Alopecia following single-dose postoperative intravesical gemcitabine in nonmuscle-invasive bladder cancer: A multi-institutional case series.

Androgenetic alopecia (AGA) is the most common cause of hair loss. To minimize systemic adverse effects of 5-alpha-reductase inhibitors, dutasteride mesotherapy has gained popularity. Although generally considered safe, alopecia at injection sites has been increasingly reported. We describe three cases of persistent alopecia following dutasteride mesotherapy in women with AGA. Three female patients with AGA underwent mesotherapy with dutasteride (0.025–0.05%). Case 1: A 44-year-old woman developed multiple alopecic patches 1 month after a single session, with trichoscopic and histologic features of scarring alopecia. Only partial improvement occurred, and surgical correction was later required. Case 2: A 30-year-old woman developed 4 alopecic patches after 2 sessions. Trichoscopy revealed mixed features of cicatricial alopecia and follicular miniaturization, with limited regrowth despite optimized medical therapy. Case 3: A 48-year-old woman developed numerous alopecic patches 3 months after a single session. Follicular openings were preserved, and miniaturized hairs predominated. Alopecia persisted long-term despite corticosteroids and adjunctive treatments. Reported cases of alopecia after mesotherapy include both scarring and non-scarring patterns, suggesting diverse mechanisms, such as mechanical injury, cytotoxicity from solvents, inflammation, or infection. In this series, none of the patients experienced full regrowth, highlighting the potential for lasting aesthetic sequelae. Published cases show similar variability but often lack detailed trichoscopic or procedural information, limiting interpretation. These findings underscore the importance of proper counseling, careful technique, and close follow-up when using dutasteride mesotherapy. This complication may be underrecognized, and clinicians should maintain vigilance for early detection and management. &nbsp.

Introduction: Hair loss has emerged as one of the most common reasons for dermatological consultations; however, reported epidemiological data remain variable.Objective: This study aims to describe the types and clinical-epidemiological characteristics of acquired alopecia in adult patients.Materials and methods: A retrospective analysis was conducted on patients diagnosed with acquired alopecia at the Instituto Dermatológico de Jalisco "Dr. José Barba Rubio" between January 1, 2018, and December 31, 2022.Results: A total of 1,888 cases of acquired alopecia were analyzed, representing the largest case series reported nationally to date. The mean age of the patients was 37.07 years. Female patients accounted for 1,065 cases (56.4%), while male patients represented 823 cases (43.6%). Overall, alopecia areata was the most frequent type, accounting for 871 cases (46.13%), followed by androgenetic alopecia (543 cases, 28.76%) and traction alopecia (127 cases, 6.73%). Non-scarring alopecias comprised 1,661 cases (88.0%) of the studied population, whereas scarring alopecias accounted for 227 cases (12.0%). Among scarring alopecias, cases with neutrophilic or mixed inflammatory infiltrates predominated, accounting for 145 cases (63.98%), with a higher prevalence among male patients. In this study, folliculitis decalvans was identified as a major cause of scarring alopecia in the Mexican population, accounting for 64 cases (3.39%) of all alopecia cases in the cohort.Conclusion: Regional studies are essential to better understand alopecia patterns and to guide tailored diagnostic and management strategies for affected patients.

