Loss of Normal Anagen Hair in Pemphigus Vulgaris Publisher Pubmed



Daneshpazhooh M¹ ; Mahmoudi HR¹ ; Rezakhani S^{1, 2} ; Valikhani M¹ ; Naraghi ZS^{1, 3} ; Mohammadi Y^{1, 4} ; Habibi A¹ ; Chamsdavatchi C¹ Show Affiliations
Source: Clinical and Experimental Dermatology Published:2015

Abstract

Background Pemphigus vulgaris (PV) is a known cause of loss of 'normal' anagen hair; that is, shedding of intact anagen hairs covered by root sheaths. However, studies on this subject are limited. Aim To investigate anagen hair shedding in patients with PV, and ascertain its association with disease severity. Methods In total, 96 consecutive patients with PV (new patients or patients in relapse) who were admitted to the dermatology wards of a tertiary hospital were enrolled in this study. Demographic data, PV phenotype, disease severity and presence of scalp lesions were recorded. A group of 10-20 hairs were pulled gently from different areas of the scalp (lesional and nonlesional skin) in all patients, and anagen hairs were counted. Disease severity was graded according to Harman score. Results Anagen hair was obtained by pull test in 59 of the 96 patients (61.5%), of whom 2 had normal scalp. The mean ± SD anagen hair count was 5.9 ± 7.6 (range 0-31). In univariate analysis, anagen hair loss (P < 0.01) and the presence of scalp lesions (P = 0.01) were associated with severe disease. Mean anagen hair count was significantly higher in the severe (mean 6.83 ± 7.89) than the moderate (mean 1.06 ± 1.94) subgroup (P < 0.001). Multivariate analysis confirmed anagen hair loss (OR = 1.16, 95% CI = 1.05-1.28, P < 0.01), but not scalp lesions (P = 0.69) as an independent predictor of disease severity. Conclusions According to our study, normal anagen effluvium is a frequent finding in patients with PV, and interestingly, this was observed in nonlesional as well as lesional scalp. In addition, severe anagen hair loss was an independent predictor of the disease severity. © 2015 British Association of Dermatologists.