Tulipoid hair: Anagen effluvium marker!

Malakar, Subrata; Mehta, Purva; Malakar, Surit

doi:10.4103/ijt.ijt_98_17

Cited by 6 publications

(1 citation statement)

References 3 publications

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“…However, we did not observe tulipoid hairs, which are characteristic of AE. 3 Observation from a single case is a major limitation of this case study, which requires further elucidation for the affirmation of our observations. Finally, both the TPMT genotype and phenotype levels of patients with AE are within normal limits.…”

Section: Discussionmentioning

confidence: 71%

Anagen effluvium due to azathioprine in a patient with normal thiopurine S-methyltransferase levels: A videodermoscopic analysis

Shah

Ankad

Rajagopal

2022

International Journal of Dermatology and Venereology

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Introduction: Anagen effluvium (AE) is caused by impaired mitotic activity of matrix cells in the hair follicles. It presents with sudden loss of hair and myelosuppression. The diagnosis is based on the clinical history, trichoscopy, and trichogram.We herein report a case in which videodermoscopy revealed new trichoscopic features of AE caused by azathioprine in a patient with normal thiopurine S-methyltransferase (TPMT) levels.Case presentation: A 20-year-old woman presented with sudden loss of hair following treatment with oral azathioprine. Evaluation of the TPMT were within normal limits both in genotype and phenotype levels. Hair pull test was positive. Trichoscopy revealed yellow dots and multiple black dots, empty yellow dots, dark lines, upright regrowing hairs, and circle hairs. Azathioprine was stopped, and minoxidil 5% and oral multivitamin were started. Posttreatment trichoscopic analysis revealed terminal hairs and upright regrowing hairs.Discussion: AE is characterized by abrupt loss of anagen hairs due to impaired metabolic activity. Trichoscopy in AE shows coudability hairs, black dots, exclamation mark hairs, multiple broken shafts, and regrowing hairs. Empty yellow dots, yellow dots with black dots, pigtail hairs, and dark lines were additional features in this study. Conclusion:Trichoscopy assists in the accurate diagnosis of AE. Adverse effects of azathioprine can be observed even with normal TPMT levels. Weekly monitoring is therefore of prime importance.

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Section: Discussionmentioning

confidence: 71%

Anagen effluvium due to azathioprine in a patient with normal thiopurine S-methyltransferase levels: A videodermoscopic analysis

Shah

Ankad

Rajagopal

2022

International Journal of Dermatology and Venereology

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Nonscarring Alopecias

Rakowska¹,

Usatine²,

Mayo³

et al. 2023

Clinical and Dermoscopic Atlas of Non-Neoplastic Dermatoses

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Anagen effluvium and the role of trichoscopy

Starace

Orlando

Bruni

et al. 2021

Clin Experimental Derm

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Black dots, broken hairs, flame hairs, yellow dots, Pohl-Pinkus constrictions, tulipoid hairs Circle hairs, pigtail hairs, vellus-like hairs, black and white terminal hairs Targeted therapy Black dots, broken hairs, flame hairs, yellow dots Circle hairs, pigtail hairs, vellus-like hairs Radiotherapy Black dots, broken hairs, flame hairs, yellow dots Circle hairs, pigtail hairs, vellus-like hairs, white cicatricial patches Pemphigus vulgaris Dotted vessels, yellow haemorrhagic crusts, diffuse scaling, erythema Circle hairs, pigtail hairs, vellus-like hairs Localized traumas, infections Black dots, broken hairs, flame hairs, yellow dots Circle hairs, pigtail hairs, vellus-like hairs Alopecia areata Black dots, exclamation-mark hairs, yellow dots, pseudomonilethrix Circle hairs, pigtail hairs, vellus-like hairs, white/pigmented terminal hairs

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Tulipoid hair: Anagen effluvium marker!

Cited by 6 publications

References 3 publications

Anagen effluvium due to azathioprine in a patient with normal thiopurine S-methyltransferase levels: A videodermoscopic analysis

Anagen effluvium due to azathioprine in a patient with normal thiopurine S-methyltransferase levels: A videodermoscopic analysis

Nonscarring Alopecias

Anagen effluvium and the role of trichoscopy

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