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Dermatology
Alopecias
Built from Dermatology, 5th Edition
What’s inside
5 sections · 174 slides
Overview
- What this topic covers
- Cicatricial vs non-cicatricial alopecia
- Building a diagnosis
- Clinical approach to scalp alopecia
- Diagnostic tests used to assess alopecia
- Clinical approach to the patient with alopecia
- Clinical approach to the patient with alopecia (continued)
Non-Cicatricial Alopecias
Hair loss where the follicle survives and can regrow
- Androgenetic alopecia: what it is
- Genetic factors in androgenetic alopecia
- Where 5α-reductase is active in the body
- Androgen-handling enzymes in the hair follicle
- Dihydrotestosterone drives follicle shrinkage
- Mechanism of antiandrogens and 5α-reductase inhibitors
- Female pattern hair loss, before and after treatment
- Widening of the central part line
- The Sinclair scale for female androgenetic alopecia
- Grading systems for pattern hair loss
- Alopecia scoring systems in common use
- Alopecia scoring systems in common use (continued)
- Alopecia scoring systems in common use (continued)
- Trichoscopy shows uneven hair thickness
- Common trichoscopy findings across the alopecias
- Blood tests: when to order them
- Layers of the hair follicle seen on biopsy
- Histopathology of androgenetic alopecia, alopecia areata, and lichen planopilaris
- Histopathology as a shared reference
- Histopathologic features of the alopecias
- Histopathologic features of the alopecias (continued)
- Histopathologic features of the alopecias (continued)
- Histopathologic features of the alopecias (continued)
- Histopathologic features of the alopecias (continued)
- Histopathologic features of the alopecias (continued)
- Histopathologic features of the alopecias (continued)
- Histopathologic features of the alopecias (continued)
- Histopathologic features of the alopecias (continued)
- Diagnosis and look-alikes of androgenetic alopecia
- Treating androgenetic alopecia: minoxidil
- Treating androgenetic alopecia: oral 5α-reductase inhibitors
- Treating androgenetic alopecia: dutasteride and other options
- The normal hair growth cycle
- Anagen, catagen, telogen, exogen
- What triggers telogen effluvium
- Triggers of telogen effluvium
- Telogen vs anagen hair under the microscope
- A visual scale for grading hair shedding
- Work-up and treatment of telogen effluvium
- Anagen effluvium
- Alopecia areata: an autoimmune hair disease
- How the immune attack unfolds
- Genetic risk in alopecia areata
- Clinical patterns of alopecia areata
- Diffuse alopecia areata
- Alopecia areata variants: circular and ophiasis
- Confluent alopecia areata patches
- Nail changes in alopecia areata
- Trichoscopy of alopecia areata through its course
- What trichoscopy shows in alopecia areata
- Diseases that travel with alopecia areata
- Conditions associated with alopecia areata
- Telling alopecia areata apart from look-alikes
- Deciding on alopecia areata treatment
- Topical and injected treatment for alopecia areata
- Topical immunotherapy protocol for alopecia areata
- Topical immunotherapy protocol for alopecia areata (continued)
- Systemic treatment for severe alopecia areata
- Trichotillomania: hair pulling disorder
- DSM-5 diagnostic criteria for trichotillomania
- Trichotillomania: patchy hair loss and broken hairs
- Treating trichotillomania
- Pressure-induced alopecia
- Temporal triangular alopecia
- Temporal triangular alopecia in an unusual site
- Traction alopecia from tight hairstyles
- Traction alopecia: trichoscopy and treatment
- Lipedematous scalp and lipedematous alopecia
- Psoriatic and syphilitic alopecia
- Hair loss in systemic lupus erythematosus
- Congenital atrichia with papular lesions
Cicatricial (Scarring) Alopecias
The follicle is destroyed and replaced by scar tissue
- What makes an alopecia scarring
- Causes of secondary cicatricial alopecia
- Scalp biopsy technique for scarring alopecia
- Classifying primary cicatricial alopecia
