Hair pull test: Evidence-based update and revision of guidelines

McDonald, Katherine; Shelley, Amanda J.; Colantonio, Sophia; Beecker, Jennifer

doi:10.1016/j.jaad.2016.10.002

Cited by 61 publications

(58 citation statements)

References 10 publications

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“…Indeed, there are no clear criteria that can clearly determine the disease activity as high or low. However, there is a recent guideline that hair pull tests should be considered positive if more than three hair losses occur . In trichoscopy, a black‐dot pattern and the presence of tapered or broken hairs suggest higher disease activity, whereas short vellus hairs imply lower activity …”

Section: Algorithmic Approach To the Management Of Aamentioning

confidence: 99%

“…However, there is a recent guideline that hair pull tests should be considered positive if more than three hair losses occur. 133 In trichoscopy, a black-dot pattern and the presence of tapered or broken hairs suggest higher disease activity, whereas short vellus hairs imply lower activity. 134 In accordance with these factors, we propose an algorithmic approach to AA management (Fig.…”

Section: No Treatment or Using Camouflagesmentioning

confidence: 99%

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Management of alopecia areata: Updates and algorithmic approach

Lee

2017

The Journal of Dermatology

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Alopecia areata is a chronic, recurrent and non-scarring alopecia. The prognoses of patients are very diverse. The larger the area of hair loss, the poorer the treatment response and greater the probability of chronic disease progression. Numerous treatments have been introduced, but curative treatments have yet to be established. The long-term efficacy of the current treatments is minimal, and the therapeutic response varies widely. Recent clinical trials have attempted to apply therapeutic metrics, such as the Severity of Alopecia Tool, and many have been designed as randomized controlled studies, enabling a more precise evaluation of existing treatments. There have been updates in practice, efficacy or indications of therapeutics that have been previously used. Moreover, the use of novel treatments such as biologics has recently been introduced. Commonly, the most important factor in determining the treatment modality for alopecia areata has been the extent of hair loss. However, if the disease activity is high and likely to progress, combination therapy with adjuvant modalities will be more desirable. This review will discuss the therapeutic effects of existing and newly-introduced treatments based on their quantity, quality of evidence and expected complications. In addition, an algorithmic approach to management of alopecia areata is proposed according to clinical subtype, severity, onset and activity of the disease.

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Section: Algorithmic Approach To the Management Of Aamentioning

confidence: 99%

Section: No Treatment or Using Camouflagesmentioning

confidence: 99%

Management of alopecia areata: Updates and algorithmic approach

Lee

2017

The Journal of Dermatology

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“…Five consecutive patients receiving treatment for chronic coccidioidomycosis with fluconazole and receiving no other medications were enrolled following their initial clinical complaint of alopecia (Table 1). Patients underwent visual inspection of the scalp and microscopic examination of at least ten hair samples after the hair pull test (8), and all hairs were found to be in the telogen state, confirming telogen effluvium consistent with the animal model. Human patients enrolled in this study had fluconazole serum levels determined by liquid chromatography-tandem mass spectrometry (ARUP Laboratories, Salt Lake City, UT).…”

mentioning

confidence: 70%

Examination of Fluconazole-Induced Alopecia in an Animal Model and Human Cohort

Thompson

Krois

Affolter

et al. 2019

Antimicrob Agents Chemother

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Fluconazole-induced alopecia is a significant problem for patients receiving long-term therapy. We evaluated the hair cycle changes of fluconazole in a rat model and investigated potential molecular mechanisms. Plasma and tissue levels of retinoic acid were not found to be causal. Human patients with alopecia attributed to fluconazole also underwent detailed assessment and in both our murine model and human cohort fluconazole induced telogen effluvium. Future work further examining the mechanism of fluconazole-induced alopecia should be undertaken.

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“…The test is positive when more than three hairs can be pulled away. 12 Non-classic symptoms and signs that suggest other types of alopecia are outlined in Tables 1 and 2.…”

Section: Examinationmentioning

confidence: 99%