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Portuguese Journal of Dermatology and Venereology

Print version ISSN 2795-501XOn-line version ISSN 2795-5001

Port J Dermatol Venereol. vol.81 no.4 Lisboa Dec. 2023  Epub Aug 28, 2023

https://doi.org/10.24875/pjdv.23000043 

DERMATOLOGY IMAGES

Tractional alopecia

Alopecia tracional

Miguel Mansilla-Polo1  2  *  https://orcid.org/0000-0001-6730-6723

Begoña Escutia-Muñoz1  2 

Rafael Botella-Estrada1  2  3 

1Department of Dermatology, Hospital Universitario y Politècnico La Fe

2Health Research Institute (IIS) La Fe

3Universitat de València. Valencia, Spain


A 28-year-old woman, with no history of interest, consulted for hair loss for at least 10 years with no apparent associated trigger. On examination, a bilateral frontotemporal pillar loss was observed (Figs. 1A and 1B), coinciding with the area of tightness of her ponytail hairstyle. She related that ever since she could remember, she always combed her hair taut with a rubber band. On trichoscopy, fine hair was noted with no other trichoscopic findings, except for seborrheic dermatitis of the scalp. With the diagnosis of tractional alopecia, measures emphasizing the change of hairstyle and off-label use oral minoxidil 1mg/day werre initiated, with evident improvement after 3 months of treatment.

Figure 1 A: loss of the right and B: left frontotemporal pillar, in a linear fashion and limited to the region of greatest tension due to the ponytail. Seborrheic dermatitis of the scalp can also be observed. 

Tractional alopecia is a type of alopecia caused by continuous exposure to pulling forces on the scalp, typically pigtails, rubber bands or helmets, which initially cause reversible hair loss, but without treatment, lead to scarring alopecia1,2. Its early recognition by every doctor and the recommendation to avoid elements that pull the hair are important.

REFERENCES

1 Larrondo J, McMichael AJ. Traction Alopecia. JAMA Dermatol 2023 May 3.doi: 10.1001/jamadermatol.2022.6298. Epub ahead of print. PMID: 37133879. [ Links ]

2 Awad A, Chim I, Sharma P, Bhoyrul B. Low-dose oral minoxidil improves hair density in traction alopecia. J Am Acad Dermatol. 2023 Feb 25:S0190-9622(23)00278-5. doi: 10.1016/j.jaad.2023.02.024. Epub ahead of print. PMID: 36842503. [ Links ]

FundingNone.

Ethical disclosures

Protection of human and animal subjects. The authors declare that the procedures followed were in accordance with the regulations of the relevant clinical research ethics committee and with those of the Code of Ethics of the World Medical Association (Declaration of Helsinki).

Confidentiality of data. The authors declare that they have followed the protocols of their work center on the publication of patient data.

Right to privacy and informed consent. The authors have obtained the written informed consent of the patients or subjects mentioned in the article. The corresponding author is in possession of this document.

Use of artificial intelligence for generating text. The authors declare that they have not used any type of generative artificial intelligence for the writing of this manuscript, nor for the creation of images, graphics, tables, or their corresponding captions.

Received: May 14, 2023; Accepted: June 02, 2023

*Correspondence: Miguel Mansilla-Polo E-mail: miguel_yecla96@hotmail.com

Conflicts of interest

None.

Creative Commons License Portuguese Society of Dermatology and Venereology. Published by Permanyer. This is an open access article under the CC BY-NC-ND license