Hair and Nail Disorders Flashcards

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1
Q

What are the causes of generalised hair loss?

A
Telogen effluvium
Endocrine e.g. thyroid
Drugs
Iron deficiency 
Diffuse alopecia areata
Malnutrition
Androgenetic alopecia
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2
Q

What is telogen effluvium?

A

Generalised hair loss after severe illness, childbirth or other stress

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3
Q

What is androgenetic hair loss?

A
General thinning of hair on front-temporal scalp, non scarring
Seen commonly in:
- men
- postmenopausal women
- when with increased androgen levels
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4
Q

What are some non-scarring causes of localised hair loss?

A
Alopecia areata
Androgenic
Trichotillomania
Traction alopecia
Tinea capitis
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5
Q

What are some scarring causes of localised hair loss?

A
Burns/trauma
Kerion
Cutaneneous discoid lupus
Herpes zoster
Lichen planus
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6
Q

What is alopecia areata?

A

Well demarcated areas of hair loss on scalp with no scarring

Autoimmune –> look for other conditions

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7
Q

What would you see if you looks closely at the hairs of someone with alopecia areata?

A

Exclamation mark hairs

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8
Q

What are alopecia totalis and alopecia universalis?

A
Totalis = whole head
Universalis = whole body

Much less common than areata

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9
Q

What is the management of alopecia areata?

A

Regrowth occurs, ranging from months to years

  • explanation
  • often no treatment required
  • intralesional steroids, PUVA
  • wig
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10
Q

What is trichotillomania?

A

Unilateral area of hair loss with small fine hairs regrowing
–> due to excessive pulling of hair
(may be underlying psychological problem)

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11
Q

What is tine capitis?

A

Fungal infection

–> erythematous scaly patch on scalp

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12
Q

Who gets tine capitis?

A

Pre pubertal children

In areas of poverty/crowded living conditions

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13
Q

How is tine capitis diagnosed?

A

Skin scrapings and hair plucking

–> Woods lamp (shows up fluorescent)

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14
Q

What is the treatment for tine capitis?

A

Oral Griseofulvin

Or other anti fungal e.g. terbinafine, fluconazole

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15
Q

What is Kerion?

A

Inflammatory tine capitis –> if untreated/severe
Boggy, indurated, tumour-like mass exuding pus +/- lymphadenopathy
Heals with scarring and hair loss

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16
Q

What is the treatment for cutaneous discoid lupus erythematosis?

A

Photoprotection
Potent topical steroids
Hydroxychloroquine if extensive

17
Q

What is hirsutism?

A

Increased hair growth in androgen dependent areas (male pattern)

18
Q

What is hypertrichosis?

A

Excessive hair growth in a non-androgen dependent distribution

19
Q

What are some causes of local hypertrichosis?

A

Naevi
Faun tail
Chronic scarring/inflammation

20
Q

What are some causes of generalised hypertrichosis?

A

Malnutrition
Anorexia
Porphyria
Drugs e.g. minoxidil, phenytoin, cyclosporin

21
Q

What are Beau’s lines?

A

Indentation/groove running from one side of the nail to another
Caused by transient arrest in nail growth which occurs during an acute illness

22
Q

What is acute paronychia?

A

Infection of the folds of tissue surrounding the nail –> local redness, swelling and pain

23
Q

What is chronic paronychia?

A

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

24
Q

What is tinea unguum?

A

Fungal nail infection
–> dystrophic nail plate with irregular surface
Oral anti fungal

25
Q

What is a subungual haematoma?

A

Bleed under nail due to trauma
Sharply demarcated and nail folds not involved
(important to differentiate from melanoma)

26
Q

What does malignant melanoma of the nail look like?

A

Like haematoma but nail fold usually involved

–> spreading pigmentation to proximal nail fold = Huchinson’s sign

27
Q

What is a myxoid cyst?

A

Small cystic lesion of proximal nail fold

28
Q

What is a periungual fibroma and which condition is it associated with?

A

aka Koenen’s tumour
Subtle growth on nail fold
Seen in tuberous sclerosis

29
Q

What are the nail features seen in 10% of patients with lichen planus?

A

Longitudinal ridging

Pterygium –> cuticle destroyed and forms scar of the nail plate