Alopecia: Clinical (To be retired)

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Alopecia: Clinical (To be retired)

Medicine and surgery

Allergy and immunology

Antihistamines for allergies

Glucocorticoids

Cardiology, cardiac surgery and vascular surgery

Coronary artery disease: Clinical (To be retired)

Heart failure: Clinical (To be retired)

Syncope: Clinical (To be retired)

Hypertension: Clinical (To be retired)

Hypercholesterolemia: Clinical (To be retired)

Peripheral vascular disease: Clinical (To be retired)

Leg ulcers: Clinical (To be retired)

Adrenergic antagonists: Alpha blockers

Adrenergic antagonists: Beta blockers

ACE inhibitors, ARBs and direct renin inhibitors

Thiazide and thiazide-like diuretics

Calcium channel blockers

Lipid-lowering medications: Statins

Lipid-lowering medications: Fibrates

Miscellaneous lipid-lowering medications

Antiplatelet medications

Dermatology and plastic surgery

Hypersensitivity skin reactions: Clinical (To be retired)

Eczematous rashes: Clinical (To be retired)

Papulosquamous skin disorders: Clinical (To be retired)

Alopecia: Clinical (To be retired)

Hypopigmentation skin disorders: Clinical (To be retired)

Benign hyperpigmented skin lesions: Clinical (To be retired)

Skin cancer: Clinical (To be retired)

Endocrinology and ENT (Otolaryngology)

Diabetes mellitus: Clinical (To be retired)

Hyperthyroidism: Clinical (To be retired)

Hypothyroidism and thyroiditis: Clinical (To be retired)

Dizziness and vertigo: Clinical (To be retired)

Hyperthyroidism medications

Hypothyroidism medications

Insulins

Hypoglycemics: Insulin secretagogues

Miscellaneous hypoglycemics

Gastroenterology and general surgery

Gastroesophageal reflux disease (GERD): Clinical (To be retired)

Peptic ulcers and stomach cancer: Clinical (To be retired)

Diarrhea: Clinical (To be retired)

Malabsorption: Clinical (To be retired)

Colorectal cancer: Clinical (To be retired)

Diverticular disease: Clinical (To be retired)

Anal conditions: Clinical (To be retired)

Cirrhosis: Clinical (To be retired)

Breast cancer: Clinical (To be retired)

Laxatives and cathartics

Antidiarrheals

Acid reducing medications

Hematology and oncology

Anemia: Clinical (To be retired)

Anticoagulants: Warfarin

Anticoagulants: Direct factor inhibitors

Antiplatelet medications

Infectious diseases

Pneumonia: Clinical (To be retired)

Urinary tract infections: Clinical (To be retired)

Skin and soft tissue infections: Clinical (To be retired)

Protein synthesis inhibitors: Aminoglycosides

Antimetabolites: Sulfonamides and trimethoprim

Miscellaneous cell wall synthesis inhibitors

Protein synthesis inhibitors: Tetracyclines

Cell wall synthesis inhibitors: Penicillins

Miscellaneous protein synthesis inhibitors

Cell wall synthesis inhibitors: Cephalosporins

DNA synthesis inhibitors: Metronidazole

DNA synthesis inhibitors: Fluoroquinolones

Herpesvirus medications

Azoles

Echinocandins

Miscellaneous antifungal medications

Anti-mite and louse medications

Nephrology and urology

Chronic kidney disease: Clinical (To be retired)

Kidney stones: Clinical (To be retired)

Urinary incontinence: Pathology review

ACE inhibitors, ARBs and direct renin inhibitors

PDE5 inhibitors

Adrenergic antagonists: Alpha blockers

Neurology and neurosurgery

Stroke: Clinical (To be retired)

Lower back pain: Clinical (To be retired)

Headaches: Clinical (To be retired)

Migraine medications

Pulmonology and thoracic surgery

Asthma: Clinical (To be retired)

