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[Temporary localized alopecia following neuroradiological procedures: 18 cases].
Ann Dermatol Venereol 2014; 141(1):15-22AD

Abstract

BACKGROUND

The treatment of cerebral lesions using endovascular radiological procedures is becoming a standard of care. Radiation-induced alopecia, a type of acute radiodermatitis, is a frequent complication. Between 2009 and 2010, a number of patients reported hair loss after embolization of a cerebral arteriovenous malformation at the Neuroradiology Department of the Strasbourg University Hospital. We therefore retrospectively investigated 18 cases to better delineate the circumstances and the risk factors associated with radiation-induced alopecia.

PATIENTS AND METHODS

We reviewed the records of 35 patients reporting hair loss among the 347 patients undergoing embolization of cerebral arteriovenous malformations between January 2008 and May 2010. Only patients with photographically documented complete circumscribed alopecia were included. Patients were examined and interviewed by a dermatologist and/or a radiologist at the time of hair loss and at a later point. The cumulative dose of radiation delivered to the skin in the 3 months preceding onset of alopecia, then over the entire period 2008-2010, was calculated. These doses included the diagnostic (angiography) and therapeutic (embolization) procedures.

RESULTS

Definite circumscribed alopecia was noted in 18 patients. Alopecia occurred between two and four weeks after embolization; it was complete and in no cases cicatricial. Complete recovery as attested by examination or photography was observed in 12 patients. The cumulative dose over the preceding three months was between 2.5 Gy and 12.3 Gy (mean: 5 Gy). The total cumulative dose since January 2008 was between 3.2 and 17 Gy (mean: 7 Gy).

DISCUSSION

We describe a series of 18 patients with radio-induced alopecia occurring after diagnostic and therapeutic procedures for cerebral arteriovenous malformations. This series is particularly interesting because it includes the largest patient sample reported to date with an uncommon large area of alopecia, and also because we were able to calculate the cumulative dose of radiation delivered to the skin. In addition, we underline the importance of the cumulative dose in interventional radiology since radio-induced alopecia probably results from the number of interventional procedures during a given time period. Moreover, analysis of these doses provided us with a new perspective on the radiobiology of the hair growth cycle. Indeed, whereas previously reported data considered alopecia as definitive where doses higher than 7 Gy were delivered, we noticed regrowth of hair with doses of up to 12 Gy.

CONCLUSION

These observations underline the specific findings of radiation-induced alopecia and underline the importance of the cumulative radiation dose delivered during the 3 months preceding alopecia.

Authors+Show Affiliations

Clinique dermatologique, université de Strasbourg, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67000, Strasbourg, France.Service de radiologie interventionnelle, université de Strasbourg, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67000, Strasbourg, France.Clinique dermatologique, université de Strasbourg, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67000, Strasbourg, France. Electronic address: dlipsker@gmail.com.

Pub Type(s)

Journal Article

Language

fre

PubMed ID

24461089

Citation

Freysz, M, et al. "[Temporary Localized Alopecia Following Neuroradiological Procedures: 18 Cases]." Annales De Dermatologie Et De Venereologie, vol. 141, no. 1, 2014, pp. 15-22.
Freysz M, Mertz L, Lipsker D. [Temporary localized alopecia following neuroradiological procedures: 18 cases]. Ann Dermatol Venereol. 2014;141(1):15-22.
Freysz, M., Mertz, L., & Lipsker, D. (2014). [Temporary localized alopecia following neuroradiological procedures: 18 cases]. Annales De Dermatologie Et De Venereologie, 141(1), pp. 15-22. doi:10.1016/j.annder.2013.09.655.
Freysz M, Mertz L, Lipsker D. [Temporary Localized Alopecia Following Neuroradiological Procedures: 18 Cases]. Ann Dermatol Venereol. 2014;141(1):15-22. PubMed PMID: 24461089.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Temporary localized alopecia following neuroradiological procedures: 18 cases]. AU - Freysz,M, AU - Mertz,L, AU - Lipsker,D, Y1 - 2013/11/07/ PY - 2013/04/24/received PY - 2013/08/24/revised PY - 2013/09/05/accepted PY - 2014/1/28/entrez PY - 2014/1/28/pubmed PY - 2014/12/15/medline KW - Alopecia KW - Alopécie KW - Embolisation KW - Embolization KW - Procedural radiology KW - Radiodermatitis KW - Radiodermite KW - Radiologie interventionnelle SP - 15 EP - 22 JF - Annales de dermatologie et de venereologie JO - Ann Dermatol Venereol VL - 141 IS - 1 N2 - BACKGROUND: The treatment of cerebral lesions using endovascular radiological procedures is becoming a standard of care. Radiation-induced alopecia, a type of acute radiodermatitis, is a frequent complication. Between 2009 and 2010, a number of patients reported hair loss after embolization of a cerebral arteriovenous malformation at the Neuroradiology Department of the Strasbourg University Hospital. We therefore retrospectively investigated 18 cases to better delineate the circumstances and the risk factors associated with radiation-induced alopecia. PATIENTS AND METHODS: We reviewed the records of 35 patients reporting hair loss among the 347 patients undergoing embolization of cerebral arteriovenous malformations between January 2008 and May 2010. Only patients with photographically documented complete circumscribed alopecia were included. Patients were examined and interviewed by a dermatologist and/or a radiologist at the time of hair loss and at a later point. The cumulative dose of radiation delivered to the skin in the 3 months preceding onset of alopecia, then over the entire period 2008-2010, was calculated. These doses included the diagnostic (angiography) and therapeutic (embolization) procedures. RESULTS: Definite circumscribed alopecia was noted in 18 patients. Alopecia occurred between two and four weeks after embolization; it was complete and in no cases cicatricial. Complete recovery as attested by examination or photography was observed in 12 patients. The cumulative dose over the preceding three months was between 2.5 Gy and 12.3 Gy (mean: 5 Gy). The total cumulative dose since January 2008 was between 3.2 and 17 Gy (mean: 7 Gy). DISCUSSION: We describe a series of 18 patients with radio-induced alopecia occurring after diagnostic and therapeutic procedures for cerebral arteriovenous malformations. This series is particularly interesting because it includes the largest patient sample reported to date with an uncommon large area of alopecia, and also because we were able to calculate the cumulative dose of radiation delivered to the skin. In addition, we underline the importance of the cumulative dose in interventional radiology since radio-induced alopecia probably results from the number of interventional procedures during a given time period. Moreover, analysis of these doses provided us with a new perspective on the radiobiology of the hair growth cycle. Indeed, whereas previously reported data considered alopecia as definitive where doses higher than 7 Gy were delivered, we noticed regrowth of hair with doses of up to 12 Gy. CONCLUSION: These observations underline the specific findings of radiation-induced alopecia and underline the importance of the cumulative radiation dose delivered during the 3 months preceding alopecia. SN - 0151-9638 UR - https://www.unboundmedicine.com/medline/citation/24461089/[Temporary_localized_alopecia_following_neuroradiological_procedures:_18_cases]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0151-9638(13)01607-4 DB - PRIME DP - Unbound Medicine ER -