Morphologic Changes in Hair Growth Secondary to Methotrexate Toxixity
Abstract
Methotrexate, a commonly used chemotherapeutic agent, is known to exert its major effects, both therapeutic and toxic, against rapidly dividing cells. Unfortunately, the rapidly dividing healthy cells within the body are also affected. The hair follicle represents one such group of cells. Damage to scalp hair roots is a sensitive indicator of methotrexate toxicity. Hair loss occurs by breaking off of the hair at a site of constriction on the hair shaft. Concern for the devastating effect of chemotherapy-induced alopecia has led to several investigations of preventive techniques. Measurements of their effectiveness have been based on subjective evaluations of the amount of hair loss experienced. Recent dermatological research, however, indicates that the magnitude of damage to the hair and hence the degree of toxicity, cannot be ascertained from hair loss alone. These are best determined from microscopic examination of epilated hair roots. A methodology available to the nurse to examine epilated hair roots is described. The methodology is critiqued according to criteria developed by Haller, Reynolds, and Horsley on its potential for further investigative research.