Supravenous Repigmentation of Hair Shafts in a Patient with Regrowing Alopecia Totalis: A Case Report and Hypothesis

Novel Insights from Clinical Practice

Rotrosen E.T.a· Lam J.a,b· Goldberg L.J.a,b

Author affiliations

aBoston University School of Medicine, Boston, MA, USA
bDepartment of Dermatology, Boston Medical Center, Boston, MA, USA

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Article / Publication Details

First-Page Preview

Abstract of Novel Insights from Clinical Practice

Received: December 16, 2021
Accepted: March 12, 2022
Published online: April 28, 2022

Number of Print Pages: 4
Number of Figures: 2
Number of Tables: 0

ISSN: 2296-9195 (Print)
eISSN: 2296-9160 (Online)

For additional information: https://www.karger.com/SAD

Abstract

Introduction: Alopecia areata (AA) is a type of nonscarring alopecia that has autoimmune etiology, in which the hair follicle, usually an immune-privileged site, becomes the target of attack. Alopecia totalis (AT) is a subset of AA in which patients completely lose hair on the scalp. Initial hair regrowth is often fine and without pigment. We present a case of AT in which pigmented hair grew only overlying superficial veins, a finding which has not been previously reported. Case Presentation: An adult female with brown hair presented with AA that progressed to AT despite the use of triamcinolone ointment and topical 2% tofacitinib ointment. She was treated with nightly augmented betamethasone dipropionate 0.05% ointment under occlusion. Two months later, she noticed diffuse regrowth of thin hair on her scalp, most of which was depigmented. However, linear bands of darkly pigmented hairs were noted overlying superficial scalp veins. Discussion/Conclusion: Loss of pigmentation and subsequent repigmentation of the hair shaft in regrowing AA is not entirely understood. Initial hair regrowth in AA tends to be fine and depigmented, although the hair will usually regain normal texture and color. Pigmentation following a vein suggests that local temperature may play a role, possibly augmented by corticosteroid induced reduced expression of inflammatory cytokines and endothelial release of the vasoconstrictor hormone endothelin, which stimulates melanogenesis.

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References Barahmani N, De Andrade M, Slusser JP, Wei Q, Hordinsky M, Price VH, et al. Human leukocyte antigen class II alleles are associated with risk of alopecia areata. J Invest Dermatol. 2008;128(1):240–3. Pratt CH, King LE, Messenger AG, Christiano AM, Sundberg JP. Alopecia areata. Nat Rev Dis Primers. 2017;3(1):17011. Paus R, Ito N, Takigawa M, Ito T. The hair follicle and immune privilege. J Investig Dermatol Symp Proc. 2003;8(2):188–94. Slominski A, Wortsman J, Plonka PM, Schallreuter KU, Paus R, Tobin DJ. Hair follicle pigmentation. J Invest Dermatol. 2005;124(1):13–21. Lamb RC, Porter M. Sudden onset hair loss and colour change. BMJ. 2013;347:f6112. Paus R, Slominski A, Czarnetzki BM. Is alopecia areata an autoimmune-response against melanogenesis-related proteins, exposed by abnormal MHC class I expression in the anagen hair bulb? Yale J Biol Med. 1993;66(6):541–54. Messenger AG, Bleehen SS. Alopecia areata: light and electron microscopic pathology of the regrowing white hair. Br J Dermatol. 1984;110(2):155–62. Navarini AA, Nobbe S. Marie Antoinette syndrome. Arch Dermatol. 2009;145(6):656. Protière C, Evans K, Camerlo J, D’Ingrado M-P, Macquart-Moulin G, Viens P, et al. Efficacy and tolerance of a scalp-cooling system for prevention of hair loss and the experience of breast cancer patients treated by adjuvant chemotherapy. Support Care Cancer. 2002;10(7):529–37. Rugo HS, Klein P, Melin SA, Hurvitz SA, Melisko ME, Moore A, et al. Association between use of a scalp cooling device and alopecia after chemotherapy for breast cancer. JAMA. 2017;317(6):606. Grevelman EG, Breed WP. Prevention of chemotherapy-induced hair loss by scalp cooling. Ann Oncol. 2005;16(3):352–8. Janssen F-PEM, Rajan V, Steenbergen W, Leeuwen GMJV, Steenhoven AAV. The relationship between local scalp skin temperature and cutaneous perfusion during scalp cooling. Physiol Meas. 2007;28(8):829–39. Leung AK, Kiefer GN. Localized acquired hypertrichosis associated with fracture and cast application. J Natl Med Assoc. 1989;81(1):65–7. Pick RY. Focal hair growth under plaster-of-Paris cast. N Y State J Med. 1980;80(11):1726. Ma HJ, Yang Y, Ma HY, Jia CY, Li TH. Acquired localized hypertrichosis induced by internal fixation and plaster cast application. Ann Dermatol. 2013;25(3):365–7. Pfiester MP, Eismann EA, Wilson LM, Parikh SN. Localized acquired hypertrichosis after cast treatment in pediatric and adolescent patients: a natural history study. J Pediatr Orthop. 2013;33(7):755–8. Ullian ME. The role of corticosteriods in the regulation of vascular tone. Cardiovasc Res. 1999;41(1):55–64. Regazzetti C, De Donatis GM, Ghorbel HH, Cardot-Leccia N, Ambrosetti D, Bahadoran P, et al. Endothelial cells promote pigmentation through endothelin receptor B activation. J Invest Dermatol. 2015;135(12):3096–104. Hrushesky WJ. Letter: serpentine supravenous fluorouracil hyperpigmentation. JAMA. 1976;236(2):138. Article / Publication Details

First-Page Preview

Abstract of Novel Insights from Clinical Practice

Received: December 16, 2021
Accepted: March 12, 2022
Published online: April 28, 2022

Number of Print Pages: 4
Number of Figures: 2
Number of Tables: 0

ISSN: 2296-9195 (Print)
eISSN: 2296-9160 (Online)

For additional information: https://www.karger.com/SAD

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