Temporary Hair Loss Simulating Alopecia Areata After Endovascular Surgery of Cerebral Arteriovenous Malformations: A Report of 3 Cases

Tosti, Antonella; Piraccini, Bianca Maria; Alagna, G.

doi:10.1001/archderm.135.12.1555

Cited by 37 publications

(22 citation statements)

References 5 publications

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“…The rectangular-patterned alopecic patches are generally located on the occipitoparietal scalp [6,7,8,9]. The patients included in our study were affected by a peculiar, rectangular-shaped alopecic area.…”

Section: Discussionmentioning

confidence: 99%

“…the gastrointestinal tract, blood, bone marrow and mucocutaneous tissues) [3]. This prolonged fluoroscopic imaging can lead to various radiation injuries of the skin, hair and subcutaneous tissues, which result in inflammation and/or hair loss [4,5,6]. Alopecia is another consequence of acute radiation syndrome and is a relatively rare complication of radiation exposure.…”

Section: Introductionmentioning

confidence: 99%

“…Non-scarring alopecia after radiation exposure during endovascular intervention displays a peculiar, geometric distribution that includes the occipitoparietal scalp. These lesions can develop even after a single short-term exposure of 3-6 Gy of radiation [6,7,8,9]. …”

Section: Introductionmentioning

confidence: 99%

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Dermoscopic Findings in Radiation-Induced Alopecia after Angioembolization

Cho

Choi²,

Lee³

et al. 2014

Dermatology

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Background: Cases of non-scarring alopecia after endovascular brain surgery have been reported, but dermoscopic findings of these lesions have rarely been published. Objective: To report the dermoscopic findings for alopecic skin lesions that developed after radiation exposure during angioembolization. Methods: Dermoscopic examination was used to evaluate alopecic skin lesions in 10 patients who presented with post-angioembolization alopecia. Results: The male to female ratio was 1:4, mean age 55.0 ± 12.3 years and mean duration to lesion development 3.4 ± 2.5 weeks. The rectangular-shaped lesions mostly occurred at the occiput and temple areas. Both yellow and black dots were the predominant dermoscopic findings in 60% (6/10) of patients, followed by short vellus hair (50%), peripilar sign (20%), broken hair (10%), coiled hair (10%) and white dots (10%). Conclusions: Alopecic skin lesions induced by radiation exposure during angioembolization share characteristic dermoscopy findings with alopecia areata. They may be misdiagnosed if a precise history is not obtained.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Dermoscopic Findings in Radiation-Induced Alopecia after Angioembolization

Cho

Choi²,

Lee³

et al. 2014

Dermatology

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“…In previously reported cases, temporary alopecia over the temporoparietal and occipital areas has occurred in interventional neuroradiological procedures involving therapeutic embolization of cerebral arteriovenous malformations and brain circulation aneurysms. Complete spontaneous hair regrowth generally occurred 2–6 months after irradiation and in some patients, the irradiation-induced epilation was misdiagnosed as alopecia areata [6,7,8,9,10,11,12,13,14,15]. Our patient presented with a deep scalp ulceration surrounded by poikilodermatous and persistent alopecic area after a single procedure for the endovascular coiling of an anterior circulation aneurysm.…”

Section: Discussionmentioning

confidence: 93%

“…The most common entrance sites of ionizing radiation associated with cardiac procedures are the scapula, back and lateral trunk under the axilla. Other common locations are the left flank (associated with mesenteric artery angiography and stent placement), the back (associated with TIPS) and the temporoparietal and occipital areas of the scalp (associated with neurovascular embolization) [1,2,5,6,7,8,9,10,11,12,13,14,15]. For most patients, clinically significant skin and hair reactions are thought to occur when the skin dose is >5 Gy.…”

Section: Discussionmentioning

confidence: 99%

Chronic Scalp Ulceration as a Late Complication of Fluoroscopically Guided Cerebral Aneurysm Embolization

2012

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Fluoroscopy-induced chronic radiation dermatitis resulting from prolonged exposure to ionizing radiation during interventional procedures has been documented in the medical literature. However, this condition often requires a high clinical suspicion in order to establish a correct diagnosis. In this report, the development of deep scalp ulceration with bone exposure following the endovascular coiling of an anterior communicating artery aneurysm 8 years before is described. A skin biopsy specimen demonstrated changes consistent with chronic radiation dermatitis and ruled out malignancy. This case report expands the clinical manifestation spectrum of fluoroscopy-induced chronic radiation skin injury and highlights the importance of recognizing these lesions early to prevent morbidity related to radiation-induced skin damage.

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