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Irfan B, Yaqoob A. Dermatological Implications of the Taqiyah and Imamah: Recommendations for Delivering Culturally Conscious Care. Cureus 2023; 15:e45528. [PMID: 37868539 PMCID: PMC10585659 DOI: 10.7759/cureus.45528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 10/24/2023] Open
Abstract
Background and objective The growing cultural and religious diversity in healthcare settings necessitates clinicians to integrate cultural competence and sensitivity into their practice. Despite significant research focusing on the hijab worn by Muslim women, there is a gap in understanding the dermatological implications of the taqiyah and imamah, worn by Muslim men. In light of this, this study aimed to offer insights into delivering culturally conscious dermatological care for Muslim men wearing these garments, thereby bridging a crucial knowledge gap. Materials and methods The study employed a comprehensive research strategy that encompassed both medical literature and foundational Islamic texts. PubMed, Web of Science, and Scopus were used for medical literature searches, while al-Maktabah al-Shamela and Sunnah.com, along with Quranic and Hadith translations were consulted for religious insights. A thematic analysis was employed to identify patterns, challenges, and unique points, ensuring a holistic understanding of the subject. Results Our findings revealed that wearing a taqiyah or imamah has both beneficial and detrimental dermatological effects, depending on factors such as climate, fabric, and hygiene practices. While the garments are rooted in Islamic tradition, their use varies based on cultural context rather than strict religious guidelines. Moreover, gender dynamics and the concept of privacy ('awrah) within Islamic teachings have implications for healthcare interactions. The study offers practical guidelines for dermatological care tailored to Muslim men wearing a taqiyah or imamah. It emphasizes the importance of material choice, hygiene practices, and the willingness of many Muslim men to be accommodating in medical settings, albeit with some reservations. The paper also discusses the role of telemedicine in culturally sensitive healthcare delivery, recommending measures such as secure communication channels and self-imaging options. Conclusion The paper provides comprehensive recommendations aimed at delivering culturally and religiously sensitive dermatological care to Muslim men wearing a taqiyah or imamah. By integrating both medical best practices and a nuanced understanding of Islamic customs, healthcare providers can foster a more trusting and effective care relationship, thereby improving patient satisfaction and dermatological outcomes.
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Affiliation(s)
- Bilal Irfan
- Microbiology and Immunology, University of Michigan, Ann Arbor, USA
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Mitchell KN, Tay YK, Heath CR, Trachtman R, Silverberg NB. Review article: Emerging issues in pediatric skin of color, part 1. Pediatr Dermatol 2021; 38 Suppl 2:20-29. [PMID: 34664330 DOI: 10.1111/pde.14775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Dermatology for the pediatric skin of color population is the application of dermatology to the genetically diverse and distinctive segment of the pediatric population that includes children of non-White racial and ethnic groups with increased pigmentation including individuals of Asian, LatinX, African, Native American, Pacific Island descent, Indigenous Peoples, among others, with overlap in particular individuals, and mixtures thereof. Treating children of color is a unique skill set within the field of pediatric dermatology, requiring knowledge and sensitivity. The discipline of pediatric skin of color can be challenging. Difficulty in diagnosis of common conditions stems from underlying pigmentation, variations in common hairstyling practices, and differences in demographics of cutaneous disease, whereas some conditions are more common in children of color, other conditions have nuances in clinical appearance and/or therapeutics with regard to skin color. This article is the first in a series of two articles looking at recently published skin-related issues of high concern in children of color. Conditions reviewed in Part 1 include (1) hairstyling hair-related concerns (traction alopecia, central centrifugal cicatricial alopecia, endocrine disruption), (2) autoimmune concerns (cutaneous lupus, vitiligo), and (3) infections (tinea capitis, progressive macular hypomelanosis).
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Affiliation(s)
- Krystal N Mitchell
- Department of Dermatology, Icahn School of Medicine at Mt Sinai, New York, New York, USA
| | - Yong Kwang Tay
- Department of Dermatology, Changi General Hospital, Singapore, Singapore
| | - Candrice R Heath
- Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA
| | - Rebecca Trachtman
- Department of Pediatrics, Division of Pediatric Rheumatology, Icahn School of Medicine at Mt Sinai, New York, New York, USA
| | - Nanette B Silverberg
- Department of Dermatology, Icahn School of Medicine at Mt Sinai, New York, New York, USA.,Department of Pediatrics, Icahn School of Medicine at Mt Sinai, New York, New York, USA
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3
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Afifi L, Oparaugo NC, Hogeling M. Review of traction alopecia in the pediatric patient: Diagnosis, prevention, and management. Pediatr Dermatol 2021; 38 Suppl 2:42-48. [PMID: 34467569 DOI: 10.1111/pde.14773] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/28/2021] [Accepted: 08/08/2021] [Indexed: 02/01/2023]
Abstract
Hairstyles and practices that frequently apply tension to the hair follicle can result in traction alopecia (TA). Many of the hairstyles and hair practices associated with a higher risk of TA begin at a young age, making early intervention and education advantageous in the pediatric population. Recognizing TA at its reversible stage in the pediatric population is critical as early interventions, and counseling will prevent permanent scarring alopecia. While TA can affect any pediatric patient, this review highlights the reported literature on specific populations with a higher reported prevalence of TA.
