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. Alopecia can be caused by many different diseases. Some of the most well known and common causes are: androgenetic alopecia, alopecia areata, telogen effluvium, anagen effluvium, and trichotillomania. Endocrine disorders such as hypothyroidism, hypoparathyroidism and Cushing's syndrome as well as malnutrition and medications are also possible causes of alopecia.
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
- Thyroiditis
- Trichotillomania
Scarring Alopecia
- Amyloidosis
- Chronic disciform lupus erythematosis
- Congenital defects
- Discoid Lupus Erythematosus
- Dissecting cellulitis
- Herpes zoster infection
- Infection
- 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
- 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)