Normal anagen effluvium: a sign of pemphigus vulgaris

Delmonte, Sergio; Semino, M.T.; Parodi, Aurora; Rebora, Alfredo

doi:10.1046/j.1365-2133.2000.03563.x

Cited by 32 publications

(44 citation statements)

References 4 publications

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“…Different patterns of hair loss have been reported in PV, including anagen shedding,[5] as observed in our patient, scarring alopecia,[6] and tufted folliculitis. [7] Some authors suggest that the scarring would result from the combination of acantholysis and secondary bacterial infection.…”

Section: Discussionsupporting

confidence: 53%

Acantholytic hair casts: A dermoscopic sign of pemphigus vulgaris of the scalp

Pirmez

2012

Int J Trichol

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We report the dermoscopic features of pemphigus vulgaris (PV) involving the scalp of a 57-year-old African-American female. Among our findings, there were hair casts – movable tubular structures that envelop the hair shafts. We suggest that the development of those casts occurs through acantholysis within the outer root sheath, a mechanism not yet considered in the literature. This report also highlights how dermoscopy may contribute to the evaluation of disease activity, especially in those cases of PV in which scalp involvement is recalcitrant to treatment. Finally, we recommend that the presence of hair casts should herald the need of therapy adjustment for better disease control.

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Section: Discussionsupporting

confidence: 53%

Acantholytic hair casts: A dermoscopic sign of pemphigus vulgaris of the scalp

Pirmez

2012

Int J Trichol

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“…It may even herald pemphigus. [9] CHEMOTHERAPY INDUCED ANAGEN EFFLUVIUM CHEMOTHERAPY INDUCED ANAGEN EFFLUVIUM Although many drugs have been occasionally described to produce hair loss, the relationship between drug intake and hair loss has only been proven for a few agents. The type of hair loss (i.e.…”

Section: Etiopathogenesis Etiopathogenesismentioning

confidence: 98%

“…Similar may be the case in pemphigus. [9] The hair follicle is a preferential target for pemphigus autoantibodies because the desmosomal proteins are overexpressed in the follicular epithelium. The hairs may come out from the lesional and perilesional areas with their outer root sheath and showing a normal anagen pattern.…”

Section: Etiopathogenesis Etiopathogenesismentioning

confidence: 99%

“…Although anagen effluvium is commonly associated with chemotherapy and radiation to the head and neck [5][6][7][8] other causes of anagen effluvium are: severe protein energy malnutrition, pemphigus vulgaris, [9] alopecia areata (AA), [10] and exposure to toxic agents like mercury, [11] boron, [12] thallium, [13] etc. Other medications that can rarely cause anagen effluvium include bismuth, levodopa, colchicine, and cyclosporine.…”

Section: Etiopathogenesis Etiopathogenesismentioning

confidence: 99%

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Anagen effluvium

Kanwar¹,

Narang²

2013

Indian J Dermatol Venereol Leprol

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Disturbances of hair follicle cycling lie at the heart of most hair growth disorders, and have dramatic effects on visible hair growth and shedding. The two common disorders due to aberration in hair follicle cycling are telogen and anagen effluvium. Though a lot of literature addresses the problem of telogen effluvium, there are not many reviews on anagen effluvium or anagen hair loss. Anagen effluvium is considered synonymous with chemotherapy-induced alopecia and other causes are rarely considered. In this review, we try to discuss the etiopathogenesis, clinical presentation, differentials, and management issues in anagen effluvium. Anagen effluvium is the abrupt loss of hairs that are in their growing phase (anagen) due to an event that impairs the mitotic or metabolic activity of hair follicle. Chemotherapy, radiation and toxic chemicals, and sometimes inflammatory diseases like alopecia areata and pemphigus are also capable of diminishing the metabolic activity of hair follicles resulting in anagen hair loss. Although it is reversible, and hair regrowth occurs after a delay of 1-3 months; sometimes it can lead to permanent alopecia and can be psychologically devastating with negative impact on individual perceptions of appearance, body image, sexuality, and self-esteem. For some patients, the emotional trauma may be so severe that it may lead to discontinuing or refusing therapy that might otherwise be beneficial. In such cases, a psychosomatic approach as well as empathic consideration of the patients concerns and fears as well as the provision of practical medical-aesthetic and styling tips are equally important and can be integrated in management.

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“…[1] Although the scalp is frequently involved in pemphigus vulgaris,[2] associated hair loss has only rarely been described. [3456] We report a rare case of pemphigus vulgaris involving the scalp that leads to hair loss.…”

Section: Introductionmentioning

confidence: 99%

Pemphigus vulgaris with loss of hair on the scalp

et al. 2013

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Pemphigus vulgaris is an autoimmune disease, which leads to flaccid bullae and erosions. Although the scalp is commonly involved, hair loss is rarely seen. We herein report a case of 32-year-old female patient with a 2-year history of pemphigus vulgaris, involving the skin and mucosa. Although clinical improvement was achieved with oral corticosteroids and mycophenolate mofetil, the patient developed tender plaques on her scalp, accompanied by hair loss. Histopathology and direct immunofluorescence were consistent with pemphigus vulgaris. Skin swab cultured Staphylococcus aureus. Treatment with oral and topical corticosteroids combined with mycophenolate mofetil resulted in clinical remission, with regrowth of scalp hair. Alopecia is an unusual clinical manifestation of pemphigus vulgaris. Our case supports the hypothesis that hair loss is induced by antibody-mediated outer root sheath keratinocyte acantholysis, in combination with skin infection, that together lead to the observed hair loss.

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Normal anagen effluvium: a sign of pemphigus vulgaris

Cited by 32 publications

References 4 publications

Acantholytic hair casts: A dermoscopic sign of pemphigus vulgaris of the scalp

Acantholytic hair casts: A dermoscopic sign of pemphigus vulgaris of the scalp

Anagen effluvium

Pemphigus vulgaris with loss of hair on the scalp

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