22 years women with diffuse hair loss for 1 month, with past history of enteric fever, before 4 months, likely cause
Correct Answer: Telogen effuvium
Description: Ans. is 'b' i.e. Telogen effluvium * Diffuse hair loss for 1 month with a history of enteric fever before 4 months suggest the diagnosis of Telogen effluvium.* To understand telogen effluvium, we need to have some knowledge of the hair growth cycle.Hair does not grow continuously on the human scalp.The anagen (growing) phase for terminal hair can extend 3 to 7 years and is a reflection of the size of the hair follicle.Catagen is the transitional portion of the hair growth cycle, between anagen and telogen and lasts only 1 to 2 weeks.During this time, there is a rapid involution and regression of the hair follicle. The hair follicle then enters the telogen phase, which is a relatively fixed period of time, approximately 100 days, regardless of the size of the hair follicle. There is no growth of the hair shaft during this phase. It is at the end of the telogen phase that the entire hair shaft, also often referred to as the club hair, will spontaneously shed, while a new hair shaft is forming within the hair canal. The white bulb at the end of the hair, along with the loosely attached collection of friable debris gives the shed hair its characteristic appearance. In the scalp of the healthy, young human adult, approximately 90% of the hair will be in the anagen (growth) phase and approximately 10% will be in the telogen (dormancy) phase.Less than 1% will be in the catagen (transitional) phase.What is Telogen Effluvium??When excessive amounts of hair simultaneously switch from anagen (growth) into telogen (dormancy) and subsequently shed several months later, the phenomenon is referred to as a telogen effluvium.Telogen effluviums can be acute or chronic.What causes Telogen Effluvium?In order to cause a large number of hair follicles to simultaneously switch from the anagen (growing) phase into the telogen (resting) phase, the body has to undergo some systemic insult.A telogen effluvium is not caused by topical medications. But because there is a required time lapse of several months between the inciting cause and the excessive shedding of hair, the exact cause of the telogen effluvium is often not positively identified.A typical and common case of telogen effluvium would be the episode of severe shedding of hair that may occur approximately 100 days after a woman has given birth. The inciting factor is probably the abrupt hormonal changes that occur at the end of pregnancy. All of the hair grows back within a year.Other causes of telogen effluvium include illness,major physicaltrauma,menopause,crash diets,severe psychological stress,major surgery (especially with general anesthesia),hypo- or hyperthyroidism,anemia's,acute and severe blood loss,heavy metal poisoning, etc.Chronic illness such as malignancy, and any chronic debilitating illness,such as systemic lupus erythematosus,end-stage renal disease, - or liver disease can cause telogen effluvium.InfectionsTyphoid, malaria, dengue Anagen effluviumAnagen effluvium is the loss of anagen hair which typically happens after radiation therapy of chemotherapy especially with alkylating agents.
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