Objective — to analyze the clinical and trichoscopic manifestations in a patient with pseudopelades of Brocq, to choose the optimal treatment tactics, to prevent the development of atrophy.The clinical case of a patient with pseudopelades of Brocq is described. The diagnosis was established on the basis of clinical, trichoscopic manifestations of pseudopelades of Brocq and treatment was prescribed.Patient V., 46 years old, complained of hair loss. She fell ill 12 months ago. There is no reason to associate hair loss with anything. The patient has no subjective complaints, sometimes there is a slight burning sensation in the area of hair loss. Gradually, the area of hair loss increased in size.Examination data: on the scalp, in the crown area, there is a zone of hair loss, with irregularly shaped foci. The skin in the balding area is pale pink, smooth, tender, and atrophic. On the periphery of the foci, the hair and skin are not changed. In the affected areas, hair is easily removed along the periphery of the foci.The balding areas resemble foci of flame and are located asymmetrically. There are no clinical signs of inflammationTrichoscopy of the pathological area shows the absence of follicular openings, smooth white zones, and branched vessels.The patient was prescribed a peripheral vasodilator and B vitamins. A corticosteroid lotion and shampoo were prescribed for a sensitive scalp.3 weeks after the start of treatment, hair loss stopped. The area of loss did not increase, and no new ones appeared. During the next 4 weeks, positive clinical dynamics were noted. Conclusions. It is important to diagnose pseudopelades of Brocq in the early stages in order to prescribe adequate treatment that prevents the development of atrophy, track the course of the process in dynamics and assess the effectiveness of the therapy.

Diagnosing a case of patchy alopecia in the setting of lupus erythematosus (LE) can be clinically challenging. Of the various causes of LE-specific alopecias, lupus panniculitis of the scalp is rarely reported. A 40-year-old woman presented with a nonscarring patch of alopecia over the scalp. Trichoscopy showed multiple follicular plugging, multiple thin and dystrophic hair shafts, empty follicles, and regularly distributed pinpoint white dots within the lesion. The clinical diagnoses of alopecia areata or early discoid LE were considered. However, the histopathological examination of the scalp biopsy showed typical hyaline-type fat necrosis of the subcutis along with moderate perivascular and perifollicular inflammatory infiltrate without any interface dermatitis. On direct immunofluorescence, staining for IgG, IgA, IgM, and C3 was negative. A diagnosis of lupus panniculitis of the scalp, presenting as patchy nonscarring alopecia, was rendered. Treatment with oral prednisolone and methotrexate led to complete recovery of alopecia. In conclusion, we report a rare case of lupus panniculitis of the scalp and discuss its differential diagnosis in the setting of LE.

Introduction. Diffuse alopecia accounts for up to 40 % of all alopecia cases, making it one of the most common reasons patients consult dermatologists and cosmetologists. The pathogenesis of chronic telogen hair loss (CTHL) remains incompletely understood, and the changes occurring in hair follicles are heterogeneous in both pathogenetic and histological terms, rendering the treatment of this condition a significant challenge for clinicians. This underscores the importance of further research in this fi eld and the search for effective therapies, one of which may involve osteopathic correction.The aim of the study: to evaluate the feasibility of incorporating osteopathic correction into the combined treatment of female patients with CTHL.Materials and methods. A prospective controlled randomized study was conducted at the «Vash Doctor» Clinic (Moscow region, Odintsovo) from January 2024 to September 2024. The study included 58 female patients diagnosed with telogen alopecia. Using randomization envelopes, participants were divided into two equal groups of 29 patients each: the main group and the control group. Patients in both groups received conventional combined conservative treatment as prescribed by a dermatologist. Patients in the main group additionally underwent osteopathic correction — 3 sessions at 14-day intervals.Results. In patients with CTHL, a reduction in hair density per cm2 and hair diameter was observed, accompanied by decreased mechanical strength. Subclinical levels of depression and anxiety were also recorded. Despite the diverse etiological factors of CTHL no predominant somatic dysfunctions were identified in the osteopathic status of the study group. Both treatment regimens demonstrated clinical efficacy, with statistically significant increases in hair diameter and mechanical strength (p<0,01). However, the inclusion of osteopathic correction resulted in a statistically significant increase in hair density per cm2 (p<0,01) and significantly higher mechanical strength values (p<0,05).Conclusion. Incorporating osteopathic correction into the combined treatment of female patients with CTHL yields statistically more significant improvements in hair density per cm², mechanical strength, and reductions in depression and anxiety levels compared to conventional therapy alone. Further research in this area appears promising.

