Limitations of Treatment-Induced Alopecia Grading Instruments in Evaluating Therapeutic Response

This study evaluates the effectiveness of the Dean Scale compared to the Common Terminology Criteria for Adverse Events (CTCAE) in assessing therapeutic response to minoxidil in patients with anticancer therapy-induced alopecia. The Dean Scale showed better diagnostic accuracy with an area under the ROC curve of 0.74, compared to 0.55 for the CTCAE scale, indicating that the CTCAE was not effective in detecting changes in hair density. However, the Dean Scale failed to capture regrowth in 45.8% of patients with moderate-to-significant clinical response. The study concludes that current classification methods for treatment-induced alopecia may not accurately capture significant hair regrowth, suggesting the adoption of the SALT II severity classification and trichoscopic evaluations for better tracking of disease progression.