Distinguishing Androgenetic Alopecia From Chronic Telogen Effluvium When Associated in the Same Patient

Rebora, Alfredo; Guarrera, Marcella; Baldari, Manuela; Vecchio, Federica

doi:10.1001/archderm.141.10.1243

Cited by 71 publications

(65 citation statements)

References 3 publications

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“…They were studied and diagnosed by means of clinical observation and trichoscopy. To confirm the diagnosis, they were submitted to the Modified Wash Test, whose details have been published elsewhere [5]. In brief, after 5 days of refraining from shampooing, the subjects were invited to wash their hair in a basin, to collect all shed hairs with the aid of a pad or gauze, and to count them.…”

Section: Methodsmentioning

confidence: 99%

Exogen Hairs in Women with and without Hair Loss

Guarrera

Rebora

2017

Skin Appendage Disord

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Contrary to the classical view of the hair cycle, in which telogen is the resting phase that precedes the release of the hair shaft, another phase has been introduced, exogen. Exogen is the phase wherein the processes for the release of the hair shaft are initiated and successfully executed. Exogen ends when the shaft is liberated. Accordingly, human hairs would be preferably released not with telogen but with exogen roots. To better understand this somehow revolutionary point and what occurs in telogen effluvium (TE) and in androgenetic alopecia (AGA), we undertook a morphological study. We examined 25 women of comparable age by collecting shedding hairs by the Modified Wash Test under stringent diagnostic criteria. Eight patients were “normal”, 5 had AGA, 9 TE, and 3 had a TE+AGA overlap. Hair roots were divided into early telogen, full telogen, and exogen. Exogens accounted, in normal women, for 2.6% of all hairs, for 5.2% in AGA, for 6.6% in TE, and for 2.3% in TE+AGA, without any significant difference. Our exogen prevalence (2.6%) did not vary in patients with AGA and TE. Therefore, the pathogenetic role of exogen in AGA and TE seems negligible.

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Section: Methodsmentioning

confidence: 99%

Exogen Hairs in Women with and without Hair Loss

Guarrera

Rebora

2017

Skin Appendage Disord

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“…The patient admitted to being apprehensive, but denied any specific cause of such an anxiety. As it is common practice in TE cases, I prescribed a modified wash test (MWT) [4]. …”

Section: Case Reportmentioning

confidence: 99%

Intermittent Chronic Telogen Effluvium

Rebora

2017

Skin Appendage Disord

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Chronic telogen effluvium is most often intermittent, alternating periods of spontaneous remissions with episodes of unexplained relapses. This article reports the case of a male who was able to graphically depict the sequence of emotional events and the corresponding severity of his telogen effluvium during 31 months. The case is interesting as it documents for the first time the intermittency of chronic telogen effluvium and the pathogenetic role of emotional strains, and it stresses the importance of the modified wash test in evaluating the severity of hair shedding.

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“…I guess that they have a telogen effluvium-androgenetic alopecia (TE-AGA) overlap. I agree with Prof. Trüeb that the latter is a challenging diagnosis, but I am relying on MWT [11], which confirms such diagnosis and assesses the relative severity of the two conditions, which is essential for a rational treatment. I tried to label this disorder inflammatory/autoimmune, but any other more appropriate title is welcome.…”

Section: Disclosure Statementmentioning

confidence: 99%