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Alopecia

»	How is alopecia classified?
»	What are some common types of patterned hair loss?
»	Can cicatricial and noncicatricial alopecia be differentiated clinically?
»	What causes common balding?
»	How effective are medical treatments for common balding?
»	Is common balding in women managed differently than in men?
»	What are the surgical options for treatment of balding?
»	Discuss the common causes of circular bald spots.
»	What is alopecia totalis?
»	How is alopecia areata treated?
»	How is tinea capitis treated?
»	What is trichotillomania?
»	Who is most likely to be affected by trichotillomania?
»	Why do cancer patients lose their hair?
»	In what other clinical settings can a telogen effluvium occur?
»	To what forms of hair loss are black patients susceptible?
»	Discuss the mechanism of central, centrifugal, cicatricial alopecia (CCCA).
»	Name some medications that cause hair loss.
»	What is alopecia mucinosa?
»	What is meant by the term “moth-eaten alopecia"?

Can cicatricial and noncicatricial alopecia be differentiated clinically?

Central, centrifugal, cicatricial alopecia, a common form of hair loss in the African-American population. In this patient, the smooth skin, devoid of most follicular openings, reflects light like a mirror.

Fig. 20.1 Central, centrifugal, cicatricial alopecia, a common form of hair loss in the African-American population. In this patient, the smooth skin, devoid of most follicular openings, reflects light like a mirror.

In the setting of alopecia, cicatricial means that there has been permanent destruction of hair follicles, and they have been replaced by fibrous tissue. Usually, an obvious scar, such as that seen after wounding, is not evident, but there is a loss of follicular openings that gives the scalp a smooth and shiny appearance (Fig. 20-1). The texture of the scalp may remain soft and supple, although sometimes induration or firmness is palpable.