A Woman With Generalized Hair Loss.

Generalized hair loss as an adverse effect of antiretroviral therapy in an HIV-1 positive man – a case report

We present six cases of frontal fibrosing alopecia, in which generalized hair loss is a feature. Although this variant of lichen planopilaris has been reported clinically in a number of patients, there is very little histological evidence that the condition exists in peripheral sites. We believe this pattern of involvement may be more common than is reported, and have provided histological evidence of lichen planopilaris being present at sites beyond the scalp and eyebrows.

Significant changes in scalp, facial and body hair occur after the menopause. These can have a significant negative impact on self-esteem and are also potential markers of endocrine or metabolic diseases. Knowledge of postmenopausal hair changes is important for clinicians to distinguish between normal physiological change and those that require further medical investigation. To assess the subjective experience of scalp, facial and body hair change in a large cohort of normal postmenopausal females. Postmenopausal females aged 45 years or over of northern European origin completed a questionnaire detailing scalp, facial and body hair changes following the menopause. Women with a history of thyroid disease, oophorectomy or premature menopause were excluded from the study. The Mann-Whitney U-test and the χ(2) test were used to assess the correlation between scalp, facial and body hair changes with age. Diffuse generalized hair loss was the most common form of scalp hair loss, reported by 26% of women. Frontal hair loss was reported by 9% of women. Facial hair gain was cited by 39% of females with the chin being the most frequent site for new growth (32% of women). Body hair loss was significantly correlated with older age (P < 0·001) and was most frequent at androgen-sensitive sites. We noted two patterns: (i) diffuse hair loss in which diffuse generalized scalp hair loss was significantly correlated with body hair loss and increasing age (P < 0·05); and (ii) frontal hair loss which was associated with higher facial hair scores and relatively younger age (P < 0·05) compared with women with diffuse hair loss. This is the first comprehensive study of the subjective hair changes in postmenopausal women. This study demonstrates two distinct patterns of hair change relating to age, which may reflect different underlying pathophysiological mechanisms and are of relevance to the medical management of these women as well as being possible predictors of health outcomes.

A basic knowledge of the hair growth cycle is needed to evaluate disorders of hair growth. This chapter presents a broad overview of the physiology and evaluation of hair growth, as well as discussions of specific types of alopecia. The epidemiology, pathogenesis, diagnosis, and treatment of androgenetic alopecia, the most common type of nonscarring hair loss, are covered. Diffuse hair shedding is generalized hair loss over the entire scalp. Diagnosis and treatment of telogen effluvium, anagen arrest (anagen effluvium), and other causes of diffuse hair shedding are covered in detail. Alopecia areata, typically characterized by patchy hair loss; cicatricial alopecia, which results from permanent scarring of the hair follicles; and miscellaneous causes of hair loss are also discussed. Tables list the causes of diffuse and cicatricial alopecia, telogen effluvium, and miscellaneous chemicals and categories of drugs that can cause alopecia, as well as miscellaneous causes of hair loss. Included is an algorithm outlining the approach to diagnosing nonscarring alopecia, as well as a variety of clinical photographs. This review contains 9 highly rendered figures, 6 tables, and 42 references.

ABSTRACTDrug-induced alopecia is a side effect characterized by generalized hair loss. It is reversible when the drug is discontinued. Among psychotropic agents, this side-effect is most often reported with the use of valproic acid and lithium. There are limited reports on atypical antipsychotic-induced hair loss. Here, we report a case of hair loss after olanzapine use which resolved after the discontinuation of olanzapine.

