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Dermatology - Clinical Medicine IV > Hair Disorders > Flashcards

Hair Disorders Flashcards

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Dermatology Board Prep flashcards
1
Q

What are the hair disorders?

A 
Alopecia Areta
Androgenetic Alopecia
Hair structure & color defects
Telogen Effluvium 
Anagen Effluvium
Pseudofolliculitis barbae & folliculitis
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2
Q

What is the hair growth cycle?

A

Anagen - period of growth – 3 to 6 years
Catagen - period of transition - 2 weeks
Telogen- period of rest - 3 to 4 months

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3
Q

What represents 90% of hairs?

A

anagen

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4
Q

What represents 10% of hairs?

A

catagen and telogen

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5
Q

What is alopecia areata?

A

discrete annular patches of hair loss without scalp disease or scaring

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6
Q

What is hair loss of the entire scalp?

A

alopecia totalis

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7
Q

What is hair loss on entire body?

A

alopecia universalis

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8
Q

What do you see on exam of alopecia areata?

A

broken off hair, exclamation point hairs at periphery of lesions

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9
Q

What do you see in nails of pt with alopecia areata?

A

nail pitting, longitudinal striation

20% pt

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10
Q

What associated disorders of alopecia areata?

A

Vitiligo
Familial multiendocrine syndrome
Thyroid disease
Stress

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11
Q

What is the work up for alopecia areata?

A

Thyroid studies
Serum Iron - Rule out Anemia
ANA - Rule out SLE

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12
Q

What is the treatments for alopecia areata?

A

Topical steroids
Intralesional injection of triamcinolone
tacrolimus (Protopic) and pimecrolimus (Elidel)

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13
Q

What does tacolimus and pimecrolimus do?

A

inhibit t lymphocyte activation

short term use only due to risk of malignancy

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14
Q

Is there a cure for alopecia areata?

A

no, supplement with wigs, make up or psychological support

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15
Q

What is androgenetic alopecia?

A

Progressive balding
Genetic predisposition
Androgen action

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16
Q

Who gets androgenetic alopecia?

A

men > females

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17
Q

How does androgenetic alopecia appear in men?

A

receding anterior hairline, bald spot on posterior crown

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18
Q

How does androgenetic alopecia appear in females?

A

Diffuse loss of hair
Thinning appearance
Endocrine work up if indicated

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19
Q

What is the pathology of AGA?

A

Circulating androgens are converted to dihydrotestosterone (DHT) by 5 alpha reductase (5R)in the hair follicle.
In AGA there is an increase of (5R) therefore an increase of DHT.
DHT causes an increase in the telogen phase and a shortening of the anagen phase

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20
Q

What is the first treatment for AGA?

A 
Topical minoxidil (Rogaine)  2% for women, 5% for men
Apply to scalp BID, if no regrowth in 4 months then d/c
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21
Q

What is another AGA treatment?

A 
Interferes with conversion of testosterone to 5-alpha=dihydrotestosterone 
PO finasteride (Propecia) 1mg PO Qday for men only.
Min 3 months- stop tx sxs return within 12 mos
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22
Q

What are the side effects of finasteride?

A

Teratogenicity (in male fetus)

Erectile dysfunction and infertility

23
Q

Who is finasteride contraindicated in?

A

women and children

24
Q

What is the most extensive tx for AGA?

A

hair transplant

25
Q

What is Loss of hair in the Telogen (resting) phase?

A

Telogen effluvium

26
Q

What is telogen effluvium associated with?

A 
Post partum
Crash dieting
Surgery 
Birth Control Pills
High Fever
Drugs - Anticoagulants, Heparin, Lithium, Accutane, Allopurinol, Propanolol, many others
27
Q

What is the treatment for telogen effluvium?

A

resurrance will grow back

28
Q

What is Loss of hairs in Anagen (growth) Phase?

A

anagen effluvium

29
Q

What causes anagen effluvium?

A

Chemotheraputic, Anticancer agents

  • Antimetabolite
  • Alkylating agents
  • Mitotic inhibitors
  • Doxorubicin
30
Q

What is the pathology of anagen effluvium?

A

1-2 weeks of high doses of chemotheraputic agents
Anagen hair shaft abruptly thinned
As this portion reaches the surface all hairs break off simultaneously

31
Q

What is the treatment effluvium?

A

reassurance - reversible with time

32
Q

What is Trauma related to hair styling?

A

Traction alopecia

33
Q

What are causes of TA?

A

“Corn Rows”
“Pony Tails”
“Hair Extensions, Weaving”

34
Q

What is the treatment for traction alopecia?

A 
Change hair style
Early TA - reversible
Early TA with anti-inflammatory -topical steroids
Late TA - permanent hair loss
Late TA - no treatment is available
35
Q

What are the causes of hair color defects?

A

Premature Canities (graying)
Poliosis (patchy decrease in melanin)
Albinism

36
Q

What is the age for whites with premature canitis?

A
37
Q

What is age for AA with premature canitis?

A
38
Q

What is the highest etiology of premature canitis?

A

GENETIC

39
Q

What do you need to work up for premature canitis?

A

Pernicious anemia
B-12 deficiency
Thyroiditis - Alters activity of melanocytes

40
Q

What is selective loss of pigmented hair?

A

rapid overnight graying

41
Q

What is Localized loss of hair pigment ?

A

poliosis

42
Q

What is poliosis etiology?

A

congenital/genetic or autoimmune

43
Q

What is the color of hair in albinism?

A

white or colorless

44
Q

What is albinism linked to?

A

genetic defect in melanin pathway, many different types

45
Q

What system does albinism also affect?

A

optic from hypopigmentation

46
Q

What do you see optically for albinism?

A

Photophobia
iris transillumination
Nystagmus
pigment deficiency in the peripheral retina

47
Q

How do you dx albinism?

A

Hair bulb assays help to indicate the status of tyrosinase activity
Multiple classifications
(OCA 1, 1A, 1B, 2, 3; OA1, AROA)
DNA sequencing

48
Q

What is the treatment for albinism?

A

Nitisinone
hereditary tyrosinemiaa type 1
Investigational, not FDA approved

49
Q

What can cause folliculitis?

A

Bacterial
Chemical irritation
Physical injury

50
Q

What is the treatment for folliculitis?

A 
Eliminate the cause
Treat underlying infection:
Most common (Staphylococcus Aureus)
“hot tub” folliculitis (Pseudomonas aeurginosa)
		Topical antibiotics
            Systemic antibiotics
51
Q

What is hair grows out of follicle, then curls and repenatrates the skin?

A

pseudofolliculitis barbae

52
Q

What causes pseuedofolliculitis barbae?

A

Curly hairs
African American men
Close shaving

53
Q

What is the treatment for pseuedofolliculitis barbae?

A

discontinue close shaving - clip hairs, depilatories, laser
treat like acne
incision and removal of hair

54
Q

How long does it take for hair to grow back?

A

cancer - years to get full, see growth over time

Dermatology - Clinical Medicine IV (31 decks)

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