Flashcards in Hair Disorders Deck (54)
What are the hair disorders?
Hair structure & color defects
Pseudofolliculitis barbae & folliculitis
What is the hair growth cycle?
Anagen - period of growth – 3 to 6 years
Catagen - period of transition - 2 weeks
Telogen- period of rest - 3 to 4 months
What represents 90% of hairs?
What represents 10% of hairs?
catagen and telogen
What is alopecia areata?
discrete annular patches of hair loss without scalp disease or scaring
What is hair loss of the entire scalp?
What is hair loss on entire body?
What do you see on exam of alopecia areata?
broken off hair, exclamation point hairs at periphery of lesions
What do you see in nails of pt with alopecia areata?
nail pitting, longitudinal striation
What associated disorders of alopecia areata?
Familial multiendocrine syndrome
What is the work up for alopecia areata?
Serum Iron - Rule out Anemia
ANA - Rule out SLE
What is the treatments for alopecia areata?
Intralesional injection of triamcinolone
tacrolimus (Protopic) and pimecrolimus (Elidel)
What does tacolimus and pimecrolimus do?
inhibit t lymphocyte activation
short term use only due to risk of malignancy
Is there a cure for alopecia areata?
no, supplement with wigs, make up or psychological support
What is androgenetic alopecia?
Who gets androgenetic alopecia?
men > females
How does androgenetic alopecia appear in men?
receding anterior hairline, bald spot on posterior crown
How does androgenetic alopecia appear in females?
Diffuse loss of hair
Endocrine work up if indicated
What is the pathology of AGA?
Circulating androgens are converted to dihydrotestosterone (DHT) by 5 alpha reductase (5R)in the hair follicle.
In AGA there is an increase of (5R) therefore an increase of DHT.
DHT causes an increase in the telogen phase and a shortening of the anagen phase
What is the first treatment for AGA?
Topical minoxidil (Rogaine) 2% for women, 5% for men
Apply to scalp BID, if no regrowth in 4 months then d/c
What is another AGA treatment?
Interferes with conversion of testosterone to 5-alpha=dihydrotestosterone
PO finasteride (Propecia) 1mg PO Qday for men only.
Min 3 months- stop tx sxs return within 12 mos
What are the side effects of finasteride?
Teratogenicity (in male fetus)
Erectile dysfunction and infertility
Who is finasteride contraindicated in?
women and children
What is the most extensive tx for AGA?
What is Loss of hair in the Telogen (resting) phase?
What is telogen effluvium associated with?
Birth Control Pills
Drugs - Anticoagulants, Heparin, Lithium, Accutane, Allopurinol, Propanolol, many others
What is the treatment for telogen effluvium?
resurrance will grow back
What is Loss of hairs in Anagen (growth) Phase?
What causes anagen effluvium?
Chemotheraputic, Anticancer agents