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Affiliation(s)
- Ladan Afifi
- Division of Dermatology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | | | - Marcia Hogeling
- Division of Dermatology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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4
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Mehta H, Kumar S, Bishnoi A. Turban Tribulations: Triad of Turban Ear, Traction Alopecia, and Traumatic Acne in a Sikh Patient. Indian Dermatol Online J 2021; 12:770-771. [PMID: 34667772 PMCID: PMC8456239 DOI: 10.4103/idoj.idoj_798_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 10/13/2020] [Accepted: 03/19/2020] [Indexed: 12/04/2022] Open
Affiliation(s)
- Hitaishi Mehta
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sheetanshu Kumar
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Anuradha Bishnoi
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Kerure AS, Deshmukh N, Agrawal S, Patwardhan NG. Follicular Unit Extraction [FUE] - One Procedure, Many Uses. Indian Dermatol Online J 2021; 12:381-388. [PMID: 34211903 PMCID: PMC8202483 DOI: 10.4103/idoj.idoj_522_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 09/14/2020] [Accepted: 10/05/2020] [Indexed: 11/04/2022] Open
Abstract
Follicular unit extraction [FUE] is a minimally invasive hair restoration surgery popularly known for its utility in androgenetic alopecia (AGA). In FUE, individual follicular grafts are extracted from donor area and implanted in the recipient area. Advantages of FUE are that it is comparatively 'scarless', has faster healing time, has less downtime and requires less technical staff. This article is aimed to highlight upon the multi-faceted utility of FUE technique in various dermatological indications like androgenetic alopecia, alopecia areata, facial hair restoration, tractional alopecia, scarring alopecia, body hair transplant, vitiligo as well as hirsutism.
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Affiliation(s)
- Amit S. Kerure
- Consultant Dermatologist and Hair Transplant Surgeon, Dr Amit Kerure Skin Clinic, Sector 9, Vashi, Navi Mumbai, India
| | | | - Sandeep Agrawal
- Department of Dermatology, IGGMC, Nagpur, Maharashtra, India
| | - Narendra G. Patwardhan
- Consultant Dermatologist and Hair Transplant, Joshi Multispeciality Hospital, Maharashtra Medical Foundation, Pune, Maharashtra, India
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6
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Abstract
Traction alopecia (TA) affects one-third of women of African descent who wear various forms of traumatic hairstyling for a prolonged period of time. The risk of TA is increased by the extent of pulling and duration of traction, as well as the use of chemical relaxation. The frequent use of tight buns or ponytails, the attachment of weaves or hair extensions, and tight braids (such as cornrows and dreadlocks) are believed to be the highest risk hairstyles. TA can also occur in the setting of religious and occupational traumatic hairstyling. In its later stages, the disease may progress into an irreversible scarring alopecia if traumatic hairstyling continues without appropriate intervention. The most common clinical presentation includes marginal alopecia and non-marginal patchy alopecia. A clue to the clinical diagnosis is the preservation of the fringe sign as opposed to its loss in frontal fibrosing alopecia (FFA). Dermoscopy can be helpful in the diagnosis and can detect the ongoing traction by the presence of hair casts. Histopathology can distinguish TA from alopecia areata, FFA, and patchy central centrifugal cicatricial alopecia. Currently, there is no cure. Therefore, it is imperative that clinicians educate high-risk populations about TA and those practices that may convey the risk of hair loss.
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Affiliation(s)
- Victoria Billero
- Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, Miami, FL, USA
| | - Mariya Miteva
- Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, Miami, FL, USA
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Polat M. Evaluation of clinical signs and early and late trichoscopy findings in traction alopecia patients with Fitzpatrick skin type II and III: a single-center, clinical study. Int J Dermatol 2017; 56:850-855. [PMID: 28369851 DOI: 10.1111/ijd.13599] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 01/26/2017] [Accepted: 02/15/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Traction alopecia refers to (often permanent) hair loss caused by prolonged physical damage. No study has yet described the unique trichoscopic findings of the condition. We describe the trichoscopic findings of traction alopecia and its relationships with the duration of traction. METHODS We studied 25 patients who were clinically diagnosed with traction alopecia. The patients were divided into two groups in terms of traction duration. Trichoscopy was performed at a minimum of two scalp locations in each patient. RESULTS Reduction in hair density, hair diameter diversity, empty follicles, and vellus hairs were observed in all patients. In addition, the following were observed: loss of follicular openings in 19 (76%) patients, yellow dots and broken hairs in 17 (68%), black dots in 12 (48%), hair casts in 7 (28%), circular hairs in 5 (20%), and arborizing red lines in 3 (12%). The trichoscopic findings varied with the duration of traction. CONCLUSIONS Traction alopecia is a chronic condition that is difficult to treat. Trichoscopy can be used for diagnosis. Our study is the first to identify the early and late trichoscopic features of traction alopecia. The limitation of the study is the lack of histologic diagnosis.