Chronic obstructive pulmonary disease (COPD): Clinical (To be retired)

Lung cancer: Clinical (To be retired)

Antihistamines for allergies

Bronchodilators: Beta 2-agonists and muscarinic antagonists

Bronchodilators: Leukotriene antagonists and methylxanthines

Pulmonary corticosteroids and mast cell inhibitors

Rheumatology and orthopedic surgery

Joint pain: Clinical (To be retired)

Rheumatoid arthritis: Clinical (To be retired)

Lower back pain: Clinical (To be retired)

Anatomy clinical correlates: Clavicle and shoulder

Anatomy clinical correlates: Arm, elbow and forearm

Anatomy clinical correlates: Wrist and hand

Anatomy clinical correlates: Median, ulnar and radial nerves

Anatomy clinical correlates: Bones, joints and muscles of the back

Anatomy clinical correlates: Hip, gluteal region and thigh

Anatomy clinical correlates: Knee

Anatomy clinical correlates: Leg and ankle

Anatomy clinical correlates: Foot

Acetaminophen (Paracetamol)

Non-steroidal anti-inflammatory drugs

Glucocorticoids

Opioid agonists, mixed agonist-antagonists and partial agonists

Antigout medications

Non-biologic disease modifying anti-rheumatic drugs (DMARDs)

Osteoporosis medications

Assessments

Alopecia: Clinical (To be retired)

USMLE® Step 2 questions

0 / 1 complete

Questions

USMLE® Step 2 style questions USMLE

of complete

A 25-year-old woman comes to her primary care physician's office because of hair loss over the past two weeks. She has type I diabetes mellitus which is controlled with an insulin pump. She reports that her hairdresser noticed a "bald spot" on her scalp when she had her hair cut two weeks ago. Physical examination shows a well-circumscribed oval patch of hair loss in the occipital region with no evidence of scarring. The surrounding hair around the periphery is broken. Which of the following is the most likely diagnosis?

Transcript

Content Reviewers

Rishi Desai, MD, MPH

Contributors

Antonella Melani, MD

Evan Debevec-McKenney

Alopecia refers to a loss of hair from part of the head or body and it can occur in a wide variety of disorders.

Assessment begins with obtaining a description of hair loss and the areas involved, as well as a medical history and family history.

Physical examination involves inspection of the scalp and other body sites.

Assessment of activity on the scalp may be done with a hair pull test, done by gripping about 20 hairs and gently pulling upward and away from the skin. Normally, about three hairs may fall out with each pull, while if more than 10 hairs are removed, the test is considered positive.

A noninvasive method of examining hair and scalp is trichoscopy, which is performed with the use of a dermatoscope. This traditionally consists of a magnifier, a non-polarised light source, a transparent plate and a liquid medium between the instrument and the skin.

In some cases, diagnostic techniques such as microscopic examination of cut or plucked hair fibers and scalp biopsies may provide additional information.

The pluck test is conducted by pulling hair out by the roots.

The root of the plucked hair is then examined under a microscope to determine the phase of growth, and is used to diagnose if there’s a defect of anagen or telogen.

Anagen hairs have sheaths attached to their roots, while telogen hairs have tiny bulbs without sheaths at their roots.

Finally, getting a scalp biopsy from the centre of the lesion gives confirmation of permanent hair loss, whereas a biopsy from the edge or an area of active inflammation may shed light on the underlying disease, and depending on the suspected diagnosis, additional laboratory studies may be performed.

Broadly, hair loss disorders can be divided into cicatricial or scarring alopecias, non scarring alopecias, and structural hair disorders.

Summary

Alopecia means hair loss, but it is not limited to the scalp as it can be anywhere in the body. For cosmetic reasons, patients may become concerned with hair loss, but it can also be an important clue to systemic disease. Common causes of alopecia include androgenic alopecia, drugs, infections such as tinea capitis, and trauma.

Elsevier

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