Hair Loss

Age: ‍ years old

Gender: ‍malefemale



HISTORY:

Presents with a ‍-‍day history of hair loss

Area of hair loss is ‍localizeddiffuse

Pattern of hair loss: ‍male patternfemale patternalopecia areatatelogen effluvium

Severity is ‍mildmoderatesevere, ‍barely noticeablenoticeable

Worsening factors: ‍none

Alleviating factors: ‍none, ‍effectiveineffective



Associated symptoms: *Try using right-click for negatives*

‍patchy hair loss

‍baldness

‍rash

‍itching

‍hair loss

‍fatigue

‍weight loss, ‍ ‍lbskg over ‍ ‍weeksmonths, ‍unintentionalintentional

‍menstrual irregularities

‍hirsutism

‍acne

‍anxiety

‍depression



Contributing factors:

‍recent childbirth

‍stress

‍poor nutrition

‍recent illness or surgery

no history of: ‍alopecia areata, ‍telogen effluvium, ‍tinea capitis, ‍androgenic alopecia, ‍thyroid disease, ‍lupus, ‍iron deficiency anemia, ‍polycystic ovary syndrome

no use of: ‍chemotherapy, ‍beta-blockers, ‍antidepressants, ‍new medication

no family history of: ‍balding





EXAM:

General appearance: ‍well-appearing, ‍apparent distress

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Head: ‍normocephalicatraumatic, scalp ‍normalrashlesion

Neck: ‍normal, ‍lymphadenopathy, ‍, c-spine ‍

Heart: ‍RRR, ‍MRG, ‍normal S1 and S2

Lungs: ‍clear bilaterally, ‍abnormal sounds, ‍retractions

Skin: ‍rashlesions on ‍





ASSESSMENT:

‍Stress-related hair loss ‍likelysuspectedpossible

DDx: stress-related hair loss, androgenetic alopecia, telogen effluvium, alopecia areata, tinea capitis, traction alopecia, trichotillomania, hypothyroidism, iron deficiency anemia, secondary syphilis, lupus erythematosus, lichen planopilaris, folliculitis decalvans, medication-induced hair loss, nutritional deficiencies, hormonal imbalances





PLAN:

Investigations:

- Blood work: ‍CBC, ‍TSH, ‍ferritin

Treatments:

- ‍Topical Minoxidil

- ‍Finasteride

- ‍Topical corticosteroids

- ‍Intralesional corticosteroids

- ‍Anthralin

- Hair transplantation

- Scalp micropigmentation

- Wigs and hairpieces

Further care:

- Referral to dermatologist

- Referral to psychologist

- Follow-up in ‍ ‍weeksmonths

- Return if hair loss worsens, if new symptoms develop such as scalp itching or redness, or if emotional distress occurs