Alopecia

Question 1

What phase?
Active hair growth. 80-85% of hairs are in this stage at a given time.

Answer 1

Anagen (Growth) Phase

Question 2

What phase?
Hair growth stops due to papilla detaching (removing blood supply). 1-3% of hairs are in this stage at a given time.

Answer 2

Catagen (transitional) phase

Question 3

What phase?
In late telogen phase, the follicle begins to grow again and hair base breaks free from the root and is shed. ~ 2 weeks, new hair shaft begins to emerge.

Answer 3

Exogen (shedding)

Question 4

What phase?
Hair is resting phase for 1-4 months, up to 10-15% of hairs in a normal scalp. Hair is no longer connected to anything but the follicle.

Answer 4

Telogen (resting):

Question 5

(a) Present follicular markings suggest a _______ alopecia.
(b) Absent follicular markings suggest a _______ alopecia.

Answer 5

a) nonscarring
b) scarring

Question 6

What issue?
(a) Most common form of male hair loss affecting 30-50% of men by age 50.
(b) Occurs in highly reproducible pattern, preferentially affecting the temples, vertex and mid frontal scalp.
(c) Key pathophysiological features of MAA are alteration in hair cycle development.
(d) Familial tendency & racial variation and heredity account for 80% of predisposition; MAA genes inherited from both mother & father.
(e) MAA morbidity is predominately psychological along with higher risk for melanoma and non-melanoma skin cancer of scalp.

Answer 6

Androgenetic alopecia (AKA MPB)

Question 7

(a) Believed to be an immunologic process. Patches that are perfectly smooth and without scarring.
(b) Involvement may extend to all of the scalp hair (alopecia totalis) or to all scalp and body hair (alopecia universalis).

Answer 7

Alopecia areata

Question 8

What issue
Temporary hair loss that usually happens after stress, a shock, or a traumatic event. It usually occurs on the top of the scalp.

Answer 8

Telogen effluvium

Question 9

What issue?
May occur following any type of trauma or inflammation that may scar hair follicles.
—(a) Examples include chemical or physical trauma, bacterial or fungal infections, severe herpes zoster, chronic discoid lupus erythematosus (DLE), scleroderma, and excessive ionizing radiation.
(1) The specific cause is often suggested by the history, the distribution of hair loss, and the appearance of the skin.

Answer 9

Cicatricial Alopecia
(Scarring alopecia)

Question 10

True / False
Scarring alopecias are treatable and can be cured.

Answer 10

False
irreversible and permanent
-It is important to diagnose and treat the scarring process as early in its course as possible.

Question 11

Treatment Alopecia

Answer 11

(1) In most areas hair re-grows and no treatment is needed.
(2) Oral corticosteroid therapy does not prevent the spread or relapse of severe alopecia.
(3) Consider treatment/counsel on how to deal with emotional stress.
(4) Consider consult to dermatology to more intense treatment

Question 12

Differential Diagnosis Alopecia

Answer 12

(1) Tinea capitis
(2) Trichotillomania
(3) Androgenic alopecia (male pattern baldness)

Question 13

Complications Alopecia

Answer 13

(1) Depression/anxiety
(2) Mid-life Crisis