Approach to Alopecia

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Questions and Answers

Which factor is NOT part of the diagnostic approach for skin conditions?

  • Signalment
  • Immediate treatment plan (correct)
  • Minimum database
  • Laboratory tests

What type of alopecia is indicated if primary hairs are lost but some secondary hairs remain?

  • Total alopecia
  • Psychogenic alopecia
  • Traction alopecia
  • AlopeciaX (correct)

What aspect of an animal's history should NOT be considered during diagnosis?

  • Favorite foods (correct)
  • Current medications
  • How long the condition has been present
  • Stressful incidents

Which of the following describes a dermatological examination element?

<p>Identifying location and distribution of lesions (B)</p> Signup and view all the answers

In which situation would you expect to see skin that appears normal but has true alopecia?

<p>With follicular dysplasias (B)</p> Signup and view all the answers

What is the main characteristic of the anagen phase of hair growth?

<p>Hair follicles are actively growing. (A)</p> Signup and view all the answers

Which of the following conditions is an example of congenital hypotrichosis?

<p>Alopecia Universalis in Sphynx (D)</p> Signup and view all the answers

What describes follicle dysplasia?

<p>Dysfunction due to structural abnormalities. (A)</p> Signup and view all the answers

Which statement about hair loss in alopecia is accurate?

<p>Hair may fall out due to breaking or lack of follicles. (C)</p> Signup and view all the answers

What is a characteristic of Canine Ectodermal Dysplasia?

<p>Hairlessness is linked to a prenatal lethal effect. (C)</p> Signup and view all the answers

What might occur during the late catagen phase?

<p>Follicles begin to shrink significantly. (B)</p> Signup and view all the answers

Which type of alopecia is associated with abnormalities of the hair shaft?

<p>Follicular lipidosis (C)</p> Signup and view all the answers

What can cause alopecia through abnormal follicle cycles?

<p>Changes in hair growth phases. (A)</p> Signup and view all the answers

What primary causes are identified for hair loss in pets?

<p>Infection and immune-mediated diseases (A)</p> Signup and view all the answers

Which of the following treatments are suggested for improving skin conditions related to alopecia?

<p>Melatonin, retinoids, and essential fatty acids (A)</p> Signup and view all the answers

What should be avoided to prevent drug-triggered alopecia?

<p>Known drug triggers (A)</p> Signup and view all the answers

What can be a consequence of severe damage to hair follicles?

<p>Permanent alopecia (B)</p> Signup and view all the answers

What role does prognosis play in the treatment of alopecia?

<p>Prognosis is dependent on the cause of hair loss (D)</p> Signup and view all the answers

Which of the following is a common non-aesthetic effect of alopecia?

<p>Psychological stress for the pet (A)</p> Signup and view all the answers

In managing hair loss, what aspect of husbandry should be evaluated?

<p>Stress management practices (A)</p> Signup and view all the answers

Which method is NOT recommended for treating underlying allergies related to hair loss?

<p>Introducing more allergens for tolerance (B)</p> Signup and view all the answers

What is a characteristic feature of hair regrowth in dogs after treatment?

<p>It may be lighter and non-pigmented. (A)</p> Signup and view all the answers

What type of skin condition is NOTIFIABLE in ectoparasites?

<p>Sheep scab caused by Psoroptes ovis (C)</p> Signup and view all the answers

Which condition is characterized by hair loss and skin damage due to stress-related behaviors in cats?

<p>Feline psychogenic alopecia (C)</p> Signup and view all the answers

What is a common treatment for resistant cases of hair loss that do not respond spontaneously?

<p>Corticosteroids or cyclosporin (A)</p> Signup and view all the answers

What is not a potential cause of loss of existing hair?

<p>Airborne allergens (A)</p> Signup and view all the answers

Which behavior can lead to loss of hair in rabbits?

<p>Nesting behaviors (B)</p> Signup and view all the answers

What medication may be used in severe cases of feline psychogenic alopecia?

<p>Tricyclic antidepressants or SSRIs (C)</p> Signup and view all the answers

What is the nature of regrowth after hair loss in dogs?

<p>Regrowth may not occur but can be spontaneous in some instances. (C)</p> Signup and view all the answers

What appears shiny and may indicate the presence of a pancreatic tumor?

<p>Paraneoplastic alopecia (B)</p> Signup and view all the answers

Which condition is indicated by scaling and crusts on the skin?

<p>Auto-immune disease (C)</p> Signup and view all the answers

What kind of hair findings suggest a cyclical disruption in hair growth?

<p>100% telogen hairs (D)</p> Signup and view all the answers

Which laboratory test is considered the most useful in diagnosing alopecia?

