Telogen Effluvium as a complication of scalp reconstruction with tissue expander: a case report
Keywords:
Telogen Effluvium, Burn Alopecia, Scalp ReconstructionAbstract
Background and aim: The treatment of burn alopecia is still considered a challenging task for plastic surgeons. Tissue expansion has been extensively described as a useful technique used in order allow the reconstruction of large scalp defects with reliable hair-bearing tissue, enhancing the final aesthetic outcome.
Case Report: We present the case of a 43-tear-old woman affected by scarring burn alopecia of left parietal area, treated with staged tissue expansion and local flap reconstruction. Despite the complete flap survival, a reversible acute hair loss 12 days after surgery, ascribable as Telogen Effluvium (TE), was reported.
Conclusions: TE is a rare and self-limiting condition potentially related with any kind surgery or stressful events. Plastic surgeons should be aware of this condition, particularly when performing scalp reconstruction, as it can be misled with other local complications. Clinical diagnosis is of paramount importance to avoid useless or even harmful treatments: reassuring the patient remains the most effective therapeutic pathway.
References
Jeong S-H, Koo S-H, Han S-K, Kim W-K. An Algorithmic Approach for Reconstruction of Burn Alopecia. Ann Plast Surg. 2010;65(3):330-337. doi:10.1097/SAP.0b013e3181d2487a
Azzi JL, Thabet C, Azzi AJ, Gilardino MS. Complications of tissue expansion in the head and neck. Head Neck. 2020;42(4):747-762. doi:10.1002/hed.26017
Raposio E. Scalp expansion: Surgical considerations and possible future directions. Indian J Plast Surg. 2018;51(01):084-088. doi:10.4103/ijps.IJPS_209_17
Hughes EC, Saleh D. Telogen Effluvium.; 2021. http://www.ncbi.nlm.nih.gov/pubmed/28613598.
Rebora A. Telogen effluvium: a comprehensive review. Clin Cosmet Investig Dermatol. 2019;Volume 12:583-590. doi:10.2147/CCID.S200471
Nalluri R, Harries M. Alopecia in general medicine. Clin Med (Northfield Il). 2016;16(1):74-78. doi:10.7861/clinmedicine.16-1-74
BROU J, VU T, McCAULEY RL, et al. The Scalp as a Donor Site. J Trauma Inj Infect Crit Care. 1990;30(5):579-581. doi:10.1097/00005373-199005000-00009
Goodman EJ. Telogen Effluvium Need Not Recur. A A Case Reports. 2013;1(1):12-13. doi:10.1097/acc.0b013e31828f2c58
Chu SY, Chou CH, Huang H Da, et al. Mechanical stretch induces hair regeneration through the alternative activation of macrophages. Nat Commun. 2019;10(1). doi:10.1038/s41467-019-09402-8
Lee Y, Gil MS, Hong JJ. Histomorphologic changes of hair follicles in human expanded scalp. Plast Reconstr Surg. 2000;105(7):2361-2365. doi:10.1097/00006534-200006000-00008
Chu Q, Martinez TF, Novak SW, et al. Regulation of the ER stress response by a mitochondrial microprotein. Nat Commun. 2019;10(1):1-13. doi:10.1038/s41467-019-12816-z
Yasir M, Goyal A, Bansal P, Sonthalia S. Corticosteroid Adverse Effects.; 2021. http://www.ncbi.nlm.nih.gov/pubmed/30285357.
UNGER R, DAWOUD T, ALBAQAMI R. Successful Hair Transplantation of Recalcitrant Alopecia Areata of the Scalp. Dermatologic Surg. 2008;34(11):1589-1594. doi:10.1111/j.1524-4725.2008.34330.x
Mysore V, Parthasaradhi A, Kharkar R, et al. Expert consensus on the management of telogen effluvium in India. Int J Trichology. 2019;11(3):107. doi:10.4103/ijt.ijt_23_19
Werner B, Mulinari-Brenner F. Clinical and histological challenge in the differential diagnosis of diffuse alopecia: female androgenetic alopecia, telogen effluvium and alopecia areata - part I. An Bras Dermatol. 2012;87(5):742-747.
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