5510 Background: Stage IVb, recurrent or persistent cervical cancer patients have limited treatment options and poor survival prognosis. Additionally, 70-90% of cervical cancers have overexpression of EGFR (epidermal growth factor receptor), a promising therapeutic target. Nimotuzumab (nimo), an EGFR antibody, 95% humanization degree, had applied in the treatment of various advanced solid tumors. So, we conducted the study to investigate its efficacy and safety. Methods: This trial is a prospective study with a total of 118 patients enrolled. There were 55 patients (pts) in the experimental group (nimo+chemotherapy) and 63 pts in the control group (chemotherapy alone). Primary efficacy endpoint is overall survival (OS). Secondary endpoints included progression-free survival (PFS), objective response rate (ORR), quality of life (QoL) and exploratory endpoints including the relationship between EGFR expression level and clinical efficacy and prognosis. The study of NCT approval number is 06781073. Results: The median age of the study population was 51.3 (range, 24.7-69.5) years. The average number of organs involved in the lesion was 2. The disease stage at initial diagnosis (2018 FIGO stage) was Ia-IVb. According to the disease status at the time of enrollment, IVB/recurrence/persistence accounted for 14.4%, 92.4%, and 9.3%, respectively. The results showed that the median OS was 15.7 (95% CI, 11.8-26.9) months in the nimo arm and 12.4 (95% CI, 7.9-21.0) months in the control arm. For recurrence pts, median OS was 21.7 (95% CI, 21.1-32.9) months vs. 12.4 (95% CI, 8.0-21.4) months for both groups. Median PFS was 7.4 (95% CI, 4.9-8.9) months in the nimo arm and 5.6 (95% CI, 4.1-6.1) months in the control arm. For recurrence pts, median PFS was 7.9 (95% CI, 5.6-12.0) months vs. 5.2 (95% CI, 3.7-8.0) months for both groups. In terms of safety, SAEs occur as follows. There were 8 pts (14.5%) in the nimo and 13 pts (23.6%) in the control group, respectively. For AEs above grade 3, there were 43 pts in the nimo and 45 pts in the control group. Adverse events related to the study drug, there were 6 cases in the nimo group with neutropenia. Among all AEs, the highest frequency was in the nimo group with 20 cases of leukopenia, 16 cases of nausea, 23 cases of anemia, and 11 cases of alopecia. In the control group, there were 17 cases of leukopenia, 21 cases of nausea, 23 cases of vomiting and 20 cases of alopecia. There was no significant difference between the two groups for adverse events. Conclusions: Adding nimotuzumab to chemotherapy in the first-line treatment for stage IVB, recurrent or persistent cervical squamous cell carcinoma could have an improvement trend on progression-free and overall survival with well tolerated toxicity, and should be considered as a new first-line therapy option.

Vitamin d-dependent rickets type 2a in a 1-year-old girl: a rare case of alopecia and hypocalcemic jerking episodes

Background:Non-scarring alopecia, including androgenetic alopecia (AGA), alopecia areata (AA), telogen effluvium (TE), and traction alopecia (TA), significantly impacts psychosocial well-being. Access to specialized dermatologic care for these conditions is often limited, particularly in underserved populations. Asynchronous teledermatology has emerged as a potential solution to extend care to these groups.Objective:To evaluate the diagnostic utility and treatment patterns of asynchronous teledermatology for non-scarring alopecia and examine its role in improving care access across diverse populations within the University of Pittsburgh Medical Center (UPMC) network.Methods:A retrospective study of 321 asynchronous teledermatology cases of non-scarring alopecia from 2022 to 2023 was conducted using the UPMC medical record system. Diagnosist, treatment type, and demographic data were analyzed. Longitudinal outcomes and adherence data were not consistently available.Results:AA was the most common diagnosis (59.5%), followed by AGA (26.5%), TE (7.5%), and TA (5.0%). A definitive diagnosis was made remotely in 91.3% of cases; only 8.7% required in-person follow-up. Treatment included over-the-counter therapies such as minoxidil and clobetasol, with prescription medications used for moderate to severe cases. Racial demographics reflected high engagement from Black (22.7%) and Asian (12.9%) patients, with 41.7% of patients residing outside Pittsburgh.Conclusion:Asynchronous teledermatology is an effective tool for diagnosing and managing non-scarring alopecia, facilitating timely intervention and improving access to dermatologic care. Future studies should access patient satisfaction, long-term outcomes, and implementation strategies to further expand equitable teledermatology access.

