Hair loss

Question 1

alopecia areata

Answer 1

chronic recurring inflammatory disorder that is associated with other autoimmune disorders like thyroiditis

Question 2

diagnosis of alopecia areata

Answer 2

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

Question 3

does alopecia atreata cause problems to the hair follicle?

Answer 3

no it doesn’t

Discoid lupus erythematosus will damage the hair follicule and cause fibrosis and scar tissue

Question 4

prognosis of alopecia atreata?

Answer 4

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

Question 5

traumatic alopecia is also known as

Answer 5

trichotillomania - or someone who pulls out their hair

Question 6

tinea capitis can also

Answer 6

result in non scarring patchy hair loss. Treat with oral terbinafine.

Question 7

patchy “moth eaten alopecia” and someone who presents with fever malaise, headache, diffuse LAD and maculopapular and uveitis and hepatitis and mild meningitis

Answer 7

secondary syphilis

Question 8

androgenic alopecia is

Answer 8

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.

Question 9

in men hair loss by androgenic alopecia is lost in:

Answer 9

temporal areas, anterior hairline, vertex

Question 10

female hair loss by androgenic alopecia is by:

Answer 10

affects the vertex and center of the scalp with sparing of the hairline

Question 11

most common cause of hair loss

Answer 11

androgenic alopecia (80% lifetime incidence)

Question 12

treatment of androgenic alopecia is

Answer 12

topical minoxidil 1st line in men and women

5 alpha reductase inhibitors (finasteride) can be used in men but no women

Question 13

telogen effluvium is

Answer 13

common cause of hair thinning but occurs diffusely across the scalp and has acute onset and resolves within a year.

Question 14

alopecia areata is characterized by

Answer 14

smooth circular areas of complete hair loss

Question 15

trichotillomania is

Answer 15

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.

Question 16

tinea capitis

Answer 16

see scaly, erythematous patches of hair loss with pruritis and tender LAD and scarring.

Question 17

acute diffuse non inflammatory hair loss is

Answer 17

telogen effluvium

most common cause of hair loss in adults

Question 18

hair growth pass through 3 phases:

Answer 18

growth phase (anagen 90% of follicles), transformative phase (catagen<1%), and rest/shedding phase (telogen 10%)

Question 19

TE follicles undergo a shift in rest and sheeding phase with growth cessation and subsequent shedding when there’s a

Answer 19

stressful event

severe weight loss, pregnancy, major illness, or surgery or psychiatric trauma

Question 20

diagnosis of telogen effluvium

Answer 20

based on clinical findings

see wide spread thinning of hair but scalp and hair shafts appear normal

Question 21

hair pull test:

Answer 21

small tracts of hair 50-60 fibers are pulled firmly extraction >10-15% of fibers are abnormal suggests telogen effluvium

Question 22

if unclear reasons for hair loss get:

Answer 22

CBC and ferritin, TSH and CMP

Question 23

Treatment of telogen effluvium

Answer 23

self limited disorder and may take up an year to resolve completely

Question 24

treatmetn of alopecia areata

Answer 24

topical steroids and also treat seborrheic dermatitis

Question 25

Treatment of trichotillomania

Answer 25

cognitive behavioral therapy