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This healthy 16-year-old boy complained that the hair on his scalp had suddenly begun to fall out. Two weeks earlier, he hadexperienced the abrupt onset of abdominal pain with vomiting, followed several days later by paresthesias in his feet and weakness in his legs. Diffusealopecia was his only physical abnormality.
The patient ultimately admitted that shortly before his symptoms began, he had tried to commit suicide by swallowing thallium-ladenrat poison. His markedly elevated serum and urine levels of thallium confirmed his story.
Alopecia is the clinical hallmark of thallium intoxication and develops in virtually everyone who survives the acute insult.It usually appears between the first and third week of illness, characteristically affects the scalp, and commonly spares the face, axillae, andpubic area. Other manifestations are variable and nonspecific.
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