To:
ADC Online Letters and ADC Fetal and Neonatal Edition Letters
Electronic Letters to:
|
|
Electronic letters published:
-
![[Read eLetter]](/icons/misc/sectionDOWN.gif)
Alopecia? Think to celiac disease
- Valentina Kiren, Giovanna Ventura, Gianluca Tornese, and Alessandro Ventura (13 December 2007)
-
alopecia can also be caused by chemical hair relaxants
- oscar,m jolobe (10 December 2007)
|
|
|||
|
Valentina Kiren, M.D. Department of Pediatrics, Burlo Garofolo Hospital, University of Trieste, Italy, Giovanna Ventura, Gianluca Tornese, and Alessandro Ventura
Send letter to journal:
valentinakappa{at}libero.it Valentina Kiren, et al.
|
We found Lio’s paper on alopecia in children (Arch. Dis. Child. Ed. Pract., December issue) very interesting, but noticed that the author does not mention celiac disease among the autoimmune diseases associated with alopecia areata. Both thyroid dysfunction and alopecia may point to celiac disease even in the absence of gastrointestinal complaints.[1, 2] Alopecia areata is in fact significantly associated to celiac disease in children as well as in adults; it might even be its only manifestation, as reported in several papers.[1, 3, 4] In these cases full recovery with hair re-growth may be achieved on a gluten free diet. [3, 4] Moreover, we have previously demonstrated that when associated to celiac disease, alopecia is one of the autoimmune disorders apparently related to the duration of exposure to gluten.[5] We are therefore convinced that all children with alopecia areata should be screened for celiac disease, particularly (but not exclusively) if thyroid dysfunction is present. 1 Tursi A, Giorgetti G, Brandimarte G, et al. Prevalence and clinical presentation of subclinical/silent celiac disease in adults: analysis on 12-yerar observation. Hepatogastroenterology 2001;48:462-4. 2 Berti I, Della Vedova R, Paduano R, et al. Coeliac disease in primary care: evaluation of a case-finding strategy. Dig Liver Dis 2006;38:461-7. 3. Corazza GR, Andreani ML, Venturo N, et al. Celiac disease and alopecia areata: report of a new association. Gastroenterology 1995;109:1333-7. 4. Naveh Y, Rosenthal E, Ben-Arieh Y, et al. Celiac disease- associated alopecia in childhood. J Pediatr 1999;134:362-4. 5. Ventura A, Magazzù G, Greco L. Duration of exposure to gluten and risk for autoimmune disorders in patients with celiac disease. Gastroenterology 1999;117:297-303. |
|||
|
|
|||
|
oscar,m jolobe, retired geriatrician manchester medical society, c/o john rylands university library, oxford road, manchester M13 9PP
Send letter to journal:
oscarjolobe{at}yahoo.co.uk oscar,m jolobe
|
Alopecia may also be attributable to the use of hair relaxants such as sodium hydroxide and guanidine hydroxide, respectively(1) or other products containing sodium, potassium, or guanine sulfites or thioglycolates(2) to straighten or "relax" tightly curly(spiral) black hair of the type found among South African blacks(1) or African- Americans(2). These products work by rearranging the cysteine disulfide bonds of the hair, but an undesirable consequence is to damage the hair shaft and to decrease its tensile strenghth(3). In one South African study in which the definitive analysis comprised 1020 subjects aged 6-21, alopecia was significantly(p < 0.0001) more prevalent among those with "relaxed" hair than among those with "natural" hair(1). In an American study, as many as 95% of 464 patients suffered hair breakage and hair loss after using a hair relaxant(4) which was subsequently withdrawn after intervention by the United States FDA. Chemical relaxants can also cause scarring alopecia, exemplified by 5 subjects in whom the initial symptom was onset of head discomfort within minutes of the application of the hair relaxant. The vertex of the head was involved, and it healed with scarring(5). Given the fact that hair relaxants have been used on children as young as six(1), hair relaxant-related alopecia should enter into the differential diagnosis of alopecia in children of African descent. References (1) Khumalo NP., Jessop S., Gumedze F., Ehrlich R Hairdressing is associated with scalp disease in African schoolchildren British Journal,of Dermatology 2007:157:106-110 (2) McMichael AJ Hair breakage in normal and weathered hair:focus on the black patient Journal of Investigative Dermatology Symposium Proceedings 2007:12:6-9 (3) Khalil EN Cosmetic and hair treatments for the black consumer Cosmetic Toiletries 1986:101:51-8 (4)Swee W., Klontz KC., Lambert LA A nationwide outbreak of alopecia associated with the use of a hair- relaxing formulation Archives of Dermatology 2000:36:1104-8 (5)Khumalo NP., Pillay K., Ngwanya RM Acute "relaxer"-associated scarring alopecia: a report of five cases British Journal of Dermatology 2007:156:1394-6 |
|||
