Telogen Effluvium

Question 1

is the transient increased shedding of normal club (telogen) hairs from resting scalp follicles.
■ Secondary to accelerated shift to anagen (growth phase) into catagen and telogen (resting phase)

Answer 1

Telogen Effluvium

Question 2

Etiology

Answer 2

A reaction pattern to a variety o physical or mental stressors.
Endocrine: Hypo- or hyperthyroidism; postpartum; discontinuation or changing type o estrogencontainingdrugs.
Nutritionalde ciency:Biotin,zinc,iron,and essential attyacid.
Rapid weight loss, caloric or protein depriva- tion,chronicironde ciency,andexcessive vitamin A ingestion.
Physical stress: Febrile illnesses, catabolic illnesses (e.g., malignancy, chronic in ection), major surgery, major trauma, acute, or chronic psychological stress.
Psychological stress: Anxiety, depression, and bipolar disorder.
Intoxication: T allium, mercury, and arsenic.
Drugs: See Table 31-2.
Idiopathic: No obvious cause is apparent in a signi cant number o cases.

Question 3

Sex prediliction

Answer 3

More common in women, caused by par- turition,cessationo anoralcontraceptive,and “crash” dieting.

Question 4

1st or 2nd most common cause of alopecia?

Answer 4

2nd

Question 5

Pathogenisis

Answer 5

E: Many more hairs than normal are shed daily. T e precipitating stimulus results in a premature shi o anagen ollicles into the telogen phase. E occurs in 3 to 4 months a ertheincitingeventoccurred.
Can become chronic but rarely goes beyond 50% loss

Question 6

manif

Answer 6

Diffuse shedding of the scalp hair. Gentle hair pull gathers.

Hairs are finer than older hairs and have tapered ends.

NAILS The precipitating stimulus or EF may also affect the growth of nails,resulting in Beau lines

Question 7

Labs

Answer 7

HAIRPULL Compared with the normal hair pull, inwhich80to90%o hairisintheanagen phase, E is characterized by a reduced per- centage o anagen hairs.
CBC Rule out iron-de ciency anemia. CHEMISTRY Serum iron, iron-binding capacity.
TSH Rule out thyroid disease. SEROLOGY ANA and RPR

Question 8

Histo

Answer 8

HISTOPATHOLOGY Increase in the proportion o ollicles in telogen.

Question 9

Tx

Answer 9

No intervention is needed or required. patient should be reassured that the process is part o a normal cycle o hair growth.

Question 10

Dx

Answer 10

history, clinical

and possible biopsy