Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Dermatology > Lecture 7: Hair and Digit Tip Disorders > Flashcards

Lecture 7: Hair and Digit Tip Disorders Flashcards

1
Q

How does hair grow?

A

Intermittently

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 4 phases of hair growth?

A
  1. Anagen: Growth
  2. Catagen: degenerate/Catabolic stage, stoppage of growth.
  3. Telogen: resting/timeout phase
  4. Exogen: hair shedding/exit phase
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How long do leg hairs usually grow for?

A

5-7m

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the 4 types of hair?

A
  • Lanugo (soft hair in fetus)
  • Vellus hair (peach fuzz), not affected by hormones
  • Intermediate hair: scalp
  • Terminal hairs: thick, pigmented hairs whose growth IS affected by hormones
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How many hairs should a normal hair pull dislodge?

A

3-5

> 5 = sus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does a trichogram measure?

A

Anagen to Telogen ratio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe a normal trichogram.

A
  • Epilate/plick 50+ hairs from scalp.
  • Ideally you see 80%-90% anagens, which are characterized by Long encircling hair sheaths.

Telogen hairs are largest at the base.

Tiny amt of Telogens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the most common form of alopecia?

A

Androgenic alopecia

Aka sex pattern hair loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the underlying pathophysiology of androgenic alopecia?

A

Terminal hairs are regressed into indeterminate/vellus hairs due to androgens.

Terminal hairs are affected by hormones!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What androgenic alopecia classification describes females?

A

Ludwig-Savin

MC type is diffuse thinning. Women wear wigs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What androgenic alopecia classification describes males?

A

Norwood Hamilton

Alexander Hamilton was a man or men have morning wood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When does androgenic alopecia commonly occur for men?

A

After puberty, done by 40s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When does androgenic alopecia commonly occur for women?

A

After 50!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Overall, what sex and ethnicity is androgenic alopecia MC in?

A

White males

toby.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What hormone specifically causes androgenic alopecia and the long-term result of exposure to it?

A
  • DHT
  • Successive cycles will produce shorter and thinner hairs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What associated S/S should we ask for a woman regarding androgenic alopecia?

A
  • Acne
  • Hirsutism
  • Irregular Menses

All hormone related

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Generally, how does male androgenic alopecia present?

A

Anterior or central hair loss.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

If I do a biopsy of androgenic alopecia, what do I expect to see?

A

Telogen phase & atrophic follicles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What hormone studies are indicated for androgenic alopecia workup?

A
  • Testosterone (total & free)
  • DHEAS
  • Prolactin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What conditions can cause androgenic alopecia?

A
  • Thyroid
  • Anemia
  • Autoimmune
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the preferred topical tx for androgenic alopecia?

A

Minoxidil/Rogaine BID

let pts know hair shedding initially is COMMON.

Can also be taken orally.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the oral medications for androgenic alopecia?

A
  • Finasteride for men
  • Spironolactone for women

Finasteride slows hair loss for 3 months, then grows it back over 6.

Finasteride inhibits conversion of test to DHT. It is the 5-alpha-reductase inhibitor also used for BPH.
Spironolactone prevents DHT from working.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the key descriptors of alopecia areata?

A

Random hair loss with NO inflammation of skin.

No scarring!

T-cell mediated autoimmune.
AReata = At Random

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Who is alopecia areata MC in?

A

Children < 25 yo

MCC of hair loss in children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Describe the pathology that occurs in alopecia areata

A
  1. Hair follicle is damaged in anagen phase.
  2. Transforms to catagen and telophase rapidly.
  3. Cannot progress beyond anagen phase if active.

However, no scarring = regrowth is possible.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is probably the buzzword for alopecia areata?

A

There is NO SKIN SCARRING

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Where is alopecia areata MC found?

A
  • Scalp
  • Beard
  • Eyebrows
  • Extremities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What would dermoscopy show for alopecia areata?

A
  • Black dots representing broken hair pushed out of the follicle.
  • Exclamation Hairs

Hair follicle broken early.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the subtypes of alopecia areata?

A
  • Alopecia areata: solitary/multiple areas of hair loss
  • AA totalis: total loss of terminal scalp hair
  • AA universalis: Total loss of all terminal body & scalp hair
  • Ophiasis: Headband-shaped hair loss
  • Nails: fine pitting/hammered brass of dorsal nail plate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How is alopecia areata typically treated?

A
  • Typically just remits on its own.
  • Mainly decreasing inflammation and reducing growth inhibitors (see next card)
  • Psych consult
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the poor prognostic factors for alopecia areata?

A
  • Began in childhood
  • Body hair involved
  • Nail involvement
  • Atopy
  • FHx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What medications are used to reduce inflammation in alopecia areata?

