Joshi Rajiv, Singh Simran
P. D. Hinduja Hospital, Mahim, Mumbai, India.
Int J Trichology. 2010 Jul;2(2):110-2. doi: 10.4103/0974-7753.77523.
A 54-yr-old woman, on azathioprine for interstitial lung disease, developed pancytopenia and presented with sudden onset of extensive hair loss from the scalp followed overnight by appearance of elongated broad mass of uncombable matted hair which had the typical appearance of Plica neuropathica. Microscopic examination of hair clipped from the matted mass revealed irregular, nodal, superficial fractures of the hair shaft resembling Trichorrhexis nodosa and irregular ruffling of the cuticles. The areas of cuticular damage appeared dark under polarized light. Plica neuropathica following pancytopenia is unusual and the findings of hair shaft cuticular damage suggests that changes in surface characteristics of hair shafts may have led to the irreversible matting leading to development of plica along with extensive hair loss due to anagen effluvium.
一名54岁的女性因间质性肺病服用硫唑嘌呤,出现全血细胞减少,头皮突然大面积脱发,一夜之间出现了一大团细长、宽大、无法梳理的纠结毛发,具有典型的神经性折叠毛发外观。对从纠结毛发团剪下的毛发进行显微镜检查,发现毛干有不规则、结节状、浅表性骨折,类似结节性脆发症,角质层有不规则起皱。角质层损伤区域在偏振光下呈深色。全血细胞减少后出现神经性折叠毛发并不常见,毛干角质层损伤的发现表明,毛干表面特征的变化可能导致了不可逆的毛发纠结,进而导致折叠毛发的形成以及生长期脱发导致的大面积脱发。