Hair loss Flashcards
alopecia areata
chronic recurring inflammatory disorder that is associated with other autoimmune disorders like thyroiditis
diagnosis of alopecia areata
established clinically with smooth circular patches of hair loss with exclamation points seen at he margins.
Develops over a few weeks in individuals under age of 30. can see nail pitting
does alopecia atreata cause problems to the hair follicle?
no it doesn’t
Discoid lupus erythematosus will damage the hair follicule and cause fibrosis and scar tissue
prognosis of alopecia atreata?
they will have spontaneous recovery within a year. relapses are common and sometimes no treatment is indicated.
In some instances, can be treated with intralesional steroids (steroid injections). can give topical steroids if pt refuses.
Only give topical immunotherapy for people who have not responded
traumatic alopecia is also known as
trichotillomania - or someone who pulls out their hair
tinea capitis can also
result in non scarring patchy hair loss. Treat with oral terbinafine.
patchy “moth eaten alopecia” and someone who presents with fever malaise, headache, diffuse LAD and maculopapular and uveitis and hepatitis and mild meningitis
secondary syphilis
androgenic alopecia is
femaile patterned baldness and this is driven by both hormonal (circulating androgens) and genetic factors and pts have a family history of similar hair loss.
in men hair loss by androgenic alopecia is lost in:
temporal areas, anterior hairline, vertex
female hair loss by androgenic alopecia is by:
affects the vertex and center of the scalp with sparing of the hairline
most common cause of hair loss
androgenic alopecia (80% lifetime incidence)
treatment of androgenic alopecia is
topical minoxidil 1st line in men and women
5 alpha reductase inhibitors (finasteride) can be used in men but no women
telogen effluvium is
common cause of hair thinning but occurs diffusely across the scalp and has acute onset and resolves within a year.
alopecia areata is characterized by
smooth circular areas of complete hair loss
trichotillomania is
compulsive hair plucking leading to a irregular pattern of broken hair strains of various lengths and seen on front and sides of the scalp and the eyebrows and eyelashes.
tinea capitis
see scaly, erythematous patches of hair loss with pruritis and tender LAD and scarring.
acute diffuse non inflammatory hair loss is
telogen effluvium
most common cause of hair loss in adults
hair growth pass through 3 phases:
growth phase (anagen 90% of follicles), transformative phase (catagen<1%), and rest/shedding phase (telogen 10%)
TE follicles undergo a shift in rest and sheeding phase with growth cessation and subsequent shedding when there’s a
stressful event
severe weight loss, pregnancy, major illness, or surgery or psychiatric trauma
diagnosis of telogen effluvium
based on clinical findings
see wide spread thinning of hair but scalp and hair shafts appear normal
hair pull test:
small tracts of hair 50-60 fibers are pulled firmly extraction >10-15% of fibers are abnormal suggests telogen effluvium
if unclear reasons for hair loss get:
CBC and ferritin, TSH and CMP
Treatment of telogen effluvium
self limited disorder and may take up an year to resolve completely
treatmetn of alopecia areata
topical steroids and also treat seborrheic dermatitis
Treatment of trichotillomania
cognitive behavioral therapy
