Hair and nail conditions

Question 1

Causes of hair greying/whitening (3)

Answer 1

Age-related loss of pigmentation
Scalp vitiligo
Regrowing hair in alopecia areata (usually repigments later)

Question 2

Potential medical causes of brittle/coarse hair (2)

Answer 2

Hypothyroidism

Iron deficiency

Question 3

What is telogen efflevium and what can trigger it?

Answer 3

Large % of hairs stop growing and enter telogen phase; start to fall out about 3 months later.
Triggers- stress, illness, operations etc

Question 4

Causes of diffuse hair loss with normal scalp skin

Answer 4

Telogen efflevium
Thyroid disease
Iron deficiency
Drugs e.g. cytotoxic agents, antithyroid medication
Lupus
Alopecia totalis

Question 5

What is the difference between alopecia areata, totalis and universalis?

Answer 5

Areata = patches
Totalis = whole scalp
Universalis = whole body

Question 6

Skin conditions which may cause hair loss (3)

Answer 6

Tinea capitis
Psoriasis
Seborrhoeic dermatitis

Question 7

Difference between hirsutism and hypertrichosis?

Answer 7

Hirsutism refers to excessive growth of hair in a female, distributed in a male secondary sexual pattern.

Question 8

Nail changes seen in psoriasis (3)

Answer 8

Pitting
Oncholysis (lifting of nail from the nail bed)
Hyperkeratosis

Question 9

What is koilonychia and when is it seen?

Answer 9

Spooning of the nail

Iron deficiency

Question 10

What are Beau’s lines?

Answer 10

Horizontal grooves in the nail, follow cessation of growth due to illness

Question 11

White nails

Answer 11

Cirrhosis

Question 12

Yellow nails

Answer 12

Bronchiectasis, lymphoedema

Question 13

Green/blue nails

Answer 13

Pseudomonas infection

Question 14

What are some causes of scarring hear loss? (3)

Answer 14

Burns/trauma
Cutaneous lupus
Lichen planus

Question 15

Condition where the patient feels compulsion to pull out hair?

Answer 15

Trichotillomania

Question 16

Investigations for suspected tinea capitis? (2)

Answer 16

Scrapings (beware false -ve)
Woods lamp (blue fluorescence)

Question 17

Commonest cause of hirsutism?

Answer 17

Polycystic ovarian syndrome

Question 18

Staphyloccal/streptococcal infection of the nail fold?

Answer 18

Paronychia

Question 19

What is Hutchinson’s sign? (2)

Answer 19

Spreading of a subungal melanoma into the skin surrounding the nail; differentiates melanoma from haematoma

Question 20

Nail involvement in lichen planus? (2)

Answer 20

Longitudinal ridging

Pterygium (“morphing” of the proximal nail fold with the nail plate)

Question 21

Types of drug eruption? (5)

Answer 21

Exanthematous drug eruption
Urticarial reactions
Erythema nodosum
SJS/TEN
Erythema multiforme