telogen effluvium
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Etiology
- psychococial stress
- childbirth (common)[3]
- seborrheic dermatitis
- psoriasis
- iron deficiency anemia, blood loss
- thyroid disease[3]
- weight loss[3]
- pharmacologic agents
- ACE inhibitors
- levodopa
- beta blockers
- oral contraceptives
- lithium
- bromocryptine
- cimetidine
- anabolic steroids[3]
- antithyroid agents[3]
- anticonvulsants[3]
- retinoids[3]
- wafarin[3]
Pathology
- abrupt arrest of hair follicle maturation in response to stress
- in telogen effluvium, 30-60% of hairs are telogen hairs
- in anagen effluvium, 100% are telogen hairs
- normally only 10-15% of hairs are telogen hairs
Clinical manifestations
- diffuse hair loss after stressful event (childbirth is common)
- the stress generally occurs 2-3 months prior to onset
- hairs may fall out at hair root when hair is combed[3]
- full recovery is usual
Laboratory
- complete blood count (CBC) [absence of anemia]
- iron studies (serum iron, TIBC, % transferrin saturation)
- thyroid-stimulating hormone
- serology
Management
- no intervention needed
- reassurance
- high-dose B vitamins & calcium (reports of benefit)
More general terms
Additional terms
References
- ↑ Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 916-18
- ↑ Color Atlas & Synopsis of Clinical Dermatology, Common & Serious Diseases, 3rd ed, Fitzpatrick et al, McGraw Hill, NY, 1997, pg 28-29
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 Medical Knowledge Self Assessment Program (MKSAP) 16, 17, 18 American College of Physicians, Philadelphia 2012, 2015, 2018.
- ↑ 4.0 4.1 Hughes CEW, Elston DM (image) Medscape: Telogen Effluvium http://emedicine.medscape.com/article/1071566-overview
- ↑ 5.0 5.1 DermNet NZ. Telogen effluvium (images) http://www.dermnetnz.org/hair-nails-sweat/telogen-effluvium.html