title: Telogen effluvium following bivalent human papillomavirus vaccine administration: a report of two cases.
abstract: We describe two cases of telogen effluvium occurring in two 11-year-old children following bivalent human papillomavirus (HPV) vaccine administration. The two children began to lose their hair following the second HPV vaccine dose. Alopecia worsened following the third vaccine dose and then resolved spontaneously within a few months. In both cases, laboratory analysis and psychiatric evaluation excluded causes other than anti-HPV vaccine. Social discomfort and isolation were associated with alopecia in the two children. The clinical presentation was consistent with a pattern of telogen effluvium. The identification of specific vaccine components responsible for triggering the adverse event remains difficult. In similar cases, suspension of immunization is not recommended, as it provides health benefits that overcome the possible adverse effect of transient telogen effluvium. Caregivers should ensure psychiatric support to their patients to manage the social and emotional distress that might be associated with hair loss.
authors.affiliation: Unit of Pharmacology, Tuscan Regional Center of Pharmacovigilance, University Hospital of Pisa, and Department of Internal Medicine, Interdepartmental Center of Research in Clinical Pharmacology and Experimental Therapeutics, University of Pisa, Pisa, Italy. m.tuccori@ao-pisa.toscana.it
authors.forename: Marco
authors.initials: M
authors.lastname: Tuccori
authors.forename: Chiara
authors.initials: C
authors.lastname: Pisani
authors.forename: Laura
authors.initials: L
authors.lastname: Bachini
authors.forename: Milena
authors.initials: M
authors.lastname: Pardini
authors.forename: Stefania
authors.initials: S
authors.lastname: Mantarro
authors.forename: Luca
authors.initials: L
authors.lastname: Antonioli
authors.forename: Matteo
authors.initials: M
authors.lastname: Fornai
authors.forename: Marinella
authors.initials: M
authors.lastname: Rubinelli
authors.forename: Carlo
authors.initials: C
authors.lastname: Cirinei
authors.forename: Corrado
authors.initials: C
authors.lastname: Blandizzi
mesh_terms: D000505:Alopecia / Q000209:etiology* / Q000523:psychology; D002648:Child; D005260:Female; D006801:Humans; D053918:Papillomavirus Vaccines / Q000008:administration & dosage / Q000009:adverse effects*; D012934:Social Isolation / Q000523:psychology
chemical_list: D053918:Papillomavirus Vaccines