Diagnosis of Hair Loss - How To Cure Hair Loss and Hair Fall

Hair loss affects men and women of all ages and often has significant social and psychological consequences.

History should orient us to the beginning of hair loss, its appearance (diffuse or local), the speed and rate of hair loss and the presence of other symptoms affecting the scalp (itching and / or burning). Must gather data and also: the patient's diet (malnutrition), the use of medications and hygiene items vkl.bilki, recently experienced stress or illness. In women need to learn about the regularity of the monthly cycle and whether it had reproductive problems. Family history should give us data on hereditary predisposition to hair loss, evidence of chronic disease in parents who may be linked to hair loss.

Obtained from the history data can guide us sometimes to the etiology of hair loss, for example, the patient reported:

Data on systemic diseases (autoimmune diseases, malignancies) observed alopecia areata, alopecia tsikatrialna and telogen effluvium (common form of diffuse alopecia, which may occur several months after birth, surgery, diet low in protein, emotional stress and use of drugs)

Infections (systemic or local) is probably a tsikatrialna alopecia, there is telogen effluvium or slimy kapitis infections

In chronic medication telogen effluvium is the most likely consequence

If the patient suffers from mental illness most likely case of triholitomaniya

After a stress or surgery telogen effluvium is most frequently observed

If any signs of abnormal hormone (hirsutism, amenorrhea or problems with pregnancy is probably for telogen effluvium

On physical examination, the patient should be given to the presence of scarring on the scalp, Kelowna or inflammation should also be palpable thyroid to determine its size, vascularity and possible presence of nodes.

Alopecia differential diagnosis includes: (1) with alopecia without any scars on the scalp, which is caused by: alopecia areata (the reason for its development is probably unknown in the case of autoimmune process observed in patients with Hashimoto's Hashomoto, pernitsiozna anemia, Addison's disease and vitiligo), secondary syphilis, traumatic alopecia, triholitomaniya (this is a manifestation of psychogenic habit in which the patient often pulls and short scalp hair from their habit can occur at any age but most often observed in adolescents), contact dermatitis, androgenetic alopecia, thyroid disease, telogen effluvium, use of drugs affecting abnormal hair shaft and (2) alopecia where there are scars after hair loss, most often caused by: Tine kapitis, herpes zoster infections celluloid of scalp folliculitis, discoid lupus erythematosus, lichen planopilaris, Morpheus, sarcoidosis, scleroderma and neoplasia-squamous cell carcinoma, basal cell carcinoma, melanoma, metastases, and lymphomas tsilindroma.

First differential diagnostic plan excludes reasons such as: malnutrition (iron deficiency, zinc deficiency) hiperandrogenni conditions (differential diagnosis is provided to them in a separate publication), hereditary hair loss driven, trauma and use of medicines.

Second differential diagnostic plan excludes diseases causing hair loss do not develop against hiperandrogenizam and includes use of the following diagnostic package: measure TSH (thyroid disease exclusion), serology for Wasserman (exclude syphilis as the cause of hair loss), serum ferritin ( rule out anemia), antinuclear antibodies (ANA), rheumatoid factor (exclude autoimmune diseases), potassium chloride (its levels are increased in infection with Tine kapitis), biopsy of the scalp for two purposes: to identify the culture infections (fungialna culture) and possibly in suspektnost for neoplasia.

In women suffering from alopecia Data hiperandrogenno condition (irregular menses, hirsutism, acne vulgaris, galactorrhea) is the following tests: values of total testosterone, free testosterone values, dehidroepiandosteron and prolactin levels.

Following the above algorithm makes the diagnosis of alopecia straightforward, although the diagnostic process can sometimes be accompanied with difficulties.

Final thoughts: (1) diseases associated with alopecia areata are: Down Syndrome, pernitsiozna anemia, diabetes, thyroiditis, polikistichen ovary syndrome. (2) The main DD to the following conditions: (a) polikistichen ovary syndrome: variable menstrual periods or amenorrhea, signs of hirsutism, acne, reduced fertility, (b) Cushing's syndrome: facial adipose, adipose neck, hirsutism, emotional lability, hypertension, osteoporosis, (c) hypothyroidism: slow thinking, weight gain, intolerance to cold, (d) hyperthyroidism: tremor, weight loss, ocular symptoms (erythema, changes in the eyelids), hot skin, event.gusha, (e) system lupus: arthralgia / arthritis, febrile episodes, weight loss, pozitivirane of avnoantitela, skin lesions, alopecia with scarring, (f) cutaneous lymphoma: a distinctive look, changes in blood counts, positive paraneoplastichni bihomichni and neoplastic markers, (g) sarcoidosis : skin lesions, ocular lesions, weight loss, cough, chest pain, shortening of breath + makrokonstilatsiya as alopecia, is demonstrated best with pulmonary Skopje, another one of its diagnostic radical is indicated when arthritis; (s) lichen planus: skin lesions are characteristic, oral lesions, itching, alopecia with scarring, (j) serobeen dermatitis, psoriasis - not a DD difficulty, and syphilis - history zeksualniya life, serological diagnosis.