Department of Dermatology, School of Medicine, Cardiff University, Cardiff, CF, UK.
Indian J Dermatol Venereol Leprol. 2017 Nov-Dec;83(6):644-649. doi: 10.4103/ijdvl.IJDVL_553_16.
Traction alopecia was first described in 1904 but is still a cause of scarring hair loss in young women worldwide. It is unique in being initially a reversible then an irreversible (scarring) form of alopecia. Linked to tightly-pulled hairstyles, it is seen across all races. The pattern of hair loss depends on the style creating it but most commonly affects the frontotemporal hairline. There are some new examination findings associated with traction alopecia, which are traction folliculitis, the fringe sign and hair casts (pseudonits) on dermatoscopy. These may prove key in prompting early specialist referral. The mainstay of current treatment is cessation of the contributing hairstyles. Camouflage, anti-inflammatory or growth-stimulating topical preparations are second line treatments. In later stages of severe traction alopecia hair transplantation may be the only effective treatment. The evidence basis for medical intervention with topical agents is anecdotal at best. Furthermore, additional research is required to clarify the pathogenesis of this biphasic alopecia. Until then, prompt diagnosis and identification of causative hairstyles are focus of current dermatological practice.
牵引性脱发于 1904 年首次被描述，但它仍然是全球年轻女性发生瘢痕性脱发的一个原因。它的独特之处在于最初是一种可逆的，然后是一种不可逆转的（瘢痕性）脱发形式。与紧束的发型有关，它可见于所有种族。脱发模式取决于造成脱发的发型，但最常见的是影响额颞部发际线。牵引性脱发与一些新的检查发现有关，即牵引性毛囊炎、刘海征和毛发套（假性发结）在皮镜下的表现。这些可能是促使早期专家转诊的关键。目前治疗的主要方法是停止使用引起脱发的发型。掩饰、抗炎或促进毛发生长的局部制剂是二线治疗。在严重牵引性脱发的后期，毛发移植可能是唯一有效的治疗方法。局部药物干预的循证医学依据充其量只是传闻。此外，还需要进一步的研究来阐明这种双相性脱发的发病机制。在那之前，及时诊断和识别致病发型是当前皮肤科实践的重点。
