Alopecia physical examination: Difference between revisions

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Latest revision as of 02:48, 29 January 2021

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2] Ogechukwu Hannah Nnabude, MD

Overview

The quantity, pattern, presence of scarring, scaling, or erythema are all helpful clues in determining the cause of the hair loss.

Physical Examination

Appearance of the Patient

The appearance of the patient can provide clues to the diagnosis of alopecia.

Head

Scalp
- Normal or with features of scarring
- If the scalp is abnormal it provides clues to the differential diagnosis
  - Scarring, which is a feature of many irreversible causes of hair loss such as tufted hair folliculitis ^[1]
  - Scaling
  - Erythema, which may be seen in vitamin A toxicity ^[2]
  - Pustules
  - Dyspigmentation
Pattern: Diffuse or patchy
- Male pattern (diffuse): Bitemporal recession +/or vertex loss ^[3]
- Female pattern (diffuse): Coronal thinning with preserved anterior hairline ^[3]
- Patchy: With preserved hair of variable length as seen in trichotillomania ^[4]
  - With exclamation point hairs (alopecia areata) ^[3]
  - With no hair (scarring, traction, syphilis, tinea)

Alopecia acquisitum centrifugum. Adapted from Dermatology Atlas.^[5]
Alopecia acquisitum centrifugum. Adapted from Dermatology Atlas.^[5]
Alopecia acquisitum centrifugum. Adapted from Dermatology Atlas.^[5]
Alopecia acquisitum centrifugum. Adapted from Dermatology Atlas.^[5]
Alopecia acquisitum centrifugum. Adapted from Dermatology Atlas.^[5]
Alopecia acquisitum centrifugum. Adapted from Dermatology Atlas.^[5]
Alopecia acquisitum centrifugum. Adapted from Dermatology Atlas.^[5]
Alopecia acquisitum centrifugum. Adapted from Dermatology Atlas.^[5]
Alopecia acquisitum centrifugum. Adapted from Dermatology Atlas.^[5]
Alopecia acquisitum centrifugum. Adapted from Dermatology Atlas.^[5]
Alopecia acquisitum centrifugum. Adapted from Dermatology Atlas.^[5]
Syringolymphoid hyperplasia with alopecia. Adapted from Dermatology Atlas.^[5]
Syringolymphoid hyperplasia with alopecia. Adapted from Dermatology Atlas.^[5]

Extremities

Patient may also have nails that have a hammered brass appearance, as seen in alopecia areata.

References

↑ "StatPearls". 2020. PMID 28613486.
↑ "StatPearls". 2020. PMID 30422511.
↑ ^3.0 ^3.1 ^3.2 Qi J, Garza LA (2014). "An overview of alopecias". Cold Spring Harb Perspect Med. 4 (3). doi:10.1101/cshperspect.a013615. PMC 3935391. PMID 24591533.
↑ Sperling LC, Cowper SE, Knopp EA. An atlas of hair pathology with clinical correlations. 2. Informa Healthcare; 2014. [Google Scholar]
↑ ^5.00 ^5.01 ^5.02 ^5.03 ^5.04 ^5.05 ^5.06 ^5.07 ^5.08 ^5.09 ^5.10 ^5.11 ^5.12 "Dermatology Atlas".

Template:WikiDoc Sources

[pmid28613486-1] "StatPearls". 2020. PMID 28613486.

[pmid30422511-2] "StatPearls". 2020. PMID 30422511.

[pmid24591533-3] 3.0 ^3.1 ^3.2 Qi J, Garza LA (2014). "An overview of alopecias". Cold Spring Harb Perspect Med. 4 (3). doi:10.1101/cshperspect.a013615. PMC 3935391. PMID 24591533.

[4] Sperling LC, Cowper SE, Knopp EA. An atlas of hair pathology with clinical correlations. 2. Informa Healthcare; 2014. [Google Scholar]

[Dermatology_Atlas-5] 5.00 ^5.01 ^5.02 ^5.03 ^5.04 ^5.05 ^5.06 ^5.07 ^5.08 ^5.09 ^5.10 ^5.11 ^5.12 "Dermatology Atlas".

