Hair

Question 1

difference between telogen and anagen hairs

Answer 1

anagen are embedded deeper and do not come out very easily, 90% of total hair

telogen hairs are less anchored and come out easily

Question 2

term for common baldness

Answer 2

androgentic alopecia

Question 3

What causes adrogentic alopecia

Answer 3

large terminal follicles transform into small vellus follicles (visible hair to invisible hair)
due to action of Dihydrotestosterone

Question 4

Describe the male pattern of baldness

Answer 4

frontotemporal and vertex thinning

–> loss of all hair except occipical fringe

Question 5

Describe the female pattern of baldness

Answer 5

retain frontal hairlines but have decreased density on crown

Question 6

difference in timing of male and female balding

Answer 6

males much earlier (10 years)

Question 7

What should you do if you see male pattern baldness in a female?

Answer 7

check DHEAS and testosterone
**checking to see if she has androgens which would be driving the pattern of baldness
DHEAS = Dehydroepiandrosterone

Question 8

Genetics of androgeni alopecia

Answer 8

autosomal dominant or multifactorial

Question 9

drug that induces anagen or increases anagen duration to increase the hair density

Answer 9

Minoxidill (Rogaine)

Question 10

in men, causes reversal of the minituration process and/or slows the progression of hair loss in androgenic alopecia

Answer 10

Minoxidil (Rogaine)

Question 11

Who benefits most from the use of minoxidil (rogaine)

Answer 11

young men to stop progression of hair loss

and women with androgenic alopecia

Question 12

inhibits type II 5 alpha reductase

Answer 12

propecia (finasteride)

**inhibits the conversion of androgen testosterone into dihydrotestosterone

Question 13

Does propecia (finasteride work?

Answer 13

yes pretty well, but it causes sexual dysfunction that may NOT be reversible

Question 14

How many hairs do you shed daily

Answer 14

100 hars

Question 15

What is telegen effluvium

Answer 15

excess shedding of hair due to pre-mature shunting of anagen to telogen phase
–> 20-35% of scalp hair lost

Question 16

When does telogen effluvium occur?

Answer 16

6 weeks to 3 months after precipitating cause

Question 17

Does hair regrow after telogen effluvium?

Answer 17

yes, in 6 to 12 mos

*unless precipitating cause is not removed

Question 18

What is the most common cause of telogen effluvium?

Answer 18

childbirth

Question 19

What is the treatment for telogen effluvium?

Answer 19

reassurance–hair will grow back

can give 2% minoxidil solution

Question 20

term for acute loss of 80-90% of scalp hair due to an extreme alteration of growth in the majority of anagen hair

Answer 20

anagen effluvium

Question 21

What commonly causes anagen effluvium? When does it occur?

Answer 21

chemo drugs and anticoagulants –> occurs 1-2 weeks after cause

Question 22

What is drug alopecia and how is it different than anagen effluvium due to chemo drugs?

Answer 22

drug alopecia presents as telogen effluvium or can be slow loss or thinning over years
-due to drugs that affect hair production
?? im not entirely sure what the distinction is other than time course and amount lost??

Question 23

immunologically mediated hair loss + nail pitting

Answer 23

alopecia areata

Question 24

describe the hair loss in alopecia areata

Answer 24

circular area of complete loss with a normal scalp

Question 25

T or F: alopecia areata may progress to loss of all scalp hair but not loss of total body hair

Answer 25

F: it can progress to both

Question 26

alopecia totalis vs alopecia universalis

Answer 26

totalis = loss of all scalp hair 
universialis = loss of all body hair

Question 27

swarm of bees on biopsy

= lymphocytes around hair bulb

Answer 27

alopecia areata

Question 28

only effects pigmented hair and not white hairs

Answer 28

alopecia areata

Question 29

hair may grow back straight or curly

Answer 29

alopecia areata

Question 30

Will hair come back in alopecia areata?

Answer 30

yes

Question 31

peripheral fringe + broken hair + history if tight braids/weaves

Answer 31

traction alopecia

Question 32

traction alopecia is reversible or permanent

Answer 32

reversible unless insult it continued –> can scar over and become permanent
**also can get S aureus folliculitis or dermatophyte infection –> scar –> permanent hair loss

Question 33

perifollicular pustule

Answer 33

primary lesion in folliculitis

**can cover a large area and be “dissecting folliculitis/cellulitis

Question 34

moth eaten scalp hair

Answer 34

secondary syphillis

Check RPR

Question 35

What ldo you check (labs, etc) when a person come into the office with hair loss that does not fit male or female pattern

Answer 35

1. scalp for scalp disease
2. CBC
3. Ferratin
4. TSH

Question 36

a person come into the office with hair loss that does not fit male or female pattern and they have a normal CBC and low ferritin, what do you do

Answer 36

give iron and get re-growth of hair