Telogen Effluvium Associated with the Dopamine Agonist Pramipexole in a 55-Year-Old Woman with Parkinson's Disease

The document reports a case of telogen effluvium, a form of hair loss, associated with the use of the dopamine agonist pramipexole in a 55-year-old woman with Parkinson's disease. The patient experienced gradual hair loss over two months after restarting pramipexole at a dose of 1 mg three times daily, having previously switched from pramipexole to another dopamine agonist, ropinirole. Laboratory tests showed normal levels of ferritin, dihydroepiandosterone sulfate, total testosterone, and thyroid-stimulating hormone. A scalp biopsy confirmed telogen effluvium, with 9 of 24 hair follicles in the telogen phase. After discontinuing pramipexole, hair regrowth was observed within four months. The document also notes that from the FDA approval of pramipexole in 1997 through September 2004, there were 36 reports of alopecia in patients taking pramipexole. The pathophysiology of telogen effluvium is not well understood, but it may involve dopamine agonists affecting hair follicle cycling through decreased serum prolactin levels. The document suggests that dermatologists consider the potential link between dopamine agonists and telogen effluvium when evaluating hair loss in patients with Parkinson's disease.