Appandages And Disorders - 1 Flashcards
Hair origin-
Layers-
Origin - Ectodermal in origin
Layers-hair shaft
Inner root sheath
Outer root sheath
Glassy membrane
Connective tissue sheath
Types of hairs
- Lanugo -• seen in fetus
• soft , fine hairs
•usually shed in utero - Vellus- •fine , medullated soft hair
•bulb is at the level of dermis
3.terminal-• thick, medullated, coarse
Hairs
•bulb is at the level of sub
Cutaneous fat
Hair cycle
•Anogen( growth phase) - 86% of hair, 3 yr duration
•catogen ( involution phase) - 1% of hair, 3 week duration
•Telogen( resting phase) - 13% of hair, 3 month duration
•exogen(shedding phase)
Alopecia
Types
- Non scarring alopecia
- Scarring alopecia
Non scarring alopecia
A-PATCHY
a)Pachy-alopecia acreta
b)trichitillomania
c)tinea capitis( non inflammatory type)
d) secondary syphilis
B-DIFFUSE
a)anogen effluvium
b)telogen effluvium
C- PATTERNED
a) androgenetic alopecia
D-SYSTEMIC
a)Sle
b) thyroid dysfunction
Alopecia acreta
- target
-signs
-how hair looks like
- nails
-histopathology
- bad prognostic factor
- treatment
Autoimmune disorder
- target- anogen hair bulb
-signs- *circular patch of complete hair loss
*No signs of inflammation
-how hair looks like- exclamation ❗ mark hair
- nails- geometrically arranged fine, superficial regular pits
-histopathology- peribulbar lymphocytic ‘ swarm of bees’ appearance
- bad prognostic factor- • early onset
• pattern like- ophiasia( occipital hair loss)
•alopecia totalis- (involvement of total hair loss)
•alopecia universalis- ( involvement of body hair)
• association with- atopy- ( type 1 hypersensitivity rnx)
•autoimmune disease
- treatment
• Localize treatment - intralestional steroids ( triamicolone acetonide)
- extensive disease- 1- systemic steroids
2-azathiprine
3- sulfasalazine
Trichotillomania
- signs
Tinea capitis ( non inflammatory)
- types
Secondary syphilis
-symptoms
Trichotillomania
-incomplete hair loss with patch
-bizzare pattern
-hairs of varying length
-perifollicular hemorrhage - present
Tinea capitis
- black dot type
•endothrix infection
Causative organism
a)T. Tonsurance
b)T. Violaceoum
- green dot type
• ectothrix infection
Causative organism
a) microsporum canis
Secondary syphilis
- moth eaten pattern of alopecia
Diffuse Non ciatricial alopecia
- type
a) Anagen effluvium
- chemotherapy/ radiotherapy( 3-4week)
⬇️
Arrest of hair growth (Anagen phase)
⬇️
Dystrophic anogen
⬇️
Hair loss
b) telogen effluvium
Major stress/ post pregnancy/ infection ( malaria/ typhoid)/surgical procedure
⬇️
Premature entry of hair into telogen phase
⬇️
3 month later
⬇️
Hair loss
Patterned non ciatricial alopecia
- synonyms
-factor
In male???
In female???
Treatment
Synonyms - androgenetic alopecia
Factor -genetic + androgen
- shortening of anogen phase
- miniaturisation of hair follicles
In male -
Hamlinton norwood grading
• frontotemporal recession
•balding of vertex
In female-
Ludvig grading
•loss of hair over central Portion of scalp
•frontal hair line maintained
Treatment
1-minoxidil
: Increases anogen phase
: Increases size of miniature hair follicles
Dosage- in male 5% minoxidil
In female 2% minoxidil
2-finasteride
: Inhibit 5 alpha reductase( type 2)
: Decrease the active anogen
Dosage- 1 mg finasteride
3- platelet rich plasma therapy
4- hair transplantation in advance stage
Scarring alopecia
Types-
1- papulosquamous disease
-caused by lichen planus/ licho plano pilaris
Hair sign- perifollicular blue- grey hue
2- connective tissue disease
- DLE
• scarring alopecia, characteristic lesions of DLE
- Discoid lesions of SLE
•scarring lesion of SLE
- linea morphea
•a/k/a- EN COUP DE SABRE
•sword ( SABRE) like scarring lesion of scalp
3- Tinea capitis
- favus
- kerion
4- Granulomatous disorder
- scarring lesions seen in sacoidosis
5-inflammatory disease
- folliculitis decalvans
• multiple hair growth from single opening
- dissecting cellulitis of scalp
•dissecting cellulitis
6- idiopathic - disorder of exclusion
- pseudopelade of Brocq
- footprints in snow’s pattern of hair
Histopathology s/o- perifollicular concentric fibrosis
