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Chapter 054. Skin Manifestations of Internal Disease (Part 5)

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To date, FDA-approved for men. b May also be scarring. Exposure to various drugs can also cause diffuse hair loss, usually by inducing a telogen effluvium. An exception is the anagen effluvium observed with antimitotic agents such as daunorubicin. Alopecia is a side effect of the following drugs: warfarin, heparin, propylthiouracil, carbimazole, vitamin A, isotretinoin, acitretin, lithium, beta blockers, colchicine, and amphetamines. Fortunately, spontaneous regrowth usually follows discontinuation of the offending agent. Less commonly, nonscarring alopecia is associated with lupus erythematosus and secondary syphilis. In systemic lupus there are two forms of alopecia—one is scarring secondary to discoid lesions (see below) and the other is nonscarring. . | Chapter 054. Skin Manifestations of Internal Disease Part 5 To date FDA-approved for men. May also be scarring. Exposure to various drugs can also cause diffuse hair loss usually by inducing a telogen effluvium. An exception is the anagen effluvium observed with antimitotic agents such as daunorubicin. Alopecia is a side effect of the following drugs warfarin heparin propylthiouracil carbimazole vitamin A isotretinoin acitretin lithium beta blockers colchicine and amphetamines. Fortunately spontaneous regrowth usually follows discontinuation of the offending agent. Less commonly nonscarring alopecia is associated with lupus erythematosus and secondary syphilis. In systemic lupus there are two forms of alopecia one is scarring secondary to discoid lesions see below and the other is nonscarring. The latter form may be diffuse and involve the entire scalp or it may be localized to the frontal scalp eventually resulting in multiple short hairs lupus hairs . Scattered poorly circumscribed patches of alopecia with a moth-eaten appearance are a manifestation of the secondary stage of syphilis. Diffuse thinning of the hair is also associated with hypothyroidism and hyperthyroidism Table 544 . Scarring alopecia is more frequently the result of a primary cutaneous disorder such as lichen planus folliculitis decalvans chroniccutaneous discoid lupus or linear scleroderma morphea than it is a sign of systemic disease. Although the scarring lesions of discoid lupus can be seen in patients with systemic lupus in the majority of cases the disease process is limited to the skin. Less common causes of scarring alopecia include sarcoidosis see Papulonodular Skin Lesions below and cutaneous metastases. In the early phases of discoid lupus lichen planus and folliculitis decalvans there are circumscribed areas of alopecia. Fibrosis and subsequent loss of follicles are observed primarily in the center of the individual lesions while the inflammatory process is most prominent at the .

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