The Spectrum of Hair Loss in Patients with Mycosis Fungoides and Sézary Syndrome

    Ming Yang Bi, Jonathan L. Curry, Angela M. Christiano, Maria Hordinsky, David A. Norris, Vera H. Price, Madeleine Duvic
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    TLDR Some patients with mycosis fungoides or Sézary syndrome experience hair loss, which may be similar to alopecia areata or linked to skin lesions, possibly due to abnormal T cells, and bexarotene can help treat it.
    In a 2011 study, researchers observed that alopecia was present in 2.5% of patients with mycosis fungoides (MF) or Sézary syndrome (SS), with 38 out of 1550 patients affected. Of these, 34% had alopecia areata-like patchy hair loss, while 66% experienced hair loss within MF lesions. The study, which was retrospective and conducted at a single center, found that scalp biopsies from some patients showed atypical T lymphocytes in the follicular epithelium or epidermis, and two patients had follicular mucinosis. The study concluded that alopecia in MF/SS patients can present similarly to alopecia areata or be associated with MF lesions. Additionally, the study found that alopecia in MF and SS might be due to follicular involvement by malignant or activated T lymphocytes, and bexarotene was effective in treating MF-associated hair loss. The similarity in HLA-DR and DQB alleles between alopecia areata and MF suggests a common pathogenesis, warranting further research for better understanding and treatment.
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