Abstract
Anagen effluvium occurs due to an agent or event that drastically reduces the metabolic activity of the matrix cells of the hair follicle. At any given time more than 80% of scalp hair are in the anagen phase of the hair cycle. Hence the resulting hair loss is abrupt and extensive. In majority of the cases, it occurs in association with cancer chemotherapy and radiation, other causes being rare. Here we report a case of a middle aged female suffering from an Atopic dermatitis who was put on treatment with Azathioprine for the same. This was followed by a diffuse and extensive hair loss from the scalp associated with painful oral ulcers and marked leucocytopenia within a month of administration. The hair grew back within four months …show more content…
Concurrently with the onset of hair loss, the patient developed painful oral ulcers over the palate. The patient was a known case of Atopic dermatitis and had been put on tablet Azathioprine 50 mg twice a day for 15 days initially which was further extended for 15 more days. The patient developed these adverse effects 24 days after the start of treatment. The patient’s complete blood count revealed marked leucocytopenia with a total leucocyte count of only 900 per cubic millimeter with the differential neutrophil count being only 7 percent.
On examination of the scalp, a diffuse non-scarring alopecia was seen. It was more on the occiput and the vertex than on the temporal and the parietal regions. There were no signs of any inflammation, scaling or atrophy. On performing a hair pull test, hair came off in massive clumps with relatively little effort. Her liver and renal function tests were within normal limits. The Anti Nuclear Antibody test was …show more content…
Quercetani R, Rebora AE, Fedi MC, Carelli G, Mei S, Chelli A, et al. Patients with profuse hair shedding may reveal anagen hair dystrophy: A diagnostic clue of alopecia areata incognita. J Eur Acad Dermatol Venereol 2011;25:808-10.
3. Sperling LC. Hair and systemic disease. Dermatol Clin 2001;19:711-26.
4. Delmonte S, Semino MT, Parodi A, Rebora A. Normal anagen effluvium: A sign of pemphigus vulgaris. Br J Dermatol 2000;142:1244-5.
5. Elhassani SB. The many faces of methyl mercury poisoning. J Toxicol Clin Toxicol 1982;19:875-906.
6. Stein KM, Odom RB, Justice GR, Martin GC. Toxic alopecia from ingestion of boric acid. Arch Dermatol 1973;108:95-7.
7. Vowels M, Chan LL, Giri N, Russell S, Lam-Po-Tang R. Factors affecting hair regrowth after bone marrow transplantation. Bone Marrow Transplant 1993;12:347-50.
8. Balasubramanian P, Jagadeesan S, Anjaneyan G, Thomas J. An interesting case report of azathioprine-induced anagen effluvium. Indian J Dermatol 2015;60:324.
9. Joshi R, Singh S. Plica neuropathica (Plica polonica) following azathioprine-induced pancytopenia. Int J Trichology 2010;2:110-2.
10. Sonthalia S, Daulatabad D. Azathioprine-associated anagen effluvium. Indian J Dermatol Venereol Leprol
Anagen effluvium occurs due to an agent or event that drastically reduces the metabolic activity of the matrix cells of the hair follicle. At any given time more than 80% of scalp hair are in the anagen phase of the hair cycle. Hence the resulting hair loss is abrupt and extensive. In majority of the cases, it occurs in association with cancer chemotherapy and radiation, other causes being rare. Here we report a case of a middle aged female suffering from an Atopic dermatitis who was put on treatment with Azathioprine for the same. This was followed by a diffuse and extensive hair loss from the scalp associated with painful oral ulcers and marked leucocytopenia within a month of administration. The hair grew back within four months …show more content…
Concurrently with the onset of hair loss, the patient developed painful oral ulcers over the palate. The patient was a known case of Atopic dermatitis and had been put on tablet Azathioprine 50 mg twice a day for 15 days initially which was further extended for 15 more days. The patient developed these adverse effects 24 days after the start of treatment. The patient’s complete blood count revealed marked leucocytopenia with a total leucocyte count of only 900 per cubic millimeter with the differential neutrophil count being only 7 percent.
On examination of the scalp, a diffuse non-scarring alopecia was seen. It was more on the occiput and the vertex than on the temporal and the parietal regions. There were no signs of any inflammation, scaling or atrophy. On performing a hair pull test, hair came off in massive clumps with relatively little effort. Her liver and renal function tests were within normal limits. The Anti Nuclear Antibody test was …show more content…
Quercetani R, Rebora AE, Fedi MC, Carelli G, Mei S, Chelli A, et al. Patients with profuse hair shedding may reveal anagen hair dystrophy: A diagnostic clue of alopecia areata incognita. J Eur Acad Dermatol Venereol 2011;25:808-10.
3. Sperling LC. Hair and systemic disease. Dermatol Clin 2001;19:711-26.
4. Delmonte S, Semino MT, Parodi A, Rebora A. Normal anagen effluvium: A sign of pemphigus vulgaris. Br J Dermatol 2000;142:1244-5.
5. Elhassani SB. The many faces of methyl mercury poisoning. J Toxicol Clin Toxicol 1982;19:875-906.
6. Stein KM, Odom RB, Justice GR, Martin GC. Toxic alopecia from ingestion of boric acid. Arch Dermatol 1973;108:95-7.
7. Vowels M, Chan LL, Giri N, Russell S, Lam-Po-Tang R. Factors affecting hair regrowth after bone marrow transplantation. Bone Marrow Transplant 1993;12:347-50.
8. Balasubramanian P, Jagadeesan S, Anjaneyan G, Thomas J. An interesting case report of azathioprine-induced anagen effluvium. Indian J Dermatol 2015;60:324.
9. Joshi R, Singh S. Plica neuropathica (Plica polonica) following azathioprine-induced pancytopenia. Int J Trichology 2010;2:110-2.
10. Sonthalia S, Daulatabad D. Azathioprine-associated anagen effluvium. Indian J Dermatol Venereol Leprol