Hair and Nail Disorders Flashcards
What are the causes of generalised hair loss?
Telogen effluvium Endocrine e.g. thyroid Drugs Iron deficiency Diffuse alopecia areata Malnutrition Androgenetic alopecia
What is telogen effluvium?
Generalised hair loss after severe illness, childbirth or other stress
What is androgenetic hair loss?
General thinning of hair on front-temporal scalp, non scarring Seen commonly in: - men - postmenopausal women - when with increased androgen levels
What are some non-scarring causes of localised hair loss?
Alopecia areata Androgenic Trichotillomania Traction alopecia Tinea capitis
What are some scarring causes of localised hair loss?
Burns/trauma Kerion Cutaneneous discoid lupus Herpes zoster Lichen planus
What is alopecia areata?
Well demarcated areas of hair loss on scalp with no scarring
Autoimmune –> look for other conditions
What would you see if you looks closely at the hairs of someone with alopecia areata?
Exclamation mark hairs
What are alopecia totalis and alopecia universalis?
Totalis = whole head Universalis = whole body
Much less common than areata
What is the management of alopecia areata?
Regrowth occurs, ranging from months to years
- explanation
- often no treatment required
- intralesional steroids, PUVA
- wig
What is trichotillomania?
Unilateral area of hair loss with small fine hairs regrowing
–> due to excessive pulling of hair
(may be underlying psychological problem)
What is tine capitis?
Fungal infection
–> erythematous scaly patch on scalp
Who gets tine capitis?
Pre pubertal children
In areas of poverty/crowded living conditions
How is tine capitis diagnosed?
Skin scrapings and hair plucking
–> Woods lamp (shows up fluorescent)
What is the treatment for tine capitis?
Oral Griseofulvin
Or other anti fungal e.g. terbinafine, fluconazole
What is Kerion?
Inflammatory tine capitis –> if untreated/severe
Boggy, indurated, tumour-like mass exuding pus +/- lymphadenopathy
Heals with scarring and hair loss
What is the treatment for cutaneous discoid lupus erythematosis?
Photoprotection
Potent topical steroids
Hydroxychloroquine if extensive
What is hirsutism?
Increased hair growth in androgen dependent areas (male pattern)
What is hypertrichosis?
Excessive hair growth in a non-androgen dependent distribution
What are some causes of local hypertrichosis?
Naevi
Faun tail
Chronic scarring/inflammation
What are some causes of generalised hypertrichosis?
Malnutrition
Anorexia
Porphyria
Drugs e.g. minoxidil, phenytoin, cyclosporin
What are Beau’s lines?
Indentation/groove running from one side of the nail to another
Caused by transient arrest in nail growth which occurs during an acute illness
What is acute paronychia?
Infection of the folds of tissue surrounding the nail –> local redness, swelling and pain
What is chronic paronychia?
Dystrophic nail paste, less swollen
Loss of cuticle –> chronic infection due to space under nail folds
Commonly caused by candida in people who have wet hands a lot
What is tinea unguum?
Fungal nail infection
–> dystrophic nail plate with irregular surface
Oral anti fungal
What is a subungual haematoma?
Bleed under nail due to trauma
Sharply demarcated and nail folds not involved
(important to differentiate from melanoma)
What does malignant melanoma of the nail look like?
Like haematoma but nail fold usually involved
–> spreading pigmentation to proximal nail fold = Huchinson’s sign
What is a myxoid cyst?
Small cystic lesion of proximal nail fold
What is a periungual fibroma and which condition is it associated with?
aka Koenen’s tumour
Subtle growth on nail fold
Seen in tuberous sclerosis
What are the nail features seen in 10% of patients with lichen planus?
Longitudinal ridging
Pterygium –> cuticle destroyed and forms scar of the nail plate
