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Pathologic Dynamics of Human Hair Loss: I. Telogen Effluvium

Pathologic Dynamics of Human Hair Loss: I. Telogen Effluvium Abstract This study concerns the behavior of the human follicle under stresses which cause temporary loss of hair. Many different agencies cause hair shedding.1 For some years now, I have been watching what happens to the follicle in a variety of natural and experimental alopecic conditions. Out of these observations has grown a biological generalization, the presentation of which is the main business of this essay. To grasp the meaning of this generalization, requires a thorough understanding of the hair cycle, and, in particular, catagen, that brief epoch during which a growing follicle (anagen) becomes transformed into a resting one (telogen). The prelude to the present theme is to be found in a previous paper dealing with the dynamics of human catagen.2 Further important readings are Montagna's3 analyses of hair cycle mechanics, and a recent study of catagen by Ellis and Moretti.4 The dynamics of change in References 1. I have deliberately chosen the word effluvium rather than defluvium because the former does not carry the connotation of sudden conspicuous hair loss of the latter. 2. Since submitting the manuscript I have seen another dramatic case of simultaneous loss of nails and hair which developed three months after an acute attack of anxiety. This was a woman who became very alarmed after breast surgery. 3. Van Scott, E. J.: Response of Hair Roots to Chemical and Physical Influence in Biology of Hair Growth , New York, Academic Press, Inc., 1958, pp. 441-449. 4. Kligman, A. M.: The Human Hair Cycle , J. Invest. Dermat. 33:307, 1957.Crossref 5. Montagna, W.: The Structure and Function of Skin , New York, Academic Press, Inc., 1958. 6. Ellis, R. A., and Moretti, G.: Vascular Patterns Associated with Catagen Hair Follicles in the Human Scalp , Ann. New York Acad. Sc. 83:448, 1959.Crossref 7. Butcher, E. O.: Restitutive Growth in the Hair Follicle of the Rat , Ann. New York Acad. Sc. 83:369, 1959.Crossref 8. Pinkus, H.: Embryology of Hair in Biology of Hair Growth , New York, Academic Press, Inc., 1958, pp. 1-32. 9. Van Scott, E. J.; Reinertson, R. P., and Steinmuller, R.: The Growing Hair Roots of the Human Scalp and Morphologic Changes Therein Following Amethopterin Therapy , J. Invest. Dermat. 29:197, 1957.Crossref 10. Galewsky, E.: Erkrankungen der Haare und des Haarbodens in Handbuch der Haut u. Geschlechtskrankheiten , Berlin, Springer-Verlag, 1932, Vol. 13, p. 221. 11. Pinkus, F.: Über den Haarausfall nach fieberhaften Krankheiten Med. Klin. Berlin , Urban & Schwarzenberg, 1906, Vol. 37, pp. 1-12. 12. Savill, A.: The Hair and Scalp , Baltimore, Williams & Wilkins Company, 1945. 13. Pinkus, F.: Einwirkung von Krankheiten auf das Kopfhaar des Menschen , Berlin, S. Karger, A.G., 1928. 14. Behrman, H. T.: The Scalp in Health and Disease , St. Louis, C. V. Mosby Company, 1952. 15. Lynfield, Y. L.: Effect of Pregnancy on the Human Hair Cycle , J. Invest. Dermat. , to be published. 16. Obermayer, M. E.: Psychocutaneous Medicine , Springfield, Ill., Charles C Thomas, Publisher, 1955. 17. Hirsch, F.: Das Haar des Menschen , Haug, Ulm-Donau, 1956. 18. Guy, W. B., and Edmundson, W. F.: Diffuse Cyclic Hair Loss in Women , A.M.A. Arch. Dermat. 81:205, 1960.Crossref 19. Crounse, R. C., and Van Scott, E. J.: Changes in the Scalp Hair Roots as a Measure of Toxicity from Cancer Chemotherapeutic Drugs , J. Invest. Dermat. , to be published. 20. Williams, C. D.: Kwashiorkor, Council on Foods and Nutrition , J.A.M.A. 153:1280 ( (Dec. 5) ) 1953.Crossref 21. Leider, M.: Practical Pediatric Dermatology , St. Louis, C. V. Mosby Company, 1956. 22. Perlman, H.: Pediatric Dermatology , Chicago, Year Book Publishers, Inc., 1960. 23. Flesch, P.: Hair Growth in Physiology and Biochemistry of the Skin , edited by S. Rothman, Chicago, University of Chicago Press, 1954, pp. 631. 24. Hamilton, J. B.: Patterned Loss of Hair in Man: Types and Incidence , Ann. New York Acad. Sc. 53:708, 1951.Crossref 25. Tedhope, G. R.; Cohen, H., and Meikle, R. W.: Alopecia Following Treatment with Dextran Sulfate and other Anticoagulant Drugs , Brit. M.J. 1:1034, 1958.Crossref 26. Hirschboeck, J. S.; Madison, F. W., and Pisciotta, W. V.: Alopecia and other Toxic Effects of Heparin and Synthetic Heparinoids , Am. J.M. Sc. 227:279, 1954.Crossref 27. Van Scott, E. J.: Evaluation of Disturbed Hair Growth in Alopecia Areata and Other Alopecias , Ann. New York Acad. Sc. 83:480, 1959.Crossref 28. Colsky, J.; Wallace, S., and Banowitch, M. M.: Treatment of Acute Gouty Arthritis with Demecolcine , A.M.A. Arch. Int. Med. 100:765, 1957.Crossref 29. Mikkelson, W. M.; Salin, R. W., and Duff, I. F.: Alopecia Totalis After Desacetylmethylcolchicine Therapy of Acute Gout , New England J. Med. 255:769, 1956.Crossref 30. Malkinson, F. D., and Lynfield, Y. L.: Colchicine Alopecia , J. Invest. Dermat. 33:371, 1959.Crossref 31. Myers, R. J., and Hamilton, J. B.: Regeneration and Rate of Growth of Hairs in Men , Ann. New York Acad. Sc. 53:562, 1951.Crossref 32. Pinkus, F.: Der Ausfall des Kopfhaars und seine Behandlung , Dermatologie und Syphilologie , Vol. 3, Pt. (1) , Halle o. S. 1924. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Pathologic Dynamics of Human Hair Loss: I. Telogen Effluvium