Scarred alopecia of the scalp is an urgent problem for both dermatologists and trichologists and accounts for approximately 5% of all cases of alopecia. A clinical case of a 47-year-old patient manifesting as foci of scar alopecia on the scalp is presented. According to the results of clinical, histological and dermatoscopic studies, the diagnosis of discoid lupus erythematosus was established. The patient was also examined by a rheumatologist (systemic lupus erythematosus was excluded, dynamic observation was shown). He received treatment with hydroxychloroquine, aevit and venarus; externally — Lorinden A ointment, bepanten plus cream, shampoos containing zinc, ultraphonophoresis with hydrocortisone ointment course. Because of the treatment, there is a clinical improvement. Observation by a dermatovenerologist and repeated examination by a rheumatologist after 6 months are indicated. Due to the complex diagnosis and the similarity of the clinical picture, timely and complete examination and treatment is important in order to prevent or stop the formation of foci of alopecia. In turn, they also affect the psychoemotional background of a person and the formation of psychosocial maladaptation.

Hair has long held cultural and psychosocial significance, symbolizing health, status, and identity. Hair loss impacts quality of life, self-esteem, and psychological well-being. While treatments like minoxidil and finasteride exist, they often yield limited results. Hair transplantation (HT), first demonstrated by Johann Friedrich Dieffenbach in 1822, has evolved into the most effective hair restoration method. Since its inception in 1975, Dermatologic Surgery has been a main source for groundbreaking publications from major players in the field, while also playing a pivotal role in documenting the history of HT. This mini review examines the historical evolution of HT techniques over the past 200 years, highlighting their advantages and limitations. A literature search was conducted using PubMed and Google Scholar with the term "hair transplantation techniques." Relevant sources were reviewed to extract information on technique development and historical origins. Key pioneers such as Dieffenbach, Menahem Hodara, and Shoji Okuda laid the groundwork for modern HT. Milestones include punch grafting, follicular unit transplantation (FUT), and follicular unit extraction (FUE). FUT emphasized natural follicular grouping, while FUE introduced minimally invasive methods with faster recovery and better aesthetics. Recent advancements include robotic-assisted procedures and bioengineered follicles, reflecting a shift toward precision and patient-centered care. The continuous evolution of HT techniques underscores its position as the most effective method for hair restoration, particularly in androgenetic alopecia cases.

Alopecia X is a dermatological disorder that mainly affects Nordic breed dogs. Its cause is not completely clear. Alopecia X is characterized by its non-inflammatory aspect, being similar to endocrine-based dermatopathies. The main lesions are progressive hair loss in the affected areas, being less pronounced on the head and distal extremities of the limbs in more advanced cases. This study aims to report a case of alopecia X in a male, uncastrated German Spitz dog. At the first visit, an initial case of bilateral symmetrical alopecia was observed on the caudal side of the thighs and perineum, without pruritus, macroscopic signs of inflammation and clinical signs of systemic diseases. The patient underwent additional tests (including trichogram, skin scraping, direct ectoparasite screening and blood profile) in which parasitic and systemic diseases were ruled out. Based on clinical aspects, racial predisposition and exclusion of systemic causes, the diagnosis of alopecia X was considered. The treatment of choice was orchiectomy associated with the use of Melatonin, initially for 3 months. After 90 days of treatment, partial regrowth of the alopecic areas was observed, as well as a reduction in the area without hair, with return of primary and secondary hairs in the affected region. It is concluded in this case that the choice of orchiectomy associated with the use of melatonin was effective in improving the dermatological condition, and can be used as an ally in the