A
  • Topical CS (class 1 or 2) with minoxidil
  • Intralesional Kenalog Q6wks into alopetic plaques
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the systemic tx for alopecia areata?

A

Short term prednisone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is the specific kid tx for alopecia areata?

A

Anthralin

Keratolytic agent that regrows hair.

Must avoid face

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is keratosis pilaris?

A

Hyperkeratinization of skin and keratotic follicular plugging

Goosebumps skin

little pils of keratin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Primary risk factor for keratosis pilaris?

A

FHx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

When is keratosis pilaris worst?

A

Winter

Better in summer, cold = goosebumps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

How does the early childhood pattern of keratosis pilaris present?

A
  • Face/arm involvement
  • Improves as they grow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

How does adolescence onset keratosis pilaris present?

A
  • Arms/legs
  • Improves by mid-20s

Face is only in early childhood!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is the only symptom usually with keratosis pilaris?

A

Occasional pruiritis

Can have erythema if associated inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Where specifically is keratosis pilaris MC?

A

Upper outer arms and thighs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Dx of keratosis pilaris is made…

A

Clinically

Biopsy showing follicular orifice distended by keratin plug if atypical.

43
Q

Main treatments for keratosis pilaris

A
  • Skin hydration via gentle Dove soaps and unscented moisturizer lotions
  • Lac-Hydrin (lactice acid lotion) BID
  • Reduction of inflmmation (if present) via steroid creams 1-2x/d for 7-10d
  • Keratolysis via SA, topical urea, or topical retinoids
44
Q

What is the main SE of keratolytic agents like SA or topical retinoids?

A

Inflammation

45
Q

Nail growth into one or both sides of the paronychium/nail bed is…

A

Onychocryptosis

creeping in

46
Q

Who is onychocryptosis MC in?

A

Males in their 20s

47
Q

What does the impingement of the nail into the dermal tissue result in?

Onychocryptosis

A
  • Erythema
  • Edema
  • Purulence
  • Granulation tissue

It functions as a foreign body

48
Q

What is onychocryptosis more commonly known as?

A

Ingrown nails

49
Q

Where is onychocryptosis MC?

A

Big toe

Gotta wear looser shoes

50
Q

Tx for onychocryptosis

A
  • Warm soaks
  • Topical mupirocin BID
  • Nail trimming
  • Cotton training
  • Surgery (nail or matrix removal)
51
Q

Post-op care for onychocryptosis/ingrown nail

A
  • Antibacterial soap
  • Mupirocin

Resume activity after 48-72hrs

52
Q

Where is onychomycosis/tinea unguium MC?

Prepare yourself

A

Toes

53
Q

Causative organism for tinea unguium/onychomycosis

A

Trichophyton rubrum

Fungi

54
Q

What structure does tinea unguium/onychomycosis invade specifically in the nail?

A

Hyponychium

H & M(ycosis)

55
Q

What is the MC complaint of onychomycosis?

A

Discoloration

Nail thickens and cause sometimes lift off bed.

No other symptoms really. its just gross.

56
Q

What kind of person might get onychomycosis?

A

A daily goer to the Gym who wears no shoes in the shower

57
Q

Although onychomycosis is mianly just a gross looking condition, what do you need to workup?

A

MELANOMA WORKUP FOR ANY TOENAIL DISCOLORATION

Either rule out clinically or biopsy it

Especially if its like a dark band

58
Q

How do you workup onychomycosis?

A

Toenail clipping under KOH prep

No antifungals 2 weeks prior

59
Q

Topical tx for onychomycosis

A
  • Ciclopirox (Penlac)
  • Efineconazole (Jublia)

48 WEEKS of treatment for jublia

60
Q

What is the home remedy for onychomycosis?

A

1:1 ratio of apple cider vinegar and water for 10 mins a day

Soak those dogs

61
Q

If you want to treat onychomycosis orally, what would you give?

A
  • Terbinafine for 6 weeks for the fingers.
  • 12 weeks for the Toes/Dogs

Dogs need lots of care

62
Q

What do you need to monitor in onychomycosis lab-wise during pharm tx?

A
  • CBC
  • LFTs

Baseline & monthly!!

Hepatoxicity
Pancytopneia
Agranulocytosis

63
Q

How long might it take a nail to regrow with onychomycosis?

A

1 year

Might be discolored for a while

64
Q

What is onycholysis?

A

Detachment from nail bed

65
Q

What color suggests bacteria caused onycholysis?

A

Green

Gray-black is just air

66
Q

What is unique about onycholysis presentation?

A
  1. No inflammation
  2. Nails are smooth

Loose Lysis

67
Q

How do you treat onycholysis?

