Anagen effluvium is a rare adverse effect of methotrexate therapy, generally associated with high-dose regimens. We report a 12-year-old girl who developed abrupt hair loss 1 week after inadvertently taking methotrexate 15 mg daily for five consecutive days (total 75 mg), without other signs of systemic toxicity. Trichoscopic examination and trichogram findings confirmed methotrexate-induced anagen effluvium, and spontaneous hair regrowth occurred after 2 months. This case underlines the importance of careful methotrexate dose monitoring and awareness that methotrexate toxicity can be associated with anagen effluvium even in the absence of other signs of toxicity.
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Article Synopsis
- Hair follicles undergo a continuous cycle of growth (anagen), regression (catagen), and rest (telogen), with the time spent in each phase affecting hair length and health.
- Traditional beliefs suggest that 85%-90% of hair follicles are in the growth phase, but recent studies indicate that these values may not be accurate due to flaws in assessment methods.
- A new examination of hair follicles during hair transplants revealed that catagen follicles (7.5%) are more prevalent than previously thought, challenging the established belief about the distribution of hair follicles in different stages.
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