Section 31- Hair Follicles

Question 1

Growth phase of hair follicle

Determines ultimate length of hair at site

Answer 1

Anagen

Question 2

Degenerative phase of hair follicle

Apoptosis driven

1% of hair in this phase

Answer 2

Catagen

Question 3

Period of relative quiescence stage in hair follicle

Answer 3

Telogen

Question 4

Active process of hair shaft shedding

Answer 4

Exogen

Question 5

Fine, non pigmented hair

Growth not affected by hormones

Answer 5

Vellus hair

Question 6

Thick pigmented hair

Growth affected by hormones

Answer 6

Terminal hair

Question 7

Lab exam for hair that determines the number of anagen and telogen hairs

Answer 7

Trichogram

Question 8

Most common type of progressive balding

Answer 8

Pattern Hair Loss

Androgenetic alopecia

Question 9

This hormone causes growth of prostate, terminal hair, AGA and acne

Answer 9

Dihydrotestosterone

Question 10

This hormone causes growth of axillary hair and lower pubic hair

Sex drive, spermatogenesis, growth of scrotum and phallus

Answer 10

Testosterone

Question 11

Testosterone is converted to DHT by this enzyme

Answer 11

5a- reductase

Question 12

Men usually exhibit pattern hair loss in these sites:

Answer 12

Frontotemporal

Vertex

Question 13

Hormone studies in women with hair loss and evidence of increased androgens

Answer 13

Testosterone- free and total
DHEAS
Prolactin

Others: TSH FT4 serum iron CBC ANA

Question 14

Management for pattern hair loss

Answer 14

Oral finasteride 1mg/ day
Topical minoxidil 2% and 5%
Antiandrogens - spironolactone cimetidine flutamide
Topical latanoprost 0.1%

Question 15

A localized loss of hair in round or oval areas with no apparent inflammation of the skin

Answer 15

Alopecia areata

Question 16

Associated conditions in alopecia areata

Answer 16

Autoimmune thyroiditis

Down syndrome

Question 17

Type of alopecia areata where there is total loss of terminal scalp hair

Answer 17

Alopecia areata totalis

Question 18

Type of alopecia areata where there is total loss of terminal scalp and body hair

Answer 18

Alopecia areata universalis

Question 19

Type of alopecia areata where there is bandlike pattern of hair loss over periphery of scalp

Answer 19

Ophiasis

Question 20

Transient increased shedding of normal club hair (telogen) from resting scalp follicles

Accelerated shift of anagen into catagen and telogen

Answer 20

Telogen effluvium

Question 21

Second most common cause of alopecia after AGA

Answer 21

Telogen effluvium

Question 22

Individuals with telogen effluvium may also affect the growth of nails and can result to this nail condition

Answer 22

Beau lines

Question 23

Nail findings in alopecia areata

Answer 23

Fine pitting (“hammered brass”) of dorsal nail plate

Question 24

Lab exams to rule out other causes of hair loss

Answer 24

Serum iron
Iron binding capacity
TSH, FT4
ANA (rule out SLE)
RPR (rule out secondary syphilis)

Question 25

Anagen cycle disrupted Scalp hair loss diffuse and extensive Due to radiation therapy, chemotherapy with alkylating agents, mercury thallium boric acid intoxications or severe protein malnutrition Regrows after discontinuation

Answer 25

Anagen effluvium

Question 26

Results from damage or destruction of hair follicle stem cells by inflammatory, infection and other pathologic processes

Answer 26

Cicatricial or scarring alopecia

Question 27

Effacement of follicular orifices in a patchy or focal distribution Replacement of the follicular structure by fibrous tissue

Answer 27

Cicatricial or scarring alopecia

Question 28

[scarring alopecia] Perifollicular erythema +/- hyperkeratosis Violaceous discoloration of the scalp Results in permanent hair loss, most common in parietal scalp May or may not be associated with lichen planus of skin/mucosa

Answer 28

Lichen planopilaris

Question 29

Variant of lichen planopilaris where there is LP like lesions with follicular spines in areas of alopecia on scalp, eyebrows, axilla and pubic areas

Answer 29

Graham-Little Syndrome

Question 30

Variant of lichen planopilaris where there is frontotemporal hairline recession and eyebrow loss in postmenopausal women with perifollicular erythema

Answer 30

Frontal fibrosing alopecia

Question 31

End stage of all non inflammatory scarring alopecias Early moth-eaten pattern with eventual coalescence into larger patches of hair loss( footprints in the snow)

Answer 31

Pseudopelade of Brocq

Question 32

Type of alopecia in relation to chemical processing, heat or chronic tension on the hair Most common in black women Begins in crown/midvertex and advances centrifugally

Answer 32

Central centrifugal scarring alopecia Hot comb alopecia

Question 33

Type of scarring alopecia that may be a symptom of cutaneous T cell lymphoma

Answer 33

Alopecia mucinosa

Question 34

[scarring alopecia] Pustular folliculitis Surviving hairs clustered (tufted folliculitis) Bogginess or induration with pustules, erosions or crusts S.aureus infection common

Answer 34

Folliculitis Decalvans

Question 35

[scarring alopecia] Most common in black men Initial deep inflammatory nodules over the occciput Sinus tracts may form S aureus secondary infection common

Answer 35

Dissecting folliculitis

Question 36

``` [scarring alopecia] Most commonly in black men Occurs in occipital scalp and nape Chronic papular or pustular eruption Keloidal scar may occur ```

Answer 36

Folliculitis keloidalis nuchae

Question 37

[scarring alopecia] Commonly called razor bumps Related to curved hair follicles that retract beneath skin surface, grow and cause a foreign body reaction S aureus secondary infection common

Answer 37

Pseudofolliculitis barbae

Question 38

[scarring alopecia] | Painful or pruritic erythematous follicular based papule with central necrosis, crusting and healing with depressed scar

Answer 38

Acne necrotica

Question 39

Treatment for scarring alopecia

Answer 39

Topical high potency and intralesional glucocorticoids-mainstay of treatment Antibiotics- for S.aureus infection

Question 40

Excessive hair growth secondary to increased androgenic activity

Answer 40

Hirsutism

Question 41

Hair density or length beyond accepted limits of normal age, race and sex

Answer 41

Hypertrichosis

Question 42

Hormonal stimulus for hair growth

Answer 42

Dihydrotestosterone

Question 43

In evaluating hirsutism, if serum testosterone is more than ___ ng/ml, exclude androgen secreting tumor

Answer 43

>200ng/ml

Question 44

If serum testosterone and DHEA are more than ___ug/d, it is suggestive of adrenal tumor

Answer 44

>800 ug/d

Question 45

Raised levels of this hormone suggests CAH

Answer 45

17-hydroxyprogesterone

Question 46

Drugs that can cause hypertrichosis

Answer 46

``` Minoxidil Phenytoin Cyclosporine Glucocorticoids Streptomycin PUVA ```