Pressure alopecia in pediatric and adult patients: Clinical and trichoscopic findings in 12 cases

Ravaioli, Giulia Maria; Starace, Michela; Alessandrini, Aurora; Guicciardi, Federica; Piraccini, Bianca Maria

doi:10.1016/j.jaad.2019.02.050

Cited by 10 publications

(12 citation statements)

References 6 publications

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“…If scarring happens, loss of follicular ostia and yellow dots may be found. [ 2 ] The second patient had follicular plugs but no yellow dots, according to the described signs for PA after 1 month. However, the first patient, who had a long-lasting alopecia, had both yellow dots and dilated infundibula with follicular plugs.…”

Section: Discussionmentioning

confidence: 99%

“…Pressure alopecia (PA) is a type of hair loss, which normally occurs following prolonged immobilization, such as long-lasting surgeries or hospitalization in intensive care units (ICU). [ 1 2 ] PA usually appears 3–28 days after the trigger, as a painful, swollen, and erythematous area, followed by an abrupt patchy hair loss. Hair tends to regrow spontaneously within 4 months.…”

Section: Introductionmentioning

confidence: 99%

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Trichoscopic findings in pressure alopecia: Report of two cases and review of the literature

2021

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Pressure alopecia (PA) is an uncommon type of hair loss due to ischemic changes of the scalp, as a result of prolonged immobilization. Clinically, it often appears within the 1 st month of the trigger and tends to resolve spontaneously within 4 months. If the duration of the immobilization is longer, irreversible alopecia can be developed. Trichoscopy is usually nonspecific, being black dots, broken, and dystrophic hairs the most frequent findings. However, yellow dots and thin hairs have also been reported. We herein present two patients with PA, one with a recent development and another one with a long-lasting alopecia. Both of them showed keratotic follicular plugs and thin hairs as the main trichoscopic findings.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Trichoscopic findings in pressure alopecia: Report of two cases and review of the literature

2021

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“…Pressure alopecia (PA) is a group of non-scarring and scarring alopecia due to ischemic changes to the scalp, often from outside forces, trauma, or immobilization during prolonged surgery or hospital stay that classically presents with erythema and sometimes ulceration to the occipital or vertex scalp. [6][7][8] One recent case report documented two White girls, aged 4 and 5 years old, who each presented with a red patch at the vertex of the scalp that progressed to a gray-crusted ulcer and eventual alopecia 3 days after their hair was styled in a high bun with extensions at an amusement park. Their hair loss was attributed to a combination of TA and PA from the heavy bun and extensions.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, while PA is more commonly associated with prolonged surgical operating times or intensive care unit stays with sustained pressure to the scalp from the operating table or hospital bed, it is important to recognize that pressure from heavy hairstyles may also contribute to the development of alopecia. 8 Hair stylists, clinicians, and patients should be aware of the potential harm associated with some common hair practices.…”

Section: Discussionmentioning

confidence: 99%

Acute onset traction‐associated ulceration and alopecia

Johns

Wright

Pourciau

2021

Pediatric Dermatology

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A 9-year-old African American girl presented to the Emergency Department (ED) for blisters on her scalp. Her hair was styled with synthetic extensions into "lemonade braids" (side swept cornrows) 11 days prior to presentation. The mother stated that the patient had her hair braided in the past with no issues, and denied use of any chemicals, hair relaxers or new products during the braiding process.The patient denied pain during braid placement but described the braids as "tight" once finished. Three days later, the patient complained of headache with scalp pruritus and pain. The mother noted that the braid on the crown of the head appeared tighter than the surrounding braids, with associated swelling at its base. Upon removal, the her mother noticed "blisters and sores" on the vertex of the patient's scalp. The hair in that area fell out over the following days. The patient's primary care physician recommended washing her hair with Dawn™ dish soap twice weekly and prescribed oral cefdinir, ketoconazole shampoo, and a compound of polymyxin B sulfate and bacitracin zinc ointment twice daily. Despite the adherence to this treatment regimen, the patient's conditioned worsened, and she subsequently presented to the ED. The patient had no systemic symptoms. On clinical exam in the ED, there were irregularly shaped ulcerations within a large patch of alopecia on the vertex scalp with no notable erythema or crusting (Figure 1). A bacterial culture was obtained which grew normal flora. Due to the temporal association

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“…Trichoscopic features include black dots, broken hairs, erythema, and ulceration. 4 Circle hairs are usually a favorable prognostic finding of reversible PA. 5 Identifying the correct type of post COVID‐19 alopecia must be a prerogative of the following studies to allow early identification and establish the correct therapy. Preventive measures in intensive care units, including intermittent head repositioning and scalp massage, should be considered to reduce the incidence of PA.…”

Section: Figurementioning

confidence: 99%