Alopecia CS-OSPE
Male patient presented with this pattern of hair loss.
What is true about this condition?
- Dihydrotestosterone causes androgenic alopecia.
- 5% minoxidil spray will be the choice over a 2% minoxidil.
Alopecia Areata
A 32 y/o male presented with 4 months duration non-pruritic on-scaly scalp lesion. Sudden hair loss (localized or generalized), Well demarcated, Exclamation point? Normal scalp, Nail: pitting, ridges. (Grey hair present usually)
What is the diagnosis? Alopecia Areata
Describe/Characteristic Features? Rapid and complete loss of hair in one or several patches, Patches of 1-5 cm in diameter its well demarcated. The characteristic feature or the primary lesion is Exclamation point.
What is the differential diagnosis?
- Tinea capitis.
- Trichotillomania.
- Secondary syphilis.
Associated diseases/Higher incidence of alopecia areata in patient with?
- Atopic dermatitis.
- Down syndrome.
- Lichen planus.
- SLE.
- Myasthenia Gravis.
- Hashimoto Thyroiditis.
- Addison’s disease.
- Vitiligo.
What are the types?
- Localized partial
- Localized extensive
- Alopecia ophiasis
- Alopecia totalis
- Alopecia universalis
Bad/Poor prognostic factors?
- Young age (Old age is NOT a poor prognosis factor)
- Atopy
- Alopecia totalis, universalis, ophiasis (Extra scalp involvement / Multiple lesions) (This patient has poor prognosis = multiple lesions)
- Nail changes: pitting or ridges
How to manage/treat this patient?
- Full history
- Examination
- Investigation (Histopathology = swarm bees)
- Education
- Observation (If small: observation)
- Intralesional Corticosteroids
- Skin Sensitizers (anthralin)
- Hair Transplant
- Topical steroids
- Systemic Steroids
- Cytotoxic Rx
- Phototherapy
- Minoxidil
What are other indications for intralesional steroids?
- Keloid
- Vitiligo
- Acne Vulgaris
- Infantile hemangioma
- Alopecia