Anagen Effluvium Due to Azathioprine in a Patient With Normal Thiopurine S-Methyltransferase Levels: A Videodermoscopic Analysis

    October 2022 in “ International journal of dermatology and venereology ”
    Swapnil Shah, Balachandra S Ankad, Tanuja Rajagopal
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    TLDR A woman's sudden hair loss was linked to azathioprine use despite normal enzyme levels, and improved after stopping the drug and starting treatment.
    A 20-year-old woman experienced sudden hair loss due to anagen effluvium (AE) after starting azathioprine, despite having normal thiopurine S-methyltransferase (TPMT) levels. Videodermoscopy revealed unique trichoscopic features such as yellow dots, black dots, and dark lines. Azathioprine was discontinued, and treatment with minoxidil and multivitamins led to significant hair regrowth within 2 months. This case highlights that AE can occur with normal TPMT levels, emphasizing the need for regular monitoring of patients on azathioprine.
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