Clinical Dermatology Department, San Gallicano Dermatological Institute-IRCCS, Rome, Italy.
Department of Plastic and Reconstructive Surgery, San Gallicano Dermatological Institute-IRCCS, Rome, Italy.
Skin Res Technol. 2020 Mar;26(2):269-276. doi: 10.1111/srt.12790. Epub 2019 Sep 26.
Chemotherapy-induced alopecia (CIA) affects 65% of patients receiving chemotherapy regimens and is often identified with the massive hair loss stage. Reflectance confocal microscopy (RCM) is a noninvasive technique used in alopecia assessment for disease characterization and state of activity.
To describe RCM features of CIA in different timing and identify specific phases of alopecia development.
A total of 16 patients treated with chemotherapy underwent dermoscopy and RCM evaluations four times during the observation: 2 and 4-6 weeks after starting and 3 and 6 months after the end of chemotherapy. Ten examinations for each stage were performed.
Four phases of CIA have been identified. Initial hair loss showed specific dots not previously described, named CIA dots. massive hair loss phase was characterized by black dots (10/10 pt), CIA dots (8/10 pt) and hair shaft abnormalities. Three months after the end of chemotherapy, during the partial regrowth phase, 10/10 patients showed thin hair in regrowth and 8/10 presented black and yellow dots. At 6 months, normal hair in regrowth appears in all patients (total regrowth phase).
Chemotherapy-induced alopecia has to be considered as a dynamic process with specific phases characterized by distinctive dermoscopic and confocal features.
化疗引起的脱发（CIA）影响 65%接受化疗方案的患者，并且通常在大量脱发阶段被识别。反射共焦显微镜（RCM）是一种用于脱发评估的非侵入性技术，用于疾病特征和活动状态。
描述 CIA 在不同时间的 RCM 特征，并确定脱发发展的特定阶段。
共对 16 名接受化疗的患者进行了四次皮肤镜和 RCM 评估：开始治疗后 2 和 4-6 周以及化疗结束后 3 和 6 个月。每个阶段进行了 10 次检查。
确定了 CIA 的四个阶段。最初的脱发显示出以前未描述的特定点，称为 CIA 点。大量脱发阶段的特征是黑色点（10/10 点）、CIA 点（8/10 点）和毛发异常。化疗结束后 3 个月，在部分再生阶段，10/10 名患者的再生毛发变薄，8/10 名患者出现黑色和黄色点。6 个月时，所有患者的再生毛发都呈现正常（完全再生阶段）。
化疗引起的脱发被认为是一个具有特定阶段的动态过程，这些阶段具有独特的皮肤镜和共焦特征。
