Hair Disorders NOT ON EXAM

Question 1

the follicle

Answer 1

-complex structure producing the cortex, medulla, and cuticle
-can completely regenerate itself- grows, falls out, regrows
-phases of growth:
-anagen- growth -3 years
-Catagen- transition- 2-3 weeks
-telogen- 3 months

Question 2

2 categories of hair loss

Answer 2

-non scarring alopecia- hair cycle abnormalities
-scarring or cicatricial- injury and inflammation to stem cell region of follicle

Question 3

scarring alopecia

Answer 3

-idiopathic
-developmental defects
-DLE
-herpes zoster
-radiotherapy
-folliculitis decalvans (neutrophilic)
-lichen planus pilaris (lymphocytic)

Question 4

non scarring alopecia

Answer 4

-tinea capitis
-alopecia aereata
-androgenetic
-traumatic
-syphilis
-telogen effluvium
-metabolic
-endocrine
-nutritional deficiency
-liver disease
-UV rays

Question 5

nonscarring alopecia

Answer 5

-alopecia areata
-male/female pattern baldness
-telogen effluvium
-trichotillomania

Question 6

non scarring: androgenic alopecia (male and female pattern baldness

Answer 6

-MC form of hair loss
-male pattern baldness receding hairline
-female pattern hair loss- diffuse thinning rarely leads to total baldness
-both androgen dependent polygenic inheritance
-male-late teens early 20s
-female-full expression mid 20s -> can also be associated with peri-menopause and menopause
-bi temporal thinning
-terminal hair follicles turn to vellus like hairs finalizing with atrophy of the follicle, then disappearance

Question 7

androgenic alopecia pathogenisis

Answer 7

-genetically susceptible individuals
-THEORY- variations in the AR gene have been identified -> provides instructions on conversion of testosterone to DHT leading to an increase of androgen receptors in hair follicles
-men- associated with heart disease, enlarged prostate, prostate cancer, insulin resistance, obesity, diabetes, hypertension
-women- associated with PCOS, hormone imbalance, irregular menstruation, acen excessive hair growth in other areas of body and weight gain
-TAKE THROUGHOUT HX

Question 8

androgenic alopecia treatment

Answer 8

-men -> minoxidil oral and topical or finasteride oral (propecia)
-women:
-minoxidil not effective in post-menopausal women
-spironolactone- androgen blocking agent
-spironolactone/minoxidil oral combo

Question 9

alopecia areata (AA)

Answer 9

-complex genetic immune mediated disease targeting blub region of anagen hair follicles
-pts complain of patchy hair loss- sometimes itchy
-round or oval patches
-hair follicle is not destroyed- has potential for regrowth
-episodes can last days, months year
-severity based on SALT scores
-extensive- alopecia totalis, alopecia universalis
-eyelashes, eyebrow, beard and sometimes other parts of body may be involved

Question 10

alopecia areata (AA) treatment

Answer 10

-many approved and not approved
-complicated but combination therapies work best
-tropical class 1 steroids
-intralesional steroid injection
-minoxidil
-anthralin intro to allergic contact dermatitis
-burst of oral steroids
-UV-B light therapy
-jak inhibitors

Question 11

targeting the inflammatory pathways in alopecia areata

Answer 11

-janus kinase inhibitors
-ruxolitinb (JAK 1,2)
-Tofacitinib (JAK 3)
-Baricitinib (JAK 1,2)
-Upadacitinib (JAK 1)
-fredratinib (JAK 2)

Question 12

telogen effluvium

Answer 12

-very common hair loss condition
-increased shedding
-stems from illness, post partum, short anagen cycle
-usually in response to trigger
-usually resolves on its own

Question 13

trichotillomania

Answer 13

-recurrent pulling of ones own hair

Question 14

hirsutism

Answer 14

-presence of excessive terminal hair growth in androgen sensitive sites
-may be hereditary
_females can be caused by PCOS and ovarian tumors