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Affiliation(s)
- Mualla Polat
- Department of Dermatology, Abant Izzet Baysal University, Faculty of Medicine, Bolu, Turkey
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Abstract
A wide prevalence of socio-religious and cultural practices in the Asian subcontinent often leads to multitude of skin diseases which may be missed by the dermatologists because of a lack of awareness. ‘Henna’ use causes IgE-mediated hypersensitivity reactions and contact dermatitis. ‘Kumkum’ application can result in pigmented contact dermatitis and lichen planus pigmentosus. Sticker ‘bindis’ and ‘alta’ induce contact leukoderma. Irritant and allergic contact dermatitis occurs after playing with ‘Holi’ colors. Threading and drawstring dermatitis lead to koebnerization of pre-existing dermatoses, infections and even squamous cell carcinoma of skin. Mild irritant reactions and contact sensitization occur secondary to balm and hair oil use. ‘Mudichood’ represents the comedogenic effect of hair oils combined with occlusion and humidity. Aromatherapy oils can cause contact dermatitis and photosensitive reactions. Heavy metal and steroid toxicity along with severe cutaneous adverse effects like erythroderma can occur as a consequent to the use of alternative medicines. Squamous cell carcinoma due to chronic heat exposure from the heating device “kangri” is seen in Kashmiris. Prayer nodules in Muslims and traction alopecia in Sikhs illustrate how religious practices can negatively affect the skin. With increasing globalization and migration, the practice of indigenous customs and traditions is no longer limited to regional territories, making it imperative for the dermatologists to be acquainted with the cutaneous side effects they can cause.
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Affiliation(s)
- Divya Gupta
- Department of Dermatology and Sexually Transmitted Diseases (STD), Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
| | - Devinder Mohan Thappa
- Department of Dermatology and Sexually Transmitted Diseases (STD), Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
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Madu P, Kundu RV. Follicular and scarring disorders in skin of color: presentation and management. Am J Clin Dermatol 2014; 15:307-21. [PMID: 24820821 DOI: 10.1007/s40257-014-0072-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Skin of color, also known as ethnic skin, is described as skin of individuals of African, Asian, Hispanic, Native-American, Middle Eastern, and Pacific Island backgrounds. Differences in hair morphology, hair grooming, cultural practices, and susceptibility to keloid scarring exist within these populations and have been implicated in hair, scalp, and skin disorders. Acne keloidalis (AK), central centrifugal cicatricial alopecia (CCCA), dissecting cellulitis of the scalp (DCS), pseudofolliculitis barbae (PFB), traction alopecia (TA), and keloids are the most prevalent follicular and scarring disorders in skin of color. They have been associated with disfigurement, permanent hair loss, emotional distress, and decreased quality of life. Hair grooming practices, such as the use of chemical relaxers, heat straightening, and tight braiding and weaving can cause scalp irritation and follicular damage and are linked to the pathogenesis of some of these conditions. Consequently, patient education and behavior modifications are integral to the prevention and management of these disorders. Scarring disorders are also of concern in ethnic populations. Keloid scarring is more prevalent in individuals of African, Asian, and Hispanic descent. The scarring alopecia CCCA is almost exclusively seen in patients of African descent. Therapeutic regimens such as intralesional corticosteroids, surgical excision, and laser therapy can be effective for these follicular and scarring disorders, but carry a risk of dyspigmentation and keloid scarring. Ethnic skin and hair may present unique challenges to the clinician, and knowledge of these differences is essential to providing quality care.
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10
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Mirmirani P, Khumalo NP. Traction alopecia: how to translate study data for public education--closing the KAP gap? Dermatol Clin 2014; 32:153-61. [PMID: 24680002 DOI: 10.1016/j.det.2013.12.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Traction alopecia (TA) affects up to 32% of women and 22% of high school girls with Afro-textured hair but can start in the preschool years. Traction induces inflammation and follicle damage. The risk of TA increases with symptomatic traction and combined hairstyles. To influence the practice of hairdressers and at risk individuals and help narrow the knowledge, attitudes, and practices (KAP) gap, scientific data should be translated into simple messages like "tolerate pain from a hairstyle and risk hair loss" and "no braids or weaves on relaxed hair". With appropriate education and public awareness, TA could potentially be eradicated.
