Eflúvio anagénico

  • Mecanismo
    • Results from hair shaft fractures - Pohl Pinkus constrictions - reflect of mitotic arrest (resulting in moniletrix like hairs)
    • Chemotherapy
      • Mitotic inhibition stops reproduction of matrix cells
      • Antimetabolites, alkylating agents, mitotis inhibitors, INH, thallium, boron
      • Reversible in few weeks following cessation
  • DDx: alopecia areata, syphilis
  • Apresentação clínica
    • início súbito (2-3 dias) depois de trigger (quimioterapia)
  • Chemotherapy induced permanent alopecia
    • Also known as CIPAL
    • Rare
    • Most common in breast cancer patients treated with taxanes, particularly docetaxel, busulfan
    • Scalp cooling is an effective technique to prevent hair loss in these patients
      • Reduced chemotherapy delivery and metabolism in hair follicles achieved byu both the lowered temperature and resulting thermal vasoconstriction
    • Posteriormente tratar como AGA
  • Tratamento
    • Reverter o trigger
    • No caso do cancro da mama arrefecer o couro cabeludo (metástases para o couro cabeludo são raras)