SetelDoc Dermatology Deep Dive
Alopecia (Hair Loss)
🪜 1. Clinical Decision Tree
🔄 Non-Scarring (Reversible)
The Clue: Follicular openings are visible. No skin atrophy or shiny appearance.
- Alopecia Areata (Smooth patches)
- Androgenetic Alopecia (Pattern)
- Telogen Effluvium (Stress/Post-partum)
- Tinea Capitis (Simple fungal)
🚫 Scarring (Permanent)
The Clue: Loss of follicular openings. Skin looks shiny, smooth, or atrophied.
- Kerion (Inflammatory fungal)
- Discoid Lupus (DLE)
- Lichen Planopilaris
- Severe Burns/Trauma
🚨 2. High Alert: Kerion
Most common cause of scarring alopecia in children if not treated rapidly. Mistaking this for a bacterial abscess is a common error.
THE CLUE:
A painful, boggy (spongy) inflammatory mass. Features pustules, thick crusting, and easily plucked hairs.
💊 3. Management Protocol
General Alopecia
- Management depends strictly on etiology: Infection, Nutritional deficiency (Iron/B12), Drugs, or Autoimmune inflammation.
For Kerion (Prevention of Scarring)
- Oral Griseofulvin: 500mg BD for 6-8 weeks.
- Oral Prednisolone: 1mg/kg/day for 1 week (dampens scarring inflammatory response).
- ⚠️ AVOID I&D: Incision and drainage will worsen scarring.