Anagen Effluvium

  • Adriana Rakowska
  • Malgorzata Olszewska
  • Lidia Rudnicka


Anagen effluvium is a common term for multiple conditions associated with diffuse hair loss from follicles in the anagen growth phase. This chapter focuses on trichoscopy of diverse diseases associated with anagen hair loss (e.g., chemotherapy-induced alopecia, loose ­anagen syndrome, short anagen syndrome). Alopecia areata incognita, which is a condition of controversial classification, also is discussed in this chapter.


Alopecia areata incognita Anagen effluvium Black dots Chemotherapy-induced ­alopecia Drug-induced alopecia Loose anagen syndrome Monilethrix-like hair Pohl-Pinkus constriction Short anagen syndrome 


  1. 1.
    Trueb RM. Chemotherapy-induced alopecia. Curr Opin Support Palliat Care. 2010;4(4):281–4.PubMedCrossRefGoogle Scholar
  2. 2.
    Ramos-e-Silva M, Chaves Azevedo-e-Silva M, Carneiro SC. Hair, nail, and pigment changes in major systemic disease. Clin Dermatol. 2008;26(3):296–305.PubMedCrossRefGoogle Scholar
  3. 3.
    Yeager CE, Olsen EA. Treatment of chemotherapy-induced alopecia. Dermatol Ther. 2011;24(4):432–42.PubMedCrossRefGoogle Scholar
  4. 4.
    Guillot B, Bessis D, Dereure O. Mucocutaneous side effects of antineoplastic chemotherapy. Expert Opin Drug Saf. 2004;3(6):579–87.PubMedCrossRefGoogle Scholar
  5. 5.
    Lee WJ, Lee JL, Chang SE, Lee MW, Kang YK, Choi JH, et al. Cutaneous adverse effects in patients treated with the multitargeted kinase inhibitors sorafenib and sunitinib. Br J Dermatol. 2009;161(5):1045–51.PubMedCrossRefGoogle Scholar
  6. 6.
    Tosti A, Pazzaglia M. Drug reactions affecting hair: diagnosis. Dermatol Clin. 2007;25(2):223–31, vii.PubMedCrossRefGoogle Scholar
  7. 7.
    Piraccini BM, Iorizzo M, Rech G, Tosti A. Drug-induced hair ­disorders. Curr Drug Saf. 2006;1(3):301–5.PubMedCrossRefGoogle Scholar
  8. 8.
    Trueb RM. Systematic approach to hair loss in women. J Dtsch Dermatol Ges. 2010;8(4):284–97, 298.PubMedGoogle Scholar
  9. 9.
    D’Agostini F, Balansky R, Pesce C, Fiallo P, Lubet RA, Kelloff GJ, et al. Induction of alopecia in mice exposed to cigarette smoke. Toxicol Lett. 2000;114(1–3):117–23.PubMedCrossRefGoogle Scholar
  10. 10.
    Severs GA, Griffin T, Werner-Wasik M. Cicatricial alopecia ­secondary to radiation therapy: case report and review of the ­literature. Cutis. 2008;81(2):147–53.PubMedGoogle Scholar
  11. 11.
    Dhurat RP, Deshpande DJ. Loose anagen hair syndrome. Int J Trichol. 2010;2(2):96–100.CrossRefGoogle Scholar
  12. 12.
    Tosti A, Piraccini BM. Loose anagen hair syndrome and loose ­anagen hair. Arch Dermatol. 2002;138(4):521–2.PubMedCrossRefGoogle Scholar
  13. 13.
    Price VH, Gummer CL. Loose anagen syndrome. J Am Acad Dermatol. 1989;20(2 Pt 1):249–56.PubMedCrossRefGoogle Scholar
  14. 14.
    Mirmirani P, Uno H, Price VH. Abnormal inner root sheath of the hair follicle in the loose anagen hair syndrome: an ultrastructural study. J Am Acad Dermatol. 2011;64(1):129–34.PubMedCrossRefGoogle Scholar
