Symptom Finder - Baldness
BALDNESS
A clever mnemonic to apply here is HAIR. The H stands for hereditary baldness and hormonal baldness, such as that caused by hypothyroidism and hyperthyroidism. The A stands for alopecia areata and autoimmune disease, such as lupus erythematosus. The I stands for inflammatory conditions, most notably tinea capitis, impetigo, or any condition associated with prolonged fever. The I also stands for intoxication, with arsenic and gold therapy most important here. Finally, the R stands for radiation. This is particularly significant today with so many victims of neoplasms being treated with this modality.
Approach to the Diagnosis
The Wood lamp and scrapings of any scaly material are useful in distinguishing tinea capitis from lupus and other disorders, but taking a skin biopsy of any unusual lesion is wise. Referral to a dermatologist is best if fungus or other infections are ruled out and the findings from thyroid function studies are normal. When there is diffuse hair loss, hypogonadism may be ruled out by ordering serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone, and estrogen.
A clever mnemonic to apply here is HAIR. The H stands for hereditary baldness and hormonal baldness, such as that caused by hypothyroidism and hyperthyroidism. The A stands for alopecia areata and autoimmune disease, such as lupus erythematosus. The I stands for inflammatory conditions, most notably tinea capitis, impetigo, or any condition associated with prolonged fever. The I also stands for intoxication, with arsenic and gold therapy most important here. Finally, the R stands for radiation. This is particularly significant today with so many victims of neoplasms being treated with this modality.
Approach to the Diagnosis
The Wood lamp and scrapings of any scaly material are useful in distinguishing tinea capitis from lupus and other disorders, but taking a skin biopsy of any unusual lesion is wise. Referral to a dermatologist is best if fungus or other infections are ruled out and the findings from thyroid function studies are normal. When there is diffuse hair loss, hypogonadism may be ruled out by ordering serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone, and estrogen.
