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There is a very wide list of diseases and conditions that can lead to alopecia. Proper history taking and physical examination, along with laboratory, microbiology, and in some cases, imaging studies, are helpful in narrowing down the diagnosis.
There is a very wide list of diseases and conditions that can lead to alopecia. Proper history taking and physical examination, along with laboratory, microbiology, and in some cases, imaging studies, are helpful in narrowing down the diagnosis.
[[Alopecia]] can be caused by many different diseases. Some of the most well known and common causes are: [[androgenetic alopecia]], [[alopecia areata]], [[telogen effluvium]], anagen effluvium, and [[trichotillomania]]. Endocrine disorders such as [[hypothyroidism]], [[hypoparathyroidism]] and [[Cushing's syndrome]] as well as [[malnutrition]] and medications are also possible causes of alopecia.
[[Alopecia]] can be caused by many different diseases. Some of the most well known and common causes are: [[androgenetic alopecia]], [[alopecia areata]], [[telogen effluvium]], anagen effluvium, traction alopecia, and [[trichotillomania]]. Endocrine disorders such as [[hypothyroidism]], [[hypoparathyroidism]] and [[Cushing's syndrome]] as well as [[malnutrition]] and medications are also possible causes of alopecia.


==Differentiating Alopecia from other Diseases==
==Differentiating Alopecia from Other diseases==
The following lists the complete differential diagnosis of Alopecia.
 
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! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Differential Diagnosis}}
! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Findings}}
! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Unique Information}}
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Androgenetic Alopecia
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* Male pattern: The frontal hairline is thinner, hair loss occurs at the crown of the scalp, hair recession is seen at the temporal aspects of the scalp; Female pattern: Hair loss occurs at the crown of the scalp, however the frontal hair line remains preserved. <ref name="pmid24591533">{{cite journal| author=Qi J, Garza LA| title=An overview of alopecias. | journal=Cold Spring Harb Perspect Med | year= 2014 | volume= 4 | issue= 3 | pages=  | pmid=24591533 | doi=10.1101/cshperspect.a013615 | pmc=3935391 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24591533  }} </ref>
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* It is the most common cause of hair loss.<ref name="pmid24591533">{{cite journal| author=Qi J, Garza LA| title=An overview of alopecias. | journal=Cold Spring Harb Perspect Med | year= 2014 | volume= 4 | issue= 3 | pages=  | pmid=24591533 | doi=10.1101/cshperspect.a013615 | pmc=3935391 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24591533  }} </ref> Unlike in telogen effluvium, hair pull test is negative.<ref name="pmid26455063">{{cite journal| author=Vidal CI| title=Overview of Alopecia: A Dermatopathologist's Perspective. | journal=Mo Med | year= 2015 | volume= 112 | issue= 4 | pages= 308-12 | pmid=26455063 | doi= | pmc=6170065 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26455063  }} </ref>
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Alopecia Areata
| style="padding: 5px 5px; background: #F5F5F5;" |
* It presents with round patches of total hair loss with retained follicular ostia with the beard and scalp being the most frequently affected areas.<ref name="pmid24591533">{{cite journal| author=Qi J, Garza LA| title=An overview of alopecias. | journal=Cold Spring Harb Perspect Med | year= 2014 | volume= 4 | issue= 3 | pages=  | pmid=24591533 | doi=10.1101/cshperspect.a013615 | pmc=3935391 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24591533  }} </ref> It occurs most often before the age of 30 and is evenly distributed between the sexes<ref name="pmid24591533">{{cite journal| author=Qi J, Garza LA| title=An overview of alopecias. | journal=Cold Spring Harb Perspect Med | year= 2014 | volume= 4 | issue= 3 | pages=  | pmid=24591533 | doi=10.1101/cshperspect.a013615 | pmc=3935391 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24591533  }} </ref>.
 
