Alopecia

Question 1

What are the 3 stages of hair loss?

Answer 1

1. Anagen
2. Catagen
3. Telogen

Question 2

Disturbances in which phase is most common?

Answer 2

Anlagen phase

Question 3

The most common type of hair loss is anagen phase disturbances due to

Answer 3

Hereditary thinning of hair in susceptible men/women and is related to an androgen receptor variation

Question 4

What are 3 types of anagen phase disturbances?

Answer 4

Androgenetic alopecia, anagen effluvium, and alopecia areata

Question 5

Which type of anagen phase disturbance is the most common?

Answer 5

Androgenic alopecia

Question 6

What is the most common cause of anagen effluvium?

Answer 6

Chemotherapy

Question 7

What are the characteristics of androgenetic alopecia?

Answer 7

Men - receded hairline, thinning in frontal/vertex region
Women - diffuse thinning in frontal/parietal region

Question 8

What are the characteristics of anagen effluvium?

Answer 8

Diffuse loss
Scaling = psoriasis or tine capitis

Question 9

What are the characteristics of alopecia areata?

Answer 9

Autoimmune - well-demarcated areas of alopecia on scalp/body
Stress
Addison’s disease, lupus erythematous, thyroid disease
Men may experience in beard area

Question 10

Alopecia is a term used to describe

Answer 10

When the whole scalp is affected

Question 11

During the anagen phase (1st) what happens?

Answer 11

Growth phase
Scalp - long hair
Eyebrows - short hair

Question 12

What term is used when the whole body is affected?

Answer 12

Alopecia universalis

Question 13

During the catagen phase (2nd) what happens?

Answer 13

Hair involutes
Shortest phase

Question 14

During the telogen phase (3rd) what happens?

Answer 14

Mature hair is shed (50-150 scalp hairs/day)

Question 15

Telogen phase disturbances are triggered by

Answer 15

High fever, certain medications, endocrine abnormalities, anemia, childbirth, and malnutrition

Question 16

Telogen phase disturbances have a sudden onset and affect

Answer 16

Men, women, and infants

Question 18

Scarring/cicatricial alopecia is the result of intense inflammatory processes of the scalp such as

Answer 18

Cutaneous discoid lupus, folliculitis decalvans, lichen planus, linear scleroderma, sarcoidosis, cutaneous metastasis

Question 19

Non-scarring/non-cicatricial alopecia include

Answer 19

Alopecia areata, androgenetic alopecia, lupus erythematous, syphilis, telogen effluvium, tinea capitis

Question 20

Scarring of the scalp indicates an inflammatory process, most likely

Answer 20

Lupus or lichen planus follicularis

Question 21

Scaling of the scalp indicates

Answer 21

Psoriasis or tinea capitis

Question 22

Patchy hair loss indicates

Answer 22

Trichotillomania (patients pulls/twists hair) or syphilis

Question 23

What diagnostic test should be used to rule out fungal sources?

Answer 23

KOH prep

Question 24

What would be seen on a KOH prep that indicates fungal cause?

Answer 24

+ hyphae

Question 25

What test should be used to rule out telogen or anagen effluvium?

Answer 25

Hair pull test

Question 26

What indicates a positive hair pull test?

Answer 26

When 5+ hairs include anagen hairs (with follicle sheath)

Question 27

Hair bulb is examined using

Answer 27

Magnifying glass

Question 28

What labs should be ordered for women?

Answer 28

Testosterone or dehydroepiandrosterone-5 (DHEA-5) levels

Question 29

Lab diagnostics for women are only needed if

Answer 29

Other symptoms are present

Question 30

What diagnostic test is used to rule out syphilis?

Answer 30

VDRL

Question 31

When the cause of alopecia is not clear, what 2 additional diagnostic tests can be used?

Answer 31

Scalp biopsy and trichogram

Question 32

If telogen effluvium is suspected with no obvious cause, what 2 diagnoses should be considered?

Answer 32

IDA or thyroid disorder

Question 33

What medications can cause hair loss?

Answer 33

Heparin, propranolol, BBs, vitamin A, warfarin, propylthiouracil, isotretinoin, lithium, amphetamines, acitretin

Question 34

What 2 topicals are used in the treatment of hair loss?

Answer 34

Minoxidil (Rogaine) and Finasteride (Proscar)

Question 35

Besides minoxidil and finasteride, what other treatment options are available?

Answer 35

UVB light, cyclosporine and topical/intralesional corticosteroids, anthralin, topical immunotherapy, contact sensitization

Question 36

Treatment of hair loss should occur for

Answer 36

8-12 months

Question 37

Minoxidil is only approved for use by

Answer 37

Women