449608
Hair Loss
- History
- Localized or generalized?
- Itchiness, erythema, dandruff
- Hair loss - on pillow, during combing?
- Area? Frontal (androgenic) vs
occipital (Infant, friction alopecia)
- Hair thinning? (Terminal -> Vellus hair)
- Hair pulling? (Trichotillomania)
- Chronic medical diseases,
psycho stressors
- FHx: androgenetic baldness
- SLE: Facial rashes, joint pain, oral ulcers
- Hypothyroidism: Malaise, oedema,
constipation, cold intolerance
- Localized or generalized?
- Normal hair loss: ~50-100 lost/day on scalp
- DDX
- Autoimmune, endocrine: SLE, hypothyroidism
- Drugs: Chemotherapy, valproiac
acid, androgens, steroids
- Infection: Tinea capitis (fungal)
- Autoimmune: Alopecia areata
- Androgenic alopecia
- Traction alopecia, Friction alopecia
- Trichotillomania, stress-induced
- Autoimmune, endocrine: SLE, hypothyroidism
- Ix
- Autoimmune markers, TFT
- Woods lamp: Fluorescence with
Microsporum species (None if
Trichophytons spp)
- Autoimmune markers, TFT
- Tx
- Systemic antifungal: Griseofulvin, Terbinafine, Itraconazole
(bulb of hair shaft cannot be effectively tx topically)
- Systemic antifungal: Griseofulvin, Terbinafine, Itraconazole
(bulb of hair shaft cannot be effectively tx topically)
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