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Dermatology Intro > Hair and Nails > Flashcards

Hair and Nails Flashcards

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1
Q

what is effluvium (defluvium)?

A

loss of hair

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2
Q

what is alopecia?

A

condition resulting from effluvium

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3
Q

what are the 2 forms of alopecia?

A

cicatricial- scaring, evidence of tissue destruction and inflammation
non-cicatricial- non-scaring and no tissue destruction

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4
Q

Etiology of scaring alopecia?

A

it is secondary to damage or destruction of the hair follicle by inflammation, infectious, non-infectious, and other pathologic processes (neoplasms, physical or chemical agents, dermatoses)

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5
Q

How do you diagnose scaring alopecia?

A

skin biopsy and fungal culture

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6
Q

How do you manage scaring alopecia?

A

it is permanent once the scaring occurs, but if the dx is made early in the inflammation stage the scaring mat be prevented

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7
Q

What are the types of diffuse non-scaring alopecia?

A 
Androgenetic 
telogen effluvium
anagen effluvium
endocrinopathies
secondary to systemic disease
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8
Q

what are the types of patchy alopecia?

A

Alopecia Areata
Trichotillomania
secondary to syphilis

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9
Q

Hx of non-scaring alopecia?

A

current or recent illness, weight loss, recent childbirth, drug injestion, hair dressing procedures, family history of baldness

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10
Q

Lab tests for alopecia?

A

CBC, ferritin, serum iron, TIBC, VDRL,RPR, thyroid panel, microscopic exam of hair and fungal culture, ANA, hormone studies for androgen axcess

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11
Q

what is androgenic alopecia (AGA)?

A

male pattern baldness and the most common cause of non-scaring alopecia, more common after menopause in women because estrogen is protective

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12
Q

etiology of AGA?

A

genetic predisposition and action of the androgen on the hair follicle (eventually the follicle atrophies completely)

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13
Q

distribution in males?

A

receding anterior hairline, M-shaped recession, bald spot occurs on posterior crown (spares the sides)- happens after puberty

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14
Q

female distrobution?

A

general thinning of the crown

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15
Q

how do you diagnose AGA?

A

by H and P, pattern of alopecia and family incidence of AGA. in females check the ROS for androgen excess (acne, hirsutism)

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16
Q

Is the course more gradual or acute?

A

gradual over years to decade

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17
Q

How do you manege AGA?

A 
no effective therapy
topical minoxidil
antiandrogens
wigs
hair transplantation 
preopecia- stops androgen to work on hair follicle and so it stops the loss
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18
Q

what is telogen effluvium?

A

transient increased shedding of normal club hair (telogen) from resting scalp follicles secondary to increased shift of anagen hairs into catagen and tologen. causes increased daily hair loss and thinning

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19
Q

etiology and patho of TE?

A

factor the affect follicle growth- pregancy, surgery, traumatic injury, significant weight loss, fever
precipitating event precedes hair loss 6-16 weeks
* 3 mo post partum, you loose a ton of hair

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20
Q

how do you diagnose TE?

A

history, clinical finding, trichogram

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21
Q

what is the distribution of TE?

A

diffuse

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22
Q

prognosis of TE and how do you treat it?

A

complete re-growth in 4-6 months (may take up to 1 year)

reassurance! (no tx)

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23
Q

what it trichotillomania?

A

self induced hair loss
females > males
primarily in children

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24
Q

etiology of tricho?

A

habit tic, child fiddles, and twists hair, which causes it to fall out and break off
in adults it is associated with depression or phychosis

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25
Q

distribution of tricho?

A

one or more asymmetrical patches of hair loss, hair are broken at various lengths, no inflammatory changes, affected side correlates with dominant hand

26
Q

How do you manage tricho?

A

treat underlying behavior or emotional disturbance. the prognosis is great in children and poor in adults

27
Q

what is traction alopecia?

A

localized hair loss due to hair styling

28
Q

etiology of traction alopecia?

A

trauma, which damages the hair, infant rubbing the occiput in the crib, too much massage of the scalp, traction due to hair style

29
Q

distribution of TA?

A

patchy hair loss without scalp abnormality, hairs fractures

30
Q

management and prognosis of TA?

