Trichodynie

Recently, Rebora et al reported on painful sensations of the scalp occurring in 34.2% of two hundred and twenty-two of their female patients see king advice far hair loss, and proposed the term trichodynia for it. In the absence of any relationship with other parameters of hair loss and any histopathological data, they did not offer any explanation for such a symptom, but speculated on the possible role of inflammation,in as much as in androgenetic alopecia a perifollicular infiltrate has been described and credited of pathogenetic importance. On the other hand, many such individuals are classified as suffering of dysmorphic delusions, chronic tactile hallucinosis, obsessive worries, or depression. Newer findings demonstrating localization of the neuropeptide substance P (SP) in the scalp skin of such such patients suggest a causal role of SP, wich is known to be involved in neurogenic inflammation and nociception. The role or SP and related substances (neuropeptides) in the pathogenesis of trichodynia, and the relation of such substances to the psyche and emotional stress (psychoneuroendocrinimmunology) need further elucidation. For the time being, it is important to realize, that a clinical diagnosis of "trichodynia" is not the final diagnosis, but only a starting point in reaching a conclusive interpretation of the symptom with its implications for treatment and prognosis.