A 48-Year-Old Woman with Advanced-Stage Epithelial Ovarian Cancer Undergoes Surgery

A 48-year-old woman with advanced-stage epithelial ovarian cancer undergoes surgery and adjuvant therapy with paclitaxel and carboplatin.  At a follow-up visit 2 weeks after her first cycle of chemotherapy, the patient reports losing "clumps" of hair in the shower and while brushing her hair that morning.  She feels moderately fatigued but has no other symptoms.  Examination shows thinning of the hair across the vertex and crown.  The skin of the scalp shows no erythema or scaling.  Which of the following is the most likely explanation for this patient's hair loss?

A) Cell-mediated autoimmune reaction
B) Deposition of IgG and complement on epidermal keratinocytes
C) Increased androgen effect on hair follicle
D) Interruption of follicular keratinocyte proliferation
E) Prolonged telogen phase of hair cycle

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