Diffused alopecia followed by severe acute respiratory syndrome coronavirus-2 infection

Shatrughan Pareek; Nitesh Kumar; Chandraprakash Chouhan

doi:10.4103/LJMS.LJMS_109_20

CASE REPORT

Year : 2021 | Volume : 5 | Issue : 2 | Page : 100-101

Diffused alopecia followed by severe acute respiratory syndrome coronavirus-2 infection

Shatrughan Pareek¹, Nitesh Kumar², Chandraprakash Chouhan³
¹ Department of Nursing, Indian Railway Health Services, Bikaner, Rajasthan, India
² Department of Emergency Medicine, AIIMS, Jodhpur, Rajasthan, India
³ Department of Dermatology, Venereology and Leprosy, Dr S. N. Medical College, Jodhpur, Rajasthan, India

Date of Submission	29-Dec-2020
Date of Acceptance	12-Jun-2021
Date of Web Publication	23-Jul-2021

Correspondence Address:
Mr. Shatrughan Pareek
Near Jaya General Store, Indra Colony, Bikaner - 334 001, Rajasthan
India

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/LJMS.LJMS_109_20

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection has a wide range of consequences of human body. In the literature, only a few cases with uncertain hair fall related to COVID-19 infection. In the case report, we enumerated a case of 33-year-old female with alopecia followed by SARS-Cov-2 infection. On the visit, the patient was afebrile; vitals were within normal range and breathing normally. The patient was not suffering from any stress, and her psychological status was sound. Physical examination revealed asymptomatic alopecia on the temporal region of her scalp. The scalp area was smooth, and there was no inflammation was there. The pull test outcome was positive. The patient was managed with topical lotions and biotin supplements. After 1 month, the hair fall was limited and pull test found negative. No cutaneous infection was observed on the scalp. The present case showed alopecia as a rare complication of SARS-Cov-2 infection. Early initiation of the therapy can decline the consequences of alopecia among SARS-Cov-2 patients.

Keywords: Diffused alopecia, patient, pull test, severe acute respiratory syndrome coronavirus 2 infection

How to cite this article:
Pareek S, Kumar N, Chouhan C. Diffused alopecia followed by severe acute respiratory syndrome coronavirus-2 infection. Libyan J Med Sci 2021;5:100-1

How to cite this URL:
Pareek S, Kumar N, Chouhan C. Diffused alopecia followed by severe acute respiratory syndrome coronavirus-2 infection. Libyan J Med Sci [serial online] 2021 [cited 2023 Mar 27];5:100-1. Available from: https://www.ljmsonline.com/text.asp?2021/5/2/100/322198

Introduction

COVID-19 is a severe acute respiratory infection caused by severe acute respiratory syndrome coronavirus-2 (SARS-Cov-2). It is extremely contagious disorder and can be spread through animal-to-human and human-to-human involvement.^[1],[2] SARS-Cov-2 infection has been reported in asymptomatic and symptomatic patients with various systemic manifestations. The disease is novel, so there is a wide range of the signs and symptoms among the patients. The postinfection complaints are varying from individual to individuals. The infection is also associated with different dermatological phenomena.^[3],[4] The hair cycle consists of three stages: anagen, catagen, and telogen. The anagen phase is considered as the growth phase of hair cycle.^[5] Hair fall is also associated with other factors such as stress.

Case Report

A 33-year-old female visited to us due to the rapid hair fall. The patient was diagnosed with SARS-Cov-2 infection 60 days ago. The diagnosis was confirmed by throat and nasal swabs (reverse transcription polymerase chain reaction [RT-PCR]). The patient was treated with azithomycin 500 mg and Osetltamivir 75 mg for 7 days. At the time of consultation, she was asymptomatic and sound health conditions. She was recovered from the infection 45 days ago, as per negative RT-PCR report assessed by nasal and throat swabs. Physical examination revealed asymptomatic alopecia on the temporal region of her scalp [Figure 1]. The scalp area was smooth, and there was no inflammation was there. The pull test outcome was positive. The patient had a negative history of kidney and liver diseases. No autoimmune disorder was reported in the investigations. The blood reports for hemoglobin, blood counts, blood sugar, and thyroid profile were within normal limits. The patient had a negative family history for alopecia areata and others autoimmune disorders.

Figure 1: Diffused Alopecia in patient with post severe acute respiratory syndrome coronavirus 2 Infection

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On examination, the patient was afebrile, breathing normally: BP – 116/80, PR – 84/min – Regular, Spo₂ – 99% room air, and temperature 98.3°F. The patient was not suffering from any stress and her psychological status was sound. The patient was managed with topical lotions and biotin supplements. After 1 month, the hair fall was limited, and pull test found negative. No cutaneous infection was observed on the scalp.

Discussion

SARS-Cov-2 infection is a pandemic and affecting mostly old age male population. In present case, the female was present with diffused alopecia. At the time of visit, patient's vitals were within normal limits. The patient has no history of autoimmune disorders. Because of SARS-Cov-2 infection, patient experienced diffused alopecia with positive pull test.

To our best knowledge, there are limited studies available to explore the association between alopecia and SARS-Cov-2 infection. Kutlu et al. reported that alopecia prevalence was increased with SARS-Cov-2 infection. Furthermore, a study has also highlighted that alopecia is associated with viral infections, i.e. Swine flu, EB infection, as well as cytomegalovirus.^[5],[6] Previous studies have reported that gray hair and alopecia are associated with of cardiovascular disorders, a known risk factor for poor prognosis for COVID-19.^[3],[6] Furthermore, diffuse hair graying and telogen effluvium should be investigated as a consequence of SARS-Cov-2.^[7],[8] If an individual in COVID-19 quarantine reports, an episode of alopecia areata could be associated with COVID-19.^[9] In addition, Sgubbi et al. communicated that new onset of alopecia areata in patient with SARS-CoV-2 infection. Anxiety and COVID-19 infection are the factors that can enhance the alopecia.^[3] However, in our case, highlighted that diffused alopecia may occur because of SARS-Cov-2 infection. Early management of hair fall is necessary during the infection to prevent hair fall complications such as diffused alopecia.

Conclusion

Alopecia is a progressive disorder related with dermatology. In order to determine the management, it is crucial to discover the factors contributing the alopecia. The present case showed alopecia as a rare complication of SARS-Cov-2 infection. Opinion on the management including topical lotion and biotin supplements are effective. Early initiation of the therapy can decline the consequences of alopecia among SARS-Cov-2 patients.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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