- NAHRS classification of primary cicatricial alopecia
- NAHRS classification of primary cicatricial alopecia (continued)
- The lichen planopilaris spectrum
- Lichen planopilaris: what drives it
- Lichen planopilaris: who gets it, how it starts
- Lichen planopilaris: active margin with scaling
- Late-stage lichen planopilaris
- Treating lichen planopilaris
- Frontal fibrosing alopecia: pathogenesis
- Three patterns of hairline recession
- Frontal fibrosing alopecia: patterns and facial findings
- Loss of eyebrow hair and “lonely hairs” in frontal fibrosing alopecia
- Frontotemporal recession in frontal fibrosing alopecia
- Treating frontal fibrosing alopecia
- Graham Little–Piccardi–Lasseur syndrome
- Fibrosing alopecia in a pattern distribution
- Classic pseudopelade: “footprints in the snow”
- Central centrifugal cicatricial alopecia: mechanism
- CCCA: clinical distribution and histopathology
- CCCA is most common in Black women
- Polytrichia: “baby doll hair” tufting
- CCCA on trichoscopy
- CCCA: ruling out look-alikes
- Treating CCCA
- Healthy hair practices for Afro-textured hair
- CCCA under the microscope
- Discoid lupus erythematosus: introduction
- How discoid lupus lesions evolve
- Discoid lupus erythematosus of the scalp
- Active discoid lupus lesion
- Late-stage, “burnt-out” discoid lupus
- Diagnosing and treating discoid lupus
- Follicular mucinosis (alopecia mucinosa)
- Keratosis follicularis spinulosa decalvans
- Folliculitis decalvans: pathophysiology
- Folliculitis decalvans: who it affects, how it looks
- Hair tufts in folliculitis decalvans
- Tufted folliculitis: “doll's hair” appearance
- Folliculitis decalvans under the microscope
- Folliculitis decalvans: further histopathology
- Treating folliculitis decalvans
- EGFR inhibitor-induced scarring alopecia
- Acne keloidalis
- Dissecting cellulitis of the scalp
- Dissecting cellulitis: nodules to draining ridges
- Dissecting cellulitis with acne keloidalis
- Dissecting cellulitis: shape and drainage
- Dissecting cellulitis: response to isotretinoin
- Treating dissecting cellulitis
- Acne necrotica and erosive pustular dermatosis
- Nonspecific “end-stage” cicatricial alopecia
Hair Shaft Abnormalities
When the hair shaft itself is fragile or an unusual shape
- Two broad groups of hair shaft abnormalities
- Hair shaft abnormalities under the microscope
- Inherited disorders with hypotrichosis or hair shaft abnormalities
- Inherited disorders with hypotrichosis or hair shaft abnormalities (continued)
- Inherited disorders with hypotrichosis or hair shaft abnormalities (continued)
- Inherited disorders with hypotrichosis or hair shaft abnormalities (continued)
- Inherited disorders with hypotrichosis or hair shaft abnormalities (continued)
- Inherited disorders with hypotrichosis or hair shaft abnormalities (continued)
- Inherited disorders with hypotrichosis or hair shaft abnormalities (continued)
- Inherited disorders with hypotrichosis or hair shaft abnormalities (continued)
- Inherited disorders with hypotrichosis or hair shaft abnormalities (continued)
- Inherited disorders with hypotrichosis or hair shaft abnormalities (continued)
- Inherited disorders with hypotrichosis or hair shaft abnormalities (continued)
- Inherited disorders with hypotrichosis or hair shaft abnormalities (continued)
- Bubble hair
- Monilethrix: beaded hair
- Monilethrix: clinical appearance
- Pili torti: twisted hair shaft
- Trichorrhexis invaginata: “bamboo hair”
- Trichorrhexis nodosa: the most common shaft defect
- Trichothiodystrophy: sulfur-deficient hair
- Loose anagen hair syndrome
- Pili annulati: ringed hair
- Pili bifurcati and pili multigemini
- Uncombable hair syndrome
- Woolly hair nevus
- Woolly hair
Alopecia Beyond the Scalp
The same diseases can affect eyebrows, lashes, beard, and body hair
- Hair loss outside the scalp
- Key takeaways
- References
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- Dermatology, 5th Edition (2-Volume Set)