| style="padding: 5px 5px; background: #F5F5F5;" |
* Close observation reveals the characteristic exclamation mark hairs.<ref name="pmid24591533">{{cite journal| author=Qi J, Garza LA| title=An overview of alopecias. | journal=Cold Spring Harb Perspect Med | year= 2014 | volume= 4 | issue= 3 | pages=  | pmid=24591533 | doi=10.1101/cshperspect.a013615 | pmc=3935391 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24591533  }} </ref> A hair pull test followed by trichogram shows telogen and pencil point shafts <ref name="pmid26455063">{{cite journal| author=Vidal CI| title=Overview of Alopecia: A Dermatopathologist's Perspective. | journal=Mo Med | year= 2015 | volume= 112 | issue= 4 | pages= 308-12 | pmid=26455063 | doi= | pmc=6170065 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks &id=26455063 }} </ref>. It is associated with several autoimmune diseases including thyroid disease, rheumatoid arthritis, inflammatory bowel disease, and vitiligo. <ref name="pmid26244028">{{cite journal| author=Villasante Fricke AC, Miteva M| title=Epidemiology and burden of alopecia areata: a systematic review. | journal=Clin Cosmet Investig Dermatol | year= 2015 | volume= 8 | issue=  | pages= 397-403 | pmid=26244028 | doi=10.2147/CCID.S53985 | pmc=4521674 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26244028  }} </ref> <ref name="pmid21616562">{{cite journal| author=Chu SY, Chen YJ, Tseng WC, Lin MW, Chen TJ, Hwang CY | display-authors=etal| title=Comorbidity profiles among patients with alopecia areata: the importance of onset age, a nationwide population-based study. | journal=J Am Acad Dermatol | year= 2011 | volume= 65 | issue= 5 | pages= 949-56 | pmid=21616562 | doi=10.1016/j.jaad.2010.08.032 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21616562  }} </ref> <ref name="pmid26499292">Chen CH, Wang KH, Lin HC, Chung SD (2016) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=26499292 Follow-up study on the relationship between alopecia areata and risk of autoimmune diseases.] ''J Dermatol'' 43 (2):228-9. [http://dx.doi.org/10.1111/1346-8138.13165 DOI:10.1111/1346-8138.13165] PMID: [https://pubmed.gov/26499292 26499292]</ref>
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Telogen Effluvium
| style="padding: 5px 5px; background: #F5F5F5;" |
* There is a massive amount of hair shedding which could be an acute self-limiting form triggered by stressors such as crash diets, childbirth, febrile illness or psychological stress or it could be chronic and present in association with female pattern hair loss. <ref>Sperling LC, Cowper SE, Knopp EA. An atlas of hair pathology with clinical correlations. 2. Informa Healthcare; 2014. [Google Scholar]</ref>
| style="padding: 5px 5px; background: #F5F5F5;" |
* Hair pull test followed by trichogram reveals numerous clubbed-shaped hairs; telogen count must exceed 20% for diagnosis. <ref name="pmid26455063">{{cite journal| author=Vidal CI| title=Overview of Alopecia: A Dermatopathologist's Perspective. | journal=Mo Med | year= 2015 | volume= 112 | issue= 4 | pages= 308-12 | pmid=26455063 | doi= | pmc=6170065 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26455063  }} </ref>
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Anagen Effluvium
| style="padding: 5px 5px; background: #F5F5F5;" |
* Associated with exposure to radiation, as in radiotherapy and cancer chemotherapy. There is diffuse hair loss and it is characterized by hair breakage that takes place in the anagen phase. <ref name="pmid24591533">{{cite journal| author=Qi J, Garza LA| title=An overview of alopecias. | journal=Cold Spring Harb Perspect Med | year= 2014 | volume= 4 | issue= 3 | pages=  | pmid=24591533 | doi=10.1101/cshperspect.a013615 | pmc=3935391 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24591533  }} </ref>
| style="padding: 5px 5px; background: #F5F5F5;" |
* Trichoscopy would reveal the characteristic narrowing, fractured hair shafts with an absence of bulbs. <ref name="pmid24591533">{{cite journal| author=Qi J, Garza LA| title=An overview of alopecias. | journal=Cold Spring Harb Perspect Med | year= 2014 | volume= 4 | issue= 3 | pages=  | pmid=24591533 | doi=10.1101/cshperspect.a013615 | pmc=3935391 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24591533  }} </ref>
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Trichotillomania
| style="padding: 5px 5px; background: #F5F5F5;" |
