Drug-induced hair colour changes

Ricci, Francesco; Simone, Clara De; Regno, Laura Del; Peris, Ketty

doi:10.1684/ejd.2016.2844

Cited by 41 publications

(38 citation statements)

References 82 publications

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“…Nevertheless, all our patients were on hydroxychloroquine of which reports on hair hypopigmentation are rare. 1,33 Of note, all these changes were not uniform and were detected on random location on one trichoscopic field, or even showing different sizes and colours in the same hair strand. We agree with previous speculation that damage to hair matrices and dermal papilla in SLE may be selective.…”

Section: Discussionmentioning

confidence: 99%

Trichoscopic signs in systemic lupus erythematosus: a comparative study with 109 patients and 305 healthy controls

Suchonwanit

Udompanich

Thadanipon

et al. 2019

Acad Dermatol Venereol

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Background Hair and scalp involvement in systemic lupus erythematosus (SLE) can manifest as scarring alopecia, non-scarring alopecia or scalp/hair shaft changes without apparent hair loss. While trichoscopic signs in chronic cutaneous lupus are well established, data on SLE patients with normal-looking or non-scarring scalp are limited.Objectives To investigate trichoscopic features of SLE patients without chronic cutaneous scalp lesions and compare the findings with normal controls, as well as determine which feature associates with systemic disease. Furthermore, we aim to explore different clinical presentations of the scalp in SLE patients and their association with disease activity.Methods Trichoscopic photographs were taken from patients and healthy controls and evaluated by one blinded hair specialist. For SLE patients, their clinical presentations and evaluations for cutaneous, extracutaneous involvement; SLE Activity Index 2000 (SLEDAI-2K) score were documented. ResultsOf 109 SLE patients and 305 healthy controls were included. Hair shaft changes were significantly more common in SLE and associated with higher SLEDAI-2K (P < 0.05). The most common feature was prominent arborizing blood vessels (60.6% vs. 18.4%, P < 0.001), followed by thick arborizing blood vessels (57.8% vs. 10.2%, P < 0.001), black dots (47.7% vs. 2%, P < 0.001), brown scattered pigmentation (5.5% vs. 0.7%, P = 0.005) and blue-grey speckled pigmentation (44% vs.0.3%, P < 0.001). When hair loss is diffuse and severe, there were associations with haematologic (P = 0.002) and renal involvement (P = 0.027 for proteinuria > 500 mg/day, P = 0.004 for proteinuria > 1 g/day).Conclusions Trichoscopic examination is a valuable tool for SLE diagnosis and monitoring. Severe diffuse non-scarring alopecia most likely indicates active disease.

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Section: Discussionmentioning

confidence: 99%

Trichoscopic signs in systemic lupus erythematosus: a comparative study with 109 patients and 305 healthy controls

Suchonwanit

Udompanich

Thadanipon

et al. 2019

Acad Dermatol Venereol

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“…This is an infrequent adverse effect and, although not serious, negatively impacts the quality of life and may influence treatment adherence. 72 We found no case of nail hyperpigmentation, but a large number of drugs of different classes may be responsible for changes in the nails, including, in addition to hyperpigmentation, reductions in the speed of growth, fragility, discoloration, transverse depressions, onycholysis, paronychia, and pyogenic granulomas of the periungual folds. Generally, these abnormalities are transient and disappear when treatment is withdrawn.…”

Section: Discussionmentioning

confidence: 64%

Drug-Induced Hyperpigmentation: Review and Case Series

García

Carrasco-Molina

2019

J Am Board Fam Med

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Background: Hyperpigmentation is a common dermatologic problem that may have substantial impact on the patient, since it affects the appearance and quality of life, and may influence treatment adherence. There are few studies of drug-induced hyperpigmentation. Methods: We studied drug-induced hyperpigmentation in patients attending an outpatient dermatology clinic in the Western Area of Valladolid (Spain) from August 1, 2017 to April 20, 2018. Results: The incidence of drug-induced hyperpigmentation was 1.31% in patients attending a first dermatology consultation in the study period. Of the 16 patients, 8 were taking more than 1 drug. The most frequent drugs identified were nonsteroidal anti-inflammatory agents (25%), antihypertensive agents (18.75%), antimalarials (12.5%), antibiotics, antineoplastic agents, psychoactive agents, simvastatin, allopurinol, amiodarone and mucolytic (6.25% each). Hyperpigmentation was found in the mucosa in 25% of patients and in photograph-exposed areas in 37.5%. Discussion: Diagnosing drug-induced hyperpigmentation is a dermatologic challenge. A differential diagnosis with hyperpigmentation caused by endocrine and metabolic disorders, the most closely-related disorders to drug-induced hyperpigmentation, and with hyperpigmentation of idiopathic origin, should be conducted. Drug-induced hyperpigmentation is a relatively frequent reason for consultation, especially in polypharmacy patients. The sample may have been biased as many patients receiving treatments frequently associated with drug-induced hyperpigmentation, such as antineoplastic drugs, are diagnosed and treated by other specialties, such as oncologists. Conclusion: Family physicians and specialists should consider drugs as a cause of hyperpigmentation to facilitate the correct diagnosis and treatment.

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“…To establish the relationship between drug intake and color modification, it is important to review the patient's complete medical history and consider all drugs taken by the patient up to 1 year before the onset of the color change . The increasingly long‐term administration of certain new drugs, such as kinase inhibitors, will make the observation of these side effects more likely in clinical practice …”

Section: Discussionmentioning

confidence: 99%