Archives of Dermatology , Volume 83 (2) – Feb 1, 1961

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Publisher
American Medical Association
Copyright
Copyright © 1961 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1961.01580080005001
Publisher site
See Article on Publisher Site

Abstract

Abstract This study concerns the behavior of the human follicle under stresses which cause temporary loss of hair. Many different agencies cause hair shedding.1 For some years now, I have been watching what happens to the follicle in a variety of natural and experimental alopecic conditions. Out of these observations has grown a biological generalization, the presentation of which is the main business of this essay. To grasp the meaning of this generalization, requires a thorough understanding of the hair cycle, and, in particular, catagen, that brief epoch during which a growing follicle (anagen) becomes transformed into a resting one (telogen). The prelude to the present theme is to be found in a previous paper dealing with the dynamics of human catagen.2 Further important readings are Montagna's3 analyses of hair cycle mechanics, and a recent study of catagen by Ellis and Moretti.4 The dynamics of change in References 1. I have deliberately chosen the word effluvium rather than defluvium because the former does not carry the connotation of sudden conspicuous hair loss of the latter. 2. Since submitting the manuscript I have seen another dramatic case of simultaneous loss of nails and hair which developed three months after an acute attack of anxiety. This was a woman who became very alarmed after breast surgery. 3. Van Scott, E. J.: Response of Hair Roots to Chemical and Physical Influence in Biology of Hair Growth , New York, Academic Press, Inc., 1958, pp. 441-449. 4. Kligman, A. M.: The Human Hair Cycle , J. Invest. Dermat. 33:307, 1957.Crossref 5. Montagna, W.: The Structure and Function of Skin , New York, Academic Press, Inc., 1958. 6. Ellis, R. A., and Moretti, G.: Vascular Patterns Associated with Catagen Hair Follicles in the Human Scalp , Ann. New York Acad. Sc. 83:448, 1959.Crossref 7. Butcher, E. O.: Restitutive Growth in the Hair Follicle of the Rat , Ann. New York Acad. Sc. 83:369, 1959.Crossref 8. Pinkus, H.: Embryology of Hair in Biology of Hair Growth , New York, Academic Press, Inc., 1958, pp. 1-32. 9. Van Scott, E. J.; Reinertson, R. P., and Steinmuller, R.: The Growing Hair Roots of the Human Scalp and Morphologic Changes Therein Following Amethopterin Therapy , J. Invest. Dermat. 29:197, 1957.Crossref 10. Galewsky, E.: Erkrankungen der Haare und des Haarbodens in Handbuch der Haut u. Geschlechtskrankheiten , Berlin, Springer-Verlag, 1932, Vol. 13, p. 221. 