الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 165 |  |  |
| | | from | 165 | | |
Abstract
Hair is considered as a sign of beauty in almost every culture. Hair disorders have dramatic effects on the appearance and self-esteem of the affected individuals. The diagnosis of hair disorders is complex. There are two types of diagnostic tools: obligate and facultative procedures. Obligate procedures include, the patient’s and his/her family’s history, a complete clinical examination, a pull test and dermoscopy of the scalp. Depending on the suspected diagnosis, facultative techniques, such as phototrichogram, or other techniques may be added.
The aim of the present study was to evaluate the different types of hair falling disorders using different methods including: detailed history and scalp examination, hair card test, hair pull test, TUG test, Trichogram and Trichoscopy.
This study included a total of 100 female patients aging between 16-55 years presenting with different types of hair fall. They were examined at the dermatology outpatient clinic of Minia University Hospital in the period from December 2018 to January 2021. According to patient’s history, examination, and previously described procedures the patients were classified into 3 groups. 40 patients had AGA, 35 patients had TE and 25 patients had TTM.
There was significant difference in the age among the three studied groups. Patients’ age mean ± S.D of 35.5± 9.5 years in AGA group, while being 30.5 ± 10.0 in TE group and 18.8 ± 4.9 years in TTM group.
There was significant difference in the family history among the three studied groups being positive in 70% of AGA group compared to 65.7% in TE group and only 28% in TTM group.
There was significant difference in the pull test among the three studied groups being positive in 94.3% of TE group compared to 47.5% in AGA group and only 28% in TTM Group.
There was no significant difference in the card test among all studied groups. It showed slightly higher pointed ends in AGA group (57.6%) indicating regrowing hairs, while slightly higher splitted ends in TE (65.7%) versus (56%) in TTM indicating broken hairs.
By analyzing our trichogram results we can conclude that in case of AGA, there was mild increase in frontal telogen rate with a more or less normal occipital telogen rate. In case of TE, there was marked increase in the telogen rate (>20%) in both frontal and occipital regions with near doubling of the normal value being slightly higher in frontal region. In TTM, the trichogram was considered normal whether frontal or occipital except for slight increase in dystrophic hairs.
Stained trichogram with Eosin is a new modification for the usual trichogram. It allowed better visualization of the hair shaft, diameter, sheath and roots. To the best of our knowledge, our study is the first to do this technique.
Regarding trichoscopic features detected, in AGA include anisotrichosis, empty hair follicles, single hair pilosebaceous unit, thin hairs and yellow Spots. While that detected in TE were, anisotrichosis, empty hair follicles, single hair pilosebaceous unit, upright regrowing hairs, hook hairs, Peripilar sign, thin hairs, honey comb pigmentation and yellow spots. In TTM, the features include upright regrowing hairs, hook hairs, yellow spots, black dots with broken hairs, micro hemorrhage red dots, trichopitlosis ”V-sign” and Hair Powder.
from the present study we can conclude that, the examination of hair loss should include complete history taking, clinical examination, trichogram whether stained or non-stained and trichoscopic evaluation, while biopsies should be postponed and rarely needed.
Trichogram is superior to and more conclusive than trichoscopy in diagnosing telogen effluvium especially in the acute stage being a diagnosis of exclusion in trichoscopy. On the other hand, trichoscopy is superior to trichogram in diagnosis of FPHL and Trichotillomania especially in early cases.
Although trichoscopy is a new diagnostic modality for diagnosis of hair loss it becomes increasingly popular as it is safe, quick, easy, noninvasive and cost affordable method for both hair and scalp evaluation. Photographic evaluation at each visit is very satisfying for the patients.