044 What’s new on hair disorders

A. Tosti Dept. of Dermatology, University of Bologna, Bologna, Italy

Telogen effluvium: Hair loss is a common complaint in patients receiving highly active anti-retroviral therapy (HAART), especially the protease inhibitor indinavir. Hair loss involves both the scalp and the body hair. Other possible side effects of indinavir therapy include development of curly hair and discoloration of the eyebrows. Contact dermatitis should be included among possible causes of telogen effluvium. Four out of eight women developed mild to moderate hair loss 2 to 4 months after an acute contact dermatitis of the scalp due to hair dyeing. The pathogenesis of telogen effluvium caused by contact dermatitis is unknown but may be related to cytokine release during the inflammatory process. Temporary patchy alopecia may follow endovascular surgery for cerebral arterovenus malformations. This is due to prolonged scalp exposure to radiation during fluroscopic imaging. Differential diagnosis with alopecia areata with ophiasis pattern may be difficult. Congenital hypotrichosis due to short anagen: This recently described disorder is characterized by short blond hair due to a short anagen phase. The condition can be familial with an autosomal dominant inheritance. The disorder appears to resolve spontaneously during puberty and adulthood. Scalp mosaicism: A 32 year-old woman presented with an epidermal nevus following Blaschko’ lines. She also presented an alopecia distribuited in a spiral pattern on the left parietal region. The alopecic area was covered by short vellus-like hairs. Topical minoxidil produced improvement of alopecic areas with gradual elongation and thickening of the vellus-like hairs. Cicatricial alopecias: In the last few years two clinical variants of lichen plano pilaris have been recognized; frontal fibrosing alopecia and fibrosing alopecia with a pattern distribution. These clinical variants are characterized by the fact that the inflammatory process does not affect randomly the scalp follicles but affects selectively the hairline follicles in frontal fibrosing alopecia or the miniaturized follicles of the androgen dependent scalp in fibrosing alopecia with a pattern distribution. A case of lichen planopilaris limited to the follicles of an epidermal nevus of the scalp has also been described.