Alopecia

Question 1

General Info

3 phases of hair cycle & what happens

Answer 1

1. anagen (active growth)
2. catagen (hair detaches)
3. Telogen (follicles rest)

Question 2

General Info

how many hairs do we lose each day normally?

Answer 2

100 to 200

Question 3

General Info

important history questions

2

Answer 3

1. is hair loss sudden or gradual?
2. is hair loss focal or diffuse?

Question 4

General Info

what does sudden hair loss indicate?

3 conditions

Answer 4

1. alopecia areata
2. telogen effluvium
3. tinea capitis

Question 5

General Info

what does gradual hair loss indicate?

2 conditions

Answer 5

1. androgenetic alopecia
2. trichotillomania

Question 6

General Info

what does focal hair loss indicate?

4 things

Answer 6

1. alopecia areata
2. androgenetic alopecia
3. tinea cavities
4. trichotillomania

Question 7

General Info

what does diffuse hair loss indicate?

4 things

Answer 7

1. telogen effluvium
2. alopecia universalis
3. iron def anemia
4. drug-induced hair loss

Question 8

General Info

physical exam steps

5 things

Answer 8

1. examine scalp for inflammation
2. examine entire scalp by small parts throughout hair
3. compare part width of the top of scalp w/ back of scalp
4. note location & extent of thinning/loss
5. perform hair pull/tug test

Question 9

Androgenetic Alopecia

AKA

Answer 9

cicatrical baldness

Question 10

Androgenetic Alopecia/Cicatrical Baldness

occurs in what % of men? by what age?

Answer 10

50% by 50

Question 11

Androgenetic Alopecia/Cicatrical Baldness

occurs in what % of women? by what age?

Answer 11

50% by 80

Question 12

Androgenetic Alopecia/Cicatrical Baldness

flow of hair loss seen in men?

Answer 12

• frontal hairline recedes
• bitemporal thinning
• thinning on top and crown

Question 13

Androgenetic Alopecia/Cicatrical Baldness

hair loss seen in women?

where?

Answer 13

• thin on the top & sides
• retiain shape of hairline

Question 14

Androgenetic Alopecia/Cicatrical Baldness

characterized by conversion of terminal hairs into what and then further into what?

Answer 14

1. indeterminate
2. vellus hairs

Question 15

Androgenetic Alopecia/Cicatrical Baldness

tx

Answer 15

• topical minoxidil 5% daily foam
• PO finasteride or dutasteride QD

Question 16

Androgenetic Alopecia/Cicatrical Baldness

how long until minoxidil makes impact?

Answer 16

6 to 12 mo

Question 17

Telogen Effluvium

triggered by?

specificially what, then 4 examples

Answer 17

Major Stress
1. pregnancy
2. surgery
3. mental stresses
4. illnesses requiring hospitalization

Question 18

Telogen Effluvium

why does it last longer for some people?

Answer 18

subtle changes to their hormone levels (meds)

Question 19

Telogen Effluvium

how does it change the hair cycle?

Answer 19

makes it faster

Question 20

Telogen Effluvium

what labs should be ordered if you suspect this?

6

Answer 20

1. TSH
2. T4
3. CBC
4. Iron Studies
5. Vit D
6. RPR

Question 21

Telogen Effluvium

what is the most common treatable cause of hair shedding in women?

Answer 21

iron deficiency

Question 22

Telogen Effluvium

tx

Answer 22

• reassurance
• tx of underlying issue that labs uncovers

Question 23

Alopecia Areata

what attacks hair follicles?

Answer 23

lymphocytes

Question 24

Alopecia Areata

associated most commonly with what other disease?

Answer 24

thyroid disease

Question 25

# Alopecia Areata resolves w/out tx after how long?

Answer 25

6 mo

Question 26

# Alopecia Areata how can re-growth hairs look?

Answer 26

thin or white

Question 27

# Alopecia Areata what type of attack on body causes this? | i.e. is it pathogen, autoimmune, malignancy, genetic?

Answer 27

autoimmune

Question 28

# Alopecia Areata where on body is this located?

Answer 28

any hair bearing part of body

Question 29

# Alopecia Areata what labs to consider?

Answer 29

thyroid panel

Question 30

# Alopecia Areata Tx | what 3 roues?

Answer 30

1. intralesional injections 2. Topical Steroids 3. Topial Shampoo

Question 31

# Alopecia Areata what to use for intralesional injfection? | med, dose, duration, freq

Answer 31

* Triamcinolone * 2.5-10 mg/mL * every 4 to 6 wks

Question 32

# Alopecia Areata what to start w/ if treating w/ steroids?

Answer 32

potent or ultra potent steroids betamethasone valerate 0.01% foam betamethasone dipropionate 0.05% lotion

Question 33

# Alopecia Areata what topical shampoo to use?

Answer 33

minoxidil 5% foam

Question 34

# Trichotillomania Caused by what?

Answer 34

forceful pulling & removal of the hair

Question 35

# Trichotillomania clinical presentation

Answer 35

1. different lengths of hair w/in patch 2. black dots from short hairs 3. lack of scale or inflammation

Question 36

# Trichotillomania tx

Answer 36

1. screen for anxiety & depression 2. Behavioral interventions 3. SSRIs if indicated