A basic knowledge of the hair growth cycle is needed to evaluate disorders of hair growth. This chapter presents a broad overview of the physiology and evaluation of hair growth, as well as discussions of specific types of alopecia. The epidemiology, pathogenesis, diagnosis, and treatment of androgenetic alopecia, the most common type of nonscarring hair loss, are covered. Diffuse hair shedding is generalized hair loss over the entire scalp. Diagnosis and treatment of telogen effluvium, anagen arrest (anagen effluvium), and other causes of diffuse hair shedding are covered in detail. Alopecia areata, typically characterized by patchy hair loss; cicatricial alopecia, which results from permanent scarring of the hair follicles; and miscellaneous causes of hair loss are also discussed. Tables list the causes of diffuse and cicatricial alopecia, telogen effluvium, and miscellaneous chemicals and categories of drugs that can cause alopecia, as well as miscellaneous causes of hair loss. Included is an algorithm outlining the approach to diagnosing nonscarring alopecia, as well as a variety of clinical photographs. This review contains 9 highly rendered figures, 6 tables, and 42 references.

Lack of Response to Laser Comb in Spontaneous and Graft-Induced Alopecia Areata in C3H/HeJ Mice

Drug-induced alopecia is a side effect characterized by generalized hair loss. It is reversible when the drug is discontinued. It is a common side effect of psychotropic drugs. Increasingly widespread use of selective serotonin reuptake inhibitor is rare and limited to case reports on the use of alopecia. The exact mechanism of drug-induced alopecia is unknown. However, alopecia an undesirable side effect, and can cause drug incompatibility. Here, we report a case of hair loss after fluoxetine use which resolved after the discontinuation of fluoxetine

Alopecia Universalis is a condition that causes generalized hair loss in the body. It is associated with nail changes in 10-15 % of Autoimmune origin conditions. Several medicines normalize hair growth, but this condition requires a treatment modality that concentrates on the root cause of hair falling all over the body. Here is a case report about the Ayurvedic approach in a 48-year-old male patient with Alopecia Universalis presented with hair loss all over the body associated with itching. We administered the Ayurveda protocol and Severity of Alopecia Tool (SALT) criteria assumed before and after assessing clinical output.

Cronkhite-Canada syndrome is characterized by gastrointestinal and ectodermal manifestations. In this paper, we describe a 64-year-old Iranian male, presenting with Cronkhite-Canada syndrome with metastatic colon cancer. The patient was suffering from hair loss, which occurred on the scalp at first and then, during 5 months, extended to the whole body. After that, his sense of taste was impaired, and 2 months later, gastrointestinal symptoms gradually started, with weight loss of 20 kg over 2 months with an initial weight of 100 kg. Finally, he was admitted to our center 10 months after the onset of symptoms. On skin examination, generalized hair loss and hyperpigmentation and dysmorphic nail changes were observed. Multiple polyps within the colon and sigmoid were observed on colonoscopy. According to biopsies, a serrated adenoma and an invasive adenocarcinoma were reported in the ascending colon and sigmoid, respectively. Other polyps were pseudopolyps, and their characteristics were not significant. Computed tomography of the lungs and abdomen showed multiple adenopathies. On biopsy, metastatic adenocarcinoma was reported. The patient underwent chemotherapy with FOLFIRI and ERBITUX. Finally, after 5 courses of chemotherapy, his regimen was changed to FOLFOX and Avastin because of evidence of progression on computed tomography. The etiology of Cronkhite-Canada syndrome is currently unknown, and the optimal therapy has not been reported so far. This syndrome has many complications; the major of them is malignancy, and the prognosis is poor with a mortality rate of 50%. Therefore, annual monitoring is necessary in these patients.

Cutaneous involvement is a frequent clinical and pathologic finding in amyloidosis associated with plasma cell dyscrasias. 1,2 Common clinical features include purpura, papules, nodules, plaques, and scleroderma-like changes. 2-5 We describe herein a patient in whom generalized hair loss and anonychia were early prominent manifestations of unsuspected amyloidosis and multiple myeloma. Report of a Case A 65-year-old woman was referred to us for examination and treatment of congestive heart failure in October 1980. Orthopnea, paroxysmal nocturnal dyspnea, and pedal edema had initially developed in 1977 and had responded to therapy with digoxin and hydrochlorothiazide until one month earlier. Coincidentally with the onset of heart disease, the patient had noticed brittleness of her fingernails and the gradual loss of all body hair. She had worn a wig for the past 18 months. Her only other symptoms included a 5.5-kg weight loss and dysarthria of three months' duration. Physical examination at the

