Abstract
Telogen effluvium (TE) is a pathogenically heterogeneous condition which so far has been classified into acute and chronic forms - or, according to Headington, into 5 different pathogenetic forms. Regrettably, Headington's classification is difficult to apply in the office, and most papers dealing with TE ignore it. The present review intends to propose a novel classification of TE and to introduce, tentatively, a new variety of TE. Three pathogenetic types of TE can be identified, whose common clinical element is the profuse shedding of hairs: (1) premature teloptosis, (2) collective teloptosis, and (3) premature entry into the telogen phase. In particular conditions, they may also be associated, as occurs in seasonal shedding and postpartum TE.
References
1.
Whiting DA: Chronic telogen effluvium: increased scalp hair shedding in middle-aged women. J Am Acad Dermatol 1996;35:899-906.
2.
Headington JT: Telogen effluvium. New concepts and review. Arch Dermatol 1993;129:356-363.
3.
Kligman AM: Pathologic dynamics of human hair loss. I. Telogen effluvium. Arch Dermatol 1961;83:175-198.
4.
Sulzberger MB, Witten VH, Kopf AW: Diffuse alopecia in women. Its unexplained apparent increase in incidence. Arch Dermatol 1960;81:556-560.
5.
Guy WB, Edmundson WF: Diffuse cyclic hair loss in women. Arch Dermatol 1960;81:205-207.
6.
Van Neste D, Leroy T, Conil S: Exogen hair characterization in human scalp. Skin Res Technol 2007;13:436-443.
7.
Higgins CA, Westgate GE, Jahoda CA: Modulation in proteolytic activity is identified as a hallmark of exogen by transcriptional profiling of hair follicles. J Invest Dermatol 2011;131:2349-2357.
8.
Hatakeyama S, et al: Retinoic acid disintegrated desmosomes and hemidesmosomes in stratified oral keratinocytes. J Oral Pathol Med 2004;33:622-628.
9.
Sanfilippo A, English JC: An overview of medicated shampoos used in dandruff treatment. P T 2006;31:396-400.
10.
Bardelli A, Rebora A: Telogen effluvium and minoxidil. J Am Acad Dermatol 1989;21(pt 1):572-573.
11.
Jiang Q, et al: UV radiation down-regulates Dsg-2 via Rac/NADPH oxidase-mediated generation of ROS in human lens epithelial cells. Int J Mol Med 2006;18:381-387.
12.
Cutrone M, Grimalt R: Transient neonatal hair loss: a common transient neonatal dermatosis. Eur J Pediatr 2005;164:630-632.
13.
Rebora A: Telogen effluvium: an etiopathogenetic theory. Int J Dermatol 1993;32:339-340.
14.
Rebora A: Telogen effluvium. Dermatology 1997;195:209-212.
15.
Bradfield RB, Bailey MA, Margen S: Morphological changes in human scalp hair roots during deprivation of protein. Science 1967;157:438-439.
16.
Strumia R: Skin signs in anorexia nervosa. Dermatoendocrinol 2009;1:268-270.
17.
Rebora A: Trichodynia: a review of the literature. Int J Dermatol 2016;55:382-384.
18.
Baldari M, Guarrera M, Rebora A: Thyroid peroxidase antibodies in patients with telogen effluvium. J Eur Acad Dermatol Venereol 2010;24:980-982.
19.
Sinclair R: Chronic telogen effluvium: a study of 5 patients over 7 years. J Am Acad Dermatol 2005;52:S12-S16.
20.
Bolduc C, Lui H, Shapiro J: Alopecia areata. http://emedicine.medscape.com/article/1069931-overview.
21.
Arck PC, et al: Stress inhibits hair growth in mice by induction of premature catagen development and deleterious perifollicular inflammatory events via neuropeptide substance P-dependent pathways. Am J Pathol 2003;162:803-814.
22.
Grimalt R, Ferrando J, Grimalt F: Trichodynia. Dermatology 1998;196:374.
23.
Defrin R, Lurie R: Indications for peripheral and central sensitization in patients with chronic scalp pain (trichodynia). Clin J Pain 2013;29:417-424.
24.
Wang L, et al: CRF receptor antagonist astressin-B reverses and prevents alopecia in CRF over-expressing mice. PLoS One 2011;6:1-9.
25.
Puavilai S, et al: Prevalence of thyroid diseases in patients with alopecia areata. Int J Dermatol 1994;33:632-633.
26.
Amino N, Tada H, Hidaka Y: The spectrum of postpartum thyroid dysfunction: diagnosis, management, and long-term prognosis. Endocr Pract 1996;2:406-410.
© 2016 S. Karger AG, Basel
2016
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.
