Chapter 40: Alopecia Buttaro: Primary Care: A Collaborative Practice, 6th Edition

Multiple Choice

1. A patient is seen in the clinic for patches of hair loss. The provider notes several well-demarcated patches on the scalp and eyebrows without areas of inflammation and several hairs within the patch with thinner shafts near the scalp. Based on these findings, which type of alopecia is most likely?

a. Alopecia areata b. Anagen effluvium c. Cicatricial alopecia d. Telogen effluvium

ANS: A a. Examination of scalp scrapings with potassium hydroxide (KOH) b. Grasping and pulling on a few dozen hairs c. Serum iron studies and a complete blood count d. Venereal Disease Research Laboratory (VDRL) test

These findings are characteristic of alopecia areata. Anagen effluvium and telogen effluvium both result in diffuse hair loss and not discrete patches. Cicatricial alopecia involves inflammation.

2. A patient diagnosed with alopecia is noted to have scaling on the affected areas of the scalp. Which confirmatory test(s) will the provider order?

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ANS: A a. Anthralin b. Cyclosporine c. Finasteride d. Minoxidil

Scaling on the scalp is suggestive of tinea capitis. To confirm this, the provider will perform scalp scraping or test hair samples with KOH preparation to look for hyphae. Grasping and pulling on hairs is used to identify anagen or telogen hairs by appearance. Serum iron and a CBC are used if anemia is suspected as a cause. VDRL is performed if syphilis is suspected.

3. A female patient is diagnosed with androgenetic alopecia. Which medication will the primary health care provider prescribe?

ANS: D

Either minoxidil or finasteride are used for androgenetic alopecia, but finasteride is Pregnancy Category X, so minoxidil is the only medication approved by the FDA for use in women. Anthralin and cyclosporine are used to treat alopecia areata.