Permanent alopecia in patients with breast cancer after taxane chemotherapy and adjuvant hormonal therapy: Clinicopathologic findings in a cohort of 10.

Slides:

Advertisements

Similar presentations

Grover disease with a contagious twist

Advertisements

Successful treatment of corticosteroid-resistant ophiasis-type alopecia areata (AA) with platelet-rich plasma (PRP) Jeff Donovan, MD, PhD, FRCPC JAAD.

Cutaneous polyarteritis nodosa presenting as a solitary blue toe

Cutaneous vasculitis in two patients taking an herbal supplement containing black cohosh Adam Ingraffea, BA, Kevin Donohue, MD, Caroline Wilkel, MD,

Volume 4, Issue 4, Pages (May 2018)

Yul W. Yang, MD, PhD, David J. DiCaudo, MD

Tofacitinib 2% ointment, a topical Janus kinase inhibitor, for the treatment of alopecia areata: A pilot study of 10 patients Lucy Y. Liu, BA, Brittany.

Diffuse hyperpigmented plaques as cutaneous manifestation of multicentric Castleman disease and treatment with thalidomide: Report of three cases Xiaoqing.

Sweet's panniculitis associated with metastatic breast cancer

Baldness reversed by chemotherapy

Expression of PD-L1 in mastocytosis

Array of cutaneous adverse effects associated with sorafenib

Extensive ulcerated pigmented nodules

Desmoplastic trichoepithelioma

Diffuse depigmentation in a patient with chronic myeloid leukemia

Unusual patterns of presentation of frontal fibrosing alopecia: A clinical and trichoscopic analysis of 98 patients Alfredo Rossi, MD, PhD, Sara Grassi,

Iatrogenic hyperpigmentation in chronically infected hepatitis C patients treated with pegylated interferon and ribavirin Jennifer Lin, MD, Jason P.

Hypertrophic scars from surgical staples mimicking folliculitis

Permanent chemotherapy-induced alopecia: A review

Ben Tallon, MBChB, Elizabeth Blanchard, MD, Lynne J. Goldberg, MD

Squamous cell carcinoma tumor thrombus encountered during Mohs micrographic surgery Gary Mendese, MD, Jeremy Bordeaux, MD, MPH, Sean Pattee, MD, Mary.

Ming Yang Bi, AB, Jonathan L. Curry, MD, Angela M

Mid-dermal elastolysis as a manifestation of immune reconstitution inflammatory syndrome in an HIV-infected patient Carlo Cota, MD, Alessandra Latini,

Follicular mucinous nevus: A possible new variant of mucinous nevus

Rachel L. Kyllo, BS, Mary Kendall Parker, MD, Ilana Rosman, MD, Amy C

Jonathan E. Blume, MD, Howard L. Stoll, MD, Richard T. Cheney, MD

Frontal fibrosing alopecia and lichen planus pigmentosus

Congenital Darier disease

A definitive case of metastatic folliculotropic melanoma

Volume 4, Issue 2, Pages (March 2018)

Dermatology physician extenders: A new risk factor?

Stephanie W. Hu, MD, Steven R. Tahan, MD, Caroline C. Kim, MD

Catherine A. Necessary, BA, David Roffwarg, MD, Darrel Ellis, MD

Relapsing polychondritis-like ear disease responding to etanercept in two patients with psoriasis and psoriatic arthritis Hsing-Chuan Lee, MD, Tsen-Fang.

Successful treatment of corticosteroid-resistant ophiasis-type alopecia areata (AA) with platelet-rich plasma (PRP) Jeff Donovan, MD, PhD, FRCPC JAAD.

Myiasis in a giant squamous cell carcinoma

Şuayib Yalçın, MD, Ömer Dizdar, MD, Başak Yalçın, MD, Özay Gököz, MD

Donna M. Hepper, MD, Peggy Wu, MD, Milan J. Anadkat, MD

Solitary mastocytoma in an adult with an unusual clinical presentation

Third-trimester impetigo herpetiformis treated with cyclosporine

Gemcitabine-associated Sweet syndrome–like eruption

IgG4-related disease presenting with scarring alopecia of the scalp

Scurvy in a patient on vemurafenib

Bullous rheumatoid neutrophilic dermatosis

SALT II: A new take on the Severity of Alopecia Tool (SALT) for determining percentage scalp hair loss Elise A. Olsen, MD, Douglas Canfield, BS Journal.

