Alopecia None Scaring Reversible Scaring Irreversible X AlajlanAlopecia

Alopecia None Scaring (Reversible) ü. Scaring (Irreversible) X Alajlan/Alopecia

Introduction & definition ü Alopecia = HAIR LOSS ü Basic hair anatomy and Physiology ü Hair growth is very dynamic ü Vellus and Terminal hair

Introduction & definition ü Alopecia = HAIR LOSS ü Basic hair anatomy and Physiology ü Hair growth is very dynamic ü Vellus and Terminal hair üHow many hairs in the body? 5 millions hairs; 100, 000 in the scalp üGrowth rate? 0. 3 mm/day for scalp hair

Androgenetic Alopecia (Male and Female Pattern Hair Loss)

Male Pattern Hair Loss

Female Pattern Hair Loss

Androgenetic Alopecia ü Androgenetic Alopecia affects up to 50% of males and 40% of females ü Autosomal dominant with variable penetrance ü 85% : +ve family history ü Role of androgens in the pathogenesis:

5 ALPHA Reductase X Systemic Treatment Fenastride Testosterone Dihydor. Testosterone (Active) Miniaturization of Terminal Hairs

Topical Treatment Minoxidil 2% and 5% Solution (uncertain mechanism)

Alopecia Areata

Alopecia Areata ü Alopecia Areata affects up to 2% ü 30%: +ve Family history ü 75% : Self recovery ü Role of immune system in the pathogenesis ü Types of alopecia areata: - localized partial - localized extensive - alopecia totalis - alopecia universalis

Treatment 1. …

Treatment 2. Intralesional Corticosteroids

Skin Sensitizers (Immune modulating Rx) - Diphencyclopropenone (DPCP) - Anthraline - others

Other Rx Topical steroids Systemic Steroids Cytotoxic Rx Phototherapy Minoxidil X Hair Transplant

Anagen effluvium Telogen effluvium

Anagen effluvium ü Always related cytotoxic chemotherapy ü Acute and severe alopecia ü Mostly reversible but not always

Telogen effluvium Chronic alopecia Anemia with chronic disease ü ü Ø Ø Ø ü ü Common and None specific Additional cause: drugs Weight loss Acute blood loss General anasthesia Low iron Others Reversible (but may be become chronic) Could it be preventable?

Vitiligo Alajlan/Vitiligo

Vitiligo ü Introduction to skin pigments Alajlan/Vitiligo

Vitiligo ü Introduction to skin pigments ü Definition ü Types: localized and generalized ü Pathogenesis ü Other associated diseases ü Natural course ü Treatment Alajlan/Vitiligo

Treatment Ø No single effective Rx Ø Topicals: . Corticosteroids. Immunomodulators Ø Light Therapy: 1. UVA or UVB 2. UVA + Psoralen = PUVA (Topical and Systemic) 3. UVB = Laser Ø Systemic Treatment: NOT USED Ø Surgical Rx: . Melanocyte Transplant. Skin Grafts Transplant Ø Bleaching Agents: Depigment all skin Alajlan/Vitiligo

Treatment Pearls • • • Tips of fingers and toes Lips Bony prominence Recurrence Rarely 100% repigmentation for large area • Adverse effect of Rx Alajlan/Vitiligo