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Letters |15 July 1996

Alopecia Associated with Fluconazole Therapy

Lowell A. Goldsmith, MD

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  • University of Rochester School of Medicine and Dentistry Rochester, NY 14642
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TO THE EDITOR:
I read with interest the recent report on reversible alopecia related to fluconazole therapy [1]. Hair shaft and hair sheath structures were not described in the report. After systemic illness, a precipitation of the telogen (resting) phase of the hair cycle often causes hair loss. Alopecia also occurs after fasting, after pregnancy, with hypothyroidism, and with iron deficiency [2]. Telogen hairs can be easily recognized on a hair pull, and the diagnosis can be confirmed by scalp biopsy. Anagen effluvium follows chemotherapy or irradiation, both of which affect the rapidly proliferating cells of the hair matrix. Such hairs can be recognized by their necrotic root sheaths or constricted hair shafts [3]. Constrictions (Pohl-Pinkus marks) analogous to Beau lines in the nails occasionally appear in such hairs because of temporarily decreased growth. Vitamin A and its analogues cause dystrophic anagen hairs that can progress to a usually reversible form of hair loss.
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Goldsmith LA. Alopecia Associated with Fluconazole Therapy. Ann Intern Med. 1996;125:153. doi: 10.7326/0003-4819-125-2-199607150-00020

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Published: Ann Intern Med. 1996;125(2):153.

DOI: 10.7326/0003-4819-125-2-199607150-00020

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Print ISSN: 0003-4819 | Online ISSN: 1539-3704

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