Dermatology Book

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AlopeciaAka: Hair Loss

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  1. Causes
    1. Nonscarring Alopecia
      1. Androgenetic Alopecia
      2. Telogen Effluvium
      3. Anagen effluvium
      4. Trichotillomania
      5. Traction Alopecia (e.g. tight braiding)
      6. Alopecia Areata
      7. Secondary Syphilis
    2. Scarring alopecia (Cicatricial alopecia)
      1. Congenital defects
      2. Trauma
        1. Chemical agents (caustic substances)
        2. Burns
        3. Radiation
      3. Inflammatory dermatoses
        1. Discoid Lupus Erythematosis
        2. Sarcoidosis
        3. Lichen planus follicularis
        4. Necrobiosis Lipoidica diabeticorum
      4. Infection
      5. Neoplasm
        1. Basal Cell Carcinoma
        2. Squamous Cell Carcinoma
        3. Metastases
        4. Lymphoma
  2. History
    1. Duration of hair loss
    2. Pattern of hair loss (see below)
    3. Progression of hair loss
    4. Family History of hair loss
      1. Androgenetic Alopecia
      2. Alopecia Areata
    5. Hair loss type
      1. Broken hairs: Tinea Capitis, Trichotillomania
      2. Hairs lost by roots
    6. Concurrent systemic illness or endocrinopathy
      1. Alopecia Areata
      2. Telogen Effluvium
    7. Concurrent psychiatric illness or significant stress
      1. Telogen Effluvium
      2. Trichotillomania
    8. Recent medication changes
      1. Telogen Effluvium
    9. Hyperandrogenism in women
      1. Androgenetic Alopecia
  3. Exam
    1. Hair distribution and areas of thinning
    2. Hair Pull Test
    3. Scalp scarring
      1. Inflammation
      2. Scaling
      3. Loss of Hair Follicles in non-scarring alopecia
    4. Hair Shaft exam
      1. Hair length and caliber
      2. Hair fragility
  4. Signs: Patterns of hair loss
    1. M-Pattern in Men or central thinning in women
      1. Androgenetic Alopecia
    2. Diffuse hair loss
      1. Alopecia Areata (or alopecia totalis, universalis)
      2. Telogen Effluvium
      3. Toxin or Chemotherapy exposure
      4. Endocrinopathy
    3. Focal hair loss
      1. Traction Alopecia
      2. Trichotillomania
      3. Tinea Capitis
      4. Alopecia Areata
      5. Systemic Lupus Erythematosus
      6. Syphilis
  5. Labs
    1. Potassium Hydroxide (KOH) of scalp scraping
    2. Consider additional labs based on alopecia type
      1. See Alopecia Areata
      2. See Androgenetic Alopecia
      3. See Telogen Effluvium
    3. Scalp Biopsy Indications (4 mm Punch Biopsy)
      1. Scarring alopecia (not diagnostic if trauma related)
      2. Unusual hair loss pattern
  6. Resources
    1. National Alopecia Areata Foundation
      1. http://www.alopeciaareata.com
  7. References
    1. Nielson (1995) Am Fam Physician 51:1513
    2. Price (1999) N Engl J Med 341:964
    3. Shapiro (2000) Can Fam Physician 46:1469
    4. Sperling (1998) Med Clin North Am 82:1155
    5. Springer (2003) Am Fam Physician 68(1):93

Alopecia (C0002170)

Definition (MSH)Absence of hair from areas where it is normally present.
Definition (CSP)baldness; absence of hair from skin areas where it is normally present.
Definition (NCI)(al-oh-PEE-shuh) The lack or loss of hair from areas of the body where hair is usually found. Alopecia can be a side effect of some cancer treatments.
ConceptsFinding (T033)
ICD9704.0, 704.00, 704.00
MSHD000505
EnglishAlopecia, Alopecia unspecified, Bald, Baldness, Falling hair, Hair Loss, Hair loss disorder, HAIR THINNING, Loss of hair, Thinning hair, Thinning of hair
Spanishalopecia, alopecia no especificada, caida del cabello, calvicie, perdida del pelo
Parent ConceptsSkin finding (C0455205), Hair and hair follicle diseases (C0554472), Hair follicle disorder (C0178668), Hair Diseases (C0018500), Functional disorder (C0277785), Alopecia (C0002170), Hypotrichosis (C0020678), Pathological Conditions, Anatomical (C0752135), Integumentary system finding (C1291044), Non-Neoplastic Hair Disorder (C1335013), Finding of hair growth (C0574768), Disorder of hair AND/OR hair follicle (C1455702), Ambiguous concept (C1274012), Duplicate concept (C1274013)
SourcesAIR, AOD, COSTAR, CSP, CST, DXP, ICD9CM, MEDLINEPLUS, MSH, MTH, MTHICD9, NCI, NDFRT, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


Anthranilate Synthase Component I (C0003170)

ConceptsAmino Acid, Peptide, or Protein (T116) , Enzyme (T126)
MSHD000878
EnglishAnthranilate Synthase Component I
SourcesMSH
Derived from the NIH UMLS (Unified Medical Language System)



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