William F. Bergfeld, MD

San Diego


Telogen Effluvium

September 14, 2005

Consider this diagnosis when a patient presents with a history of rapid, diffuse hair loss. Telogen effluvium affects the entire scalp, but the crown and bitemporal areas may appear to be mainly involved if there is associated androgenetic alopecia.

Trichorrhexis Nodosa

September 14, 2005

Abnormalities of the hair shaft, whether traumatic or acquired, may result in hair breakage (which gives the appearance of failure of the hair to grow) and hair loss. Trichorrhexis nodosa-traumatic fractures of hair shaft-may result from UV exposure, permanent wave procedures, coloring of the hair, or the use of hot combs. The condition may also be congenital. The hairs have a broken, “flyaway” appearance, and characteristic grayish white nodules on the hair shaft can be seen with the naked eye.

Localized Discoid Lupus Erythematosus

September 14, 2005

Many disorders that scar the skin also affect the scalp. Systemic lupus erythematosus, when associated with high fever and extensive systemic involvement, can cause a diffuse anagen effluvium. Hair loss caused by localized discoid lupus erythematosus (DLE) is more common. DLE may affect the scalp, where it is seen as circumscribed areas of often irreversible hair loss.

Alopecia Areata

September 14, 2005

Although alopecia areata is an inflammatory, autoimmune type of hair loss, it is characterized as a nonscarring type; the hair grows back in all but extremely long-standing cases.