Abstract

Chemotherapy-induced alopecia (CIA) affects 65% of patients receiving chemotherapy regimens and is often identified with the massive hair loss stage. Reflectance confocal microscopy (RCM) is a noninvasive technique used in alopecia assessment for disease characterization and state of activity. To describe RCM features of CIA in different timing and identify specific phases of alopecia development. A total of 16 patients treated with chemotherapy underwent dermoscopy and RCM evaluations four times during the observation: 2 and 4-6weeks after starting and 3 and 6months after the end of chemotherapy. Ten examinations for each stage were performed. Four phases of CIA have been identified. Initial hair loss showed specific dots not previously described, named CIA dots. massive hair loss phase was characterized by black dots (10/10 pt), CIA dots (8/10 pt) and hair shaft abnormalities. Three months after the end of chemotherapy, during the partial regrowth phase, 10/10 patients showed thin hair in regrowth and 8/10 presented black and yellow dots. At 6months, normal hair in regrowth appears in all patients (total regrowth phase). Chemotherapy-induced alopecia has to be considered as a dynamic process with specific phases characterized by distinctive dermoscopic and confocal features.

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