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Hair loss in a 16‐year‐old girl
Author(s) -
Hunt William,
McGrath Emily
Publication year - 2014
Publication title -
prescriber
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.106
H-Index - 3
eISSN - 1931-2253
pISSN - 0959-6682
DOI - 10.1002/psb.1286
Subject(s) - girl , citation , medicine , library science , art history , art , computer science , psychology , developmental psychology
Prescriber 19 November 2014 z 33 prescriber.co.uk A16-year-old girl presented with gradually increasing hair loss and thinning. She had noticed thinning all over her scalp, with visible areas of complete hair loss along the hairline at the temples and back of the scalp during the previous year. There was an associated itchiness of her scalp. She had no personal history of autoimmune disease, however, she did have a family history of vitiligo. On examination there was diffuse hair thinning, and patches of non-scarring hair loss at the vertex and also in the temporal and occipital areas (see Figures 1 and 2). Exclamation mark hairs were seen on dermoscopy. Blood tests demonstrated normal thyroid function and a negative antinuclear antibody result. At this stage the working diagnosis was alopecia areata, with the possible differential diagnoses being telogen effluvium or lichen planopilaris. The patient was prescribed a trial of clobetasol propionate 0.05 per cent shampoo (Etrivex), which gave limited benefit initially with some benefit after a month. In order to help determine the diagnosis, diagnostic punch biopsies were organised at the anterior and posterior portions of the scalp. These both demonstrated a patchy mild lymphocytic inflammation involving the hair follicles, with involution of the hair bulb. These findings strongly supported the diagnosis of alopecia areata. The diagnosis and possible prognoses of alopecia were explained to the patient, and she was provided with written information, including the contact details for an alopecia support group. At four months from her initial presentation, the patient had continued to use clobetasol propionate 0.05 per cent shampoo and had noticed some regrowth on the vertex of her scalp, although anteriorly there was still hair loss. The patient was prescribed clobetasol propionate 0.05 per cent (Dermovate Scalp Application; unlicensed) to apply once daily at night and wash off the next morning. This seemed to encourage further hair regrowth and the patient continued with it on an intermittent basis. At eight months from her initial presentation, the hair was much thicker, with only a small patch of hair loss at the vertex. Future management strategies were clobetasol propionate Hair loss in a 16-year-old girl