Geriatric hair and scalp disorders
Robert A. Norman in Geriatric Dermatology, 2020
Anagen effluvium is the shedding of anagen or growing hairs following common therapeutic doses of chemotherapeutic drugs or radiation, usually for the treatment of cancer. Because 90% or more of scalp hair is typically in the anagen phase at any given time, up to 90% of hair may be lost as the hair shafts are attenuated by the abrupt interference with, or cessation of, mitosis in the hair matrix. Hair matrix cells are especially vulnerable to the effects of toxic drugs and radiation because they are so metabolically active, dividing on average every 9–12 hours. Shedding generally begins within days to a few weeks after therapy as the attenuated hair shafts reach the surface of the scalp. The 10% of hairs not lost in the immediate 2–3 weeks post therapy are probably telogen hairs that will be shed as a natural event, rendering the loss of scalp hair virtually complete in many patients. If the insult is temporary, as in the case of intermittent or episodic therapy, regrowth should be virtually complete because the bulge area has not been subjected to injury. As discussed in the introduction, this side-effect may be the most traumatic one that cancer patients endure.
Telogen effluvium: Pathogenesis, clinical features, diagnosis, and management
Jerry Shapiro, Nina Otberg in Hair Loss and Restoration, 2015
Anagen effluvium is a result of a disturbance of hair follicle matrix cells. The anagen phase is interrupted and the hair falls out 7–14 days after the initiating event without entering catagen or telogen. Two different types of anagen effluvium can be distinguished: (1) Dystrophic anagen effluvium, which can be caused by chemotherapy, radiation, toxins, or alopecia areata, and (2) IAR. Microscopic investigation of the hair bulbs, obtained from a hair pull test or trichogram, usually shows a tapered tip where the weakened hair shaft is broken shortly above the bulb (dystrophic hair) [7].
Trichoscopy I: Non-Cicatricial Alopecia
Rubina Alves, Ramon Grimalt in Techniques in the Evaluation and Management of Hair Diseases, 2021
Anagen effluvium results from exposure to drugs (mainly chemotherapeutic agents), toxins, or radiotherapy [4]. In anagen effluvium due to toxicity, active hair loss is characterized by the presence of black dots, broken hairs, exclamation marks, flame hairs, and Pohl-Pinkus constrictions. In hair regrowth, vellus hairs and pigtail hairs are detected [24].
Current status and prospects for the diagnosis of pemphigus vulgaris
Published in Expert Review of Clinical Immunology, 2021
Ali Nili, Ali Salehi Farid, Masoud Asgari, Soheil Tavakolpour, Hamidreza Mahmoudi, Maryam Daneshpazhooh
As a characteristic sign, applying mechanical pressure to the adjacent normal skin may cause or accentuate the erosion, a condition termed Nikolsky’s sign [17]. Anagen effluvium, which is regarded as Nikolsky’s sign of the outer root sheath of hair, can be found in lesional and non-lesional scalp regions, and it has been associated with disease severity [14,18]. It has been reported that PV can additionally affect nail apparatus, particularly in severe cases, presenting as paronychia, nail plate irregularity and discoloration, onychomadesis, and onycholysis [19]. Oral or cutaneous lesions are frequently associated with infections caused by viruses or bacteria. Both mucosal and dermal blisters heal without scarring, though it is not uncommon for post-inflammatory pigmentation to occur [8].
Safety of the current drug treatments for vitiligo
Published in Expert Opinion on Drug Safety, 2020
Torello Lotti, Komal Agarwal, Indrashis Podder, Francesca Satolli, Martin Kassir, Robert A Schwartz, Uwe Wollina, Stephan Grabbe, Alexander A Navarini, Simon M Mueller, Mohamad Goldust
Its major adverse effects include [18]: Genitourinary: Bladder fibrosis, necrosis, contractures, dysuria, urgency, hemorrhagic cystitis (dose related and caused by acrolein metabolite).Carcinogenesis: Bladder cancer, leukemia, non-Hodgkin’s lymphoma.Gastrointestinal: Anorexia, stomatitis, hepatotoxicity.Hematological: PancytopeniaReproductive: Amenorrhea, azoospermia, ovarian failure.Dermatologic: Anagen effluvium, pigmentation of nails and skin, pigmented band on teeth.
Long-term effects of total skin electron beam therapy for mycosis fungoides on hair and nail loss and regrowth
Published in Journal of Dermatological Treatment, 2022
Debra L. Breneman, Alyssa Breneman, Elaine Ballman, John C. Breneman
Radiation-induced hair loss is thought to be an anagen effluvium related to direct damage to the hair follicle from radiation treatment (11). In our study, most patients had complete loss of scalp hair during treatment, but new growth appeared about 2 months following treatment completion. Persistent cosmetically obvious alopecia was noted in the two patients who were treated with TSEBT and concomitant chemotherapy. Less regrowth of scalp hair was noted in the temples and occiput areas due to the technique of delivering the electron beam. Some loss of eyebrows and eyelashes developed, but complete regrowth occurred in most patients.
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