L-20   TELOGEN EFFLUVIUM & PSEUDO-TELOGEN EFFLUVIUM

A. Rebora. Genua, Italy.

Telogen effluvium (TE) is a relatively frequent condition characterized by an abundant shedding of hair in telogen phase. Typically, shedding begins about 3 months after the occurrence of a causal event and lasts not less than 2 months. Often, TE is accompanied by scalp paresthesias (trichodynia). There are two forms of TE, acute and chronic. Etiology is multivarious including, in the acute form, drugs, delivery, major surgery, haemorrhages, occasional stressing events, and, in the chronic form, drugs, autoimmune diseases, crashing diets, repeated or continuous stressing events. The mechanism by which hair is shed is unclear, but there is experimental evidence to maintain that it may depend on a mitotic arrest. Diagnosis is not difficult: TE should be distinguished from pseudo-TE or premature teloptosis. Quantitating the severity of hair shedding is important from the prognostic point of view. Also important is understanding if the disease is still active at the moment of the consultation. Women, who are mostly affected, should be investigated with some laboratory tests to exclude organic causes. Treatment may be useless, as TE is often self-healing with complete recovery. In severe cases, topical and occasionally even systemic corticosteroids may be useful.