Kanti V, Nuwayhid R, Lindner J, Hillmann K, Bangemann N, Kleine-Tebbe A, Blume-Peytavi U, Garcia Bartels N
Department of Dermatology and Allergy, Clinical Research Center for Hair and Skin Science, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Department of Gynecology and Obstetrics, Ostalb-Hospital, Aalen, Germany.
J Eur Acad Dermatol Venereol. 2016 Jan;30(1):112-8. doi: 10.1111/jdv.13396. Epub 2015 Sep 25.
In women receiving antineoplastic therapy, hair loss is often accompanied by distressing hair or scalp sensations, such as hair pain (trichodynia) and pruritus. A scientific approach to objectively evaluate the course and characteristics of these unpleasant sensations is of great importance for the establishment of treatment strategies.
An observational cohort study was conducted in 34 female breast cancer patients, postoperatively undergoing chemotherapy (group C, n = 17) or endocrine therapy with tamoxifen (group T, n = 17). For 28 weeks after therapy initiation, patients experiencing hair pain and/or scalp pruritus were required to complete a specially developed diary, based on a modification of pain questionnaires. Sensations were journalized in terms of time of onset, duration, intensity on a numeric rating scale, dependence on touching the scalp or hair and character of the sensation, chosen from given descriptors or using own words.
In group C, all patients who completed the questionnaire experienced hair and scalp sensations: 87% both trichodynia and pruritus, 13% trichodynia only. Reported intensities ranged between 1 and 10. In group T, 31% of participants reported hair and scalp sensations: 12% both trichodynia and pruritus, 12% pruritus only, 7% trichodynia only. Intensities were rated between 1 and 5. No sensations were reported after week 11 in either group.
Hair and scalp sensations in group C were significantly more common, lasted longer, and were of greater intensity and more differentiated qualities than in group T. The occurrence of trichodynia in chemotherapy patients corresponded with the onset and duration of hair loss, thus suggesting a possible correlation.
在接受抗肿瘤治疗的女性中，脱发往往伴随着令人苦恼的头发或头皮感觉，如头发疼痛（毛发痛）和瘙痒。采用科学方法客观评估这些不适感觉的过程和特征对于制定治疗策略至关重要。
对34名女性乳腺癌患者进行了一项观察性队列研究，这些患者术后接受化疗（C组，n = 17）或他莫昔芬内分泌治疗（T组，n = 17）。在治疗开始后的28周内，经历头发疼痛和/或头皮瘙痒的患者需要根据疼痛问卷的修改版完成一份专门设计的日记。感觉记录内容包括发作时间、持续时间、数字评分量表上的强度、对触摸头皮或头发的依赖性以及感觉特征，可从给定描述词中选择或用自己的话描述。
在C组中，所有完成问卷的患者都经历了头发和头皮感觉：87%同时出现毛发痛和瘙痒，13%仅出现毛发痛。报告的强度范围为1至10。在T组中，31%的参与者报告了头发和头皮感觉：12%同时出现毛发痛和瘙痒，12%仅出现瘙痒，7%仅出现毛发痛。强度评分为1至5。两组在第11周后均未报告有感觉。
C组的头发和头皮感觉比T组明显更常见、持续时间更长、强度更大且性质更具差异性。化疗患者中毛发痛的发生与脱发的开始和持续时间相对应，因此提示可能存在相关性。
