10.5826/dpc.1301a61
text/xml
2160-9381
2625
en
Vibhu Mendiratta
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
Plica Polonica Secondary to Chemotherapeutic Drugs Combination 
Text.Serial.Journal
https://dpcj.org/index.php/dpc
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2023-01-31
2022-06-01
2023-01-31
2023-03-01
e2023061
Dermatol Pract Concept
Vibhu Mendiratta
2023/01/31
10.5826/dpc.1301a61
e2023061
Department of Dermatology & STD, Lady Hardinge Medical College, New Delhi, India
2160-9381
en
e2023061
Kumar S, Brar BK, Kapoor P. Drug-associated plica polonica: an unusual presentation. Int J Trichology. 2019;11(2):80-81. doi: 10.4103/ijt.ijt_96_16. PMID: 28932066.
Plica Polonica Secondary to Chemotherapeutic Drugs Combination 
https://dpcj.org/index.php/dpc/article/download/2625/1927
       Plica Polonica Secondary to Chemotherapeutic
                     Drugs Combination
                                Rashi Pangti1, Anukriti Yadav1, Vibhu Mendiratta1


1 Department of Dermatology & STD, Lady Hardinge Medical College, New Delhi, India



Citation: Pangti R, Yadav A, Mendiratta V. Plica Polonica Secondary to Chemotherapeutic Drugs Combination. Dermatol Pract Concept.
2023;13(1):e2023061. DOI: https://doi.org/10.5826/dpc.1301a61
Accepted: July 6, 2022; Published: January 2023
Copyright: ©2023 Pangti et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use,
distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing Interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding Author: Rashi Pangti, Assistant Professor, Department of Dermatology & STD, Lady Hardinge Medical College and
associated hospitals, New Delhi-110001, India. Phone: +91-9990226358 E-mail: rashipangti457@gmail.com




Case Presentation                                                        patho-mechanism of this condition are not known. Multiple
                                                                         factors like unkept hair, frequent combing, use of a new or
A 36-year-old female presented with sudden onset of matting              harsh shampoo, psychiatric condition, and parasitic infes-
of hair for the past three days along with non-cicatricial loss          tation have been implicated [1,2]. Drug-induced matting of
of hair from the frontal scalp and vertex (Figure 1, A and B).           hair has been reported secondary to docetaxel, methotrexate,
The patient had been on chemotherapy (cyclophosphamide                   azathioprine, combination of paclitaxel, carboplatin, and
and adriamycin) for the past one month for stage 4 breast                combination of cisplatin, cyclophosphamide, doxorubicin
cancer. The patient had proper hair care habits. There was no            [1,2]. Chemotherapeutic drugs disrupt the anagen phase of
evidence of pediculosis capitis, psychiatric illness, or history         the hair cycle causing weakening of the partially keratinized
of new shampoo use. A diagnosis of plica polonica was made               proximal portion of the hair shaft, breakage, and shedding
based on history and examination.                                        of anagen hair (anagen effluvium) [1,2]. The drugs can also
                                                                         cause cuticular damage to the proximal hair shaft predis-

Teaching Point                                                           posing to hair matting [2]. In our patient, cytotoxic agents
                                                                         (cyclophosphamide and adriamycin) lead to the matting of
Plica polonica is characterized by an irreversible twisting,             hair. The only suitable treatment for this condition is cutting
matting, and entanglement of hair. The exact causation and               matted hair or shaving [1,2].




Image Letter | Dermatol Pract Concept. 2023;13(1):e2023061                                                                            1
    Figure 1. (A) Matting of hair as seen from back. (B) Anagen effluvium over vertex of scalp.




References                                                               2. Kumar S, Brar BK, Kapoor P. Drug-associated plica polonica:
                                                                            an unusual presentation. Int J Trichology. 2019;11(2):80-81.
1. Gupta S, Kumar R, Vijay A, Jain SK. Plica polonica in a patient          DOI: 10.4103/ijt.ijt_96_16. PMID: 28932066. PMCID:
   on chemotherapy: a case report with review of literature. Int            PMC6463449.
   J Trichology. 2017;9(3):124–126. DOI: 10.4103/ijt.ijt_4_19.
   PMID: 31007476. PMCID: PMC5596649.




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