Alopecia as a Rare but Distinct Manifestation of Pemphigus Vulgaris

The study, conducted between June 2003 and July 2010, found that alopecia is a rare but distinct manifestation of pemphigus vulgaris (PV), occurring in 5.4% of the 92 patients treated at a tertiary center. It was observed that alopecia in PV patients may be underreported due to the lack of routine hair examination. The research included five patients with PV who presented with hair loss and alopecic patches. Tests such as hair pull tests, direct immunofluorescence, and detection of anti-desmoglein autoantibodies were conducted, along with histopathological analysis of scalp biopsies. The results indicated that hair follicle weakening, due to anti-desmoglein autoantibody-mediated acantholysis and secondary factors like infection, led to the hair loss. Notably, the bulge stem cell area of the hair follicles remained intact, and the alopecia was non-scarring, with all patients experiencing hair regrowth within 2-4 weeks of treatment. The study concluded that alopecia, particularly anagen effluvium, should be considered in the diagnosis of PV, and that patients with alopecia may be more prone to disease relapses.