Hair and Scalp Disorders

Question 1

What is Alopecia Areata?

Answer 1

Sudden hair loss where hair follicles are preserved
Thought to be autoimmune

Question 2

What are clinical features of Alopecia Areata?

Answer 2

Sudden patches of hair loss affecting scalp or beard
Patches are well circumscribed with normal skin underneath
Exclamation mark hairs might be seen- short hairs that narrow at the base

Question 3

What is the management of Alopecia Areata?

Answer 3

If evidence of re-growth no treatment required

If no re-growth
- Topical potent steroids such as betnovate
- Minoxidil
- phototherapy
- contact immunotherapy
- wigs

Question 4

What is Hirsutism?

Answer 4

Androgen dependent hair growth in women

Question 5

What are causes of Hirsutism?

Answer 5

Cushing Syndrome
PCOS= most common
Congenital Adrenal Hyperplasia
Obesity
Adrenal tumour
Drugs- phenytoin, corticosteroids

Question 6

What investigations are required for Hirsutism?

Answer 6

Measure testosterone levels

Can Assess using Ferriman-Gallwey score
- 9 body areas scored 0-4
- Score >15= moderate or severe

Question 7

What is the management of Hirsutism?

Answer 7

Weight loss if required
Cosmetic techniques such as waxing
If additional treatment required
- Facial hirsutism- topical eflornithine 1st line
- COCP in premenopausal women

Consider 2 WW if concerns of neoplasm- sudden onset hair growth or virilisation

Question 8

What is Hypertrichosis?

Answer 8

Androgen Independent hair growth

Question 9

What are causes of Hypertrichosis?

Answer 9

Minoxidil, Ciclosporin, Diazoxide
Congenital hypertrichosis languinosa/terminalis
Porphyria cutanea tarda
Anorexia nervosa