Chronic Telogen Effluvium: A Study of 5 Patients Over 7 Years

The study followed five women diagnosed with chronic telogen effluvium (CTE), observing them for a minimum of 7 years. Four of the patients experienced ongoing hair shedding without a visible reduction in hair density or follicular miniaturization, suggesting that CTE may not necessarily progress to female pattern hair loss (FPHL). One patient developed FPHL, which partially reversed with spironolactone treatment. The study highlights the difficulty in differentiating CTE from FPHL due to variability in scalp biopsy specimens and recommends using three side-by-side punch biopsy specimens with horizontal sections for better diagnostic accuracy. The study concludes that further research is needed to understand the natural history of CTE and its potential progression to FPHL, as well as to determine the effectiveness of treatments like spironolactone in CTE, which currently lacks evidence.