Alopecia areata

Published on 02/04/2015 by admin

Filed under Internal Medicine

Last modified 02/04/2015

Print this page

rate 1 star rate 2 star rate 3 star rate 4 star rate 5 star
Your rating: none, Average: 0 (0 votes)

This article have been viewed 815 times

185 Alopecia areata

Instruction

Examine this patient’s scalp.

Salient features

History

• Young adult (75% of patients are below the age of 40 years)

• History of atopy

• Ask whether there is a family history (25% give a family history)

• Ask the patient whether there are any local symptoms and if the hair loss is cosmetically unacceptable.

Examination

• Well-defined patch of hair loss (Fig. 185.1); short, fractured, exclamation-point hairs may be seen at periphery.

• Regrowing hair in the patch appears as a fine, depigmented downy growth.

image

Fig. 185.1 Alopecia areata.

Proceed as follows:

• Look for patches of hair loss over the eyebrows and beard area

• Examine the nails for fine pitting, transverse lines, dystrophy, fragmentation (anonychorrhexis) and ridging and 20-nail dystrophy (roughened nail surface and brittle free nail edge) (Fig. 185.2)

• Tell the examiner that you would like to:

• look for atopy
• look for other autoimmune conditions including vitiligo (see below).
image

Fig. 185.2 Nail dystrophy.

Diagnosis

This patient has alopecia areata (lesion), which is suspected to be of autoimmune aetiology; it may be cosmetically unacceptable to the patient (functional status).

Advanced-level questions

What are the signs of disease activity?

Buy Membership for Internal Medicine Category to continue reading. Learn more here

Related posts:

Default ThumbnailSixth cranial nerve palsy Charcot’s joint Optic atrophy Default ThumbnailHepatomegaly Carotid artery aneurysm Felty’s syndrome