Hair Loss

leac
Mind Map by , created almost 6 years ago

Approach to hair loss / hair thinning in Paediatrics

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leac
Created by leac almost 6 years ago
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Hair Loss
1 History
1.1 Localized or generalized?
1.2 Itchiness, erythema, dandruff
1.3 Hair loss - on pillow, during combing?
1.4 Area? Frontal (androgenic) vs occipital (Infant, friction alopecia)
1.5 Hair thinning? (Terminal -> Vellus hair)
1.6 Hair pulling? (Trichotillomania)
1.7 Chronic medical diseases, psycho stressors
1.8 FHx: androgenetic baldness
1.9 SLE: Facial rashes, joint pain, oral ulcers
1.10 Hypothyroidism: Malaise, oedema, constipation, cold intolerance
2 Normal hair loss: ~50-100 lost/day on scalp
3 DDX
3.1 Autoimmune, endocrine: SLE, hypothyroidism
3.2 Drugs: Chemotherapy, valproiac acid, androgens, steroids
3.3 Infection: Tinea capitis (fungal)
3.4 Autoimmune: Alopecia areata
3.5 Androgenic alopecia
3.6 Traction alopecia, Friction alopecia
3.7 Trichotillomania, stress-induced
4 Ix
4.1 Autoimmune markers, TFT
4.2 Woods lamp: Fluorescence with Microsporum species (None if Trichophytons spp)
5 Tx
5.1 Systemic antifungal: Griseofulvin, Terbinafine, Itraconazole (bulb of hair shaft cannot be effectively tx topically)

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