* It occurs as a result of a lack of impulse control in which an individual pulls on hair. Scalp inspection reveals uneven patches of hair loss with broken hairs that remain well attached to the skin. <ref>Sperling LC, Cowper SE, Knopp EA. An atlas of hair pathology with clinical correlations. 2. Informa Healthcare; 2014. [Google Scholar]</ref> The most frequently selected areas are scalp, eyebrows, eyelashes, body hair, facial hair, and pubic hair. It usually starts around the age of 12–13 years <ref name="pmid20946585">{{cite journal| author=Quercetani R, Rebora AE, Fedi MC, Carelli G, Mei S, Chelli A | display-authors=etal| title=Patients with profuse hair shedding may reveal anagen hair dystrophy: a diagnostic clue of alopecia areata incognita. | journal=J Eur Acad Dermatol Venereol | year= 2011 | volume= 25 | issue= 7 | pages= 808-10 | pmid=20946585 | doi=10.1111/j.1468-3083.2010.03869.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20946585  }} </ref> and is more common in males during the childhood years while it is more common in females in the adult years. <ref name="pmid24591533">{{cite journal| author=Qi J, Garza LA| title=An overview of alopecias. | journal=Cold Spring Harb Perspect Med | year= 2014 | volume= 4 | issue= 3 | pages=  | pmid=24591533 | doi=10.1101/cshperspect.a013615 | pmc=3935391 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24591533  }} </ref>
| style="padding: 5px 5px; background: #F5F5F5;" |
* Scalp inspection reveals uneven patches of hair loss with broken hairs that remain well attached to the skin. <ref>Sperling LC, Cowper SE, Knopp EA. An atlas of hair pathology with clinical correlations. 2. Informa Healthcare; 2014. [Google Scholar]</ref>.  A characteristic finding that distinguishes trichotillomania from alopecia areata is that the affected are not totally devoid of hair shafts. <ref>Habif TP 2010. Hair diseases. In Clinical dermatology, 5th ed Mosby, Maryland Heights, MO [Google Scholar]</ref> <ref>Otberg N, Shapiro J 2012. Hair growth disorders. In Fitzpatrick’s dermatology in general medicine, 8th ed (ed. Goldsmith LA, et al.). McGraw-Hill, New York [Google Scholar]</ref>
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Traction Alopecia
| style="padding: 5px 5px; background: #F5F5F5;" |
* It is due to from tension on hair follicles for a prolonged period of time caused from tight hairstyles including braids and ponytails. Black populations are more prone due to widespread use of tight hairstyles. <ref>Otberg N, Shapiro J 2012. Hair growth disorders. In Fitzpatrick’s dermatology in general medicine, 8th ed (ed. Goldsmith LA, et al.). McGraw-Hill, New York [Google Scholar]</ref> <ref name="pmid24591533">{{cite journal| author=Qi J, Garza LA| title=An overview of alopecias. | journal=Cold Spring Harb Perspect Med | year= 2014 | volume= 4 | issue= 3 | pages=  | pmid=24591533 | doi=10.1101/cshperspect.a013615 | pmc=3935391 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24591533  }} </ref> <ref name="pmid15113284">{{cite journal| author=Callender VD, McMichael AJ, Cohen GF| title=Medical and surgical therapies for alopecias in black women. | journal=Dermatol Ther | year= 2004 | volume= 17 | issue= 2 | pages= 164-76 | pmid=15113284 | doi=10.1111/j.1396-0296.2004.04017.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15113284  }} </ref>
| style="padding: 5px 5px; background: #F5F5F5;" |
* Black populations are most at risk. <ref>Habif TP 2010. Hair diseases. In Clinical dermatology, 5th ed Mosby, Maryland Heights, MO [Google Scholar]</ref> With early detection and switching to more loose hairstyles, it is reversible but with prolonged tension on the scalp destruction of the hair follicles will occur making the condition irreversible. <ref name="pmid15113284">{{cite journal| author=Callender VD, McMichael AJ, Cohen GF| title=Medical and surgical therapies for alopecias in black women. | journal=Dermatol Ther | year= 2004 | volume= 17 | issue= 2 | pages= 164-76 | pmid=15113284 | doi=10.1111/j.1396-0296.2004.04017.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15113284  }} </ref>
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Chronic Cutaneous Lupus Erythematosus
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* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
| style="padding: 5px 5px; background: #F5F5F5;" |
* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Tinea Capitis
| style="padding: 5px 5px; background: #F5F5F5;" |
* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
| style="padding: 5px 5px; background: #F5F5F5;" |
* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name]
|}
 
