P5   REPAIR OF “EN COUP DE SABRE”-INDUCED ALOPECIA WITH FOLLI CULAR UNIT TRANSPLANTATION

Park SW, Kim JW, Wang HY. Dept. of Dermatology, Inje University, Pusan , Korea

A 22 year-old woman presented with alopecia on left frontal and partial scalp and depressed groove on left forehead. At the age of 18 years, her hair on left frontal and parietal scalp began to fall out. One year later, the alopecic area showed atrophic change. Perpendicular linear atrophy spread from left forehead to eyebrow. At the age of 21 years the lesion ceased.

Histopathology of a skin biopsy taken from the atrophic alopecic patch of scalp, revealed atrophic epidermal and dermal structures; decreased blood vessels and number of hair follicles, miniaturization of hair follicles, loss of subcutaneous fat, coarse collagen fibers. The diagnosis of “en coup de sabre” was established from clinical and histopathologic finding. From August 1998 to April 1999, the patient received corticosteroid, hydroxychloroquine therapy. But the therapy had little effect and the lesion showed no change. So hair transplantation was tried as a therapeutic challenge. Follicular unit transplantation consisting of two to three hairs with Choi hair transplanters was formed. 100 follicular units and 33 follicular units were transplanted in the frontal hairline and parietal area respectively. Excellent results were observed. A ten-month follow-up study showed an 86.5% of survival rate and 10-14 cm (mean 12cm) length of the transplanted hairs. Re-biopsy was performed in transplanted area. Histopathology revealed terminal anagen hair follicles with distinct oblique angles different from pre-existing miniaturized hair follicle and perifollicular fat tissue around transplanted hair follicle was also observed.

To the best of our knowledge, this was the first time follicular unit transplantation had been tried in “en coup de sabre”- induced alopecia and this method was fast, convenient and cosmetically satisfactory as compared to a punch graft.