Postfebrile telogen effluvium: hair fall after Rickettsia conorii infection

Rebora, Alfredo; Ciccarese, Giulia; Drago, Francesco

doi:10.23736/s0392-0488.17.05643-7

Cited by 7 publications

(5 citation statements)

References 4 publications

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“…We also found increase of exogen in both ATE and DAA. We speculate in both conditions, rather than shedding after telogen, as in the normal physiological condition termed teloptosis, [8,32] exogen may occur during immature telogen, released earlier than it should be; an illustration of the shortened telogen phase.…”

Section: Discussionmentioning

confidence: 84%

“…Immediate anagen release, delayed anagen release, immediate telogen release, short anagen syndrome and delayed telogen release have been proposed to be the mechanisms of TE by Headington, [31] and premature teloptosis, collective teloptosis and premature entry into telogen as described by Rebora. [8] The pathogenic mechanism of ATE in this study is considered to be immediate anagen release or premature entry into telogen. We also found increase of exogen in both ATE and DAA.…”

Section: Discussionmentioning

confidence: 99%

“…individuals. [8,9] In contrast, both anagen and telogen hairs have been found in patients with DAA, [10,11] although there has been confusion about the timing of hair root types and the exact percentage of anagen and telogen hairs. [12,13] In comparison, Rebora and colleagues suggest AA incognita presents almost exclusively with telogen hairs.…”

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confidence: 99%

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Sequential cyclic changes of hair roots revealed by dermoscopy demonstrate a progressive mechanism of diffuse alopecia areata over time

Zhang

Zhu

et al. 2018

Experimental Dermatology

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Background Diffuse alopecia areata (DAA) often leads to a complete hair shedding within a few months. Objective To explore features and mechanisms underlying DAA. Materials and Methods Scalp and hair root dermoscopy were conducted on 23 DAA patients throughout the disease process, 20 patchy Alopecia areata patients, 23 acute telogen effluvium (ATE) patients and 10 normal controls. Histopathology was also evaluated. Results We found almost all hair roots were anagen in early stage DAA in 18 patients (18/23, 78.3%) within the first 4‐8 weeks after hair loss onset. Anagen effluvium (~4 weeks) was followed by catagen (~4 weeks) and then telogen/exogen (~8 weeks) effluvium with overlap. Hair root and proximal hair shaft depigmentation was more prominent in later DAA disease stages. Black dots, exclamation mark hairs and inconsistent thickness of hair shafts were found more often in early than later DAA (Ps < 0.01). Early DAA histopathology revealed more prominent inflammation and hair follicle regression than that observed in the later stages. Patchy alopecia areata patients showed mixed anagen, catagen and telogen hair roots while ATE patients showed increased exogen and mildly decreased hair root pigmentation. Conclusion Sequential cyclic staging of shed hairs in DAA indicates the insult may be hair‐cycle specific. We suggest that DAA is initially an anagen effluvium disease involving an intense inflammatory insult, later progressing to a brief catagen effluvium, and then to telogen effluvium with premature exogen, in later stages of DAA.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

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Sequential cyclic changes of hair roots revealed by dermoscopy demonstrate a progressive mechanism of diffuse alopecia areata over time

Zhang

Zhu

et al. 2018

Experimental Dermatology

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“…Almost all the cases came from the major islands. 68.9% of the cases were reported in Sicily (1953 cases) [5][6][7][8][9][10][11][12][13][14][15]20,25,26,31,33,34,36,42], 29.60% in Sardinia (838 cases) [18,19,29,32,35], the remaining 1.4% were reported from the other Italian regions [16,17,[21][22][23][24]28,30,[38][39][40][41]43,44,46,47,[49][50][51]. 18 imported cases were reported [43,44,48,50,51], 12 were African tick bite fevers (ATBF) [43,44,…”

Section: Infections In Italymentioning

confidence: 99%

Rickettsiosis with Pleural Effusion: A Systematic Review with a Focus on Rickettsiosis in Italy

et al. 2022

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Background: Motivated by a case finding of Mediterranean spotted fever (MSF) associated with atypical pneumonia and pleural effusion in which Rickettsia conorii subsp. israelensis was identified by molecular methods in the pleural fluid, we wanted to summarize the clinical presentations of rickettsiosis in Italy by systematic research and to make a systematic review of all the global cases of rickettsiosis associated with pleural effusion. Methods: For the literature search, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was followed. We chose to select only the studies published in last 25 years and confirmed both with serological and molecular assays. Results: Human cases of rickettsiosis in Italy were reported in 48 papers describing 2831 patients with very different clinical presentations; the majority was MSF accounted to R. conorii and was reported in Sicily. Pleural effusion associated with infection with microorganisms belonging to Rickettsiales was described in 487 patients. It was rarely associated with microorganisms different from O. tsutsugamushi; also rarely, cases of scrub typhus were reported outside Southeast Asia and in the largest majority, the diagnosis was achieved with serology. Conclusions: MSF, especially when caused by R. conorii subsp. israelensis, may be a severe disease. A high index of suspicion is required to promptly start life-saving therapy. Pleural effusion and interstitial pneumonia may be part of the clinical picture of severe rickettsial disease and should not lead the physician away from this diagnosis

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“…The examiner counts the number of all collected hairs and the percentage of the vellus hairs. Studying the hair roots under a microscope may provide additional information, namely, the presence and the prevalence of exogen and/or dystrophic roots (Rebora et al 2014;Quercetani et al 2011). The latter, associated with a global number exceeding 350, is diagnostic of AAI.…”

mentioning

confidence: 99%