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Dermatology > Non-inflammatory Alopecia > Flashcards

Non-inflammatory Alopecia Flashcards

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Dermatology Board Prep flashcards
1
Q

T/F: alopecia is typically infectious (folliculitis) but it is not always

A

True

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2
Q

What are the stages in the hair cycle

A

1) Anagen - growth phase
2) Catagen- transition
3) Telogen- resting
4) Exogen- release/ shedding

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3
Q

What are the influeneces of the hair cycle

A

1) External: photoperiod, ambient temperature, nutrtion
2) Genetic
3) Hormonal
4) Neuronal
5) Immunologic
6) Cellular (mast cells, macrophages)
7) Signaling (growth factors, cytokines)

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4
Q

What endocrinopathies cause alopecia

A

1) Hyperadrenocortisim (spontaneous, atypical, iatrogenic)
2) Hypothyroidism
3) Sex hormone imbalances ( Testicular neoplasia, cystic ovaries, ovary neoplasia, estrogen exogenous supplementation), sex hormone producing adrenal tumors
4) Grown hormone deficiency (pituitary dwarfism)
5) Diabetes mellitus (maybe secondary to bacterial pyoderma)

*skin biopsies not particularly useful for differentiation

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5
Q

What might cause sex hormone imbalances leading to alopecia

A

-Testicular neoplasia (ie sertoli cell tumor)
-Cystic ovaries
-Ovarian neoplasia
-Exogenous supplementation (estrogen)
-Sex hormone producing adrenal tumors (ie progestens)
-Contact with sex hormone topicals used by owners

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6
Q

T/F: skin biopsies are not particularly useful for differentiation of endocrinopathy causes of alopecia

A

True

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7
Q

How can hormone imbalances effect the coat

A

1) Hair follicle cycle abnormalities
-Telogenization of follicles (stuck in resting phase)
-Failure to regrow after clipping
-Hair loss

2) Hanges in hair quality- coarse and frizzy

3) Changes in coat color- bleaching or darkening

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8
Q

Alopecia due to hormone imbalances is typically

A

bilaterally symmetrical truncal/ tail coat thinning

sparing the head and distal extremities

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9
Q

What signs might you see of disordered keratinization from hormone imbalances

A

1) Hyperkeratosis- thickening of stratum corneum
2) Scaling/seborrhea
3) Comedo (black head formation)

non-specific

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10
Q

Hair due to hormone imbalance will be

A

dull, dry, brittle +/- texture and color change

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11
Q

changes in hair thickness (atrophy) is seen with

A

hyperadrenocorticism
excess progestogen exposure
diabetes mellitus

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12
Q

alopecia or coat thinning due to hormone imbalances is typically spared at the

A

head and distal extremities

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13
Q

If you see a comedone in a cushing’s patient, why might you also want to diagnostically work the case up more

A

even though HAC can cause comedones, they are also immunocompromised which demodex could also cause comedones

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14
Q

With HAC, you can see cutaneous atrophy, what is that

A

often first noted in areas of old scars
striae (stretch marks)- ventrum
visible blood vessels
palpably thin
loss of elasticity
calcinosis cutis

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15
Q

vascular proliferations often seen in Cushing patients
differential for hemangiomas
might want to biopsy if cushings not diagnosed

A

Phlebectasia

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16
Q

What should you beware of with long-term, daily, low dose prednisone or prednisolone for allergy management, daily budesonide for IBD, and hgiher dose daily or EOD therapy for immune mediated disease

A

Iatrogenic hyperadrenocorticism

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17
Q

Alopecia over the bridging of the nose makes you suspicious for

A

Hypothyroidism

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18
Q

T/F: rat tail hypotrichosis is specific for hypothyroidism

A

False

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19
Q

What are the hypometabolic skin changes seen with hypothyroidism

A

1) Hyperkeratotic- thickening of stratum corneum (panum and areas of wear)
2) Epidermis normal to thickenined
3) Dermis normal to thickened
+/- mucin accumulation in dermis

20
Q

What are your differentials for paw pad hyperkeratosis

A

1) Hypothyroidism
2) Zinc responsive dermatosis
3) Superficial Necrolytic Dermatosis (Liver failure)
4) Pemphigus
5) Idiopathic

21
Q

With endocrinopathies, what might you see with response to therapy

A

May see initial - gets worse before better
1) Increased shedding/exfoliative dermatitis, scaling 3-6 weeks into treatments
2) Initial hair regrowth - often darker

Best normalization of coat/skin associated with optimal control:
-TT4 high normal to slightly supra-normal on BID therapy
-Cortisol normalized

22
Q

How long does it take for the skincoat to get better after treating endocrinopathies

