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Fluconazole is relatively free of serious toxicity, but this report describes a disconcerting effect of prolonged therapy: alopecia. Investigators surveyed 26 centers in the NIAID Mycoses Study Group and received 33 reports of substantial alopecia from 11 centers. All patients were receiving long-term fluconazole for a variety of fungal infections; one third had AIDS. The incidence of alopecia was 12.5% at one study site and 20% at another.
Twenty-nine of the 33 patients had received at least 400 mg of fluconazole daily for a mean of seven months. Hair loss was mainly in the scalp, but 10 also had loss of facial, axillary, pubic, leg, or chest hair. Three patients needed wigs. Hair loss began, on average, three months after starting fluconaz…