00:01
Our topic here is alopecia areata.
00:04
What does alopecia mean to you?
It means loss of hair, period.
00:08
Now, specifically, this
alopecia areata is --
well, could be most likely
associated with autoimmune disease
or the cause is autoimmune.
00:19
The reason I say that is whenever
you have one autoimmune disease,
it’s very possible that you have others,
including maybe something like
Hashimoto thyroid disease,
With alopecia areata, we have
a non-scarring alopecia type.
00:33
So here, you take a look at
the head of this individual,
and the scalp specifically.
00:37
You’ll notice that we have
hair that’s being lost.
00:40
Patches of loss on the scalp,
or maybe perhaps, the beard.
00:44
Then sometimes causes loss
of all hair on scalp.
00:48
We call this alopecia totalis.
00:52
And all hair on body,
and therefore, we call this alopecia
universalis, as the name implies.
01:00
In general, alopecia
means loss of hair.
01:02
Here, specifically, areata.
01:05
Think of autoimmune disease, please.
01:08
And remember, this is a
non-scarring type of alopecia.
01:13
Management:
maybe perhaps, topical steroids,
maybe intralesional type of steroids,
oral steroids, or light treatment.
01:22
Overall, steroid is something
that you want to keep in mind
when dealing with
autoimmune diseases.
01:27
The pathology: the hair bulb was
attacked by the lymphocytes,
as you can imagine, if we’re
referring to autoimmune disease.
01:35
Differential diagnoses: As we
have continued now the theme
of not only your diseases
but the differentials.
01:42
If it’s tinea capitis, what
does that mean to you?
It’s a fungal infection
versus autoimmune disease.
01:47
And the reason that we have
capitis is because well, here,
it might be a fungal
infection of the scalp.
01:53
And of course, this type of fungal
infection, what am I referring to?
Superficial, or are we
dealing with systemic?
Superficial
Good.
02:00
Tinea capitis, we’ll talk about
the organism soon enough
called Trichophyton rubrum,
as we shall take a look at.
02:09
Here, causes erythema,
scaling, and bogginess,
things that you normally would
not find with alopecia areata.
02:15
Remember, this is more or
less a fungal infection.
02:18
So therefore, there might be
positive occipital lymphadenopathy,
which might be noted
with tinea capitis,
which is not present
with alopecia areata.
02:28
The KOH examination, as you
can imagine with tineas,
would demonstrate
your fungal organism,
which obviously has no relevance
with alopecia areata.
02:37
And with this differential,
you can clearly see
that tinea capitis is something
that will be easy to identify.
02:44
Another differential will be
cutaneous lupus erythematosus.
02:48
When we talk about SLE,
we’ll then divide in dermatology
our erythematosus into a
few different components.
02:55
Specifically, cutaneous,
it’s more inflammatory with
distinctive pigmentary changes.
03:01
A differential for what
are we doing right now?
Alopecia areata.
03:05
Cutaneous lupus creates scarring
and permanent alopecia.
03:09
The only thing that you have in common between
these two conditions is the alopecia.
03:14
However, you don’t have
scarring with areata,
and with lupus, scarring
is much more prevalent.
03:25
Here’s one we haven’t
discussed as of yet.
03:27
We have hair loss that’s taking
place, perhaps, on the head.
03:30
We have a condition
called trichotillomania.
03:33
Have fun saying that.
03:34
It’s fun, rubber baby buggy
bumpers,
trichotillomania.
03:38
Non-scarring loss.
03:39
So far, the only common denominator between
trichotillomania and alopecia areata
is the non-scarring, okay?
But in trichotillomania,
what’s happening?
You’re plucking your hair.
03:50
You’ve seen those individuals.
03:52
In terms of IQ, well, IQ has nothing
to do with plucking your hair,
but maybe perhaps, this
individual feels great comfort or
maybe perhaps even finds peace
with plucking his or her hair.
04:04
Most common in young girls with
coexisting psychiatric disturbances.
04:09
Characterized by wide variation
in length of the retaining hair
depending as to how much
you’re plucking out.