Hair Growth Disorders

Hair types
Lanugo
Vellus
Terminal
Alopecia sikatrial
Alopesia non sikatrial
Diagnostic procedure:
Hair shedding count
Hair pull test
Hair pluck (trichogram)
Biopsy

Alopecia Areata
Etiology:
Autoimmune
Heredity
 Pathogenesis:
Disturbed hair follicle cycling
(Anagen terminated prematurely Telogen)
Diagnosis:
Clinical manifestation
- Exclamation point hairs
Histologic findings
- Telogen
- Follicles miniaturize
- Peribulbar infiltrate

Management:
CS
PUVA
Minoxidil topical
Laser
Education & pshysiological support

Androgenetic Alopecia
Gradual loss of hairs, chiefly from the vertex & frontotemporal regions
Etiology:
Heredity
Androgen dependent
Pathogenesis:
Follicles miniaturized + Shortening of anagen duration

Telogen
Finer & lighter hairs vellus hairs

Hamilton
classification

Ludwig classification

Diagnosis:
Clinical manifestation
Histologic findings
- Telogen
- Follicles miniaturize
- No inflammatory cells
 - Variability in shaft diameter
Management:
Minoxidil topical
Finasteride oral
Antiandrogen oral
Hair transplantation

Telogen Effluvium
Excessive shedding of normal telogen club hairs
Induced by:
Surgery
Parturition
Fever
Drugs
Dieting
Diseases
Traction
Pathogenesis:
Precipitous shift of anagen hairs to telogen hairs shed
Clinical manifestation:
Hair lost at the root
Diffuse
Diagnosis:
Anamnesis
Clinical manifestation
Hair Pull test > 4-6 club hairs
Histologic findings
Telogen hairs (12-15%)
Visible depigmented club-shapped bulb
Differential diagnosis:
Androgenetic alopecia
Trichotillomania
Management:
~ precipitating factors

Trichotillomania
Compulsive practice of plucking hairs
~ obsesive-compulsive disorder, anxiety, depression
Clinical manifestation:
Irregular patches
Rough texture
Variability length
Diagnosis:
Anamnesis
Skin window
Histologic findings
 Empty anagen follicles
Pigmen cast
Hemorrhage
Differential diagnosis:
Alopecia areata
Management:
Behaviour modification
Psychotherapy & psychopharmacologic

Pigmentary
Disorders

VITILIGO
50% < 20 yrs
>
Clinical Manifestations:
Depigmented white patches
Various sizes & configurations
4 types:
Localized / focal / segmental
Generalized
Universal
Acrofacial
Etiology: Multifactorial genetic basis
Pathogenesis:
Autoimmunity
Humoral
Autocytotoxicity
Cellular immune mechanisms
Associated conditions:
Ocular abnormalities
Diabetes Mellitus
Thyroiditis
 Alopecia areata
Management:
Spontaneous recovery < 15 - 20%
Cosmetic concern
Sun protection
Topical steroid
Tacrolimus ointment
Phototherapy
Surgical treatment
Total depigmentation

ALBINISM
Partial or complete congenital absence of pigmen in the:
Skin, Hair & Eyes Occulocutaneous Albinism (OCA 1-4)
Eyes Occular Albinism

Pathogenesis:
Enzymatic deffects Dysruption of melanin synthesis

MELASMA
Brown patches with irregular borders & symmetric distribution in the face
Epidemiology:
, reproductive age, darker skin
Etiopathogenesis:
Genetik
Hormonal
UV radiation
Cosmetic
Medication
Clinical pattern:
Centrofacial
Malar
Mandibular
Diagnostic procedure:

Woods lamp
Management:
Sun Protection
Hypopigmenting agents
Hydroquinone, tretinoid, azelaic acid, kojic acid, Kligman formula
Chemical peels
Laser