Ebook The alopecias diagnosis and treatments: Part 2
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Ebook The alopecias diagnosis and treatments: Part 2
10Traumatic alopeciaPierre BouhannaTraumatic alopecia is a hair loss essentially caused by physical trauma. Schematically there are three possible eti Ebook The alopecias diagnosis and treatments: Part 2iologies for these alopecia':•Trichotillomania is a traction alopecia due to a compulsive disorder. Patients pull on and pluck hairs, often resulting in bizarre patterns of alopecia. In trichotillomania, the patient, with psychological disorders, will manipulate his or her hair, unconsciously or del Ebook The alopecias diagnosis and treatments: Part 2iberately, but repeatedly, to cause more or less severe baldness.•Cosmetic alopecia is caused by the excessively strong or aggressive care and handlinEbook The alopecias diagnosis and treatments: Part 2
g of hair.•Traumatic accident alopecia is easy to diagnosis.We will not deal here with some hair dysplasias (see Chapter 4) that are responsible for b10Traumatic alopeciaPierre BouhannaTraumatic alopecia is a hair loss essentially caused by physical trauma. Schematically there are three possible eti Ebook The alopecias diagnosis and treatments: Part 2child.TRICHOTILLOMANIAPsychopathological aspectsTrichotillomania is a tic of hair removal that occurs most often in boys under 6 years and in girls over 6 years (Figure 10.2)?"* The most severe cases occur in women between adolescence and 40 years (Figure 10.3); in these instances, the psychological Ebook The alopecias diagnosis and treatments: Part 2 disorders are major.Figure 10.2 Trichotillomania in a 2-year-old child.Figure 10.3 Circumscribed alopecia caused by trichotillomania located at the lEbook The alopecias diagnosis and treatments: Part 2
eft half of the scalp in a young woman. (Note the angle and the rectilinear border.)91t he a Io pec lasFigure 10.4 Circumscribed alopecia caused by tr10Traumatic alopeciaPierre BouhannaTraumatic alopecia is a hair loss essentially caused by physical trauma. Schematically there are three possible eti Ebook The alopecias diagnosis and treatments: Part 2clear boundary (Figure 10.4). The skin surface is normal and nonsqua-mous. The manipulated hairs are broken at different lengths. The parietal region is the most frequently affected.In adults, the area of alopecia is often extensive, with short broken hairs. It can be localized to the vertex (Figure Ebook The alopecias diagnosis and treatments: Part 2 10.5), appear unilaterally in the fronto-parietal-occipital region (Figures 10.3 and 10.6) or, exceptionally, be seen on the entire scalp.Tics of remEbook The alopecias diagnosis and treatments: Part 2
oving eyelashes, eyebrows, or other body hair (pubic or perianal) are exceptional.DiagnosisHistological aspects: The most constant element is that man10Traumatic alopeciaPierre BouhannaTraumatic alopecia is a hair loss essentially caused by physical trauma. Schematically there are three possible eti Ebook The alopecias diagnosis and treatments: Part 2perifollicular hemorrhage and fractured fibers. Later stages of trichotillomania characteristically demonstrate the presence of normal follicles surrounded by empty follicles in a noninflammatory dermis. Numerous catagen follicles (characterized by numerous apoptotic cells and a wavy surrounding vit Ebook The alopecias diagnosis and treatments: Part 2reous membrane) and pigment casts within the upper segments of the follicle may be noted.Trichoscopy5-6 (Figure 10.7) is useful to confirm the evidencEbook The alopecias diagnosis and treatments: Part 2
e of pulling. The scalp presents short, coiled,Figure 10.5 Circumscribed alopecia caused by trichotillomania located at the vertex in an elderly woman10Traumatic alopeciaPierre BouhannaTraumatic alopecia is a hair loss essentially caused by physical trauma. Schematically there are three possible eti Ebook The alopecias diagnosis and treatments: Part 2ngular and geometric contours.)fractured hairs. The broken hair shafts show longitudinal splitting (see Chapter 3).Trichograms (1) show the almost exclusive presence of normal anagen hair (see Chapter 2).Differential diagnosisIn children, a patch caused in trichotillomania may be confused with ringw Ebook The alopecias diagnosis and treatments: Part 2orm or alopecia areata.92t rau mat ic alopeciaFigure 10.7 Trichotillomania with erosion, black spots, hairs in “tulip” and hairs in “V.” (Courtesy ofEbook The alopecias diagnosis and treatments: Part 2
Dr. Y. Bourezanc.)With ringworm, the skin surface is rough. Infected hair is recognized on examination by Wood lamp and by microscopic examination.In 10Traumatic alopeciaPierre BouhannaTraumatic alopecia is a hair loss essentially caused by physical trauma. Schematically there are three possible eti Ebook The alopecias diagnosis and treatments: Part 2r white, at first. In addition, abnormalities deriving from dystrophy of hair bulbs are visible on a trichogram.lhe major forms of trichotillomania in adults should be differentiated with a careful clinical examination and a trichogram from androgenetic alopecia localized to the vertex and which can Ebook The alopecias diagnosis and treatments: Part 2 be associated (Figure 10.8).10Traumatic alopeciaPierre BouhannaTraumatic alopecia is a hair loss essentially caused by physical trauma. Schematically there are three possible eti10Traumatic alopeciaPierre BouhannaTraumatic alopecia is a hair loss essentially caused by physical trauma. Schematically there are three possible etiGọi ngay
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