TRICHODYNIE

Recently, Rebora et al reported on painful sensations of the scalp occ urring 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 l oss and any histopathological data, they did not offer any explanation for such a symptom, but speculated on the possible role of inflammati on,in as much as in androgenetic alopecia a perifollicular infiltrate has been described and credited of pathogenetic importance, On the oth er hand, many such individuals are classified as suffering of dysmorph ic delusions, chronic tactile hallucinosis, obsessive worries, or depr ession. Newer findings demonstrating localization of tile neuropeptide substance P (SP) in the scalp skin of such such patients suggest a ca usal role of SP, wich is known to be involved in neurogenic inflammati on and nociception. The role or SP and related substances (neuropeptid es) in the pathogenesis of trichodynia, and the relation of such subst ances to the psyche and emotional stress (psychoneuroendocrinimmunolog y) need further elucidation. For the time being, it is important to re alize, that a clinical diagnosis of ''trichodynia'' is not the final d iagnosis, but only a starting point in reaching a conclusive interpret ation of the symptom with its implications for treatment and prognosis .