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Anagen Effluvium Caused by Thallium Poisoning

Caren Campbell, MD1; Soon Bahrami, MD1; Cindy Owen, MD1
[+] Author Affiliations
1Division of Dermatology, University of Louisville, Louisville, Kentucky
JAMA Dermatol. 2016;152(6):724-726. doi:10.1001/jamadermatol.2016.0194.
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This case report describes anagen effluvium caused by thallium poisoning.

Anagen effluvium is the abrupt loss of hair during the growth phase due to an insult that impairs mitotic or metabolic activity of the hair follicle. This form of hair loss is essentially synonymous with chemotherapy-induced alopecia. Less common causes include medications, radiation, toxic chemicals, and inflammatory disease. Thallium, once considered the “poisoner’s poison,” is an odorless, flavorless, colorless heavy metal and a rare cause of anagen effluvium.

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Figure 1.
Clinical View of the Left Temporal Scalp

Diffuse alopecia is apparent with preserved follicular ostia.

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Figure 2.
A 4-mm Punch Biopsy Specimen From the Right Occipital Scalp

Nonscarring, noninflammatory alopecia is seen, with mild miniaturization of some hair follicles (hematoxylin-eosin, original magnification ×40).

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