 
===The following lists the complete differential diagnosis of Alopecia: ===


===Non-Scarring Alopecia===
===Non-Scarring Alopecia===
Line 122: Line 181:
**Pressure alopecia (alopecia after extended bed rest)
**Pressure alopecia (alopecia after extended bed rest)
**Trichotillomania (compulsion to pull out one’s own hair)
**Trichotillomania (compulsion to pull out one’s own hair)


==References==
==References==

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Ogechukwu Hannah Nnabude, MD

Overview

There is a very wide list of diseases and conditions that can lead to alopecia. Proper history taking and physical examination, along with laboratory, microbiology, and in some cases, imaging studies, are helpful in narrowing down the diagnosis. Alopecia can be caused by many different diseases. Some of the most well known and common causes are: androgenetic alopecia, alopecia areata, telogen effluvium, anagen effluvium, traction alopecia, and trichotillomania. Endocrine disorders such as hypothyroidism, hypoparathyroidism and Cushing's syndrome as well as malnutrition and medications are also possible causes of alopecia.

Differentiating Alopecia from Other diseases
Differential Diagnosis Findings Unique Information
Androgenetic Alopecia
  • Male pattern: The frontal hairline is thinner, hair loss occurs at the crown of the scalp, hair recession is seen at the temporal aspects of the scalp; Female pattern: Hair loss occurs at the crown of the scalp, however the frontal hair line remains preserved. [1]
  • It is the most common cause of hair loss.[1] Unlike in telogen effluvium, hair pull test is negative.[2]
Alopecia Areata
  • It presents with round patches of total hair loss with retained follicular ostia with the beard and scalp being the most frequently affected areas.[1] It occurs most often before the age of 30 and is evenly distributed between the sexes[1].
  • Close observation reveals the characteristic exclamation mark hairs.[1] A hair pull test followed by trichogram shows telogen and pencil point shafts [2]. It is associated with several autoimmune diseases including thyroid disease, rheumatoid arthritis, inflammatory bowel disease, and vitiligo. [3] [4] [5]
Telogen Effluvium
  • There is a massive amount of hair shedding which could be an acute self-limiting form triggered by stressors such as crash diets, childbirth, febrile illness or psychological stress or it could be chronic and present in association with female pattern hair loss. [6]
  • Hair pull test followed by trichogram reveals numerous clubbed-shaped hairs; telogen count must exceed 20% for diagnosis. [2]
Anagen Effluvium
  • Associated with exposure to radiation, as in radiotherapy and cancer chemotherapy. There is diffuse hair loss and it is characterized by hair breakage that takes place in the anagen phase. [1]
  • Trichoscopy would reveal the characteristic narrowing, fractured hair shafts with an absence of bulbs. [1]
Trichotillomania
  • It occurs as a result of a lack of impulse control in which an individual pulls on hair. Scalp inspection reveals uneven patches of hair loss with broken hairs that remain well attached to the skin. [7] The most frequently selected areas are scalp, eyebrows, eyelashes, body hair, facial hair, and pubic hair. It usually starts around the age of 12–13 years [8] and is more common in males during the childhood years while it is more common in females in the adult years. [1]
  • Scalp inspection reveals uneven patches of hair loss with broken hairs that remain well attached to the skin. [9]. A characteristic finding that distinguishes trichotillomania from alopecia areata is that the affected are not totally devoid of hair shafts. [10] [11]
Traction Alopecia
  • It is due to from tension on hair follicles for a prolonged period of time caused from tight hairstyles including braids and ponytails. Black populations are more prone due to widespread use of tight hairstyles. [12] [1] [13]
  • Black populations are most at risk. [14] With early detection and switching to more loose hairstyles, it is reversible but with prolonged tension on the scalp destruction of the hair follicles will occur making the condition irreversible. [13]
Chronic Cutaneous Lupus Erythematosus
  • On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
  • On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
Tinea Capitis
  • On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
  • On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name]