A

careful explanation if the cause, hair loss can be permanent

31
Q

what is anagen effluvium?

A

pattern follows telogen effluvium, diffuse and involves the entire scalp
more rapid in onset and more prominent

32
Q

etiology of AE?

A

rapid growth arrest of damage to anagen hairs that skin catagen and tologen and are shed
secondary to drugs, intoxication, and chemotherapy

33
Q

management of AE?

A

patient should be warned of occurrence , but will recover when the cause is removed

34
Q

what is alopecia areata?

A

localized loss of hair in round or oval areas without skin inflmmation
most commonly on the scalp

35
Q

etiology of alopecia areata?

A

associated with vitiligo, hashimoto’s (possible autoimmune association)

36
Q

distribution of AA?

A

scattered discrete areas or confluent areas in the scalp eyebrows, eye lashes pubic hair or beard
exclamation point hair are diagnostic and thin white grey hairs correspond with new growth (good sign)

37
Q

management of AA?

A

no curative process, treat with steroids

important = physiological support

38
Q

what is alopecia totalis?

A

entire scalp is involved

39
Q

What is alopecia universalis?

A

hair loss over the entire body

40
Q

what is onycholysis?

A

separation of nail form nail bed

41
Q

etiology of onycholysis?

A

idiopathic and proposes to be secondary to trauma and wearing long nails
systemic causes: psoriasis, eczema, tinea poor peripheral circulation

42
Q

what if all nails are invloved?

A

consider phototoxic reaction to thyrotoxicosis

43
Q

clinical features of onycholysis?

A

one or more nails separated at the hyponycium

can demonstrate signs of secondary infection

44
Q

how do you manage onycholysis?

A

the idiopathic type resolves spontaneously, infection may prevent reattachment so keep nails short and reduce trauma

45
Q

what are beau’s lines?

A

horizontal depression occurring across the nail plate of all the nails due to interruption in the growth of the nail occurring during an illness,stress on the body operation, or even prolonged labor

46
Q

clinical features of beau’s lines?

A

horizontal trough across the nail plate of all the nails

not generally noticed until s months after the precipitating factor

47
Q

management of beau’s lines?

A

deformity usually grows out

48
Q

definition of clubbed nails?

A

loss of normal angle between the posterior nail fold and the nail plate, posy nail field feels spongy, nail becomes more curved, distal phalanx enlarges as well

49
Q

etiology of clubbing?

A

due to pulmonary and cardiovascuar abnormalities, cirrhosis, CD, US, thyrotoxicosis, and autosomal dominant trait

50
Q

Koilonychia

A

spoon nails- a concavity in the nail plate

51
Q

etiology of spoon nails?

A

may occur congenitally or associated with iron deficiency anemia, raynauds phenomenon, physical or chemical trauma
-responds well to treatment of anemia if that is the cause

52
Q

what are pitted nails?

A

minute “pits” which occur on random or uniform pattern across the nail plate- cells retain their nucleus that falls out and leaves pits

53
Q

etiology of pitted nails?

A

psoriasis and alopecia areata

secondary to parakeratosis

54
Q

what is a habit tic?

A

longitudinal depression in the nail due to repeated scratching or picking at the cuticle because this damages the nail matrix and the nail grows weird
management- reform behavior

55
Q

what is leukonychia?

A

white spots on the nails secondary to trauma

56
Q

what are splinter hemorrhages?

A

tiny subungal hemorrhages- red or brown pigmented linear splinter like lesions
due to trauma. bacterial endocarditis and SLE

57
Q

Nail hyper pigmentation?

A

brown nails from external staining from dyes and nicotine, medication, and nail polish

58
Q

what is lamellar nail dystrophy?

A

splitting of the nail into its component layers secondary to repeated wetting and drying out from immersion in water

59
Q

what is the clinical appearance of LND?

A

tips of the fingernails are split into layers

tell patent to reduce exposure to water as well as use protective measures

60
Q

How do you tell the difference between nail trauma and malignant melanoma?

A
  1. first inspect the nail fold for Hutchinson’s sign
  2. hematoma will move up the nail bed as the nail grows (malignant melanoma can only spread)
  3. normal nail hemorrhage can be scarped away and hemorrhage can be removed

Dermatology Intro (3 decks)

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