Ann Dermatol.  2020 Apr;32(2):141-145. 10.5021/ad.2020.32.2.141.

Analysis of Microscopic Examination of Pulled Out Hair in Telogen Effluvium Patients

Affiliations
  • 1Department of Dermatology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea. derma09@hanmail.net

Abstract

BACKGROUND
Telogen effluvium (TE) is characterized by massive hair shedding and results from an abrupt conversion of anagen to telogen. Differentiation of TE with other hair disorders showing massive hair shedding is difficult.
OBJECTIVE
To evaluate the morphologic characteristics of pulled out hair of TE.
METHODS
We analyzed microscopic examination of pulled out hairs by hair pull test in TE patients, and compared these hairs with pulled out hairs in diffuse alopecia areata (AA) patients and healthy volunteers.
RESULTS
Hair microscopic examination in 44 TE patients (370 hairs) and 30 healthy volunteers (295 hairs) were as follows: typical club hair, 32.7%, 62.7%; club hair with tail, 23.5%, 23.7%; club hair with remnant sheath, 23.0%, 6.8%; club hair with both tail and remnant sheath, 18.9%, 5.4%; and unclassified hair, 1.9%, 1.4%. The examination in 7 diffuse AA patients (63 hairs) was as follows: typical club hair, 23.9%; atypical club hair, 47.7%; and distinctive AA hair, 28.4%. There was statistical difference between TE patients and healthy volunteers group (p=0.000).
CONCLUSION
Increased atypical club hair in microscopic hair examination might be characteristics of TE.

Keyword

Alopecia; Alopecia areata; Hair

MeSH Terms

Alopecia
Alopecia Areata
Hair*
Healthy Volunteers
Humans
Tail

Figure

  • Fig. 1 Pulled out hairs were classified microscopically by morphology into typical club hair (A), club hair with tail (B), club hair with remnant sheath (C), and club hair with both tail and remnant sheath (D) (A~D: ×40).

  • Fig. 2 Distinctive AA hairs include hair with tapering of proximal hair shaft (A), hair with breakage of proximal hair shaft (B) and hair with surface undulation (C) (A~C: ×40).

  • Fig. 3 Analysis of morphologic characteristics of pulled out hairs between 3 groups of telogen effluvium patients, diffuse alopecia areata patients, and healthy volunteers (*p<0.05). Distinctive AA hairs were excluded in this analysis. TE: telogen effluvium, AA: alopecia areata.


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