II. Definition

  1. Non-scarring Alopecia involving altered hair cycle

III. Pathophysiology

  1. Altered growth cycle where Telogen phase predominates
  2. Timing
    1. Onset occurs 2-4 months after inciting event
    2. Resolves months after causative factor resolves

IV. Symptoms

  1. Increased Hair Loss with brushing or showering
  2. Loss of 100-300 hairs per day
  3. Affects scalp, axillary and pubic hair

V. Signs: Hair pluck test

  1. Hairs in Telogen phase approach 50% (normally <15%)
  2. Consider work-up if >70% in Telogen phase

VI. Causes

  1. Endocrine disorders
    1. Hypothyroidism
    2. Hyperthyroidism
  2. Hematologic disorders
    1. Severe Iron Deficiency Anemia
  3. Stressors
    1. Crash dieting or significant dietary limitations
    2. Severe chronic illness or acute infection
    3. Postpartum effluvium
    4. Major surgery
    5. Serious psychological stressors
  4. Medications
    1. Heparin and other Anticoagulants
    2. Heavy metals
    3. Etretinate (Tegison)
    4. Anticonvulsants
    5. Antithyroid Drugs (e.g. Methimazole, PTU)
    6. Hormonal agents
    7. Alkylating Agents
    8. Lithium
    9. Antihypertensives
      1. Beta Blockers
      2. ACE Inhibitors

VII. Differential diagnosis

  1. Early Androgenetic Alopecia
  2. Syphilis (consider if regrowth delayed)

VIII. Associated Conditions

  1. Comorbid Androgenetic Alopecia is often present

X. Management

  1. Treat underlying cause

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Ontology: Telogen effluvium (C0263518)

Definition (NCI) A scalp hair loss condition characterized by excessive shedding of hair in the resting phase of growth, usually following a fever or major body stress.(NICHD)
Concepts Disease or Syndrome (T047)
ICD9 704.02
ICD10 L65.0
SnomedCT 201147004, 39479004
English telogen effluvium (diagnosis), telogen effluvium, Telogen Effluvium, Telogen effluvium (disorder), effluvium; telogen, telogen; effluvium, Telogen effluvium
German Telogeneffluvium, Telogen effluvium
Korean 휴지기 탈모
Czech Telogenní alopecie
Dutch telogeen effluvium, effluvium; telogeen, telogeen; effluvium, Telogeen effluvium
French Effluves télogènes
Hungarian Telogen effluvium
Italian Telogen effluvio
Japanese キュウシキダツモウ, 休止期脱毛
Portuguese Eflúvio telogénico
Spanish Efluvio telógeno, efluvio telógeno (trastorno), efluvio telógeno, efluvium telógeno