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This quiz will test your diagnostic skills in diagnosing hair loss.
Diffuse hair loss from the scalp may present as an acute or subacute process without scarring, accompanied by shedding of telogen (bulb) or anagen (tapered) hairs, or more slowly as chronic thinning. In most cases, a careful history and examination reveals the cause. Where none is obvious, look for iron deficiency and thyroid disease.
A patient may present reporting one or more bald areas. This may or may not be accompanied by an inflammatory process with varying degrees of irritation, soreness, erythema, scaling and pustules and can be followed by permanent scarring (cicatricial alopecia). If scaling is present, a scraping should be arranged for mycology. It is often helpful to obtain one or more scalp biopsies from the active inflammatory edge. Refer to a dermatologist for specific diagnosis and management.
For each of the fourteen cases, study the image(s) and then answer the questions. You can click on the image to view a larger version if required.
Each case should take approximately 2 minutes to complete. There is a list of suggested further reading material at the end of the quiz.
When you finish the quiz, you can download a certificate.
Make a diagnosis
Scarring alopecia due to follicultis decalvans
Outline the clinical features
Folliculitis decalvans is a chronic pyogenic process that causes painful crusted sores and may eventually result in extensive areas of cicatricial alopecia. It is also known as tufted folliculitis because of the 'toothbrush' appearance in longstanding cases, where numerous hairs exit the same follicular orifice. Swabs culture Staphylococcus aureus, so prolonged courses of antibiotics are the mainstay of treatment.