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Dermatology - Chapters > Ch. 20&21 - Hair & Nail Disorders > Flashcards

Ch. 20&21 - Hair & Nail Disorders Flashcards

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Dermatology Board Prep flashcards
0
Q

an idiopathic hair disorder characterized by ell circumscribed, round or oval patches of NON-SCARRING hair loss

A

Alopecia areata

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1
Q

What are important elements of the history that should be included in the evaluation of a patient with hair loss?

A
  1. time of onset
  2. meds taken
  3. recent emotional or phys. stress
  4. diet
  5. grooming techniques,
  6. family hx of baldness or hair disorders
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2
Q

Which phase of the hair cycle is abruptly terminated in the affected area in alopecia areata?

A

anagen

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3
Q

What areas of the body des alopecia areata effect?

A

scalp, beard, eyebrows, eyelashes

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4
Q

5% of patients with Alopecia Areata may develop which disorder?

A

Alopecia Totalis

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5
Q

hair disorder where the patient loses all body hair

A

Alopecia universalis

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6
Q

What is the treatment for Alopecia Areata?

A
  1. Steroids
    • topical (clobetasol)
    • intralesional (injection)
  2. spontaneous remission
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7
Q

term used to describe excessive shedding of normal telogen club hairs

A

Telogen Effluvium

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8
Q

When does Telogen Effluvium appear?

A

approximately 2-4 mths after the inciting event

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9
Q

What are the two forms of Androgenetic Alopecia?

A

Male & Female Pattern Hair Loss

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10
Q

Who does Androgenetic alopecia most often occur in?

A

genetically predisposed men and women

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11
Q

What causes hair follicle miniaturization in male androgenetic alopecia?

A

DHT (dihydrotestosterone)

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12
Q

What regions of the scalp does Androgenetic alopecia involve?

A

vertex and frontotemporal regions

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13
Q

What is the treatment options for men with MPHL?

A
  1. Minoxidil (Rogaine) topically BID
  2. Finasteride (Propecia)
  3. hair tranplants
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14
Q

What is the treatment for FPHL?

A
  1. minoxidil BID
  2. spironolactone
  3. Hair transplant/wig
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15
Q

T/F: Common baldness is androgen-dependent in females.

A

FALSE; in MALES

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16
Q

When does Telogen effulvium most often occur?

A

postpartum

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17
Q

T/F: the normal hair cycle is disturbed in telogen effluvium.

A

true

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18
Q

A superficial fungal infection of the scalp.

A

Tinea Capitis

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19
Q

What are the most common dermatophytes that cause Tinea Capitis?

A
  1. Trichophyton tonsurans

2. Microsporum canis

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20
Q

Who is more commonly affected by Tinea Capitis?

A

More common in children (equal in male & female) & African Americans

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21
Q

Tinea Capitis causes…

A
  1. Seborrheic-like dermatitis
  2. “Black dot” ringworm
  3. Kerion
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22
Q

What is needed to be done to confirm the diagnosis of tinea capitis?

A

A KOH preparation or fungal culture

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23
Q

What is the therapy for Tinea capitis?

A
  1. oral antifungals (for 4-8 wks)
    • griseofulvin (Grispeg)
    • Terbinafine (Lamasil)
  2. Selenium Sulfide shampoo to dec. shedding of spores
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24
Q

a traumatic, self-induced alopecia resulting from compulsive plucking, twisting, and rubbing, which cause broken or epilated hair shafts.

A

Tichotillomania

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25
Q

Which areas of the body are affected by Trichotillomania?

A
  1. scalp (most often)
  2. eyebrows
  3. eyelashes
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26
Q

What are the characteristics that aid in diagnosis of Trichotillomania?

A
  1. bizarre patterns of non-scarring alopecia

2. coarse-feeling, broken hairs

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27
Q

What is the treatment for Trichotillomania?

A

psychiatric help

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28
Q

What hair disorder represents as patchy “moth-eaten” alopecia or generalized thinning?

A

Syphilis

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29
Q

Which hair disorder is an autoimmune disorder that often affects the scalp and cause patchy, scarring alopecia?

A

Discoid Lupus Erythematosus (DLE)

30
Q

What is the goal of treatment in DLE?

A

to prevent the follicular destruction that results in permanent alopecia.

31
Q

What are the treatments for DLE?

A
  1. Sun protection
  2. Steroids
    • topical (clobetasol)
    • intralesional
  3. antimalarials
32
Q

Which hair disorder is inflammatory in nature and presents as perifollicular erythema, violaceous scalp, and scarring?

A

Lichen Planopilaris

33
Q

Which hair disorder is a slowly progressive, scarring alopecia that begins in the crown and then spreads outward?

