'Exclamation mark' alopecia is seen in?
Ans. D. Alopecia areata. (Ref Harrison, 18th/Pg. 298)Alopecia areata is characterized by abortive hair growth and the formation of a short, stubby, 'exclamation mark' hair at the edge of the area of hair loss. 'Alopecia' is a generic term for hair loss; areata is the plural of area. 'Alopecia areata' is a descriptive term for a disorder characterized by one or more discrete circular areas of hair loss and which can occur anywhere on the body. Alopecia totalis and universalis are variants of alopecia areata, differentiated only by the extent of the hair loss.Telogen effluvium# Acute telogen effluvium relates to a specific form of diffuse alopecia - eviction of hairshafts that have prematurely entered the telogen phase (telogen hair increase to 25%, normal-13%).# Excessive loss of hair can occur.# Telogen Effluvium tends to become apparent 6-12 weeks following the cause.# Such a hairloss can result in l-2cm stubble in extreme cases within weeks.# Causes include:- Pyrexia (body temperature reaching 103.5 C +),- Childbirth (rare)- Telogen gravidarum,- severe infection (especially toxaemia),- major surgery,- protein deficiency due to unsupervised diets,- drugs including beta blockers, anti-depressants, minoxidil,- severe psychological stress.# Spontaneous regrowth occurs in 3-6 months.Anagen effluviumAnagen effluvium is the dramatic and rapid hair loss most commonly seen in association with cancer chemotherapy and radiotherapy to the scalp. Other causes are:high-dose colchicine; thallium, mercury, and arsenic poisoning; and cantharadin. The insult to the hair follicle is sufficiently severe to cause an immediate metabolicarrest with complete cessation of hair production. The hair may come out by the root or, if the insult is brief, the hair shaft will narrow, providing a point of weaknessthat subsequently snaps off. The follicle may remain in anagen, in which case recovery is quick, or move into telogen, in which case regrowth will be delayed by about3 months.Androgenetic alopeciaAndrogenetic alopecia is a progressive patterned baldness, which is sufficiently common among both men and women to be considered a secondary sexualphenomenon. It is also called common baldness, male-patterned baldness, and female- patterned alopecia. When it occurs prematurely in a man, it can be anunwanted and distressing event and patients may present for treatment. Among women it is usually both unwanted and unexpected at any age and women commonlypresent for both diagnosis and treatment.Educational points:**Causes of Cicatrical (scarring) Alopecia# Favus# Folliculitis Decalvans,# Hyperkeratosis Cystica Follicularis# Herpes Zoster(Shingles)# Lichen Planus (Planopilaris)# Lupus Erythematosus (discoid & systemic)# Morphoea# Neoplasma(Benign/malignant)# Pseudo-pelade (Brocq) - a form of scarring alopecia resembling alopecia areata# Scleroderma# Sarcoidosis# Traction Alopecia# Tufted Folliculitis
Androgenetic alopecia
Telogen effluvium
Anagen effluvium
Alopecia areata
Alopecia