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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 discoid lupus erythematosus
Outline the clinical features
Discoid lupus erythematosus is a more common explanation for symptomatic bald patches, characterised by diffuse erythema and scaling. There may be folliculocentric scaling and erythema peripherally, which may be difficult to distinguish clinically from lichen planus. Typical indurated red scaly plaques with scarring are frequently also present on the nose and cheeks.