Hair and Nail Disease (Derm) Flashcards
Three stages of hair
anagen –> catagen –> telogen
“Simple Baldness”, “Hereditary Alopecia”,
“Pattern Alopecia”
Adrogenetic alopecia
Non scarring
Cause of androgen-alo
Genetically determined miniaturization of follicles triggered by androgens
alopecia on top of scalp
androgenetic alopecia
treatment for andro-alo
Minoxidil, Finasteride, Hair Transplants
Stress hair loss
Telogen effluvium
Non scarring
Cause of telogen effluvium
Disrupted growth cycle of hairs causing premature shift from anagen to telogen
Triggers for telogen effluvium
Pregnancy, Surgery, High Fever, Extreme diet,…..
Diffuse scalp involvement.
“Coming out in Bunches”
Telogen effluvium
Tx for telogen effluvium
Remove the trigger.
Minoxidil?
Time
Reassurance
Alopecia:
Autoimmune -Can associate with other AI disease.
T-cells attack the hair bulb (“Swarm of Bees”)
HLA determined.
Alopecia Areata
Alopecia in Circular patches on scalp or beard
Alopecia areata
All scalp hair lost
A. totalis
All body hair lost
A. universalis
Tx for alopecia areata
Can be difficult.
- Watch and wait.
- Topical or IL steroids.
- Minoxidil.
- Anthralin.
- Protopic/Elidel?
Secondary alopecia
Diffuse hair thinning as a complication of an existing medication or medical problem.
Common causes of Secondary alopecia
Chemotherapy, Meds, Thyroid dz, Iron deficiency, Nutritional disorders, Renal or Hepatic failure, other Chronic illness.
Tx for secondary alopecia
Remove the cause.
Minoxidil?
Fungus growth on scalp and hair shafts.
Tinea capitis
Possible scarring
________ kids most common having tinea capitis
african america - d/t hair structure
Cause of tinea capitis
Most common: Trichophyton tonsurans
Kerion
‘Kerion’-intense inflammatory reaction due to zoophilic fungi.
Tx tinea capitis
Griseofulvin is the standard.
microsized 15-25mg/kg/day
ultramicrosized 10-15mg/kg/d
Terbinafine? Itraconazole?
Lupus and hair
Discoid lupus of the scalp results in destruction of hair units
Often scarring
Few have +ANA
Area of discoid lupus
Discoid (round) patches with redness, scale, scarring anywhere on scalp or beard.
tx discoid lupus
Topical or systemic steroids. Hydroxychloroquine.
Other causes of alopecia
Traction Alopecia Lichen Planopilaris Folliculitis Decalvans Pseudopalade Central Centrifugal Cicatricial Alopecia Hair Shaft abnormalities
Pediculus humanus capitis
head lice
pthirus pubis
pubic lice
tx for lice
Permethrin (Nix, Elimite) GBH (Kwell, Lindane) Malathion (Ovide) Vaseline-for eyelids. Cetaphil cleanser-*new* Remove nits. Hot water and dryer for clothes and bedding. Unwashables in bag for 2 weeks.
inflammation of the nail folds
can be infectious or noninfectious
paronychia
cause of acute paronychia
trauma, bacteria, contact dermatitis, acute eczema flair
causes of chronic paronychia
irritant contact dermatitis, eczema, psoriasis, candida
Ingrown Nails
Always cut nails straight across. Don’t tear or pull. Proper fitting shoes. Soaks. Antibiotics. Surgery.
Fungal growth on or under the nail
Onychomycosis
Common organism for onychomycosis
Trichophyton rubrum or T. mentagrophytes
Treatment onychomycosis
terbinafine (Lamisil)
itraconazole (Sporonox)
ciclopirox (Penlac lacquer)
