title: Dandruff-associated smouldering alopecia: a chronobiological assessment over 5 years.
abstract: BACKGROUND
  In some individuals, dandruff may be recurrent and even chronic. This represents a difficult-to-treat condition. Excessive hair shedding and diffuse alopecia may develop.
  
  
  OBJECTIVE
  To evaluate the chronobiological aspects of dandruff, hair shedding and alopecia.
  
  
  METHODS
  This study was performed in eight men suffering from such a scalp condition. They were examined 40 times at regular intervals for five consecutive years. Hair-density assessments and trichograms were performed at least twice per trimester on the parietal region of the scalp, corresponding to an area where dandruff was present.
  
  
  RESULTS
  A positive correlation was found between the percentage of telogen hairs and dandruff severity as assessed by the squamometry index. Bimodal yearly biorhythms were found for dandruff severity, telogen counts and hair loss between two consecutive visits. The chronobiological fluctuations were prominent in some study participants, but remained inconspicuous in others. The biorhythms were almost synchronized in all participants, showing variations over the year.
  
  
  CONCLUSIONS
  The biorhythms on the hair cycle in dandruff are not fundamentally different from those previously reported in subjects without dandruff. The periodicity may be an intrinsic feature of human skin.
authors.affiliation: Department of Dermatopathology, University Hospital Sart Tilman, Liège, Belgium.
authors.forename: C
authors.initials: C
authors.lastname: Piérard-Franchimont
authors.forename: E
authors.initials: E
authors.lastname: Xhauflaire-Uhoda
authors.forename: G
authors.initials: G
authors.lastname: Loussouarn
authors.forename: D
authors.initials: D
authors.lastname: Saint Léger
authors.forename: G E
authors.initials: GE
authors.lastname: Piérard
mesh_terms: D000328:Adult; D000505:Alopecia / Q000209:etiology*; D012628:Dermatitis, Seborrheic / Q000150:complications*; D003881:Dermatomycoses / Q000150:complications; D006197:Hair / Q000254:growth & development; D006801:Humans; D008290:Malassezia / Q000302:isolation & purification; D008297:Male; D010507:Periodicity; D012536:Scalp Dermatoses / Q000150:complications*; D012720:Severity of Illness Index; D013997:Time Factors