A

by about 3-6 weeks

23
Q

With treating endocrinopathies, you get the best normalization of coat/skin with

A

1) TT4 high normal to slightly supra-normal on BID therapy
2) Cortisol normalized

24
Q

Perianal adenomas/adenocarcinomas

A

excess androgen produced from testicular tumors or adrenals

hyperplasia of circumanal glands and tail glands
-regress after neutering

25
Q

Sertoli cell tumors have the highest incidence in

A

cryptorchid

the non-neoplastic testicle is usually atrophied

26
Q

What 6 things do you see with Sertoli cell tumor

A

1) Non-neoplastic testicle is usually atrophied
2) Feminization
3) Aspermatogenesis
4) Prostatic disease
5) Bone marrow hypoplasia
6) Linear preputial erythema or hyperpigmentation

Metastatic disease is uncommon

27
Q

What might you see with hyperestrogenism due to cystic ovaries

A

1) Caudal thighs, ventrum, flank alopecia that may become truncal
2) Gynecomastia
3) Abnormal estrous cycles (prolonged or shortened)

28
Q

What causes iatrogenic hyperestrogenism

A

chronic contact with human topical hormone replacement (estrogen)

29
Q

What might resolve alopecia X in an intact male

A

castration

30
Q

What are some other names for Alopecia X

A

-Adrenal Sex Hormone imbalance
-Maturity onset growth hormone responseive dermatosis
-Estrogen, testosterone responsive dermatosis
-Castration responsive dermatosis
-Pseudo-Cushings disease

31
Q

What breeds are associated with Alopecia X

A

nordic breeds most common: pomeranian, chow chow, samoyed, keeshond, siberian husky, malamute, norweigan elkhound, finish spitz, american eskimo

miniature poodle

32
Q

What kind of dogs are alopecia X common in

A

Intact males
young dogs- 2.5 yrs at onset
northern breeds, mini poodle

33
Q

Alopecia X causes

A

hair cycle arrest

34
Q

What is Telogen Effluvium

A

acute widespread alopecia from telogen defluxion

severe illness/metabolic stress (fever, pregnancy, lactation, shock, drugs) cause hairs to go into telogen stage
hair loss starting 3-4 weeks or more (1-3 months) after incident as new hairs regrowing

35
Q

What causes telogen effluvium

A

severe illness/metabolic stress (fever, pregnancy, lactation, shock, drugs) cause hairs to go into telogen stage
hair loss starting 3-4 weeks or more (1-3 months) after incident as new hairs regrowing

36
Q

Post-Clipping alopecia

A

follicular arrest in dogs with history of clipping, surgically scrubbed +/- epidural

no hair regrowth, unknown etiology
rest of the coat/skin is normal

regrowth in 6-24 months (usually <1 year)

melatonin? thyroid hormone?
try low level laser 2x weekly for 2 month

37
Q

canine flank alopecia is common in what species

A

Airedales, Boxers, Schnauzers, Bulldogs

38
Q

What is seen with canine flank alopecia

A

alopecia restricted to the flank of boxers, bulldogs, schnauzers, airedales

hyperpigmentation
may be seasonally cyclic

may involve melatonin deficiency
normal dogs- decreased photoperiod, increased melationin to stimulate winter pelage

39
Q

What may cause canine flank alopecia seen in boxers and schnauzers and bulldogs and airedales

A

may involve melatonin deficiency
normal dogs- decreased photoperiod, increased melationin to stimulate winter pelage

may be able to resolve with melatonin supplementation

40
Q

How do you treat the follicular dysplasia seen with canine flank alopecia

A

often responds to melatonin therapy
50-75% respond
melatonin implant with 4-6 month release

low level laser- twice weekly for 2 months

41
Q

blue, fawn color coat seen in doberman, great dane, whippet where alopecia is restricted to the dilute area of the coat
Starts 6-12 months to 2-3 years

A

Color Dilution Alopecia (follicular dysplasia)

42
Q

When does color dilution alopecia typically present

A

younger dogs
Starts 6-12 months to 2-3 years

43
Q

What do you see diagnostically with color dilution alopecia

A

hairs with macromelanosomes that weaken the hair shafts
biopsies: pigment coloring around hair follicle

44
Q

What breeds do you see acquired pattern alopecia (pattern baldness) in

A

Dachshund, boston terrier, chihuahua, whippet

45
Q

Acquired Pattern Alopecia (pattern baldness)

A

Alopecia that develops as young dogs (1-3 years)
occurs in dachshund, boston terrier, chihuahua, whippet

may respond to melatonin therapy
photobiomodulation?

No need to treat (cosmetic)

46
Q

What breeds typically get caudal thigh alopecia

A

greyhounds

Dermatology (10 decks)

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