Absence of chemotherapy-induced alopecia with paclitaxel in a case of hypothyroidism: case report.

and pilosebaceous testosterone available for conversion to DHT. This synergic action may explain why our patient did not show alopecia while taking triptorelin with tamoxifen. Moreover, minoxidil lengthened and enlarged the small vellus hairs and decreased shedding, highlighting the hypothesis of a relative hyperandrogenism as the cause of alopecia. Female sex hormonebinding globulin (SHBG) levels are inversely correlated with the grade of alopecia [5]. In our patient, the SHBG levels were low, potentially due to the AI effect. Considering the pivotal importance of pharmacological castration in premenopausal endocrine-responsive BC patients and the widespread use of AIs in the metastatic and, probably in the near future, adjuvant settings, potential alopecia should not be a determinant in making clinical decisions. However, oncologists must be aware of such atypical adverse events for treatment planning, in order to highlight its consequent distress and to provide psychological counseling, especially in young patients.