tailieunhanh - Chapter 054. Skin Manifestations of Internal Disease (Part 4)

Most patients with trichotillomania, pressure-induced alopecia. The most common causes of nonscarring alopecia include telogen effluvium, androgenetic alopecia, alopecia areata, tinea capitis, and some cases of traumatic alopecia (Table 54-5). In women with androgenetic alopecia, an elevation in circulating levels of androgens may be seen as a result of ovarian or adrenal gland dysfunction. When there are signs of virilization, such as a deepened voice and enlarged clitoris, the possibility of an ovarian or adrenal gland tumor should be considered. Table 54-5 Nonscarring Alopecia (Primary Cutaneous Disorders) Clinical Characteristics is Pathogenes Treatment Telogen effluvium Diffuse shedding of normal causes hairs Stress Observation; the discontinue drugs that any have normally. | Chapter 054. Skin Manifestations of Internal Disease Part 4 Most patients with trichotillomania pressure-induced alopecia. The most common causes of nonscarring alopecia include telogen effluvium androgenetic alopecia alopecia areata tinea capitis and some cases of traumatic alopecia Table 54-5 . In women with androgenetic alopecia an elevation in circulating levels of androgens may be seen as a result of ovarian or adrenal gland dysfunction. When there are signs of virilization such as a deepened voice and enlarged clitoris the possibility of an ovarian or adrenal gland tumor should be considered. Table 54-5 Nonscarring Alopecia Primary Cutaneous Disorders Clinical Characteristics Pathogenes is Treatment Telogen effluvium Diffuse shedding of normal hairs Follows either major stress high fever severe infection or change in hormones post partum Reversible without treatment Stress causes the normally asynchronous growth cycles of individual hairs to become synchronous therefore large numbers of growing anagen hairs simultaneously enter the dying telogen phase Observation discontinue any drugs that have alopecia as a side effect must exclude underlying metabolic causes . hypothyroidism hyperthyroidism Androgeneti c alopecia male Miniaturizatio n of hairs along the Increased sensitivity of If no evidence of hyperandrogen pattern female pattern midline of the scalp Recession of the anterior scalp line in men and some women Alopecia areata Well-circumscribed circular areas of hair loss 2-5 cm in diameter In extensive cases coalescence of lesions and or involvement of other hair-bearing surfaces affected hairs to the effects of testosterone Increased levels of circulating androgens ovarian or adrenal source in women state then topical minoxidil finasteride hair transplant The germinative zones of the hair follicles are surrounded by T lymphocytes Occasional associated diseases hyperthyroidism hypothyroidism Topical anthralin intralesional glucocorticoids topical .