Alopecia X is a dermatological disorder that mainly affects Nordic breed dogs. Its cause is not completely clear. Alopecia X is characterized by its non-inflammatory aspect, being similar to endocrine-based dermatopathies. The main lesions are progressive hair loss in the affected areas, being less pronounced on the head and distal extremities of the limbs in more advanced cases. This study aims to report a case of alopecia X in a male, uncastrated German Spitz dog. At the first visit, an initial case of bilateral symmetrical alopecia was observed on the caudal side of the thighs and perineum, without pruritus, macroscopic signs of inflammation and clinical signs of systemic diseases. The patient underwent additional tests (including trichogram, skin scraping, direct ectoparasite screening and blood profile) in which parasitic and systemic diseases were ruled out. Based on clinical aspects, racial predisposition and exclusion of systemic causes, the diagnosis of alopecia X was considered. The treatment of choice was orchiectomy associated with the use of Melatonin, initially for 3 months. After 90 days of treatment, partial regrowth of the alopecic areas was observed, as well as a reduction in the area without hair, with return of primary and secondary hairs in the affected region. It is concluded in this case that the choice of orchiectomy associated with the use of melatonin was effective in improving the dermatological condition, and can be used as an ally in the

A 15-year-old boy presented with a 2-year history of patches of hair loss on his body and skin changes. Initial examination revealed scattered erythematous patches with associated follicular accentuation and concurrent nonscarring alopecia, predominantly affecting his limbs. Histopathology revealed spongiosis in the superficial to mid part of the hair follicle. Additionally noted was exocytosis of lymphocytes, which displayed subtle cytological atypia marked by nuclear irregularity and slight enlargement. Immunohistochemistry indicated a predominance of CD4+ T cells, raising the possibility of mycosis fungoides. An external expert histopathological opinion was sought and the diagnosis of folliculotropic mycosis fungoides was confirmed.

ABSTRACT Background: Patchy/focal alopecia can be noncicatricial or cicatricial. Trichopathology may play an important role in confirming and/or establishing the diagnosis of cicatricial alopecia. Aims: The aim of this study was to study the trichopathologic features of common cicatricial conditions presenting with patchy scalp alopecia. Materials and Methods: This cross-sectional study was conducted over a period of 1 year in the department of dermatology and pathology in a tertiary care hospital in North India. Adult patients (age >18 years) presenting with patchy cicatricial alopecia as well as clinically doubtful noncicatricial conditions over the scalp were included in this study. In doubtful cases of noncicatricial alopecia, a single 4-mm punch biopsy was performed for transverse sectioning with hematoxylin and eosin stain. In all cases of cicatricial alopecia, two 4-mm punch biopsies were performed, one for transverse sectioning and the second for vertical sectioning and direct immunofluorescence (DIF). The final diagnosis was made on the basis of the trichopathologic findings. Results: A total of 23 cases were included in our study with the majority (52.2%) being in the age group of 20–30 years. The mean age at diagnosis was 30.5 ± 11.38 years. On the basis of trichopathologic findings, a final diagnosis was made in 18 (78.3%) cases. However, 5 (21.7%) cases remained undiagnosed and were labeled as nonspecific. According to the final diagnosis based on the trichopathologic findings, maximum cases were of discoid lupus erythematosus (DLE) (26.1%), followed by lichen planopilaris (21.7%), pseudopelade of Brocq (13%), alopecia areata (8.7%), folliculitis decalvans (4.3%), and traction alopecia (4.3%). Trichopathologic examination revealed hyperkeratosis (60%), basal cell vacuolization (55%), epidermal atrophy (55%,) perifollicular lymphocytic infiltrate (30%), pigment incontinence (30%), perifollicular fibrosis (25%), and thickened basement membrane (25%). Only four cases showed deposits of immunoreactants in DIF and all four were finally diagnosed as DLE. Conclusions: Trichopathology along with special stain is a useful tool in the diagnosis of patchy alopecia and must be carried out in cases where diagnosis is in doubt clinically, particularly in cases of cicatricial alopecia. DIF may have a supportive role in histopathologically inconclusive cases and should be carried out, particularly when DLE is suspected. Trichopathology in combination with DIF is an important tool in the diagnosis of the majority of cases of cicatricial as well as clinically doubtful cases of noncicatricial alopecia.

