86 - Telogen Effluvium Flashcards
Characterized by a premature termination of the anagen phase of hair follicles, with a resultant increase in telogen phase hairs leading to excessive and diffuse loss of club hairs
Telogen effluvium
Most common cause of diffuse hair loss
Telogen effluvium
Approximately, the loss of more than _____% of scalp hairs has been reported to be necessary to clinically detect diffuse hair loss
25
3 subgroups of telogen effluvium
Classic acute telogen effluvium
Chronic diffuse telogen hair loss
Chronic telogen effluvium
Most classic type of TE
Acute TE
In acute TE, acute and diffuse hair shedding is noted _____ months from causative events
2 to 4
Telogen hair shedding may last longer than 6 months
Secondary to various causes including thyroid disorders, acrodermatitis entertopathica, malnutrition, and drugs
Chronic diffuse telogen hair loss
Idiopathic form of diffuse club hair loss seen in middle-aged women
Telogen hair shedding extends more than 6 months to several years with fluctuation
Chronic telogen effluvium
Potential etiologies: Acute TE
Effluvium of the newborn Febrile illness Surgery Pregnancy Weight loss (crash diet) Drugs (may cause CDHTL)
Potential etiologies: CDTHL
Thyroid disease Aging Malnutrition Iron deficiency (controversial) Zinc deficiency (severe cases) Systemic illness Psychological stress (controversial) STD (HIV infection and syphilis) Miscellaneous
Potential etiologies: Chronic TE
Idiopathic (shortening of anagen)
On average, telogen hair accounts for around _____% of scalp hair
10
In effluvium of the newborn, the shedding starts within _____ after birth
4 months
Probably the most widely recognized form of classic TE
Postpartum alopecia or
Telogen gravidarum
Postpartum alopecia is observed _____ after childbirth
2 to 3 months
Calorie restriction of _____ has been reported to be associated with hair loss
0 to 1200 kcal per day
5 distinct pathogenesis accounting for TE
Immediate anagen release Delayed anagen release Short anagen Immediate telogen release Delayed telogen release
Modulated exogen (postulated)
The hair follicle is programmed to release club hair to approximately _____ after the end of previous anagen and enters into new anagen
100 days
Club hairs are shed from the telogen root sheath sac
Exogen
Telogen hair follicle without the hair shaft
“Kenogen” follicles
A daily telogen hair loss more than _____ has been widely used as the “gold standard” for distinguishing abnormal hair loss
100
Hair pull test needs to be repeated in at least _____ scalp areas
3
Including the frontal, occipital, and temporal regions
The presence of tapered “pencil point” hairs suggests
Alopecia areata
Trichoscopy findings in TE
Decrease in hair density and empty hair openings or short-vellus hairs
Y/N: Diagnosis of TE by trichoscopy is based on exclusion
Yes
Histopathologic findings in TE
Normal total hair count
Increase in telogen hair ratio
Normal hair size
Absence of significant inflammation or fibrotic changes
Preferentially affects the top of the scalp, and the frontal hairline is usually preserved
Female pattern hair loss
Characteristic FPHL signs on dermoscopy
Hair diameter diversity
Peripilar signs (brown halo around the follicular ostium)
Empty follicles
Terminal to vellus-like hair ratio: FPHL (>/
Acute and diffuse loss of hairs without apparent alopecic patches
Hair pull test is strongly positive and collects telogen hairs
Alopecia areata incognita
Detection of numerous yellow dots of various size and uniform in color by dermoscopy or peribulbar lymphocytic infiltration by histopathologic examination
Alopecia areata incognito
Affected individuals claim hair shedding; however, clinicopathologic examinations fail to detect any evidence of active hair loss
Included in body dysmorphic disorder
Underlying depressive or anxiety disorders may be present
Psychogenic pseudoeffluvium