[1]

[2]

[3]

[4]

[5]

@@ Line 1: / Line 1: @@
 __NOTOC__
 {{Alopecia}}
+{{CMG}}; {{AE}} {{KS}} [[Ogechukwu Hannah Nnabude, MD]]
-{{CMG}}
 ==Overview==
+The quantity, pattern, presence of scarring, scaling, or erythema are all helpful clues in determining the cause of the hair loss.
 ==Physical Examination==
@@ Line 11: / Line 10: @@
 ===Appearance of the Patient===
 The appearance of the patient can provide clues to the diagnosis of alopecia.
+====Head====
 *[[Scalp]]
-:*Normal or with features of [[scarring]]
+**Normal or with features of [[scarring]]
-:*If scalp is abnormal it provides clues to the differential diagnosis
+**If the scalp is abnormal it provides clues to the differential diagnosis
-::*Scaling
+***[[Scarring]], which is a feature of many irreversible causes of hair loss such as [[tufted hair folliculitis]] <ref name="pmid28613486">{{cite journal| author=| title=StatPearls | journal= | year= 2020 | volume=  | issue=  | pages=  | pmid=28613486 | doi= | pmc= | url= }} </ref>
-::*[[Erythema]]
+***Scaling
-::*[[Pustules]]
+***[[Erythema]], which may be seen in vitamin A toxicity <ref name="pmid30422511">{{cite journal| author=| title=StatPearls | journal= | year= 2020 | volume=  | issue=  | pages=  | pmid=30422511 | doi= | pmc= | url= }} </ref>
-::*Dyspigmentation
+***[[Pustules]]
+***Dyspigmentation
 *Pattern: Diffuse or patchy
-:*Male pattern (diffuse): Bitemporal recession +/or vertex loss
+**Male pattern (diffuse): Bitemporal recession +/or vertex loss <ref name="pmid24591533">{{cite journal| author=Qi J, Garza LA| title=An overview of alopecias. | journal=Cold Spring Harb Perspect Med | year= 2014 | volume= 4 | issue= 3 | pages=  | pmid=24591533 | doi=10.1101/cshperspect.a013615 | pmc=3935391 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24591533  }} </ref>
-:*Female pattern (diffuse): Coronal thinning with preserved anterior hairline
+**Female pattern (diffuse): Coronal thinning with preserved anterior hairline <ref name="pmid24591533">{{cite journal| author=Qi J, Garza LA| title=An overview of alopecias. | journal=Cold Spring Harb Perspect Med | year= 2014 | volume= 4 | issue= 3 | pages=  | pmid=24591533 | doi=10.1101/cshperspect.a013615 | pmc=3935391 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24591533  }} </ref>
-:*Patchy: With preserved hair of variable length (breakage)
+**Patchy: With preserved hair of variable length as seen in [[trichotillomania]] <ref>Sperling LC, Cowper SE, Knopp EA. An atlas of hair pathology with clinical correlations. 2. Informa Healthcare; 2014. [Google Scholar]</ref>
-::*With exclamation point hairs ([[alopecia areata]])
+***With exclamation point hairs ([[alopecia areata]]) <ref name="pmid24591533">{{cite journal| author=Qi J, Garza LA| title=An overview of alopecias. | journal=Cold Spring Harb Perspect Med | year= 2014 | volume= 4 | issue= 3 | pages=  | pmid=24591533 | doi=10.1101/cshperspect.a013615 | pmc=3935391 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24591533  }} </ref>
-::*With no hair ([[scarring]], traction, [[syphilis]], [[tinea]])
+***With no hair ([[scarring]], traction, [[syphilis]], [[tinea]])
-*Patient may also have nails that have a hammered brass appearance.
+<gallery>
+Image:Alopecia acquisitum centrifugum01.jpg|Alopecia acquisitum centrifugum. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Alopecia acquisitum centrifugum02.jpg|Alopecia acquisitum centrifugum. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Alopecia acquisitum centrifugum03.jpg|Alopecia acquisitum centrifugum. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Alopecia acquisitum centrifugum04.jpg|Alopecia acquisitum centrifugum. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Alopecia acquisitum centrifugum05.jpg|Alopecia acquisitum centrifugum. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Alopecia acquisitum centrifugum06.jpg|Alopecia acquisitum centrifugum. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Alopecia acquisitum centrifugum07.jpg|Alopecia acquisitum centrifugum. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Alopecia acquisitum centrifugum08.jpg|Alopecia acquisitum centrifugum. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Alopecia acquisitum centrifugum09.jpg|Alopecia acquisitum centrifugum. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Alopecia acquisitum centrifugum10.jpg|Alopecia acquisitum centrifugum. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Alopecia acquisitum centrifugum11.jpg|Alopecia acquisitum centrifugum. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Syringolymphoid hyperplasia alopecia 01.jpeg|Syringolymphoid hyperplasia with alopecia. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Syringolymphoid hyperplasia alopecia 02.jpeg|Syringolymphoid hyperplasia with alopecia. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+</gallery>
+====Extremities====
+*Patient may also have nails that have a hammered brass appearance, as seen in alopecia areata.
 ==References==
 {{Reflist|2}}
+{{WikiDoc Help Menu}}
+{{WikiDoc Sources}}
+[[Category:Needs overview]]
+[[Category:Disease]]
+[[Category:Dermatology]]