Alopecia other diagnostic studies: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Alopecia}} | {{Alopecia}} | ||
{{CMG}} | {{CMG}} [[Ogechukwu Hannah Nnabude, MD]] | ||
==Overview== | |||
There are tests that can be completed outside of the laboratory that will help to confirm the diagnosis. | |||
==Other Diagnostic Studies== | ==Other Diagnostic Studies== | ||
===[[Hair Pull Test]]=== | |||
This is a test for the evaluation of excessive shedding, it is not diagnostic of a particular hair loss but indicates active hair loss is occurring. Hair should not be washed 24-48 hour prior to a hair pull test. It is performed by gently grasping 40-60 hairs and gently pull upward from different parts of the scalp. <ref name="pmid28791288">Xu L, Liu KX, Senna MM (2017) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=28791288 A Practical Approach to the Diagnosis and Management of Hair Loss in Children and Adolescents.] ''Front Med (Lausanne)'' 4 ():112. [http://dx.doi.org/10.3389/fmed.2017.00112 DOI:10.3389/fmed.2017.00112] PMID: [https://pubmed.gov/28791288 28791288]</ref> | |||
A positive test is when three to six or more strands are pulled out. <ref name="pmid28010890">{{cite journal| author=McDonald KA, Shelley AJ, Colantonio S, Beecker J| title=Hair pull test: Evidence-based update and revision of guidelines. | journal=J Am Acad Dermatol | year= 2017 | volume= 76 | issue= 3 | pages= 472-477 | pmid=28010890 | doi=10.1016/j.jaad.2016.10.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28010890 }} </ref> <ref name="pmid20927232">Dhurat R, Saraogi P (2009) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=20927232 Hair evaluation methods: merits and demerits.] ''Int J Trichology'' 1 (2):108-19. [http://dx.doi.org/10.4103/0974-7753.58553 DOI:10.4103/0974-7753.58553] PMID: [https://pubmed.gov/20927232 20927232]</ref> | |||
The pull test is positive in: | |||
* [[androgenetic alopecia]] | |||
* [[alopecia areata]] <ref name="pmid28791288">{{cite journal| author=Xu L, Liu KX, Senna MM| title=A Practical Approach to the Diagnosis and Management of Hair Loss in Children and Adolescents. | journal=Front Med (Lausanne) | year= 2017 | volume= 4 | issue= | pages= 112 | pmid=28791288 | doi=10.3389/fmed.2017.00112 | pmc=5522886 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28791288 }} </ref> and scarring alopecia | |||
* [[telogen effluvium]] <ref name="pmid24636654">{{cite journal| author=Castelo-Soccio L| title=Diagnosis and management of alopecia in children. | journal=Pediatr Clin North Am | year= 2014 | volume= 61 | issue= 2 | pages= 427-42 | pmid=24636654 | doi=10.1016/j.pcl.2013.12.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24636654 }} </ref> <ref name="pmid26370644">Alves R, Grimalt R (2015) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=26370644 Hair loss in children.] ''Curr Probl Dermatol'' 47 ():55-66. [http://dx.doi.org/10.1159/000369405 DOI:10.1159/000369405] PMID: [https://pubmed.gov/26370644 26370644]</ref> <ref name="pmid8447677">{{cite journal| author=Headington JT| title=Telogen effluvium. New concepts and review. | journal=Arch Dermatol | year= 1993 | volume= 129 | issue= 3 | pages= 356-63 | pmid=8447677 | doi=10.1001/archderm.129.3.356 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8447677 }} </ref> | |||
* [[anagen effluvium]] | |||
* [[loose anagen syndrome]] | |||
Evaluation of the pulled hair may uncover vital information. For example, if the bulb of the hair is dark, it indicates that the hair is in the anagen phase, or if it is white, it indicates that the hair is in the [[telogen phase]]. | |||
===[[Trichoscopy]]=== | |||
This is a noninvasive test for the examination of the hair and scalp. The test utilizes a [[dermoscope]] or a [[video dermoscope]]. <ref name="pmid18664157">{{cite journal| author=Rudnicka L, Olszewska M, Rakowska A, Kowalska-Oledzka E, Slowinska M| title=Trichoscopy: a new method for diagnosing hair loss. | journal=J Drugs Dermatol | year= 2008 | volume= 7 | issue= 7 | pages= 651-4 | pmid=18664157 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18664157 }} </ref> The [[Alopecia Areata Predictive Score]] makes use of it to predict the treatment outcome in patients with patchy [[alopecia areata]]. <ref name="pmid31301100">Waśkiel-Burnat A, Rakowska A, Sikora M, Olszewska M, Rudnicka L (2020) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=31301100 Alopecia areata predictive score: A new trichoscopy-based tool to predict treatment outcome in patients with patchy alopecia areata.] ''J Cosmet Dermatol'' 19 (3):746-751. [http://dx.doi.org/10.1111/jocd.13064 DOI:10.1111/jocd.13064] PMID: [https://pubmed.gov/31301100 31301100]</ref> | |||
===[[Biopsy]]=== | |||
A [[biopsy]] will reveal the most information regarding hair loss. | |||
===[[Microbiology Testing]]=== | |||
Potassium hydroxide preparation and [[fungal]] [[cultures]] can be used in the diagnosis of tinea capitis. [[Wood's light]] can also be used to check for signs of [[fungal]] infection. | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
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[[Category:Needs overview]] | [[Category:Needs overview]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Dermatology]] | [[Category:Dermatology]] | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Ogechukwu Hannah Nnabude, MD
Overview
There are tests that can be completed outside of the laboratory that will help to confirm the diagnosis.