A

Central Centrifugal Cicatricial Alopecia (aka Triple C)

34
Q

What is thought to cause Central Centrifugal Cicatricial Alopecia?

A
  1. heat
  2. chemicals
  3. traction
35
Q

Who does CCC Alopecia most common in?

A

African American women

36
Q

What are the growth rates of fingernails and toenails?

A 
Fingernails = 3mm/mth
Toenail = 1mm/mth
37
Q

T/F: Appearance alone is usually not enough to make the diagnosis of a nail disorder.

A

TRUE

38
Q

T/F: Therapy is often difficult or unsuccessful for nail disorders.

A

TRUE

39
Q

T/F: The physical appearance of the nail can be used reliably to make a diagnosis.

A

FALSE: CANNOT be used

40
Q

Nail disorder involving an inflammatory process of the nail fold.

A

Paronychia

41
Q

inflammatory nail disorder that is most often the result of a bacterial infection (Staph or Strep)

A

acute paronychia

42
Q

How does Acute Paronychia present upon physical examination?

A

painful, red, and swollen, and may be accompanied by pus

43
Q

What is the appropriate therapy for acute paronychia?

A
  • it should first be incised and drained

- then treated with antibiotics

44
Q

An inflammatory nail disorder that is most often the result of a yeast infection.

A

Chronic paronychia

45
Q

Who is chronic paronychia common in?

A

people who constantly have wet hands

46
Q

How does chronic paronychia present upon physical examination?

A

loss of cuticle, slight tenderness, swelling, erythema, and sometimes separation of the nail fold from the plate.

47
Q

T/F: Trauma and exposure to water must be stopped to cure chronic paronychia.

A

TRUE

48
Q

nail disorder that is caused by a viral infection and only presents usually on one digit.

A

Herpetic Whitlow

49
Q

What is the treatment for Herpetic Whitlow?

A

oral antivirals (Valacyclovir)

50
Q

term used to describe fungal infections of the nail?

A

onychomycosis

51
Q

What are the most common dermatophytes that cause onychomycosis?

A
  1. Trichophytn rubrum

2. T. mentagrophytes

52
Q

What is onychomycosis usually associated with?

A

Tinea pedis

53
Q

What is the most common site of onychomycosis?

A

toenails (uncommon for all 10 to be involved)

54
Q

How does the nail present during physical examination with onychomycosis?

A

white, thick, and crumbly nail plate

55
Q

What is needed to be done to determine onychomycosis?

A

A KOH prep. or fungal culture

56
Q

What is the treatment for onychomycosis?

A

-oral antifungals (terbinafine or itraconazole)

57
Q

a neoplastic nail disorder which presents as a papule at the proximal nail fold and causes longitudinal groove in the nail

A

digital myxoid cyst

58
Q

neoplastic nail disorder which presents as a wide band of longitudinal pigmentation in variegated color usually on the 1st or 2nd digit.

A

melanoma

59
Q

What is a key determining factor that a patient has melanoma of the nail?

A

Hutchinson’s sign (pigment on the nail folds as well as nail)

60
Q

what nail manifestation is described as punctate depressions of the nail plate and transient disturbance of the nail matrix?

A

pitting

61
Q

What conditions is pitting associated with?

A
  1. psoriasis
  2. alopecia areata
  3. eczema
62
Q

Which nail manifestation is the result of abnormal keratinization of the nail matrix and bed?

A

nail psoriasis

63
Q

Which disorder can nail psoriasis mimic?

A

onychomycosis

64
Q

How does nail psoriasis present upon physical examination?

A

pitting and thickened nail plate, brown, discolored nail with distal separation, hyperkeratosis of the epidermis

65
Q

How does the nail manifestions of lichen planus present clinically?

A

thinning, splitting, scarring, and pterygium of the nail

66
Q

nail sign of systemic disease that presents as transverse & longitudinal curvature of the nails

A

clubbing

67
Q

Which systemic diseases is clubbing most commonly caused by?

A

pulmonary & cardiovascular disorders

68
Q

nail sign of systemic disease that presents as spooning of nails

A

koilonychia

69
Q

What is koilonychia associated with?

A

iron deficiency (most common) & thyroid disease

70
Q

Nail sign of system disease that presents as transverse grooves or white lines in the nail plate.

A

Beau’s Lines

71
Q

What is Beau’s lines caused by?

A

disruption in nail growth (due to an illness or chemo)

72
Q

What nail sign of systemic disease presents as 90/10 in coloration of nails? (90% white/10% pink)

A

Terry’s Nails

73
Q

Which systemic diseases is Terry’s nails associated with?

A

cirrhosis, CHF, DM

Dermatology - Chapters (18 decks)

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