A case of adult T-cell leukemia/lymphoma in the Midwest

Warren L. Macaulay (1915–2006) Walter Burgdorf, MD, Werner Kempf, MD

Keratosis follicularis spinulosa decalvans in a family

Rapid onset of CD8+ aggressive T-cell lymphoma during bexarotene therapy in a patient with Sézary syndrome Alexander Kreuter, MD, Peter Altmeyer, MD

Cutaneous metastatic disease: Burkitt lymphoma

The merits of adding toluidine blue–stained slides in Mohs surgery in the treatment of a microcystic adnexal carcinoma Steven Q. Wang, MD, Leonard H.

Lip edema Journal of the American Academy of Dermatology

Dema T. Alniemi, MD, Laura McGevna, MD JAAD Case Reports

Jay S. Herbst, MD, FAAD, Alexander T. Herbst, BS JAAD Case Reports

Drug-induced alopecia after dupilumab therapy

Volume 5, Issue 3, Pages (March 2019)

Ali Haydar Parlak, MD, Cetin Boran, MD, Mehmet Ata Topçuoglu, MD

Treatment of shiitake dermatitis by balneo PUVA therapy

Tofacitinib therapy for children with severe alopecia areata

Subcutaneous sarcoidosis presenting after treatment of Cushing's disease Jill C. Fichtel, MD, Anna Kay Wiggins Duckworth, MD, Temitope Soares, PharmD,

Jose Fernández-Vozmediano, PhD, Jose Armario-Hita, MD

Ivanka Kovalyshyn, BA, Amin D. Bijal, MD, Mario E

Clinicopathologic lessons in distinguishing cicatricial alopecia: 7 Cases of lichen planopilaris misdiagnosed as discoid lupus Vinod E. Nambudiri, MD,

Violaceous plaque on the forehead clinically resembling angiosarcoma: Cutaneous metastasis in a patient with prostatic adenocarcinoma John S. Boswell,

Atypical Mycobacterium furunculosis occurring after pedicures

Rare presentation of disseminated follicular lymphoma as an ill-defined reticular patch over the scalp and forehead Faezeh Talebi-Liasi, MD, Sophia Sandhu,

Acanthosis nigricans in a patient with sarcoma of unknown origin

Cutaneous polyarteritis nodosa presenting as a solitary blue toe

Hyperpigmented, hypertrichotic, and sclerodermoid plaques: An unusual variant of Muckle–Wells syndrome Mohammad A. El-Darouti, MD Journal of the American.

Eosinophilic pustular folliculitis induced by chemotherapy

Presentation transcript:

Permanent alopecia in patients with breast cancer after taxane chemotherapy and adjuvant hormonal therapy: Clinicopathologic findings in a cohort of 10 patients Athina Fonia, MRCP, Carlo Cota, MD, Jane F. Setterfield, FRCP, Lynne J. Goldberg, MD, David A. Fenton, FRCP, Catherine M. Stefanato, MD, FRCPath Journal of the American Academy of Dermatology Volume 76, Issue 5, Pages 948-957 (May 2017) DOI: 10.1016/j.jaad.2016.12.027 Copyright © 2016 American Academy of Dermatology, Inc. Terms and Conditions

Fig 1 Patient 1, type A clinical pattern of alopecia. Diffuse scalp hair loss involving the (A) occiput, (B) vertex, and (C) temporal areas. Journal of the American Academy of Dermatology 2017 76, 948-957DOI: (10.1016/j.jaad.2016.12.027) Copyright © 2016 American Academy of Dermatology, Inc. Terms and Conditions

Fig 2 Patient 1. Histopathology of type A clinical pattern of alopecia. A, Isthmus. Note the preservation of the follicular units with diffuse “shift out of anagen” and “follicular inertia” of miniaturized telogen and intermediate/vellus-sized hair follicles. B, Higher power showing a stellate morphology of the miniaturized telogen hair follicles. C, Subisthmus. Numerous end-stage fibrous tracts. D, Detail showing loss of vascularity and a characteristic solar elastosis–like appearance with obliteration. (Hematoxylin–eosin stain; original magnification: A and C, ×40; B and D, ×200.) Journal of the American Academy of Dermatology 2017 76, 948-957DOI: (10.1016/j.jaad.2016.12.027) Copyright © 2016 American Academy of Dermatology, Inc. Terms and Conditions

