Alopecia

Question 1

Types of alopecia

Answer 1

1. Alopecia areata
2. Trichotillomania and traction alopecia
3. Lichen planopilaris
4. Scarring alopecia

Question 2

Answer 2

Alopecia areata

swarm of bees = lymps surrounding anagen hair bulbs, some eos also present

Question 3

Answer 3

Trichotillomania and traction alopecia

Trichomalacia (damaged or distorted follicles)

May have intrafollicular hemorrhage and pigment casts

‘swiss cheese’ appearance due to dilated follicular infundibula

Question 4

Answer 4

trichotillomania

‘swiss cheese’ appearance due to dilated follicular infundibula

Question 5

Answer 5

Lichen planopilaris

• Alopecia secondary to inflammatory destruction of follicles
• May see LP changes (interface inflammation with dyskeratotic cells)
• Only superifical portions of follicles

DDX:

• lupus-associated alopecia: usually deeper infiltrate, dermal mucin

Question 6

Answer 6

AKA cicatricial alopecia

Often non-specific, end-stage finding in many different causes of alopecia

Specific entities:

1. central centrifugal scarring alopecia (pictured)
   
   • pseudopelade
   • folliculitis decalvans
2. dissecting cellulitis
3. acne keloidalis

Question 7

Answer 7

Pseudopelade