11. Pinkus, F.: Über den Haarausfall nach fieberhaften Krankheiten Med. Klin. Berlin , Urban & Schwarzenberg, 1906, Vol. 37, pp. 1-12. 12. Savill, A.: The Hair and Scalp , Baltimore, Williams & Wilkins Company, 1945. 13. Pinkus, F.: Einwirkung von Krankheiten auf das Kopfhaar des Menschen , Berlin, S. Karger, A.G., 1928. 14. Behrman, H. T.: The Scalp in Health and Disease , St. Louis, C. V. Mosby Company, 1952. 15. Lynfield, Y. L.: Effect of Pregnancy on the Human Hair Cycle , J. Invest. Dermat. , to be published. 16. Obermayer, M. E.: Psychocutaneous Medicine , Springfield, Ill., Charles C Thomas, Publisher, 1955. 17. Hirsch, F.: Das Haar des Menschen , Haug, Ulm-Donau, 1956. 18. Guy, W. B., and Edmundson, W. F.: Diffuse Cyclic Hair Loss in Women , A.M.A. Arch. Dermat. 81:205, 1960.Crossref 19. Crounse, R. C., and Van Scott, E. J.: Changes in the Scalp Hair Roots as a Measure of Toxicity from Cancer Chemotherapeutic Drugs , J. Invest. Dermat. , to be published. 20. Williams, C. D.: Kwashiorkor, Council on Foods and Nutrition , J.A.M.A. 153:1280 ( (Dec. 5) ) 1953.Crossref 21. Leider, M.: Practical Pediatric Dermatology , St. Louis, C. V. Mosby Company, 1956. 22. Perlman, H.: Pediatric Dermatology , Chicago, Year Book Publishers, Inc., 1960. 23. Flesch, P.: Hair Growth in Physiology and Biochemistry of the Skin , edited by S. Rothman, Chicago, University of Chicago Press, 1954, pp. 631. 24. Hamilton, J. B.: Patterned Loss of Hair in Man: Types and Incidence , Ann. New York Acad. Sc. 53:708, 1951.Crossref 25. Tedhope, G. R.; Cohen, H., and Meikle, R. W.: Alopecia Following Treatment with Dextran Sulfate and other Anticoagulant Drugs , Brit. M.J. 1:1034, 1958.Crossref 26. Hirschboeck, J. S.; Madison, F. W., and Pisciotta, W. V.: Alopecia and other Toxic Effects of Heparin and Synthetic Heparinoids , Am. J.M. Sc. 227:279, 1954.Crossref 27. Van Scott, E. J.: Evaluation of Disturbed Hair Growth in Alopecia Areata and Other Alopecias , Ann. New York Acad. Sc. 83:480, 1959.Crossref 28. Colsky, J.; Wallace, S., and Banowitch, M. M.: Treatment of Acute Gouty Arthritis with Demecolcine , A.M.A. Arch. Int. Med. 100:765, 1957.Crossref 29. Mikkelson, W. M.; Salin, R. W., and Duff, I. F.: Alopecia Totalis After Desacetylmethylcolchicine Therapy of Acute Gout , New England J. Med. 255:769, 1956.Crossref 30. Malkinson, F. D., and Lynfield, Y. L.: Colchicine Alopecia , J. Invest. Dermat. 33:371, 1959.Crossref 31. Myers, R. J., and Hamilton, J. B.: Regeneration and Rate of Growth of Hairs in Men , Ann. New York Acad. Sc. 53:562, 1951.Crossref 32. Pinkus, F.: Der Ausfall des Kopfhaars und seine Behandlung , Dermatologie und Syphilologie , Vol. 3, Pt. (1) , Halle o. S. 1924.

Journal

Archives of DermatologyAmerican Medical Association

Published: Feb 1, 1961

References

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