<p>Trichography (B)</p> Signup and view all the answers

What should be the first step in the treatment of alopecia?

<p>Identify the primary cause (C)</p> Signup and view all the answers

What does the presence of hyphae and spores indicate in a trichography test?

<p>Dermatophytosis (B)</p> Signup and view all the answers

Which testing method involves assessing the skin for fungal infections?

<p>Skin scrapes (A)</p> Signup and view all the answers

Which condition mainly presents as an aesthetic issue and may require acceptance as treatment?

<p>Follicular dysplasia (A)</p> Signup and view all the answers

Which breed is NOT typically associated with colour dilution alopecia?

<p>Schnauzer (D)</p> Signup and view all the answers

What is the main characteristic of cyclical follicular dysplasia?

<p>Bilateral flank alopecia (A)</p> Signup and view all the answers

What hormone may help in treating cyclical follicular dysplasia?

<p>Melatonin (A)</p> Signup and view all the answers

What condition results from hormonal imbalances leading to hair cycle arrest?

<p>Alopecia X (C)</p> Signup and view all the answers

What cause is typically associated with telogen effluvium?

<p>Stressful events (A)</p> Signup and view all the answers

In which breeds is atrophic follicular pattern baldness more common?

<p>Dachshund and Chihuahua (B)</p> Signup and view all the answers

Which hormone's imbalance is not typically implicated in endocrine-related hair loss?

<p>Aldosterone (B)</p> Signup and view all the answers

What is the main cause of immune-mediated diseases affecting hair follicles?

<p>Autoimmune responses (A)</p> Signup and view all the answers

Which type of alopecia often occurs in young to middle-aged dogs with specific breeds affected?

<p>Sebaceous adenitis (B)</p> Signup and view all the answers

What is a significant characteristic of telogen follicles in an abnormal cycle?

<p>Miniaturisation of hair shafts (D)</p> Signup and view all the answers

Which systemic disease is most likely to interrupt the hair growth cycle?

<p>Hepatic disease (A)</p> Signup and view all the answers

What skin condition can result from infection of hair follicles?

<p>Dermatophilosis (A)</p> Signup and view all the answers

What type of skin response may occur with drug reactions related to hair loss?

<p>Delayed or immediate hair loss (C)</p> Signup and view all the answers

What characteristic is unique to idiopathic bald thigh syndrome in dogs?

<p>Exclusively affects sighthounds (B)</p> Signup and view all the answers

Flashcards

Anagen Phase

The phase of hair growth where the hair follicle is fully functional and the hair shaft grows.

Catagen Phase

The transitional phase of hair growth where the follicle begins to shrink and the hair shaft stops growing.

Telogen Phase

The resting phase of hair growth where the follicle is atrophied and the hair is shed.

Lack of Follicles

A type of hair loss characterized by a lack of hair follicles, often resulting in various degrees of hairlessness.

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Follicle Dysplasia

A group of alopecia disorders where the hair follicles are structurally abnormal, leading to hair loss.

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Follicle Dysfunction

This type of alopecia occurs when the hair follicle is unable to produce hair due to a lack of proper function.

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Colour Dilution Alopecia

A type of alopecia that affects the hair shaft's structure. It is often associated with certain coat colors.

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Black Hair Follicle Dysplasia

This type of alopecia specifically affects black hair follicles, leading to hair loss in those areas.

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Diagnostic Approach for Skin Conditions

A systematic approach to identify the cause of skin problems in animals, starting with basic information and progressing to specific tests.

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Signalment

The age, breed, color, and sex of an animal, which can provide clues about potential skin conditions.

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Lesion Distribution

The pattern of hair loss, whether localized or widespread, symmetrical or asymmetrical, and the specific areas affected.

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Skin Appearance

The appearance of the skin, including any bumps, pus, scales, or crusts. This can help determine the nature of the skin problem.

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Hair Loss Types

Observing whether all hair has been lost or only broken hairs remain, which can indicate different types of conditions.

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Feline Psychogenic Alopecia

A skin condition characterized by hair loss and/or skin damage caused by excessive grooming in response to stress. This behavior is often triggered by emotional, environmental, or even physical factors.

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Diagnosis of Exclusion

A diagnostic approach where the diagnosis is made after ruling out other medical conditions that could cause hair loss.

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Desensitization

The process of gradually exposing an animal to a feared stimulus, while simultaneously providing positive reinforcement, to modify their behavior.

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Counterconditioning

A technique used to change the emotional response to a stimulus by associating it with a positive experience.

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Psychopharmacology

Medications used to treat mental health conditions, such as anxiety or depression, in animals.

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Serotonin Reuptake Inhibitors (SSRIs)

A class of antidepressants that work by increasing the levels of serotonin, a neurotransmitter that plays a role in mood regulation.

