Abnormal hair



Hair abnormalities can be generally divided into: In addition to the soles of the palms, the skin of the whole body has hair growth, in which the hair is long, thick, hard and thick, soft () hair is short, thin, soft and pale, hair distribution, type It varies by gender and age. Hair abnormality refers to the distribution, quantity, color and structure of hair. Clinically, hair loss (alopecia) and hirsutism are more common and important. Hair loss, alopecia, hirsutism, hair discoloration, hair deformity, hair deterioration. The cause can be divided into congenital, hereditary, primary, acquired, iatrogenic and traumatic.



First, congenital hereditary

(a) congenital alopecia

1. Congenital alopecia is an autosomal dominant inheritance with a family history and a part of a close relative marriage history. Generally divided into systemic and localized, often associated with malformations of nails, teeth, and skeletal dysplasia.

2. ROthlnnd-Thomsen syndrome: autosomal recessive inheritance. Hair sparse, head baldness, with forest ruins.

3. Ataxia cataract syndrome: autosomal recessive inheritance. There are sparse hair with cataracts and mental retardation.

4. Hair thinning, nail deformity syndrome: autosomal dominant inheritance.

5. Generalized baldness syndrome: Consider ectodermal dysplasia.

6. Male pattern hair loss: the disease is due to genetic susceptibility and androgen increase.

7. Female androgenetic alopecia: it is also a dual factor of genetic factors and increased males.

8. Shrinkage: autosomal dominant inheritance.

(2) Acquired hair loss is also called acquired hair loss

Endocrine factor

(1) anterior pituitary dysfunction.

(2) hypogonadism.

(3) Hypothyroidism.

(4) hypoparathyroidism.

2. Chronic diseases: systemic lupus erythematosus, cirrhosis, nephritis, malignant tumors. It is a dystrophic mechanism.

3. Dermatological diseases: leprosy, syphilis, exfoliative dermatitis, jaundice, purulent scleroderma, radiation dermatitis. Plaque atrophy, facial atrophic follicular keratosis.

4. Severe acute infectious diseases: typhoid, epidemic cerebrospinal meningitis, measles, scarlet fever. It is nutritionally impaired and temporary.

5. Pharmacological: Commonly used as rabbit inhibitors, anti-tumor drugs such as: Baixuening, cyclophosphamide, methotrexate, bisphedrine, ethylimine, sulphate and so on. Toxicity of the drug.

6. Traumatic lesions: local hair follicle damage.

7. Senile alopecia: a physiological change in aging.

8. Alopecia areata: Currently supporting alopecia areata is associated with immune dysfunction. Often associated with autoimmune diseases. According to statistics, thyroid disease is most related to alopecia areata, accounting for 8%-28%, and the incidence of women is higher than that of men.

9. pseudo-alopecia areata: also known as atrophic alopecia areata. The reason is unknown, and it will not be regenerated after being released. It is currently considered to be a variant of the flat moss dance.

10. Male pattern hair loss: It is currently believed that genetic susceptibility is associated with increased androgen levels and dual factors.

11. Female androgen-derived alopecia: The cause is also related to genetic susceptibility and increased androgen.

12. Resting hair loss: caused by pulling, drugs, and chronic systemic diseases.

13. Hair loss during the growth period: It is often caused by the use of immunosuppressants to inhibit hair growth.

Second, hirsutism

(a) congenital hirsutism

1. Systemic hirsutism: at birth, it is congenital. Then the puberty puberty begins in adolescence due to endocrine disorders.

2. Congenital color fatigue: At birth, there is a large uplift, clear boundaries, accompanied by black coarse hair.

3. Congenital fetusesis: an autosomal dominant inheritance. There are two types: one for the dog face and one for the monkey face.

(2) Acquired hirsutism

1. Women's hirsutism: Hairy hair is a physiological phenomenon during pregnancy. Women with diabetes syndrome cause long hairs and are caused by pituitary tumors.

2. acquired fetal hair growth: common in the prime and old age, more with visceral tumors.

3. iatrogenic hirsutism: long-term clinical use of corticosteroids, testosterone, penicillin and minoxidil, streptomycin, can cause hirsutism.

Third, the color change of the hair

(a) congenital

1. Albinism: It is congenital.

2. Rothmund syndrome: autosomal recessive inheritance. Early white hair in the head, accompanied by strains of Confucianism.

3. Ataxia telangiectasia: autosomal recessive inheritance. The hair is gray.

(2) Acquired nature: more common in the spontaneous from the rapids.


an examination

Related inspection

Hair hair mineral inspection

Diagnostic ideas According to the etiology analysis, among the 46 types of hair abnormal diseases, there are 22 congenital genetic factors, accounting for 48.88%. 23 acquired species, accounting for 51.12%. Among them, 6 kinds of endocrine, 3 groups of drugs (17 kinds of drugs), 4 kinds of acute and chronic diseases (19 kinds of diseases), physiological (one is pregnancy, one is senile), one kind of trauma, the cause is unknown 6 kinds. Therefore, acquired abnormal diseases, mainly: endocrine abnormalities, various acute and chronic disease groups, drug-induced, especially immunosuppressant anticancer drugs. Therefore, the history of the disease should focus on family history and genetic history. The history of medication, especially immunosuppressive drugs, should also be used as a key investigation and inquiry. As for acute and chronic diseases and infectious diseases, attention should be paid to systemic lupus erythematosus and scleroderma in leprosy, syphilis and connective tissue diseases. And jaundice, purulent sputum, and chronic wasting diseases.


Differential diagnosis

Dry hair: also known as dry hair, dry hair and so on. It is dull due to lack of moisture, even dry coke, easy to fall, often accompanied by dry skin. The main ingredient of hair is a protein containing sulfurous amino acids, so daily intake of protein-rich foods such as fish, lean pork, milk, dairy products and soy products. Dry hair is caused by the dry scalp (the sebum secretion of the scalp is not enough).

Hair is scarce: Some people, the hair on the body is very rare, medically known as "special hair is scarce." Idiopathic hair thinness has a family history. In addition to the loss of pubic hair and armpit hair, the body hair is usually sparse, but there is no other discomfort, the sex hormones and sexual functions are normal, and the endocrine hormones are normal. This disease has no effect on the human body, nor does it affect fertility and does not require treatment. Of course, the loss of pubic hair can sometimes occur in some organic diseases, such as anterior pituitary dysfunction, hypothyroidism, testicular feminization syndrome. However, patients with vaginal hair should be accompanied by other symptoms, such as hypothyroidism, accompanied by hair, eyelashes, eyebrows, hair loss, cold, generalized edema, weight gain, and decreased thyroid hormone levels. Patients with sexual dysfunction also have abnormalities such as spasm, poor sexual organ development, poor breast development, amenorrhea, and low levels of sex hormones. If you are not at ease, you can go to an endocrinology specialist to check for thyroid hormones, gonadal hormones, androgen receptors, estrogen receptors, B-ultrasound, and chromosomes. In case there is indeed the above disease, the corresponding treatment can be accepted.

Permanent hair loss: (ie male hair loss) the hair loss process is gradually produced. At the beginning, the hair on the forehead of the head is obviously retracted, and the hair at the top of the head is scarce; then it develops gradually, and finally it develops to the back of the head, with a thin strip of hair on both sides of the head.

The hair is light and brown: common in phenylketonuria, the patient is reduced in melanin synthesis due to inhibition of tyrosinase, so the child's hair is pale and brown. Phenylketonuria (PKU) is a hereditary disease caused by a deficiency or loss of activity of phenylalanine hydroxylase (PAH) in the liver. It is more common in hereditary amino acid metabolism-deficient diseases.