An unusual syndrome of progressive baldness resulting from a distinctive hamartoma of the hair follicle is presented. The patient also had myasthenia gravis, an enlarged sella turcica, and an abnormal urinary amino acid pattern and was suspected of having lupus erythematosus. The generalized hair loss was diagnosed as alopecia universalis until multiple skin biopsies revealed a basal cell hamartoma of each hair follicle. Histochemically and by electron microscopic studies the tumor had characteristics of epithelial cells. A wax reconstruction showed the normal anatomic relationship of sebaceous glands and the arrectores pilorum muscles to this tumor. This study emphasizes the importance of skin biopsy in alopecia of unknown cause and suggests that further study of abnormal ectodermal tissues might provide insight into hair keratin defects.

Paclitaxel is a novel antineoplastic that effects cytotoxicity by promoting intracellular tubulin polymerization and stabilizes abnormal microtubule structures against depolymerization. Although its clinical development had been hampered by misconceptions about its pharmacology, its scarcity, difficulties extracting it from its natural source, formulation problems, and frequent severe hypersensitivity reactions, paclitaxel recently was approved for treatment-refractory ovarian cancer. Two major adverse effects are dosage- and schedule-related myelosuppression and mucositis. Neurotoxicity is directly related to both the individual and cumulative doses. Other relevant toxicities are hypersensitivity reactions, effects on cardiac rate and rhythm, arthralgias and myalgias, generalized hair loss, and mild nausea and emesis. Continuing clinical studies will evaluate paclitaxel as initial therapy for ovarian cancer and its utility in other malignancies. In addition, major efforts are under way to develop alternative sources to increase the availability of taxene analogs and reduce our dependence on yew species.

Pili torti is a congenital or acquired human disease characterized by flattening and twisting of the hair shaft by 180 degrees. A similar condition has been previously reported in a litter of kittens with generalized hair loss, associated with systemic signs and followed by death at a young age. A 1-year-old castrated male domestic short-haired cat was presented for noninflammatory and nonpruritic symmetrical multifocal alopecia involving the head, pinnae, forelimbs, tail and chest. The cat was otherwise healthy. Microscopic examination of hair shafts revealed pili torti and a typical combination of anagen and telogen roots, occasionally spiral in shape, without evidence of mites or dermatophytes. Histopathological examination showed the same hair shaft abnormality, with normal epidermis, dermis, hair follicles and other adnexa. Scanning electron microscopy confirmed a hair shaft dysplasia characterized by pili torti, similar to that described in humans. To the best of the authors' knowledge, this is the first case report of pili torti in a healthy young adult cat.

Autoimmune polyglandular syndrome type 2 (APS2) is characterized by the coexistence of primary adrenal insufficiency with autoimmune thyroid disease and/or type 1 diabetes. APS2 frequently includes conditions affecting non-endocrine organs, such as alopecia, vitiligo, celiac disease, and autoimmune gastritis associated with vitamin B12 deficiency. We report the case of a 30-year-old male with a history of Hashimoto's disease and alopecia universalis, who presented with diarrhea, anorexia, hypoglycemia, and abdominal pain. Physical examination revealed orthostatic hypotension, a non-tender abdomen, and generalized hair loss. Initial laboratory workup showed hyponatremia and hyperkalemia. Further testing, including serum cortisol, ACTH, aldosterone, and 21-hydroxylase antibodies, confirmed the diagnosis of Addison's disease. The patient was treated with prednisone and fludrocortisone. Only two previous cases of APS2 associated with alopecia universalis have been reported: one with concurrent Crohn's disease and another with hypoparathyroidism. This case highlights the importance of recognizing non-endocrine manifestations in patients with autoimmune endocrinopathies to facilitate earlier diagnosis and management.