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Tricyclic Antidepressants

A class of antidepressants that work by blocking the reuptake of serotonin and norepinephrine, two neurotransmitters that affect mood and energy levels.

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Behavioral Modification

A comprehensive approach that involves addressing both environmental and psychological factors to manage stress and improve the cat's well-being.

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Dermatophytosis

Hair loss resulting from the presence of microscopic fungi, often characterized by broken hair shafts and the presence of hyphae and spores.

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Trichography

Examination of hairs plucked from the skin to identify abnormalities, such as broken hair shafts, increased telogen hairs, and the presence of Demodex mites.

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Telogen Effluvium

A common cause of hair loss characterized by a sudden shedding of hair during the resting phase, often due to stress or hormonal changes.

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Follicular Dysplasia

A condition in which hair follicles are abnormally developed, resulting in hair loss or irregular hair growth.

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Seborrhea

Skin condition characterized by excessive oil production, possibly associated with thyroid problems or other underlying health conditions.

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Paraneoplastic Alopecia

Hair loss associated with the presence of a tumor, especially in the pancreas.

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Hyperadrenocorticism-Related Alopecia

Hair loss due to excessive production of adrenal hormones, often caused by a condition known as hyperadrenocorticism.

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Abnormal Hair Growth Cycle

An abnormal hair growth cycle can lead to alopecia (hair loss).

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Triggers of Alopecia

Alopecia can be caused by various factors, including drugs, stress, and endocrine disorders. These triggers should be identified and managed to treat hair loss.

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Prognosis of Alopecia

The prognosis of alopecia depends on its underlying cause. Some cases can be reversed, while others may be permanent.

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Damage to Hair Follicles

Damage to hair follicles, often caused by infections, immune disorders, or even trauma, can lead to alopecia.

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Permanent Alopecia

If the damage to hair follicles is severe, permanent alopecia might occur, meaning the hair won't grow back.

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Loss of Existing Hair

Alopecia can be caused by the loss of existing hair, often due to allergies, infections, poor husbandry, or psychological factors.

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Treating Allergic Alopecia

To treat alopecia caused by allergies, identify the allergens and then either avoid them or undergo immunotherapy.

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Treating Alopecia Caused by Infections

When dealing with alopecia caused by infections, treating the underlying infection is key, whether caused by bacteria, parasites, or other pathogens.

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Cyclical Follicular Dysplasia (Seasonal Alopecia)

A condition characterized by hair loss primarily on the flanks of dogs, often occurring in autumn or spring. It's believed to be linked to changes in melatonin levels, impacting the hair growth cycle.

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Structural Follicular Dysplasia

A condition in which hair follicles develop abnormally, causing weak hairs that break easily, leading to hair loss. It often affects young to middle-aged dogs and can spread from the lumbar area to the trunk.

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Black Hair Follicular Dysplasia

A rare condition specifically in black haired areas of dogs. It involves defective pigmentation and hair formation, resulting in hair loss that starts around 1 month of age. It shares similarities with color dilution alopecia.

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Atrophic Follicular Pattern Baldness

A disorder that affects the hair follicles, leading to miniaturization and a reduction in hair thickness. This is often seen in short-coated breeds and can result in pattern baldness in areas like the ears, abdomen, or thighs. As it progresses, the skin may become darker.

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Idiopathic Bald Thigh Syndrome of Sighthounds

A specific baldness condition observed in Greyhounds and other sighthounds. It involves structural defects in the hair shaft due to downregulation of genes critical for hair formation. Unlike follicular pattern baldness, it doesn't exhibit hyperpigmentation.

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Abnormal Follicle Cycle

An abnormal hair cycle marked by the shrinking of hair shafts, a persistence of telogen follicles (resting phase), and an increase in hairless telogen follicles. This can be triggered by various factors, including endocrine diseases, Alopecia X, systemic diseases, drug therapies, stress, or after clipping.

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Endocrine Disease Impact on Hair Cycle

A variety of conditions that can affect hair growth due to disruptions in hormone balance. These include hypothyroidism, hyperadrenocorticism (Cushing's disease), hyperoestrogenism/testosterone excess, and pituitary dwarfism.

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Alopecia X

A condition characterized by hair cycle arrest, primarily affecting primary hairs while leaving secondary hairs intact. It causes gradual hair loss on the trunk and thighs, with head and limbs usually spared. The cause is likely an imbalance of adrenal sex hormones.

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Systemic Disease Impact on Hair Cycle

Various systemic diseases can disrupt the hair growth cycle, leading to hair loss. Examples include liver disease, kidney failure, pancreatic disease, and cancer, often due to the paraneoplastic syndrome.

