

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:

  1. We started off the year by looking at the Cleveland Clinic experience with alopecia and by creating the alopecia database. This was a project that was in the works for some time, but had never really gained momentum. We successfully qualified and organized over 800 patients, with many more to be entered. This database has offered us a wealth of knowledge, and is yet to provide much needed information on patients with alopecia.
  2. The first scientific project focused on identifying stem cell markers in scarring and non-scarring alopecia, done in collaboration with the excellent Dr. Klaus Sellheyer. This work was chosen for an oral presentation at two meetings: the American Society of Dermatopathology in Seattle, WA, and the NIH Cicatricial alopecia conference, in Bethesda, MD. The completed study was subsequently published in the British Journal of Dermatology, 2011.
  3. We completed a study focusing on the levels of Vitamin D in patients with alopecia. This project was also chosen for a poster and oral presentation at the NIH Cicatricial conference, October 2011 in Bethesda, MD. The first draft of the paper was revised and resubmitted for publication.

    In addition, I will be presenting a talk on the role of Vitamin D in alopecia at the upcoming AAD meeting, 2012 San Diego, CA.
  4. We compiled our experience with Lichen Planopilaris and Pioglitazone and presented this work at the NIH Cicatricial conference, October 2011 in Bethesda, MD. Some aspects of the work were included in Cleveland clinic yearly outcomes book and we are preparing this to be published in a peer reviewed journal.
  5. My current project is focused on devising a protocol for alopecia areata clinical trials for the NAAF,under the guidance of Dr. Bergfeld, and in collaboration with Dr. Shapiro. This project has taken a lot of effort but finally coming to fruition.

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.

  

MENTEE EXPERIENCES - 2010 Mentorship Awards Minimize
Renee Beach, MD, Resident, University of Ottawa; Mentor: Nonhlanhla Khumalo, MD, Groote Schuur Hospital, Cape Town, South Africa, Cytokine profiles in Afro-textured hair, pediatric dermatology, adult academic dermatology

I embarked on a four-week elective at the University of Cape Town’s (UCT) Groote Schuur hospital (GSH) under the tutelage of Dr. Nonhlanhla Khumalo (January 24, 2010 – February 19, 2010).

My daily schedule consisted of 8 am teaching sessions where the UCT registrars prepared for their upcoming exams, followed by clinic at the GSH (adult general dermatology), the Red Cross Children’s Hospital (pediatric general dermatology), or the Hair Disorders clinic at the GSH. In the afternoons, I completed a research study with Dr. Khumalo that focused on women with afro-textured hair. In the evenings, I took the research study samples of sebum to the lab and prepared them for extraction.

The research study is entitled “ICANAR - Inflammatory cytokines in afro-textured natural and relaxed hair”, and the main question asks whether or not there is a difference in the cytokine profile obtained from the scalp sebum of women who chemically process their hair compared to women who do not. Sub group analyses will examine whether or not there is any difference between types of chemical processing used on the hair (e.g. sodium hydroxide vs. guanidine preparations). The study will analyze sebum samples in women with afro-textured hair before and after shampoo/conditioner and before and after chemical processing. I obtained and prepared 525 sebum samples from the research participants over a total of 110 patient visits. Currently, we are awaiting the cytokine kit arrival so that the samples can be analyzed.

Clinic experiences at the hospitals in Cape Town were high-yield. There was a fantastic diversity of skin types and pigment complexions. I became more and more comfortable with subtle morphological differences found in non-Caucasian type skin. There were several conditions I encountered that I had not seen in a North American setting such as pellagra, measles, diphtheria, oral Kaposi’s sarcoma, papular pruritic eruption (PPE) of HIV, atopic dermatitis with post-inflammatory depigmentation in Fitzpatrick type V skin.

I had an unforgettably positive experience. I would like to thank Dr. Khumalo for her consistent teaching, mentorship and warmth. I’d also like to thank the North American Hair Research Society for providing the grant that helped to make the elective financially possible.
  

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