Permanent Alopecia After Systemic Chemotherapy: A Clinicopathological Study of 10 Cases

    Mariya Miteva, Cosimo Misciali, Píer Alessandro Fanti, Colombina Vincenzi, Paolo Romanelli, Antonella Tosti
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    TLDR Chemotherapy can cause permanent, non-reversible hair loss similar to pattern baldness.
    The study investigated permanent alopecia in 10 patients who had undergone systemic chemotherapy, revealing histological features similar to androgenetic alopecia. Patients had a reduced number of terminal hairs, an increased number of telogen and miniaturized vellus-like hairs, and a terminal to vellus hair ratio of 1:1, which is lower than normal. The anagen to telogen ratio was also lower than normal at 3.6:1. The study suggested that the cause of permanent alopecia could be due to a reduction in stem cell populations or a failure of hair matrix cells to reconnect with the dermal papilla post-chemotherapy. It highlighted that this type of alopecia is non-reversible and non-scarring, and can be misdiagnosed as androgenetic alopecia without proper clinicopathological correlation. The prevalence of chemotherapy-induced permanent alopecia is unclear, necessitating further research for understanding and prevention.
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