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Hair Loss Post-Clipping

A delay in hair regrowth after clipping. This can be breed-related, with heavily coated breeds often experiencing prolonged telogen phases. It may take months for hair to return to its normal length.

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Follicle Damage: Infections

Various infections can damage hair follicles and lead to hair loss. These include bacterial infections like Dermatophilus congolensis (mud fever), fungal infections like ringworm, and mite infestations like demodecosis.

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Sebaceous Adenitis

An autoimmune condition targeting sebaceous glands within hair follicles. It often affects dogs, although it can be seen in rare cases in other mammals. It leads to varying hair loss patterns depending on the breed. Secondary infections are common.

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Follicle Damage: Drug Reaction

Hair loss can occur due to reactions to topical medications or injections. The hair loss might be immediate or delayed, and regrowth might not occur. It's crucial to avoid using the triggering product.

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Follicle Damage: Neoplasia

A condition involving benign, but often hidden, tumors in horses that can lead to hair loss. These tumors can be found in various locations.

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Follicle Damage: Zinc Responsive Dermatosis

A condition in dogs linked to zinc deficiency. It can be genetic or due to a diet low in zinc. Symptoms include hair loss, skin problems, and possibly digestive issues.

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Study Notes

Approach to Alopecia

  • Alopecia is defined as a lack of hair in normally haired areas.
  • Alopecia can be generalised, multifocal, or localised.
  • The hair growth cycle is controlled by intrinsic and extrinsic factors.
    • Intrinsic factors involve cellular processes within the follicle.
    • Extrinsic factors include:
      • Environment (photoperiod, temperature)
      • Hormones (melatonin, prolactin, sex hormones, thyroxine, glucocorticoids, growth hormone)
      • Nutrition
      • General health
      • Genetic factors
  • Hair continuously grows and sheds in a mosaic pattern.
  • The hair cycle includes anagen (growth), catagen (transition), and telogen (resting) phases.
    • Different types of hair follicles exist, such as simple and compound, and primary and secondary hairs.
    • Horses have only simple follicles and primary hairs, while dogs and cats have both simple and compound follicles and primary and secondary hairs.
  • Pathogenesis of Alopecia can be categorized into two possibilities, either failure of follicle growth or loss of existing hair
    • Failure of hair follicle to grow may include: lack of follicles, follicle dysplasia, abnormal follicle cycle, and damage to follicles.
      • Examples for the lack of follicles include congenital hypotrichosis, alopecia universalis, and hereditary hypotrichosis, such as in the sphinx cat, Devon Rex, and Chinese Crested Dog breeds.
      • Follicle dysplasia includes various types, some breed-related, and can be linked to coat coloring, with structural abnormalities in the follicle and can occur early or later in life as these follicles atrophy
      • Examples of canine follicilar dysplasias include structural follicle dysplasia, follicular lipidosis, colour dilution alopecia, and cyclical follicular dysplasia.
      • Possible causes for damage of follicles include infection, immune-mediated disease, neoplasia (occult sarcoids in horses), trauma, and tail gland hyperplasia.
      • Infections could be bacterial (e.g. dermatphilus congolensis, mud fever), fungal (ringworm), mites (e.g., demodecosis).
      • Specific to sighthound breeds, idiopathic bald thigh syndrome
    • Loss of existing hair may include: hair falling out of follicles and breaking of hair. This may include allergies (atopic or food hypersensitivity; contact dermatitis, sweet itch; bacterial, fungal, infestations (fleas, mites, scabies), pruritus, self-mutilation (psychiatric issues including pain related licking, in cats and rabbits, etc.), or extraneous mutilation (e.g., barbering of companions, feather pecking in hens, trauma, dermatophytosis).

Lesion Distribution

  • Lesion distribution can be focal (damaged follicles), symmetrical, multifocal, or generalised.
    • Distribution patterns and characteristics aid in diagnosis.

Diagnosis and Approach

  • A diagnostic approach must involve a systematic minimum database, including:
    • Signalment
    • History
    • Physical examination
    • Dermatological examination
    • Laboratory tests (e.g., trichograms, skin scrapes, biopsy, hormone assays, etc.)
  • Diagnostic methods consider issues like the presence of broken hairs, abnormal hair-follicle cycle, possible parasitic or infectious causes, allergies, various types of pain, or self-mutilation.
  • Identifying the primary cause is fundamental to treatment.

Treatment Approach

  • Treatment varies depending on the underlying cause.
  • Treatment may focus on:
    • Treating the underlying cause
    • Managing secondary complications
    • Often in some cases, the alopecia issue may need only to be addressed aesthetically. Specific treatment may address the primary cause involving abnormal follicle cycle, damage to follicles, or loss of existing hair.

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