Chemotherapy-Induced Alopecia: A Novel Observation

The letter describes a novel trichoscopic pattern observed in two patients with chemotherapy-induced alopecia, where their hair regrew with a 'black and white' appearance after treatment for breast cancer with 5-fluorouracil, epirubicin, cyclophosphamide, and taxanes. The authors hypothesize that this bicolored hair regrowth is due to the reactivation of damaged but not destroyed follicular melanocytes, possibly as a result of the end of a taxane-associated blockade of microtubules or the migration and activation of amelanotic melanocytes. They note that this phenomenon is not exclusive to chemotherapy-induced alopecia, as white tips can also occur in nasal hairs and after alopecia areata. The authors suggest that further studies are needed to understand the duration of these pigmentary changes and the underlying processes.