Tuesday, March 9, 2010

Alopecia

Alopecia - Chronic


 

Definition  

    A chronic dermatological disorder involving hair loss from the scalp and sometimes the     body


 

Medical History  

* Family history of Alopecia

* Mental disorder

* Stress

* Infectious disease

* Autoimmune disease

* Cancer

* Chemotherapy

* Severe

* Traumatic AND/OR non-traumatic injury

* Disorder of endocrine system


 

Findings  

* Loss of hair


 

Tests  


 

Evaluation of nonscarring alopecia when the diagnosis is unclear  

* Thyroid stimulating hormone measurement

* VDRL titer measurement

* ANA measurement

* Serum ferritin measurement


 

Evaluation of scarring alopecia  

* Punch biopsy


 

Differential Diagnosis  

* Male pattern alopecia

* Alopecia areata

* Telogen effluvium

* Trichotillomania

* Traumatic alopecia

* Tinea capitis

* Scarring alopecia

* Discoid lupus erythematosus

* Syphilis


 


 


 

Treatment  


 

Drug Therapy  


 


 

Mild to moderate male pattern alopecia  


 

MINOXIDIL  

Adults (male): Apply 1 mL of a 5% solution topically twice daily


 

FINASTERIDE (Related toxicological information in FINASTERIDE)  

Adults (male): 1 mg orally once daily


 

MINOXIDIL - FINASTERIDE

Adults (male): Minoxidil 1 mL of a 5% solution topically twice daily AND finasteride 1 mg orally once daily


 


 

Women with mild to moderate androgenetic alopecia and no evidence of hyperandrogenism  


 

MINOXIDIL  

Adults (female): Apply 2% solution topically twice daily


 


 

Alopecia areata in adults and children older than 10 years of age  


 

TRIAMCINOLONE ACETONIDE  

Adults: 0.1 mL diluted in sterile saline to 10 mg/mL injected intradermally at multiple sites within the area; maximum dose 2 mL per visit every 4 to 6 weeks; discontinue after 6 months if no improvement

Pediatrics (>10 years): 0.1 mL diluted in sterile saline to 10 mg/mL injected intradermally at multiple sites within the area; maximum dose 2 mL per visit every 4 to 6 weeks; discontinue after 6 months if no improvement


 

HYDROCORTISONE SODIUM SUCCINATE  

Adults: 25 mg/mL, 0.05 to 0.1 mL injected intradermally; multiple injections may be given; a Dermajet™ may also be used


 

MINOXIDIL  

Adults: Apply a 5% solution topically twice daily .


 

Anthralin  

Adults: 0.1%, 0.25%, 0.5%, or 1% cream topically to affected area once daily; gradually increase duration of time on the scalp from 5 minutes up to 1 hour; after each application rinse the scalp thoroughly with water followed by soap


 


 

Alopecia areata in children 10 years of age and younger  


 

MINOXIDIL  


 


 

Anthralin  


 


 

Procedural Therapy  


 

Male pattern alopecia  

* Hair transplant: Newer techniques in hair transplantation can provide excellent, undetectable results in advanced male pattern hair loss .


 

Non-Procedural Therapy  


 

Alopecia  

* Use of Hairpieces or Wigs

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SYSTEM BASED CLASSIFICATION OF DISEASES

SYSTEM BASED CLASSIFICATION OF DISEASES

Bone and Joint Diseases

  1. Gout and Hyperurecemia
  2. Osteoarthritis
  3. Rheumatoid Arthritis
  4. Acute coronary Syndroms

Cardiovascular Diseases

  1. Arrhymias
  2. Cardiopulmanary Resuscitation
  3. Heart Failure
  4. Hypertension
  5. Hyperlipidemia
  6. Ischemic Heart Diseases
  7. Shock
  8. Stroke
  9. Venous Thromboembolism

Dermatrologic Diseases

  1. Acne
  2. Psoriasis
  3. Skin Disorders and Cutaneous Drug Eruptions

Endocrine Diseases

  1. Cirrhosis
  2. Portal Hypertension

Gastrointestinal Diseases

  1. Irritable Bowel Syndrome
  2. Constipation
  3. Diarrhea
  4. Gastroesophagal Reflux Disease
  5. Hepatitis, Viral
    1. Hepatitis A
    2. Hepatitis B
    3. Hepatitis C
  6. Nausea and Vomiting
  7. Pancreatitis
  8. Peptic Ulcer disease

Gynecologic and Obstetric Diseases

  1. Contraception
  2. Hormone therapy

Hematologic Diseases

  1. Anemia
    1. Megaloblastic Anemia

i. Megaloblastic Anemia due to Folate Deficiency

ii. Megaloblastic Anemia due to Vitamine B12 Deficiency

    1. Sickle Cell anemia
    2. Hemolytic Anemia
    3. Iron Deficiency Anemia
    4. Aplastic Anemia
    5. Iron Deficiency Anemia

Infectious Diseases

  1. Central Nervous System infections
  2. Endocarditis
  3. Fungal infections, Invasive
  4. Gastrointestinal Infection
  5. HIV / AIDS
  6. Intra-Abdominal Infection
  7. Respiratory Tract infections, Lower
  8. Respiratory Tract infections, Upper
  9. Sepsis and Septic Shock
  10. Sexually transmited Diseases (STD)
  11. Skin and soft tissue infection
  12. Tuberculosis
  13. Urinary tract infection and prostatitis

Neurologic Diseases

  1. Epilepsy
  2. Headache
    1. Migraine
    2. Cluster Headache
  3. Pain management
  4. Parkinson’s Diseases
  5. Status epilepticus

Nutritional Diseases

  1. Enteral Nutrition
  2. Obesity
  3. Parentaral Nutrition

Onchologic Diseases

  1. Breast cancer
  2. Colorectal Cancer
  3. Lung cancer
  4. Lymphomas
  5. Prostate cancer
  6. Cervical Cancer
  7. Esophageal Cancer
  8. Gastric Cancer
  9. Head and Neck Cancer
  10. Lung Cancer
  11. Ovarian Cancer
  12. Pancreatic Cancer
  13. Primary bone Cancer
  14. Primary Brain cancer
  15. Testicular Cancer
  16. Thyroid Gland Cancer
  17. Urinar Bladder cancer
  18. Uterine Cancer

Ophtalmic Diseases

  1. Glaucoma

Psychiatric Diseases

  1. Alzhimer’s Diseases
  2. Anxiety Disease
  3. Bipolar Diseases
  4. Depressive diseases
  5. Schizophrenia
  6. Sleep Diseases
  7. Substance-Related Diseases

Renal Diseases

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  2. Acute renal Failure
  3. Chronic Renal Failure
  4. Drug Dosing in renal insufficiency
  5. Electrolyte Homeostasis

Respiratory Diseases

  1. Allergic Rhinitis
  2. Asthma
  3. Chronic Obstructive Pulmonary Diseases

Urologic Diseases

  1. Benign Prostatic, Hyperplasia
  2. Erectile Dysfunction
  3. Urinary Incontinence