alopecia (hair loss) Flashcards

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1
Q

3 stages of hair growth

A
  1. growth stage = anagen phase
    .2. transitional stage = catagen stage
  2. resting stage = telogen phase
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2
Q

categories of alopecia

A

non scarring or scarring

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3
Q

clinical presentation of alopecia

A

• male-pattern or female-pattern alopecia • males: fronto-temporal areas progressing to vertex, entire scalp may be bald • females: widening of central part, “Christmas tree” pattern

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4
Q

management of alopecia

A

• minoxidil (Rogaine®) solution or foam to reduce rate of loss/partial restoration • spironolactone in women (anti-androgenic effects), cyproterone acetate (Diane-35®) • finasteride (Propecia®) (5-α-reductase inhibitor) 1 mg/d in men • hair transplant

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5
Q

non-scarring alopecia

A

intact hair follicles onexam

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6
Q

scarring

A

absent hair follicle on exam

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7
Q

DDX of non scarring alopecia

A

autoimmune- alopecia areta
endocrine: hypothyriodism, androgens
micronutrient: zinc, iron
toxins, heavy metal, anticoagulants, chemotherapy, vitamin a
trauma to hair follicle: trichotillomania
other: symphills, severeillness, childbirth

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8
Q

telogen effluvium

A

uniform decrease in hair density secondary to hairs leaving the growth (anagen) stage and entering the resting (telogen) stage of the cycle

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9
Q

pathophysyiology of telgen effluvium

A

precipitated by: malnutrition, Fe deficiency, thyroid dysfunction, post-partum/miscarriage, scalp diseases (seborrheic dermatitis, allergic contact dermatitis), medications (e.g. OCP), physical/mental stress • hair loss typically occurs 2-4 mo after exposure to precipitant • regrowth occurs within a few months but may not be complete

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10
Q

ANAGEN EFFLUVIUM

A

hair loss due to insult to hair follicle impairing its mitotic activity (growth stage)

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11
Q

causes of anagen effluvium

A
  • precipated by chemotherapeutic agents (most common), other meds (bismuth, levodopa, colchicine, cyclosporine), exposure to chemicals (thallium, boron, arsenic)
  • dose-dependent effect
  • hair loss 7-14 d after single pulse of chemotherapy; most clinically apparent after 1-2 mo
  • reversible effect; follicles resume normal mitotic activity few weeks after agent stopped
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12
Q

ALOPECIA AREATA

A

autoimmune disorder characterized by patches of complete hair loss often localized to scalp but can affect eyebrows, beard, eyelashes, etc.

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13
Q

what other changes can be seen in alopecia areata

A

dystrophihc nails, exclamation mark pattents

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14
Q

alopeci areata is seen in what other dieseases

A

pernicious anaemia. vitilifgo, thyroid disease, addision’s disease

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15
Q

subtypes of alopecia areata

A

alopecia totalis: loss of scalp hair and eyebrow

alopecia universalis: loss of all body hair

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16
Q

causes of scarring alopecia

A
  • physical: radiation, burns
  • infections: fungal, bacterial, TB, leprosy, viral (HZV)
  • inflammatory ƒ lichen planus (lichen planopilaris) ƒ DLE (note that SLE can cause an alopecia unrelated to discoid lupus lesions which are nonscarring) ƒ morphea: “coup de sabre” with involvement of centre of scalp ƒ central centrifugal cicatricial alopecia: seen in up to 40% of black women, starting at central scalp; one of most commonly diagnosed scarring alopecias, may be associated with hair care practices in this population