Hair and Nail Disease (Derm)

Question 1

Three stages of hair

Answer 1

anagen –> catagen –> telogen

Question 2

“Simple Baldness”, “Hereditary Alopecia”,

“Pattern Alopecia”

Answer 2

Adrogenetic alopecia

Non scarring

Question 3

Cause of androgen-alo

Answer 3

Genetically determined miniaturization of follicles triggered by androgens

Question 4

alopecia on top of scalp

Answer 4

androgenetic alopecia

Question 5

treatment for andro-alo

Answer 5

Minoxidil, Finasteride, Hair Transplants

Question 6

Stress hair loss

Answer 6

Telogen effluvium

Non scarring

Question 7

Cause of telogen effluvium

Answer 7

Disrupted growth cycle of hairs causing premature shift from anagen to telogen

Question 8

Triggers for telogen effluvium

Answer 8

Pregnancy, Surgery, High Fever, Extreme diet,…..

Question 9

Diffuse scalp involvement.

“Coming out in Bunches”

Answer 9

Telogen effluvium

Question 10

Tx for telogen effluvium

Answer 10

Remove the trigger.
Minoxidil?
Time
Reassurance

Question 11

Alopecia:
Autoimmune -Can associate with other AI disease.
T-cells attack the hair bulb (“Swarm of Bees”)
HLA determined.

Answer 11

Alopecia Areata

Question 12

Alopecia in Circular patches on scalp or beard

Answer 12

Alopecia areata

Question 13

All scalp hair lost

Answer 13

A. totalis

Question 14

All body hair lost

Answer 14

A. universalis

Question 15

Tx for alopecia areata

Answer 15

Can be difficult.

• Watch and wait.
• Topical or IL steroids.
• Minoxidil.
• Anthralin.
• Protopic/Elidel?

Question 16

Secondary alopecia

Answer 16

Diffuse hair thinning as a complication of an existing medication or medical problem.

Question 17

Common causes of Secondary alopecia

Answer 17

Chemotherapy, Meds, Thyroid dz, Iron deficiency, Nutritional disorders, Renal or Hepatic failure, other Chronic illness.

Question 18

Tx for secondary alopecia

Answer 18

Remove the cause.

Minoxidil?

Question 19

Fungus growth on scalp and hair shafts.

Answer 19

Tinea capitis

Possible scarring

Question 20

________ kids most common having tinea capitis

Answer 20

african america - d/t hair structure

Question 21

Cause of tinea capitis

Answer 21

Most common: Trichophyton tonsurans

Question 22

Kerion

Answer 22

‘Kerion’-intense inflammatory reaction due to zoophilic fungi.

Question 23

Tx tinea capitis

Answer 23

Griseofulvin is the standard.
microsized 15-25mg/kg/day
ultramicrosized 10-15mg/kg/d
Terbinafine? Itraconazole?

Question 24

Lupus and hair

Answer 24

Discoid lupus of the scalp results in destruction of hair units
Often scarring
Few have +ANA

Question 25

Area of discoid lupus

Answer 25

Discoid (round) patches with redness, scale, scarring anywhere on scalp or beard.

Question 26

tx discoid lupus

Answer 26

Topical or systemic steroids. Hydroxychloroquine.

Question 27

Other causes of alopecia

Answer 27

``` Traction Alopecia Lichen Planopilaris Folliculitis Decalvans Pseudopalade Central Centrifugal Cicatricial Alopecia Hair Shaft abnormalities ```

Question 28

Pediculus humanus capitis

Answer 28

head lice

Question 29

pthirus pubis

Answer 29

pubic lice

Question 30

tx for lice

Answer 30

``` Permethrin (Nix, Elimite) GBH (Kwell, Lindane) Malathion (Ovide) Vaseline-for eyelids. Cetaphil cleanser-*new* Remove nits. Hot water and dryer for clothes and bedding. Unwashables in bag for 2 weeks. ```

Question 31

inflammation of the nail folds | can be infectious or noninfectious

Answer 31

paronychia

Question 32

cause of acute paronychia

Answer 32

trauma, bacteria, contact dermatitis, acute eczema flair

Question 33

causes of chronic paronychia

Answer 33

irritant contact dermatitis, eczema, psoriasis, candida

Question 34

Ingrown Nails

Answer 34

``` Always cut nails straight across. Don’t tear or pull. Proper fitting shoes. Soaks. Antibiotics. Surgery. ```

Question 35

Fungal growth on or under the nail

Answer 35

Onychomycosis

Question 36

Common organism for onychomycosis

Answer 36

Trichophyton rubrum or T. mentagrophytes

Question 37

Treatment onychomycosis

Answer 37

terbinafine (Lamisil) itraconazole (Sporonox) ciclopirox (Penlac lacquer)