筆者らは頭頂部打撲によって外傷性脱毛症を発症した19歳の男性患者において柴胡清肝湯（一貫堂）が奏効した一症例を経験したので報告する。この患者は頭頂部の打撲後に職場近くの脳神経外科を受診したが，数日後から頭頂部の皮下血腫と脱毛症が発症したために，星総合病院漢方外来に紹介された。身体所見で右胸脇苦満と，咽頭の慢性炎症が認められたこと，ならびにこの脱毛症が毛根部の炎症（毛包炎）によるものと考え，一貫堂の柴胡清肝湯を採用した。その結果は劇的で，約三か月間で脱毛症，咽頭の炎症が改善した。そして精神的な抑うつと易怒性も著明に改善した。本方剤の持つ心身両面への作用を再認識した。

Hair loss is a reality that plagues many people. One of the most common causes of hair loss today is androgenic alopecia, which is a progressive miniaturization of the follicle. After the COVID-19 pandemic, cases of alopecia had a sharp increase in the number of registered cases, indicating that an infection caused by the SARS-CoV-2 virus possibly stimulated a hair loss due to the stress caused by the infection, modified in the immune system and there were micro thrombi in the region of the hair follicle. There are some medicines in the markets that are well protected with drugs of international knowledge, such as minoxidil, finasteride and spirinolactone, which are already used for the treatment of alopecia. However, these drugs have difficulties in reaching the hair follicles, therefore, the delivery of drugs in polymeric nanoparticles demonstrated a promising strategy, with greater efficiency in the vectorization of these assets into the interior of the hair follicles, thus promoting greater efficiency. in the treatment of the pathology in question.

Dermal filler-induced alopecia is a rare yet significant complication of aesthetic procedures primarily associated with vascular occlusion and subsequent tissue ischemia. Hyaluronic acid (HA) fillers, though widely used for facial rejuvenation, can lead to adverse outcomes such as skin necrosis and hair loss, particularly in high-risk areas like the temples and glabella. This case report aims to highlight the clinical presentation, diagnostic approach, and multidisciplinary management of filler-induced alopecia, contributing to the existing literature with a comprehensive review of previously reported cases. A 21-year-old female presented with localized skin necrosis and alopecia four days after receiving 7 mL of HA filler injections in the temples, tear trough, and eyebrow glabella regions. Trichoscopy revealed follicular dropout and white dots, consistent with ischemic hair loss. Treatment included hyaluronidase injections (1500 units), intralesional corticosteroids, topical minoxidil, and CO2 laser therapy. Over 1 year of follow-up, the patient achieved complete hair regrowth and resolution of facial scarring. Only 16 cases of filler-induced alopecia have been documented, predominantly involving HA fillers. This case underscores the importance of early recognition and intervention with hyaluronidase to mitigate ischemic damage. The multidisciplinary management approach employed here demonstrates the potential for full cosmetic recovery. Filler-induced alopecia, though rare, necessitates heightened awareness among dermatologists and aesthetic practitioners. Adhering to recommended injection techniques and dosages, alongside the judicious use of ultrasound guidance, can minimize risks and improve patient safety.