Other Diagnostic Studies
Hair Pull Test
This is a test for the evaluation of excessive shedding, it is not diagnostic of a particular hair loss but indicates active hair loss is occurring. Hair should not be washed 24-48 hour prior to a hair pull test. It is performed by gently grasping 40-60 hairs and gently pull upward from different parts of the scalp. [1] A positive test is when three to six or more strands are pulled out. [2] [3] The pull test is positive in:
- androgenetic alopecia
- alopecia areata [1] and scarring alopecia
- telogen effluvium [4] [5] [6]
- anagen effluvium
- loose anagen syndrome
Evaluation of the pulled hair may uncover vital information. For example, if the bulb of the hair is dark, it indicates that the hair is in the anagen phase, or if it is white, it indicates that the hair is in the telogen phase.
Trichoscopy
This is a noninvasive test for the examination of the hair and scalp. The test utilizes a dermoscope or a video dermoscope. [7] The Alopecia Areata Predictive Score makes use of it to predict the treatment outcome in patients with patchy alopecia areata. [8]
Biopsy
A biopsy will reveal the most information regarding hair loss.
Microbiology Testing
Potassium hydroxide preparation and fungal cultures can be used in the diagnosis of tinea capitis. Wood's light can also be used to check for signs of fungal infection.
References
- ↑ 1.0 1.1 Xu L, Liu KX, Senna MM (2017) A Practical Approach to the Diagnosis and Management of Hair Loss in Children and Adolescents. Front Med (Lausanne) 4 ():112. DOI:10.3389/fmed.2017.00112 PMID: 28791288
- ↑ McDonald KA, Shelley AJ, Colantonio S, Beecker J (2017). "Hair pull test: Evidence-based update and revision of guidelines". J Am Acad Dermatol. 76 (3): 472–477. doi:10.1016/j.jaad.2016.10.002. PMID 28010890.
- ↑ Dhurat R, Saraogi P (2009) Hair evaluation methods: merits and demerits. Int J Trichology 1 (2):108-19. DOI:10.4103/0974-7753.58553 PMID: 20927232
- ↑ Castelo-Soccio L (2014). "Diagnosis and management of alopecia in children". Pediatr Clin North Am. 61 (2): 427–42. doi:10.1016/j.pcl.2013.12.002. PMID 24636654.
- ↑ Alves R, Grimalt R (2015) Hair loss in children. Curr Probl Dermatol 47 ():55-66. DOI:10.1159/000369405 PMID: 26370644
- ↑ Headington JT (1993). "Telogen effluvium. New concepts and review". Arch Dermatol. 129 (3): 356–63. doi:10.1001/archderm.129.3.356. PMID 8447677.
- ↑ Rudnicka L, Olszewska M, Rakowska A, Kowalska-Oledzka E, Slowinska M (2008). "Trichoscopy: a new method for diagnosing hair loss". J Drugs Dermatol. 7 (7): 651–4. PMID 18664157.
- ↑ Waśkiel-Burnat A, Rakowska A, Sikora M, Olszewska M, Rudnicka L (2020) Alopecia areata predictive score: A new trichoscopy-based tool to predict treatment outcome in patients with patchy alopecia areata. J Cosmet Dermatol 19 (3):746-751. DOI:10.1111/jocd.13064 PMID: 31301100