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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
Diffuse alopecia areata
Outline the clinical features
Alopecia areata is best known as a cause of localised bald patches but occasionally presents as a severe diffuse shedding and thinning. Careful inspection should reveal areas where hair is completely absent. Remaining hairs are more likely to be white as the lack of melanisation appears to offer some degree of resistance to the autoimmune process.