Hair Loss (Alopecia) - General (Diffuse and Focal) Differential Diagnosis Algorithm



DIFFUSE

Scarring - Irreversible-biopsy required

 • Lupus erythematosus

 • Lichen planopilaris

Pattern

 • Androgenetic alopecia

Anagen Effluvium

 • Chemotherapy

 • Loose anagen syndrome

Discrete Patches

 • Alopecia totalis (all scalp and facial hair)

 • Alopecia universalis (all body hair)

Telogen Effluvium

 - Endocrine

    • Hypothyroidism

    • Hyperthyroidism

    • Hypopituitarism

    • Post-partum

 - Dietary

    • Iron deficiency

    • Zinc deficiency

    • Copper deficiency

    • Vitamin A Excess

 - Drugs

    • Oral contraceptives

    • Hyperthyroid drugs

    • Anticoagulants

    • Lithium

 - Stress Related

    • Post-infectious

    • Post-operative

    • Psychological stress

FOCAL / LOCALIZED

Scarring - Irreversible-biopsy required

 - Infectious

     • Tinea capitis with kerion

     • Folliculitis decalvans

 - Secondary to Skin Disease

     • Discoid lupus erythematosus

     • Lichen planopilaris

     • Pseudopelade of Brocq

     • Alopecia Mucinosa

     • Keratosis Follicularis

     • Aplasia cutis

Non-Scarring - Reversible

 - Broken Hair Shafts

     • Tinea capitis

     • Trichotillomania

     • Traction alopecia

     • Congenital hair shaft abnormalities

 - Hair Shafts Intact or Absent

     • Alopecia areata

     • Secondary syphilis



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