Pressure alopecia | |
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Other names | Postoperative alopecia, pressure-induced alopecia. |
Specialty | Dermatology |
Pressure alopecia, also known as postoperative alopecia, and pressure-induced alopecia, [1] occurs in adults after prolonged pressure on the scalp during general anesthesia, with the head fixed in one position, and may also occur in chronically ill persons after prolonged bed rest in one position that causes persistent pressure on one part of the scalp, all likely due to pressure-induced ischemia. [2] : 762
Pressure alopecia usually manifests as a skin-colored hairless patch on the occiput. Hair loss usually becomes noticeable 3-28 days after the initial trigger. Depending on the severity of ischemia pressure alopecia can be scarring or non-scarring.
Pressure alopecia is diagnosed based on clinical history and the symptoms. Treatment is usually not needed because the condition spontaneously resolves within months.
Pressure alopecia typically affects the occiput and manifests as a distinct area that is bald and skin-colored. [3] Other symptoms include swelling, erythema and tenderness. [4]
Hair regeneration takes place between one and four months following the triggering incident, with hair loss often becoming apparent three to 28 days later. A patient may experience nonscarring or scarring alopecia, depending on the severity of pressure-induced tissue ischemia. [5] Alopecia that is not scarred is the outcome of milder ischemia, while alopecia that is scarred is the consequence of persistent ischemia that causes ulcer formation. [6]
This condition's primary cause is pressure-induced skin capillary blood flow restriction, which causes ischemia and localized hypoxemia in compressed hair follicles. [7]
Risk factors for developing pressure alopecia include extended surgeries, obesity, mental health issues, acidosis, intraoperative hypoperfusion, Trendelenburg posture, and performance status. [7]
Pressure alopecia has been documented following protracted critical care unit (ICU) stays and surgical procedures. [5] Cervical collar use, orthodontic headgear, and electroencephalogram (EEG) electrode application have all been associated with reports of pressure alopecia. [8]
Clinical criteria such as the development of alopecia in the occiput and ulceration or scarring, along with a usual history of protracted surgery or immobility, are used to diagnose pressure alopecia. [5]
Because the condition is typically self-limited and reversible, treatment is not usually required. [4]
Pressure alopecia is usually reversible, with hair growing back in a few months. [5]
Alopecia areata, also known as spot baldness, is a condition in which hair is lost from some or all areas of the body. It often results in a few bald spots on the scalp, each about the size of a coin. Psychological stress and illness are possible factors in bringing on alopecia areata in individuals at risk, but in most cases there is no obvious trigger. People are generally otherwise healthy. In a few cases, all the hair on the scalp is lost, or all body hair is lost. Hair loss can be permanent, or temporary.
Alopecia universalis(AU), also known as alopecia areata universalis, is a medical condition involving the loss of all body hair, including eyebrows, eyelashes, chest hair, armpit hair, and pubic hair. It is the most severe form of alopecia areata (AA). People with the condition are usually healthy and have no other symptoms and a normal life expectancy.
Trichology is the study of the hair and scalp. The term derives from Ancient Greek θρίξ (thríx), "hair" and -λογία -logia. In most jurisdictions the title of a trichologist, not the field of trichology, is considered a para-medical discipline.
White piedra is a mycosis of the hair caused by several species of fungi in the genus Trichosporon. It is characterized by soft nodules composed of yeast cells and arthroconidia that encompass hair shafts.
Pili torti is characterized by short and brittle hairs that appear flattened and twisted when viewed through a microscope.
Madarosis is a condition that results in the loss of eyelashes, and sometimes eyebrows. The term "madarosis" is derived from the ancient Greek "madaros", meaning "bald". It originally was a disease of only losing eyelashes but it currently is the loss of both eyelashes and eyebrows. Eyebrows and eyelashes are both important in the prevention of bacteria and other foreign objects from entering the eye. A majority of patients with madarosis have leprosy, and it was reported that 76% of patients with varying types of leprosy had madarosis.
Pseudopelade of Brocq is a flesh- to pink-colored, irregularly shaped alopecia that may begin in a moth-eaten pattern with eventual coalescence into larger patches of alopecia.
Targetoid hemosiderotic hemangioma, also known as a hobnail hemangioma is a skin condition characterized by a central brown or purplish papule that is surrounded by an ecchymotic halo. It may appear similar to melanoma. It was first described by Santa Cruz and Aronberg in 1988.
Erosive pustular dermatitis of the scalp presents with pustules, erosions, and crusts on the scalp of primarily older Caucasian females, and on biopsy, has a lymphoplasmacytic infiltrate with or without foreign body giant cells and pilosebaceous atrophy.
Kinking hair, or acquired progressive kinking of hair, is a skin condition primarily reposted in postpubescent males with androgenetic alopecia, presenting with gradual curling and darkening of the frontal, temporal, auricular, and vertex hairs which, under the microscope, show kinks and twists with or without longitudinal grooving.
Keratosis pilaris atropicans is a group of idiopathic genodermatoses that consists of three unique clinical entities: atrophoderma vermiculatum, keratosis follicularis spinulosa decalvans, and keratosis pilaris atrophicans faciei.
Hair casts, also known as pseudonits, represent remnants of the inner root sheath, and often occur in great numbers and may mimic nits in the scalp.
Melanonychia is a black or brown pigmentation of a nail, and may be present as a normal finding on many digits in Afro-Caribbeans, as a result of trauma, systemic disease, or medications, or as a postinflammatory event from such localized events as lichen planus or fixed drug eruption.
Trichostasis spinulosa is a common but rarely diagnosed disorder of the hair follicles that clinically gives the impression of blackheads, but the follicles are filled with funnel-shaped, horny plugs that are bundles of vellus hairs.
Graham-Little syndrome or Graham Little-Piccardi-Lassueur syndrome is a cutaneous condition characterized by lichen planus-like skin lesions. It is named after Ernest Graham-Little.
Giant solitary trichoepithelioma is a cutaneous condition characterized by a skin lesion that may be up to several centimetres in diameter.
A pilar sheath acanthoma is a cutaneous condition most often found on the face, particularly above the upper lip in adults. Pilar sheath acanthoma is a skin-colored, 5-10 mm diameter papule or nodule with a keratin-filled pore in the center. Pilar sheath acanthoma diagnosis confirmed by shave or excisional biopsy. Successful treatment requires surgical excision.
Lipedematous alopecia is a disorder characterized by a thick boggy scalp and hair loss. Symptoms include pain, puritis, headaches, and paresthesia. The cause of lipedematous alopecia is unknown. The diagnosis is made my excluding other disorders, MRI, CT scan, and histopathology. There is no accepted treatment however surgical debunking has been found effective.
In the field of dermatology, the Renbök phenomenon is a phenomenon where one skin condition inhibits another. It is also known as the reverse Koebner phenomenon. The term was first used by Happle et al. in 1991. The word "Renbök" is a neologism, made from a reversal of the letters of the name "Köbner".
Frictional alopecia is the loss of hair that is caused by rubbing of the hair, follicles, or skin around the follicle. The most typical example of this is the loss of ankle hair among people who wear socks constantly for years. The hair may not grow back even years after the source of friction has ended.