Defining Predictive Factors for Permanent Chemotherapy-Induced Alopecia: Trichoscopy, Reflectance Confocal Microscopy...

Area of Science:

• Dermatology
• Oncology
• Medical Imaging

Background:

• Limited literature exists on trichoscopy for permanent chemotherapy-induced alopecia (pCIA).
• No prior studies have utilized reflectance confocal microscopy (RCM) for pCIA assessment.
• Understanding pCIA development is crucial for managing cancer patients undergoing chemotherapy.

Purpose of the Study:

• To monitor chemotherapy-induced alopecia (CIA) development using trichoscopy and RCM.
• To identify predictor factors for permanent CIA (pCIA).
• To correlate trichoscopic and RCM findings with pCIA development.

Main Methods:

• A multicentre, prospective, observational study.
• Enrolled 77 cancer patients undergoing chemotherapy with drugs known to cause pCIA.
• Followed patients for 2 years post-recruitment, utilizing trichoscopy and RCM.

Main Results:

• Trichoscopy in pCIA patients showed yellow dots, persistent regrowing hairs, and increased miniaturization post-chemotherapy.
• RCM revealed persistent inflammatory cells around adnexal structures, leading to fibrosis and altered rimming.
• Six months after chemotherapy cessation, these findings were evident in patients with pCIA.

Conclusions:

• Trichoscopy and RCM are effective in monitoring CIA development phases.
• Predictor factors for pCIA include cyclophosphamide/taxane chemotherapy history.
• Diffuse yellow dots on trichoscopy and persistent inflammatory infiltrate on RCM are key indicators of pCIA.