Contin Leticia Arsie, Santos Leopoldo Duailibe Nogueira, Pereira Ivan José Netto, Rocha Vanessa Barreto
Department of Dermatology, Hospital do Servidor Público Municipal de São Paulo, São Paulo, Brazil.
Dermatology, Hospital das Clínicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil.
Skin Appendage Disord. 2021 Jun;7(4):311-314. doi: 10.1159/000513087. Epub 2021 Mar 23.
Many procedures are performed on the scalp, such as excision of pilar and sebaceous cysts, melanocytic nevi, and reduction surgery for scarring alopecia, among others. In hair transplants, telogen effluvium is often reported 3 months after surgery; however, hair loss usually happens much earlier, around second week after the procedure, not compatible with the time required for hair to enter telogen and exogenous phases in normal conditions.
We report 3 cases of anagen hair loss 4 weeks after surgeries, with perilesional trichoscopy suggesting anagen effluvium, with typical signs such as black dots and exclamation hairs.
There are only a few reports about hair loss around operated areas. The cause of this postoperative anagen effluvium is probably a transient ischemia.
The practical importance of this phenomenon is to properly orient patients because most of the hair will be lost, since 85% of them are anagens, and also will have spontaneous recovery in the next 3 months.
头皮上会进行多种手术，例如切除毛囊囊肿、皮脂腺囊肿、黑素细胞痣以及瘢痕性秃发的修复手术等。在毛发移植手术中，通常术后3个月会出现休止期脱发；然而，脱发往往在术后更早出现，大约在术后第二周，这与正常情况下毛发进入休止期和外源性阶段所需的时间不符。
我们报告了3例术后4周生长期脱发的病例，病变周围的毛囊镜检查提示生长期脱发，有黑点和惊叹号样毛发等典型表现。
关于手术区域周围脱发的报道较少。这种术后生长期脱发的原因可能是短暂性缺血。
这一现象的实际重要性在于要正确引导患者，因为大部分毛发将会脱落，其中85%处于生长期，并且在接下来的3个月内会自然恢复。
