What are the other Names for this Condition? (Also known as/Synonyms)

• Medication-Induced Alopecia Mucinosa

What is Drug-Induced Alopecia Mucinosa? (Definition/Background Information)

• Alopecia mucinosa is a rare inflammatory condition of hair-bearing skin, resulting in a thickening of skin that is accompanied by hair loss. It may consist of many subtypes including the primary and secondary subtype
• Drug-Induced Alopecia Mucinosa is a type of secondary alopecia mucinosa that is caused by the administration or usage of certain medications
• The condition can affect the scalp, face, and neck, and any other part of the body. Drug-Induced Alopecia Mucinosa can affect individuals of all ages; it is seen in both children and adults
• Some symptoms of this disorder include the appearance of tiny pink bumps on the skin, loss of hair in the affected area, and itchy skin. Drug-Induced Alopecia Mucinosa may be diagnosed by studying the presenting symptoms, skin biopsy, and establishing the underlying cause
• Drug-Induced Alopecia Mucinosa may be treated by primarily discontinuing or stopping the offending medication, and using topical and systemic steroids to treat the skin symptoms
• The prognosis of Drug-Induced Alopecia Mucinosa is typically good upon stoppage of the drug causing the condition. With appropriate treatment, the skin condition may be suitably managed and the outcomes are good

Who gets Drug-Induced Alopecia Mucinosa? (Age and Sex Distribution)

• Drug-Induced Alopecia Mucinosa is a rare inflammatory skin condition that can affect individuals of any age category
• The condition can occur worldwide, without racial, ethnic or gender bias

What are the Risk Factors for Drug-Induced Alopecia Mucinosa? (Predisposing Factors)

The risk factors of Drug-Induced Alopecia Mucinosa include the use of the following medications:

• Adalimumab
• Imatinib

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Drug-Induced Alopecia Mucinosa? (Etiology)

• Alopecia mucinosa results from an overproduction of mucin by cells in the hair follicle. Mucin is a glycoprotein and a component of mucus
• Drug-Induced Alopecia Mucinosa occurs due to the administration of certain medications, which leads to hair loss
• Sometimes, the appearance of signs and symptoms may not be observed immediately following usage of the medication

What are the Signs and Symptoms of Drug-Induced Alopecia Mucinosa?

The signs and symptoms of Drug-Induced Alopecia Mucinosa may vary from one individual to another, depending on the medication and age of the affected individual. The typical signs and symptoms include:

• Red or pink grouped papules (raised bumps in the skin): These may be limited to one location or widespread throughout the body
• The number of skin lesions may be few or many
• Red plaques (large, raised, or thickened patches of skin) with pores that are hair follicle openings
• Oozing mucin from pores, especially if the skin is touched or squeezed
• Hair loss in the affected (hair-bearing) area of skin, which may result in scarring of the follicle, with permanent hair loss
• Itchy skin at the site of lesions (pruritic plaques); itching can lead to scarring
• There may be scaling over the skin lesions
• Formation of skin nodules

How is Drug-Induced Alopecia Mucinosa Diagnosed?

The diagnosis of Drug-Induced Alopecia Mucinosa is made through the following tests and exams:

• A complete physical examination and review of the individual’s medical history (that includes current medications being taken)
• Assessment of symptoms and physical inspection of the skin lesions
• Skin biopsy: A skin biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

A differential diagnosis may be performed to eliminate the following conditions prior to arriving at a diagnosis of alopecia mucinosa:

• Alopecia areata
• Seborrheic dermatitis
• Telogen effluvium

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Drug-Induced Alopecia Mucinosa?

Complications of Drug-Induced Alopecia Mucinosa may include the following:

• Permanent hair loss at the site of lesions, if scarring has taken place
• Emotional stress due to cosmetic concerns
• Superimposed bacterial, viral, and fungal infections at the affected skin sites
• Recurrence of the condition with more severe signs and symptoms can occur on further use of the causative drug

How is Drug-Induced Alopecia Mucinosa Treated?

The following treatment options may be considered for Drug-Induced Alopecia Mucinosa: 

• Discontinuing the medication responsible for the side effect, which may result in resolution of the condition
• Use of topical, intralesional (injectable), or systemic (oral) corticosteroids. Corticosteroids are a type of steroid hormone that provides relief at sites of inflammation
• Antibiotic, antiviral, or antifungal medications to address infections, as needed
• UVB phototherapy or Psoralen with UVA light (PUVA), or photochemotherapy
• Use of creams containing nitrogen mustard
• UVA1 phototherapy: The skin is exposed to electromagnetic radiation or wavelengths of light between 340 and 400 nanometers. The therapy works by limiting cell-mediated immune function
• Appropriate therapy for emotional aspects of hair loss

How can Drug-Induced Alopecia Mucinosa be Prevented?

Currently, it may not be possible to prevent Drug-Induced Alopecia Mucinosa.

• Stopping the medication causing the condition as early as possible is important. The healthcare provider may prescribe alternative medications to treat any existing/underlying condition
• Also, eliminating the causative medication usually helps in preventing relapses or recurrence

What is the Prognosis of Drug-Induced Alopecia Mucinosa? (Outcomes/Resolutions)

• Immediately stopping the use of drugs causing alopecia mucinosa and treating the skin symptoms can result in a good prognosis
• In many cases, the signs and symptoms of Drug-Induced Alopecia Mucinosa tend to improve following discontinuation of the offending medication and through adequate treatment

Additional and Relevant Useful Information for Drug-Induced Alopecia Mucinosa:

Alopecia mucinosa belongs to a subset of conditions known as follicular mucinosis. There are two other conditions that belong to the same subset that include urticaria-like follicular mucinosis (a very uncommon condition) and cutaneous lymphoma related follicular mucinosis.