Fig 3 Patient 3, type B clinical pattern of alopecia. A and B, Hair regrowth after minoxidil 5% treatment in this patient who presented with diffuse scalp alopecia with accentuation on the vertex of the scalp. Note thinning of the temporal area. C, Biopsy specimen obtained from the vertex of the scalp before hair regrowth (clinically involved area). Isthmus: histopathology showing preservation of the follicular units with increased telogen hair follicles and miniaturization. D, Miniaturization with variation of hair follicle size, consistent with female pattern hair loss. E, A dysmorphic telogen hair follicle at 6 o'clock and an anagen hair follicle at 12 o'clock. (Hematoxylin–eosin stain; original magnification: C, ×40; D and E, ×200.) Journal of the American Academy of Dermatology 2017 76, 948-957DOI: (10.1016/j.jaad.2016.12.027) Copyright © 2016 American Academy of Dermatology, Inc. Terms and Conditions

Fig 4 Patient 3, histopathology of type B clinical pattern of alopecia. Biopsy specimen obtained from the occiput of the scalp before hair regrowth (clinically uninvolved area). A, Subisthmus. Miniaturization with variation in hair follicle size of anagen hair follicles. B and C, Peribulbar lymphoid cell infiltrate involving also the inferior follicular segments of miniaturized hair follicles. D, Isthmus. A dysmorphic telogen hair follicle (at 9 o'clock) with an anagen terminal hair follicle (middle) and an anagen vellus hair follicle (at 1 o'clock). (Hematoxylin–eosin stain; original magnification: A, ×40; B and C, ×400; D, ×200.) Journal of the American Academy of Dermatology 2017 76, 948-957DOI: (10.1016/j.jaad.2016.12.027) Copyright © 2016 American Academy of Dermatology, Inc. Terms and Conditions

Fig 5 Patient 10, type C clinical pattern of alopecia. A, Patchy hair loss on a background of a diffuse hair loss with (B) occipital involvement in an ophiasis-like pattern. C, Biopsy specimen obtained from the vertex of the scalp. Histopathology of vertical sections shows an atrophic epidermis with miniaturized hair follicles in the dermis and subcutaneous tissue with numerous end-stage fibrous tracts and a dysmophic telogen hair follicle (inset). D, Detail of the end-stage avascular obliterated fibrous tracts with solar elastosis–like appearance. (Hematoylin–eosin stain; original magnification: C, ×40; inset and D, ×200.) Journal of the American Academy of Dermatology 2017 76, 948-957DOI: (10.1016/j.jaad.2016.12.027) Copyright © 2016 American Academy of Dermatology, Inc. Terms and Conditions

Fig 6 Patient 10. Histopathology of type C clinical pattern of alopecia. Biopsy specimen obtained from the vertex of the scalp. A, Isthmus. Histopathology of horizontal sections showing preservation of the follicular units with diffuse miniaturization and (B) numerous vellus hair follicles. C, Subisthmus. Peribulbar lymphoid cell infiltrate involving also the inferior follicular segment. D, Another inferior segment of a hair follicle with lymphoid cell infiltrate and pigment casts. (Hematoxylin–eosin stain; original magnification: A, ×40; B, ×100; C, ×200; D, ×400.) Journal of the American Academy of Dermatology 2017 76, 948-957DOI: (10.1016/j.jaad.2016.12.027) Copyright © 2016 American Academy of Dermatology, Inc. Terms and Conditions

Fig 7 Chemoinflammatory and hormonal hair follicle cycle disruption steps. A, Taxane attacking the hair bulb of an anagen hair follicle inducing an anagen effluvium. B, Disrupted peribulbar area of immune privilege loss with bulbar antigen exposure triggering alopecia areata–like features, including peribulbar lymphoid cell infiltrate, shift out of anagen with “inflammatory” telogen effluvium, and miniaturization. C, The residual hair follicles with underlying obliterated end-stage fibrous tracts cannot recycle and are “arrested” in a status of “follicular inertia.” D, Further miniaturization caused by adjuvant antiestrogen hormonal therapy imparting features of female pattern hair loss (FPHL). Journal of the American Academy of Dermatology 2017 76, 948-957DOI: (10.1016/j.jaad.2016.12.027) Copyright © 2016 American Academy of Dermatology, Inc. Terms and Conditions