Hair and Nail Disorders

Question 1

Onychomycosis Diagnosis

Answer 1

KOH** examination if able to obtain scrapings
Nail culture (often performed when patients have a negative KOH examination)
Nail plate biopsy (most sensitive test)

Question 2

Onychomycosis 1st Line Treatment

Answer 2

Oral Terbinafine (Lamisil) (treatment success around 75%)
Need to tx. at least 6 weeks
cannot be used with statins! (monitor LFTs)

Question 3

Paronychia

Answer 3

Infection around a fingernail
Usually caused by Staph. Aureus
Treatment: Antibiotics and warm soaks for mild, well-localized cases
*more superficial than felon

Question 4

Androgenic Alopecia Treatment

Answer 4

Finasteride (Propecia)
Topical Minoxidil (Rogaine) 5% soln OTC
Works better in younger men who have been balding for less than 10 year

Question 5

Alopecia Areata

Answer 5

Rapid hair loss in distinct, well-defined round or oval patches of COMPLETE hair loss (this is not just thinning of the hair)
Thought to be autoimmune

Question 6

Telogen Effluvium

Answer 6

Alteration of the normalhair cycle
Thinning/shedding of hair resulting from the early entry ofhairsinto thetelogen phase
seen postpartum frequently

Question 7

Trichotillomania

Answer 7

Impulse control disorder from pulling out hair
Irregular, short growth hairs
Unilateral to patient’s dominant hand
Treatment: SSRI, Cognitive therapy