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Affiliation(s)
- Paradi Mirmirani
- Department of Dermatology, The Permanente Medical Group, Vallejo, CA, USA; Department of Dermatology, University of California, San Francisco, CA, USA; Department of Dermatology, Case Western Reserve University, Cleveland, OH, USA
| | - Nonhlanhla P Khumalo
- Division of Dermatology Ward G23, Groote Schuur Hospital Main Road Observatory and the University of Cape Town, Western Province 7925, South Africa.
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11
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Kluger N, Cavelier-Balloy B, Assouly P. [Traction alopecias]. Ann Dermatol Venereol 2013; 140:304-14; quiz 303, 315. [PMID: 23567235 DOI: 10.1016/j.annder.2013.02.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Revised: 01/19/2013] [Accepted: 02/08/2013] [Indexed: 11/17/2022]
Affiliation(s)
- N Kluger
- Department of Dermatology, Institute of Clinical Medicine, University of Helsinki, Skin and Allergies Hospital, Helsinki University Central Hospital, Meilahdentie 2, PO Box 160, 00029 Hus, Finlande
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12
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Kluger N. [Devotional dermatoses]. Ann Dermatol Venereol 2012; 139:309-20; quiz 308, 322. [PMID: 22482487 DOI: 10.1016/j.annder.2012.01.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Revised: 12/22/2011] [Accepted: 01/06/2012] [Indexed: 11/16/2022]
Affiliation(s)
- N Kluger
- Departments of Dermatology, Allergology and Venereology, Institute of Clinical Medicine, University of Helsinki, Skin and Allergies Hospital, Helsinki University Central Hospital, Meilahdentie 2, Helsinki, Finland.
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13
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Khumalo NP, Ngwanya RM, Jessop S, Gumedze F, Ehrlich R. Marginal traction alopecia severity score: development and test of reliability. J Cosmet Dermatol 2007; 6:262-9. [DOI: 10.1111/j.1473-2165.2007.00345.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Affiliation(s)
- A Petit
- Service de Dermatologie 1, Hôpital Saint-Louis, 1, avenue Claude Vellefaux, 75010 Paris.
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15
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Feit NE, Weinberg JM, DeLeo VA. Cutaneous disease and religious practice: case of allergic contact dermatitis to tefillin and review of the literature. Int J Dermatol 2004; 43:886-8. [PMID: 15569008 DOI: 10.1111/j.1365-4632.2004.02228.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Neal E Feit
- Department of Dermatology, St. Luke's-Roosevelt, Hospital Center and Beth Israel Medical Center, New York, NY 10025, USA
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Abstract
Hair loss is a common problem that challenges the patient and clinician with a host of cosmetic, psychological and medical issues. Alopecia occurs in both men and women, and in all racial and ethnic populations, but the etiology varies considerably from group to group. In black women, many forms of alopecia are associated with hair-care practices (e.g., traction alopecia, trichorrhexis nodosa, and central centrifugal cicatricial alopecia). The use of thermal or chemical hair straightening, and hair braiding or weaving are examples of styling techniques that place African American women at high risk for various "traumatic" alopecias. Although the exact cause of these alopecias is unknown, a multifactorial etiology including both genetic and environmental factors is suspected. A careful history and physical examination, together with an acute sensitivity to the patient's perceptions (e.g., self-esteem and social problems), are critical in determining the best therapy course. Therapeutic options for these patients range from alteration of current hair grooming practices or products, to use of specific medical treatments, to hair replacement surgery. Since early intervention is often a key to preventing irreversible alopecia, the purpose of the present article is to educate the dermatologist on all aspects of therapy for hair loss in black women--including not only a discussion of the main medical and surgical therapies but also an overview of ethnic hair cosmetics, specific suggestions for alterations of hair-care practices, and recommendations for patient education and compliance.
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Affiliation(s)
- Valerie D Callender
- Department of Dermatology, Howard University College of Medicine, 2041 Georgia Avenue NW, Washington, DC 20060, USA.
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Abstract
BACKGROUND Traction alopecia associated with the nurse's cap is a relatively common form of occupational hair loss. METHODS We examined 199 healthy South Korean nurses to assess the clinical and pathologic characteristics of traction alopecia caused by prolonged traction exerted at the point of attachment of the nurse's cap. RESULTS Seven nurses (3.5% of 199) had hair loss at the pin site used to secure the nurse's cap. The lesions were exclusively localized on the parieto-occipital scalp. Histopathologic findings revealed characteristic cicatricial changes which showed a marked decrease in the number of hair follicles without inflammation. CONCLUSIONS Nurse's cap alopecia is not an uncommon occupational alopecia, and appears to be a distinct clinical entity which should be distinguished from other forms of patchy alopecia.
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Affiliation(s)
- S M Hwang
- Department of Dermatology, Yonsei University, Wonju College of Medicine, South Korea
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