  15. 15.
    Olsen EA, Bettencourt MS, Cote NL. The presence of loose anagen hairs obtained by hair pull in the normal population. J Investig Dermatol Symp Proc. 1999;4(3):258–60.PubMedCrossRefGoogle Scholar
  16. 16.
    Antaya RJ, Sideridou E, Olsen EA. Short anagen syndrome. J Am Acad Dermatol. 2005;53(2 Suppl 1):S130–4.PubMedCrossRefGoogle Scholar
  17. 17.
    Barraud-Klenovsek MM, Trueb RM. Congenital hypotrichosis due to short anagen. Br J Dermatol. 2000;143(3):612–7.PubMedCrossRefGoogle Scholar
  18. 18.
    Giacomini F, Starace M, Tosti A. Short anagen syndrome. Pediatr Dermatol. 2011;28(2):133–4.PubMedCrossRefGoogle Scholar
  19. 19.
    Quercetani R, Rebora AE, Fedi MC, Carelli G, Mei S, Chelli A, et al. Patients with profuse hair shedding may reveal anagen hair dystrophy: a diagnostic clue of alopecia areata incognita. J Eur Acad Dermatol Venereol. 2011;25(7):808–10.PubMedCrossRefGoogle Scholar
  20. 20.
    Tosti A, Whiting D, Iorizzo M, Pazzaglia M, Misciali C, Vincenzi C, et al. The role of scalp dermoscopy in the diagnosis of alopecia areata incognita. J Am Acad Dermatol. 2008;59(1):64–7.PubMedCrossRefGoogle Scholar
  21. 21.
    Rakowska A, Slowinska M, Kowalska-Oledzka E, Olszewska M, Czuwara J, Rudnicka L. Alopecia areata incognita: true or false? J Am Acad Dermatol. 2009;60(1):162–3.PubMedCrossRefGoogle Scholar
  22. 22.
    Rebora A. Alopecia areata incognita: a comment. Clinics (Sao Paulo). 2011;66(8):1481–2.CrossRefGoogle Scholar
  23. 23.
    Rebora A. Alopecia areata incognita: a hypothesis. Dermatologica. 1987;174(5):214–8.PubMedCrossRefGoogle Scholar
  24. 24.
    Baden HP, Kubilus J, Baden L. A stain for plucked anagen hairs. J Am Acad Dermatol. 1979;1(2):121–2.PubMedCrossRefGoogle Scholar
  25. 25.
    Cantatore-Francis JL, Orlow SJ. Practical guidelines for evaluation of loose anagen hair syndrome. Arch Dermatol. 2009;145(10):1123–8.PubMedCrossRefGoogle Scholar
  26. 26.
    Rebora A. Alopecia areata incognita. J Am Acad Dermatol. 2011;65(6):1228.PubMedCrossRefGoogle Scholar
  27. 27.
    Rebora A. A comment regarding ‘follicular Swiss cheese’ in the diagnosis of alopecia areata. J Cutan Pathol. 2012;39(2):307–8.PubMedCrossRefGoogle Scholar
  28. 28.
    Molina L, Donati A, Valente NS, Romiti R. Alopecia areata incognita. Clinics (Sao Paulo). 2011;66(3):513–5.CrossRefGoogle Scholar
  29. 29.
    Muller CS, El Shabrawi-Caelen L. ‘Follicular Swiss cheese’ ­pattern—another histopathologic clue to alopecia areata. J Cutan Pathol. 2011;38(2):185–9.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2012

Authors and Affiliations

  • Adriana Rakowska
    • 1
  • Malgorzata Olszewska
    • 2
  • Lidia Rudnicka
    • 3
    • 4
  1. 1.Department of DermatologyCSK MSWWarsawPoland
  2. 2.Department of DermatologyMedical University of WarsawWarsawPoland
  3. 3.Faculty of Health SciencesMedical University of WarsawWarsawPoland
  4. 4.Department of DermatologyCSK MSWWarsawPoland

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