A case of telogen effluvium associated with drug-induced hyperprolactinemia.

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  • Nonogaki Kaori
    Dermatology Unit, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
  • Ueki rie
    Dermatology Unit, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan

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Other Title
  • 薬剤性高プロラクチン血症に伴った休止期脱毛症の１例
  • ヤクザイセイ コウプロラクチン ケッショウ ニ トモナッタ キュウシキ ダツモウショウ ノ 1レイ

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A 77-year-old woman who had been taking olanzapine, valproic acid, and trazodone for 2 years for dementia was referred to our department with hair loss. Her family noticed her hair shedding after one month taking risperidone. At initial presentation, diffuse hair loss was observed all over her scalp and her hair pulled out easily. No exclamation-point hair, broken hair, or other types of diseased hair was noted. Scalp biopsy revealed a moderate increase in catagen/telogen follicles and no inflammatory cell infiltration. A high serum prolactin (PRL) level of 137.7 ng/ml was also noted. Based on these findings, telogen effluvium associated with drug-induced hyperprolactinemia was suspected. Dose tapering and discontinuation of the risperidone therapy resulted in a reduced PRL level of 67.1 ng/ml at 3 months after the first presentation, with improved alopecia and visually apparent increased hair volume. Drug-induced telogen effluvium is a hard-to-notice condition and should be added to the differential diagnoses of diffuse alopecia.

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