D'incan M, Roger H, Gabrillargues J, Mansard S, Parent S, Chazal J, Irthum B, Souteyrand P
Service de Dermatologie, Hôtel-Dieu/Polyclinique, Clermont-Ferrand, France.
Ann Dermatol Venereol. 2002 May;129(5 Pt 1):703-6.
Intraoperative fluoroscopy imaging during coronaroplasty or transjugular intrahepatic portosystemic shunt may induce chronic radiodermatitis. Temporary hair loss is a peculiar form of radiodermatitis following endovascular surgery of the cerebral arteries.
Six patients (2 women, 4 men, age range: 27-47 years old) were seen for a solitary plaque of alopecia. In all of the cases, the plaque had appeared two weeks after a neuroradiologically guided embolization procedure. No other skin lesions were seen. Alopecia spontaneously and completely regressed within three to four months. However, it reappeared after a subsequent embolization (one case) but not after arteriographies (five cases).
Five similar cases have been reported in the literature. Transient alopecia often occurs after neurologically guided endovascular surgery of the cerebral arteries. This side-effect is well known by neurosurgeons and thus, these patients are rarely referred to a dermatologist. Two differential diagnoses must be evoqued: alopecia aerata and anticonvulsant - induced alopecia. The role played as cofactor by carbamazepine which is a photosensitivant drug, is discussed.
冠状动脉成形术或经颈静脉肝内门体分流术期间的术中透视成像可能会诱发慢性放射性皮炎。暂时性脱发是脑动脉血管内手术后放射性皮炎的一种特殊形式。
6例患者(2名女性,4名男性,年龄范围:27 - 47岁)因单发斑秃就诊。所有病例中,斑秃均在神经放射学引导的栓塞术后两周出现。未发现其他皮肤损害。脱发在三到四个月内自发且完全消退。然而,在随后的栓塞术后(1例)脱发再次出现,但在血管造影术后(5例)未再出现。
文献中已报道了5例类似病例。暂时性脱发常发生在神经放射学引导的脑动脉血管内手术后。这种副作用神经外科医生很熟悉,因此,这些患者很少转诊至皮肤科医生处。必须考虑两种鉴别诊断:斑秃和抗惊厥药诱发的脱发。还讨论了作为光敏药物的卡马西平作为辅助因素所起的作用。