85 - Androgenetic Alopecia

Question 1

Most common type of hair loss

Nonscarring progressive miniaturization of the hair follicle with shortening of the anagen pahse

Answer 1

Androgenetic alopecia

Question 2

Most frequent clinical pattern in men with AGA
Recession of the frontal hairline, mainly in a triangular pattern, later followed by a vertex thinning with progression until the top of the scalp is completely bald

Answer 2

Hamilton-Norwood type

Question 3

Most common type of AGA in women

Diffuse thinning of the centroparietal region with maintenance of the frontal hair line

Answer 3

Ludwig type

Question 4

Diffuse centroparietal thinning similar to the Ludwig pattern with an additional breaching of the frontal hair line

Answer 4

Olsen type

Question 5

Molecular studies have recognized _____ genetic regions associated with AGA

Answer 5

12

Question 6

Androgen chiefly responsible for the follicular pathology
Probably acts primarily on dermal papilla, the predominant site of androgen receptor and type II 5alpha-reductase expression within the hair follicle

Answer 6

Dihydrotestosterone

Question 7

The scalp skin usually appears normal in AGA, but frequently associated findings include

Answer 7

Seborrhea

Seborrheic dermatitis

Question 8

Balding scalp examination should include checking for

Answer 8

Photodamage

Field cancerization

Question 9

For the hair pull test (Saboraud maneuver), approximately _____ hairs are grasped between the thumb, index, and middle fingers from the base of the hairs near the scalp and firmly, but not forcelly, tugged away from the scalp

Answer 9

50 to 60

Question 10

If more than _____% of the grasped hairs are pulled away from the scalp, this constitutes a positive pull test

Answer 10

10

Question 11

A positive pull test confirms

Answer 11

Active hair shedding

Question 12

In AGA, the hair pull test may be positive in the frontal region, while it is typically negative in the

Answer 12

Occipital region

Question 13

Typical findings in AGA on phototrichogram

Answer 13

Reduced hair density in a pattern distribution compared to the occipital area
Anagen-to-telogen ratio is normal or decreased when comparing frontal or vertex to the occiput

Question 14

The preferred area for biopsy is the

Answer 14

Central scalp in an area representative of the hair loss process

Question 15

Biopsies should not be taken from the _____ as miniaturized hairs may be present in the region independent of AGA

Answer 15

Bitemporal area

Question 16

Histologically AGA presents an increased number and proportion of miniaturized (vellus-like) hair follicles with a typically less than _____ ratio of terminal to vellus-like hair follicles compared with a greater than 7:1 ration in the normal scalp

Answer 16

3:1

Question 17

Histologically AGA presents an increased number and proportion of miniaturized (vellus-like) hair follicles with a typically less than _____ ratio of terminal to vellus-like hair follicles compared with a greater than 7:1 ration in the normal scalp

Answer 17

3:1

Question 18

Measurement of _____ may be considered depending on patient history, especially when diffuse effluvium is suspected

Answer 18

Ferritin level

Thyroid-stimulating hormone

Question 19

Acute or chronic diffuse hair loss caused by an increased number of hair follicles in telogen
Reduced hair density over the entire scalp
Associated with a precipitating event, like a severe illness or psychological trauma, crash diet or certain medications
Hair pull test is diffusely positive

Answer 19

Telogen effluvium

Question 20

Does not follow a patterned distribution

Patchy or total hair loss, hair loss in other body sites, and nail abnormalities

Answer 20

Diffuse alopecia areata

Question 21

Scarring alopecia of the vertex region that most commonly occurs in women of African descent

Answer 21

Central centrifugal cicatricial alopecia

Question 22

Frontotemporal band-like scarring alopecia, characterized by frontotemporal band like recession, loss of eyebrows, perifollicular erythema and hyperkeratosis
Lymphocytic scarring alopecia

Answer 22

Frontal fibrosing alopecia

Question 23

Result of chronic tension on the hair shaft
Hair loss is reversible initially, but may become permanent
History of tight braiding of the hair

Answer 23

Traction alopecia

Question 24

Diffuse and progressive hair loss of the scalp and the body, beginning during early childhood

Answer 24

Hypotrichosis simplex

Question 25

Inherited disorders involving the skin, its appendages, nails, and teeth

Answer 25

Ectodermal dysplasias

Question 26

Best clinical evidence according to current study data

Answer 26

Topical application of minoxidil

Question 27

The patients should be informed about transitory increased telogen hair shedding, usually appearing within the first _____ of minoxidil initiation

Answer 27

8 weeks

Question 28

Main side effect of topical minoxidil

Answer 28

Hypertrichosis

Question 29

Irritation is more common with the 5% solution of minoxidil because of its higher content in

Answer 29

Propylene glycol

Question 30

Y/N: It is recommended to pause topical minoxidil use during pregnancy and lactation

Answer 30

Yes

Question 31

In male patients older than 18 years of age with mild to moderate AGA, a systemic therapy with 5alpha-reductase type 2 inhibitor

Answer 31

Finasteride (1 mg/day)

Question 32

Finasteride is contraindicated in patients with

Answer 32

Active depression

Current sexual dysfunction

Question 33

In case of ineffective treatment with 1 mg finasteride over 12 months, the off-label use of the 5alpha-reductase inhibitor _____ at a dose of 0.5 mg a day can be considered

Answer 33

Dutasteride