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Senior - Derm 3 > 15 - Hair > Flashcards

15 - Hair Flashcards

1
Q

Types of hair?

A
  1. Terminal hairs - thick pigmented hair
    - scalp, beard, axilla, pubic
  2. Lanugo hairs - fine hairs of fetus
  3. Vellus hair - short fine hairs
    - covers much of body
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2
Q

Androgen and hair?

A

Terminal hairs require androgens

Vellus hair are independent of androgens

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3
Q

Stages of hair growth?

A

Catagen (transitional phase)
Telogen (resting phase)
Anagen (growing phase)

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4
Q

Most hair is in what stage?

A

Anagen (growing) phase - 90%

Telogen (resting phase) 10%

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5
Q

Alopecial chart

A

Slide 7

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6
Q

telogen effluvium

A 
Diffuse loss of hair
Normal healthy scalp
Loss of resting hair 
Last 4 weeks 
Any age
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7
Q

telogen effluvium, how much hair is lost?

A

Up to 50%

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8
Q

Who gets telogen effluvium the most?

A

Women, its also related to stress mostly

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9
Q

Etiology of telogen effluvium?

A 
Loss of resting hairs
Ready to be shed 
Follows: 
- physical, emotional stress
- delivery of child
- dc oral contraceptives
- high fever, surgery
- serious wt loss
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10
Q

Tx for telogen effluvium?

A

Reassurance - it’ll grow back

Full recovery expectd

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11
Q

What is androgenic alopcia?

A

Male pattern baldness

- due to progressive shortening of successive androgen cycles

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12
Q

Pt profile for androgenic alopecia?

A

Family hx

Thinning age is 12-40

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13
Q

Morphology of androgenic alopcia?

A

Top/vertex - androgen sensitive

Sides - androgen independent

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14
Q

Tx for androgenic alopecia

A 
Minoxidil (rogane) topical
Finasteride (propecia) oral
Dutasteride (avodart) oral
Transplant
Advancement flaps
Hair weave 
Toupe
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15
Q

How does minoxidil (rogaine) work?

A

Increases duration of anagen - follicles rest to grow and enlarges miniaturized follicles

Can take up to 1 yr to start working

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16
Q

Ideal candidate for minoxidil?

A

Male
<30 yrs
<5 yrs hair loss

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17
Q

How does dutasteride (avodart) work?

A

Dual inhibitor of type I and II 5a-reductases

- inhibits conversion of testosterone to DHT

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18
Q

Androgenic alopecia - female pattern etiology

A

Begins in 20-30’s to perimenopausal

- drop in estrogens relitive to increase in androgens

19
Q

Morphology of female pattern baldness?

A

Loss on vertex

- not as complete as male pattern

20
Q

Labs for female pattern?

A

Check

DHEA-S
Prolactin
Testosterone
SHGB

21
Q

Tx for female pattern baldness?

A

OTC minoxidil

22
Q

What is alopecia aretata?

A

Partial loss of scalp hair

  • alopecia totalis - 100% loss on head
  • alopecia universalis - 100% loss of all hair
  • Alopecia areata, ophiasis pattern (band like loss)
23
Q

Presentation of alopecia aretata?

A

Sudden asymptomatic loss
Round, sharply defined patches
“Exclamation point” hair

24
Q

With alopecia aretata you should check for?

A

Nail pitting

- 10-66% incidence

25
Q

Etiology of alopecia areata?

A

Autoimmune disease
- thyroid disease and vitiligo are associated with it
Family/genetic

Stress??

26
Q

Alopecial aretata txt?

A

<10 y/o

  • minoxidil
  • anthralin
10+ 
<50% of scalp
- intralesional steroid 
- minoxidil
- anthralin
>50% of scalp
- minoxidil +/- topical steroid
- topical immunotherapy
- anthralin
- systemic corticosteroids
- prosthesis
27
Q

Prognosis for alopecia areata?

A

Best for adults w small area

Totalis, universalis or ophiasis has worse prognosis

28
Q

What is trichorrhexis nodosa?

A

Brittle hair due to overworking
Weak points/nodes in hair shaft
- can cause permanent loss due to scarring

Broken fried over dyed hair

29
Q

Tx for trichorrhexis nodosa?

A

Must stop all hair tx

Screen for HYPOthyroid

30
Q

Traction alopecia

A

Tight braiding of hair

  • fractures hair shaft
  • damages follicle
  • hair line recedes
31
Q

Tx for traction alopecia?

A

Stop what youre doing

32
Q

What is hirsutism?

A

Presence of terminal hairs in females in a male-like pattern

33
Q

How bad is hirsutism?

A

Its benign

- cosmetic only

34
Q

Etiology of hirsutism?

A

High androgen levels
- from ovaries or adrenal glands

Or

Increased follicle sensitivity to normal androgen levels

35
Q

Possible causes of hirsutism?

A 
PCOS 
Cushing
Androgen-secreting tumors
Corticosteroids
Obesity
36
Q

MCC of hirsutism?

A

PCOS

37
Q

Tx hirsutism

A 
Cannot be cured (suppression only)
Oral contraceptives
Low dose corticosteroids
Spironolactone 
Eflornithine HCL  (vaniqua)
Laser, electrolysis
Waxing, tweezing, plucking
38
Q

Hirsuitism presentation?

A

Slide 50 has a sweet pic

39
Q

Hypertrichosis is?

A

Excessive hair growth (density, length) beyond accepted limits normal for age, race, sex
- in areas that are NOT androgen sensitive

40
Q

Hypertrichosis hair types

A

May involve lanugo, vellus, or terminal hair

41
Q

Hypertrichosis spares?

A

Palms and soles

42
Q

Etology of hypertrichosis?

A 
Genetic d/o
Drugs
- minoxidil
- phenytoin
- cyclosporine
- corticosteroids

Internal malignancy

43
Q

What did the farmer call the cow with no milk?

A

An udder failure

Senior - Derm 3 (7 decks)

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