Probably diagnosis for a male with patchy loss of scalp hair, eyebrows & beard with grey hair in few areas is...

DERMATOLOGY

Question 58

Probably diagnosis for a male with patchy loss of scalp hair, eyebrows & beard with grey hair in few areas is...

a.       Alopecia aereata

b.      Anagen effluvium

c.       Telogen effluvium

d.      Androgenic alopecia

Answer

a.       Alopecia Areata

Reference :

Rook’s Dermatology, Behl 10^th Edition Page 421

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Discussion

Alopecia areata (AA) accounts for about 2% of new dermatological outpatient attendances in the UK and the USA. It is not at present possible to attribute all or indeed any case of AA to a single cause. Among the many factors that appear to be implicated

Explanation

The characteristic initial lesion of AA is commonly a circumscribed, totally bald, smooth patch; it is often noticed by chance by a parent, hairdresser or friend. Exclamation-mark hairs may be present at its margin, where hairs that appear normal may also be very readily extracted

Subsequent progress is very varied; the initial patch may regrow within a few months, or further patches may appear after an interval of 3-6 weeks and then in a cyclical fashion.

These intervals are of varying duration. A succession of discrete patches may rapidly become confluent by the diffuse loss of remaining hair.

In some cases, the initial hair loss is diffuse and total denudation of the scalp has been reported within 48h. However, diffuse hair loss may occur over part or the whole of the scalp without the development of bald areas

Regrowth is often at first fine and unpigmented, but usually the hairs gradually resume their normal calibre and colour.

Comments

Ä     Regrowth in one region of the scalp may occur while the alopecia is extending in others from an active progressing area.

Ä     The distal end of an exclamation-mark hair has a greater calibre than proximally

Ä     The scalp is the first affected site in over 60% of cases. In dark-haired men, patches in the beard are conspicuous and in such individuals are often the first to be noticed. The eyebrows and eyelashes are lost in many cases of AA and may be the only sites affected. The term alopecia totalis is applied to total or almost total loss of scalp hair and alopecia universalis is the loss of all body hair.

Tips

Ä     The extension of alopecia along the scalp margin is known as ophiasis

Ä     Alopecia strictly confined to one-half of the body has been reported after a head injury

Ä     Klingmüller showed that white hairs were spared initially by the disease process. Patients with sudden diffuse onset of AA would appear to 'go white' over the course of a few days