A

Tx underlying cause if there is one

68
Q

What does paronychia start as and progress to?

A

Inflammation of proximal/lateral nail fold into cellulitis into abscess

The classic cellulitis => abscess

69
Q

MCC of paronychia

A

Trauma

2nd is bacteria

70
Q

How much hand washing is a RF for paronychia

A

50-100 times a day?

OCD ppl prob could meet this

71
Q

MCC bacteria for acute paronychia

A

Staph

72
Q

If acute paronychia has GREEN purulence, what might be the bacteria?

A

Pseudomonas

73
Q

If you do a Tzanck for acute paronychia, what are you prob considering in your DDx

A

Herpetic Whitlow

74
Q

Normal tx of non-cellulitis acute paronychia

A
  • Warm soaks
  • I&D if it becomes fluctuant
75
Q

Tx of cellulitis acute paronychia

A

Augmentin BID x 10d

Clinda, Keflex

76
Q

Besides treating acute paronychia, what should u do?

A

Consult hand surgeon IF significant cellulitis or lymphangitis, Tenosynovitis, deep space infection, osteomyelitis

77
Q

How does chronic paronychia typically present?

A
  • Waxing and waning inflammation
  • Pain
  • Swelling for 6 weeks
78
Q

Tx of chronic paronychia

A
  • Keep dry
  • Don’t touch
  • Warm antiseptic soaks
  • Topical antifungals

Oral antifungals if severe

79
Q

Where is Herpetic whitlow MC?

A

Distal finger

80
Q

Who is HSV1 herpetic whitlow MC in and why?

A

Children because they suck their fingers

Can also be caused by gingivostomatitis

81
Q

Who is HSV2 herpetic whitlow MC in?

A

Adults working in healthcare

82
Q

PRIOR to the herpetic whitlow lesions, what symptoms occur?

A
  • Burning
  • Pruritis

Its like shingles for your fingers

83
Q

How is herpetic whitlow Dx?

A

Clinical

Tzanck if ya want

84
Q

What should you NOT do with herpetic whitlow tx?

A

DO NOT I&D

85
Q

How do you tx herpetic whitlow?

A
  • Acyclovir/Valcyclovir
  • OTC pain meds

Self-limiting over 3 weeks

86
Q

What is Felon?

A

Soft tissue infection of pulp space of distal phalanx due to infection

87
Q

Where is Felon MC?

A
  • Thumb
  • Index finger
88
Q

Why is Felon scary

A

Rapid and severe progression

Can turn into osteitis, osteomyelitis, septic joint, or tenosynovitis.

A Felon is much more SEVERE than a misdemeanor

89
Q

How do you workup Felon

A
  • Gram stain + C&S
  • Tzanck to r/o herpetic whitlow
  • XR

a thorough bkg check on felons

90
Q

How do you manage a Felon?

A

Augmentin BID x 10 days
Surgical decompression

Treat it like its in a CELLulitis

91
Q

Why do clubbed nails occur?

A

Primarily idiopathic, but can occur due to prolonged hypoxia.

I have a clubbed pinky :(

92
Q

What condition is the MCC of clubbed nails besides being idiopathic?

A

Lung CA

hypoxia?

93
Q

What is melanonychia?

A

Nail pigmentation due to melanin

Melanin nails

94
Q

Who is melanonychia MC in?

A

Darker skinned

95
Q

What are the possible underlying conditions that can result in melanonychia?

A
  • Infections
  • Skin conditions
  • Trauma
  • Tumors (Bowens or SCC)
  • Addisons/Cushing’s
  • Iatrogenic
96
Q

What is the MCC of melanonychia in children?

A

Nail matrix nevus

97
Q

MC associated condition with pitted nails?

A

Psoriasis

98
Q

MCC of splinter hemorrhages

A

Trauma to nail

99
Q

Medical conditions that can cause splinter hemorrhages

A
  • APS
  • IE
  • IVDU
  • Psoriasis
  • Rheumatic HD
  • SLE
100
Q

Who are terry nails MC in?

A

Liver dz/Cirrhosis

101
Q

What happens to the nail bed in terry nails?

A
  • Less blood
  • More connective tissue

Increased pallor

102
Q

What does a single beau line suggest in terms of etiology?

A

Repeated trauma/infection

103
Q

What do multiple beau lines suggest for etiology?

A
  • Acute kidney failure
  • Mumps
  • Thyroid
  • Syphilis
  • Chemo
  • Endocarditis
  • Melanoma
  • DM
  • PNA
  • Scarlet Fever
  • Zinc Deficiency

not memorizing this grrr

Dermatology (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions