module II

Question 1

Autoimmune
-Can occur anywhere that hair is present, although it is commonly associated with absence of hair on the scalp area
-The most common cause of permanent hair loss is androgenetic alopecia (AGA) or male-pattern baldness (common baldness)-it can occur in both sexes
Ask about medications
-Drugs that cause hair loss include hormones, anticonvulsants, anticoagulants, oral contraceptives, beta blockers, antimetabolites, antithyroid drugs, and excessive amounts of vitamin A or topical Retin-A
-Stopping treatment warning-alopecia may return
Treatment :
determined by patient’s age, severity
Finasteride, Minoxidil
-In nonscarring alopecia, the scalp will have normal texture and color. In contrast, the scalp of a patient with scarring alopecia has no visible hair follicles (or no follicular openings) and is atrophied and smooth.

Answer 1

Alopecia

Question 2

nonsystematic causes of non scarring alopecia

Answer 2

hair pulling (trichotillomania)-more commonly seen in children, excessive traction of the frontal and temporal areas of the scalp (from tight cornrows or tight ponytails), trauma (both physical and chemical), radiation therapy to the head, local bacterial infection, and local fungal infection.

Question 3

systemic causes of non scarring alopecia

Answer 3

alopecia areata, telogen effluvium (TE), androgenetic baldness (common baldness), vitiligo, Hashimoto’s thyroiditis, Addison’s disease, systemic lupus erythematosus (SLE), hypothyroidism or hyperthyroidism, secondary syphilis, severe herpes zoster of the scalp, drug-induced alopecia (common in patients on cyclophosphamide therapy), iron-deficiency anemia, and pituitary insufficiency.
TE—excessive shedding of scalp hair that resul

Question 4

causes of scarring alopecia

Answer 4

include trauma (physical or chemical), severe bacterial or fungal infections of the scalp, scleroderma, discoid lupus erythematosus, lichen planopilaris, and excessive radiation.Kerion formation in tinea capitis

Question 5

telogen effluvium (TE)

Answer 5

excessive shedding of scalp hair that results from an increased number of hair follicles entering the resting stage (telogen)—can be caused by fever and certain drugs; therefore, a search for these possible causes should be included in the history taking. TE may also be caused by stress, pregnancy and/or childbirth, extreme weight loss, and general anesthesia. TE is almost nonexistent in men. I

Question 6

treatments of alopecia

Answer 6

Finasteride once daily is approved for the treatment of androgenetic baldness in men only,
-Because it is metabolized in the liver, finasteride should be used with caution in patients with liver disease
-Topical treatments for men and women containing minoxidil are available over the counter (OTC).
-The best candidates for treatment with topical minoxidil are patients with recent onset of alopecia (less than 5 years), those younger than age 50 years, and patients with smaller areas of hair loss

Question 7

Pigmentation Changes (Vitiligo)

Answer 7

Loss of pigmentation
Most often occurs in 20’s
Thought to be autoimmune
Treatment includes topical steroids, light therapy and psoralen (oral or topical) with Ava therapy, skin grafting , depigmentation with topical cream, surgical approach