Chapter 054. Skin Manifestations of Internal Disease (Part 4)

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Most patients with trichotillomania, pressure-induced alopecia. The most common causes of nonscarring alopecia include telogen effluvium, androgenetic alopecia, alopecia areata, tinea capitis, and some cases of traumatic alopecia (Table 54-5). In women with androgenetic alopecia, an elevation in circulating levels of androgens may be seen as a result of ovarian or adrenal gland dysfunction. When there are signs of virilization, such as a deepened voice and enlarged clitoris, the possibility of an ovarian or adrenal gland tumor should be considered. Table 54-5 Nonscarring Alopecia (Primary Cutaneous Disorders) Clinical Characteristics is Pathogenes Treatment Telogen effluvium Diffuse shedding of normal causes hairs Stress Observation; the discontinue drugs that any have normally...

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Nội dung Text: Chapter 054. Skin Manifestations of Internal Disease (Part 4)

Chapter 054. Skin Manifestations of Internal Disease (Part 4) a Most patients with trichotillomania, pressure-induced alopecia. The most common causes of nonscarring alopecia include telogen effluvium, androgenetic alopecia, alopecia areata, tinea capitis, and some cases of traumatic alopecia (Table 54-5). In women with androgenetic alopecia, an elevation in circulating levels of androgens may be seen as a result of ovarian or adrenal gland dysfunction. When there are signs of virilization, such as a deepened voice and enlarged clitoris, the possibility of an ovarian or adrenal gland tumor should be considered. Table 54-5 Nonscarring Alopecia (Primary Cutaneous Disorders)
Clinical Pathogenes Treatment Characteristics is Telogen Diffuse Stress Observation; effluvium shedding of normal causes the discontinue any hairs normally drugs that have asynchronous alopecia as a side Follows either growth cycles of effect; must exclude major stress (high individual hairs to underlying metabolic fever, severe become causes, e.g., infection) or change synchronous; hypothyroidism, in hormones (post therefore, large hyperthyroidism partum) numbers of Reversible growing (anagen) without treatment hairs simultaneously enter the dying (telogen) phase Androgeneti Miniaturizatio Increased If no evidence c alopecia (male n of hairs along the sensitivity of of hyperandrogen
pattern; female midline of the scalp affected hairs to state, then topical pattern) the effects of minoxidil; Recession of testosterone finasteridea; hair the anterior scalp transplant line in men and Increased some women levels of circulating androgens (ovarian or adrenal source in women) Alopecia Well- The Topical areata circumscribed, germinative zones anthralin; circular areas of hair of the hair follicles intralesional loss, 2–5 cm in are surrounded by glucocorticoids; diameter T lymphocytes topical contact sensitizers In extensive Occasional cases, coalescence of associated lesions and/or diseases: involvement of other hyperthyroidism, hair-bearing surfaces hypothyroidism,
of the body vitiligo, Down syndrome Pitting of the nails Tinea Varies from Invasion of Oral scaling with minimal hairs by griseofulvin or hair loss to discrete dermatophytes, terbinafine plus 2.5% patches with "black most commonly selenium sulfide or dots" (broken hairs) Trichophyton ketoconazole to boggy plaque with tonsurans shampoo; examine pustules (kerion) family members Traumatic Broken hairs Traction Discontinuatio alopeciab with curlers, n of offending hair Irregular rubber bands, style or chemical outline braiding treatments; trichotillomania may Exposure to require hair clipping heat or chemicals and observation of (e.g., hair shaved hairs or straighteners) biopsy for diagnosis,
Mechanical possibly followed by pulling psychotherapy (trichotillomania)