Alopecia, or hair loss, is an emerging global disease. Its etiopathogenesis includes nutritional deficiencies, oxidative stress, and deficiency of physiological factors. Around 2% of the general population has the probability of developing alopecia at any one period. Vitamin D and interleukin-6 (IL-6) have a major role in alopecia. The present goal of research is to investigate the role of vitamin D and IL-6 in the saliva of patients with non-scarring alopecia. The study involved 51 cases of non-scarring alopecia and 50 healthy controls with an age range between 18 and 40 years. A detailed history and clinical examination were done. Salivary vitamin D and IL-6 were determined to compare within the groups. The average vitamin D level in cases (104.64 ± 46.95 pmol/L) was significantly lower as compared to controls (223 ± 12.03 pmol/L) (p < 0.001). Whereas the average amount of IL-6 was significantly higher (170.54 ± 63.68 ng/L) than the control group (56.38 ± 46.52 ng/L) (p < 0.001). No correlation of vitamin D level with IL-6 was detected in study subjects. Vitamin D significantly influences the development of non-scarring alopecia. Patients with non-scarring alopecia had low amount of vitamin D indicate its role in etiology of hair loss. IL-6 may cause a collapse of the hair bulb, having a significant part in the pathogenesis of alopecia indicating chronic inflammatory or autoimmune condition. This research will aid in diagnosing scalp disease using salivary biomarkers and improve the treatment of alopecia.

274 Background: Single-dose administration of intravesical gemcitabine is a common part of clinical practice following transurethral resection (TURBT) of non-muscle invasive bladder cancer (NMIBC). Although the side effect profile for gemcitabine is well characterized in systemic and local therapy, rare side effects continue to be identified with ongoing use. Here we identify several cases of treatment-related alopecia with adjuvant single dose intravesical administration for NMIBC after TURBT. Methods: Using our single-institutional IRB-approved Cysview registry database, we identified patients who underwent TURBT for NMIBC and received a single dose of intravesical gemcitabine post-TURBT between January 2020 and June 2023 at Keck Hospital of USC. Patients with a history of low grade NMIBC or those undergoing their first TURBT received 2g of gemcitabine dissolved in 100 cc of saline 1h after tumor resection. We reviewed patient-reported adverse events and included patients who reported alopecia following gemcitabine instillation. Patients were questioned on the degree and length of hair loss and information was collected from patient charts. Results: Overall, 9 patients (2 male, 7 female) reported hair loss following single dose intravesical gemcitabine after the TURBT. One patient had an autoimmune disease. The hair loss started within a few days of gemcitabine instillation and resolved spontaneously. The table shows the clinicopathologic characteristics of this cohort in detail. Three patients experienced severe hair loss. The resection extent during TURBT was classified as small (&lt;2 cm), medium (2-5 cm), or large (&gt;5 cm). Three patients had a large resection, 2 patients a medium one and 3 patients a small resection. None of the patients had previous intravesical gemcitabine; however, 2 patients had a history of intravesical BCG and 1 had intravesical mitomycin before. Conclusions: This study demonstrates that hair loss is a rare but possible adverse effect of intravesical gemcitabine after TURBT. Prior to surgery, patients should be counseled regarding this potential side-effect. Additional research and multicenter studies are required to describe the occurrence and cause of this adverse event. Demographic, clinical, and pathologic characteristics of patients. Patient ID Age Sex History of other IVT Pathology of TURBT Number of prior TURBT Resection extent Severity of hair loss Prior UBC 1 73 M None LGTa 1 large moderate LGTa 2 88 M MMC LGTa multiple large severe LGTa 3 76 F BCG CIS multiple small moderate HGT1 in upper tract,HGTa &amp; LGTa in bladder 4 56 F BCG HGTa multiple large severe LG+HGTa 5 66 F None HGTa none small moderate None 6 84 F None LGTa none small severe None 7 62 F None LGTa 1 medium moderate LGTa 8 68 F None HGTa multiple medium mild LGTa 9 64 F None LGTa none medium severe None LG= Low Grade, HG = High Grade.