Alopecia differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Ogechukwu Hannah Nnabude, MD

Overview

There is a very wide list of diseases and conditions that can lead to alopecia. Proper history taking and physical examination, along with laboratory, microbiology, and in some cases, imaging studies, are helpful in narrowing down the diagnosis.

Differentiating Alopecia from other Diseases

The following lists the complete differential diagnosis of Alopecia.

Non-Scarring Alopecia

• Adrenocortical insufficiency (primary or secondary)
• Anagen effluvium (anagen=growing hair)
• Cushing's syndrome
• Diffuse hair thinning due to metabolic causes
• Hyperthyroidism
• Hypoparathyroidism
• Hypothyroidism
• Pituitary insufficiency
• Secondary syphilis
• Sheehan's syndrome
• Telogen effluvium (telogen=resting hair)
• Temporary hair loss
  • Pregnancy
  • Malnutrition
    • Malabsorption
    • Protein deficiency
    • Tryptophan deficiency
    • Nontropical sprue
    • Vitamin A deficiency
    • Vitamin B deficiency
    • Vitamin D deficiency
    • Rickets
• Thyroiditis
• Trichotillomania

Scarring Alopecia

• Amyloidosis
• Chronic disciform lupus erythematosis
• Congenital defects
• Discoid Lupus Erythematosus
• Dissecting cellulitis
• Herpes zoster infection
• Infection
  • Favus
  • Typhoid Fever
  • Leptospirosis
  • Secondary syphilis
• Inflammatory dermatoses
• Lichen planopilaris
• Lymphoma
• Morphea
• Mycosis fungoides
• Neoplasm
• Neurodermatitis
• Physical or chemical agents:
  • ACE inhibitors
  • Allopurinol
  • Androgens
  • Anticoagulants
  • Anticonvulsants
  • Antimycotic agents
  • Arsenic
  • Azathioprine
  • Beta blockers
  • Borates
  • Cadmium
  • Chemotherapeutics
  • Chlorambucil
  • Cisplatin
  • Clofibrate
  • Cyclophosphamide
  • Cytarabine
  • Estrogens
  • Fluororacil
  • Gentamycin
  • Gold compounds
  • Heparins
  • Indomethacin
  • Levodopa
  • Linolic acid
  • Mercury and derivatives
  • Methotrexate
  • Niacin
  • Oral contraceptives
  • Propranolol
  • Retinoids
  • Salicylates
  • Selenium
  • Squalenes
  • Steroids
  • Thallium
  • Undecylenic acid
  • Vitamin A overdose
  • Warfarin
• Pseudofolliculitis barbae
• Psoriasis
• Sarcoidosis
• Scleroderma
• Systemic Lupus Erythematosus

Miscellaneous

• Addison's Disease
• Anemia
• Cancer
• Diabetes Mellitus
• Pneumonia
• Scarlet Fever
• Schmidt's Syndrome
• Stress
  • Labor
  • Surgery
• Testicular feminization syndrome
• Turner's Syndrome
• Typhoid fever
• Mechanical effects
  • Traction alopecia
  • Pressure alopecia (alopecia after extended bed rest)
  • Trichotillomania (compulsion to pull out one’s own hair)