The following lists the complete differential diagnosis of Alopecia:

Non-Scarring Alopecia

Scarring Alopecia

Miscellaneous

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 Qi J, Garza LA (2014). "An overview of alopecias". Cold Spring Harb Perspect Med. 4 (3). doi:10.1101/cshperspect.a013615. PMC 3935391. PMID 24591533.
  2. ↑ 2.0 2.1 2.2 Vidal CI (2015). "Overview of Alopecia: A Dermatopathologist's Perspective". Mo Med. 112 (4): 308–12. PMC 6170065. PMID 26455063.
  3. ↑ Villasante Fricke AC, Miteva M (2015). "Epidemiology and burden of alopecia areata: a systematic review". Clin Cosmet Investig Dermatol. 8: 397–403. doi:10.2147/CCID.S53985. PMC 4521674. PMID 26244028.
  4. ↑ Chu SY, Chen YJ, Tseng WC, Lin MW, Chen TJ, Hwang CY; et al. (2011). "Comorbidity profiles among patients with alopecia areata: the importance of onset age, a nationwide population-based study". J Am Acad Dermatol. 65 (5): 949–56. doi:10.1016/j.jaad.2010.08.032. PMID 21616562.
  5. ↑ Chen CH, Wang KH, Lin HC, Chung SD (2016) Follow-up study on the relationship between alopecia areata and risk of autoimmune diseases. J Dermatol 43 (2):228-9. DOI:10.1111/1346-8138.13165 PMID: 26499292
  6. ↑ Sperling LC, Cowper SE, Knopp EA. An atlas of hair pathology with clinical correlations. 2. Informa Healthcare; 2014. [Google Scholar]
  7. ↑ Sperling LC, Cowper SE, Knopp EA. An atlas of hair pathology with clinical correlations. 2. Informa Healthcare; 2014. [Google Scholar]
  8. ↑ Quercetani R, Rebora AE, Fedi MC, Carelli G, Mei S, Chelli A; et al. (2011). "Patients with profuse hair shedding may reveal anagen hair dystrophy: a diagnostic clue of alopecia areata incognita". J Eur Acad Dermatol Venereol. 25 (7): 808–10. doi:10.1111/j.1468-3083.2010.03869.x. PMID 20946585.
  9. ↑ Sperling LC, Cowper SE, Knopp EA. An atlas of hair pathology with clinical correlations. 2. Informa Healthcare; 2014. [Google Scholar]
  10. ↑ Habif TP 2010. Hair diseases. In Clinical dermatology, 5th ed Mosby, Maryland Heights, MO [Google Scholar]
  11. ↑ Otberg N, Shapiro J 2012. Hair growth disorders. In Fitzpatrick’s dermatology in general medicine, 8th ed (ed. Goldsmith LA, et al.). McGraw-Hill, New York [Google Scholar]
  12. ↑ Otberg N, Shapiro J 2012. Hair growth disorders. In Fitzpatrick’s dermatology in general medicine, 8th ed (ed. Goldsmith LA, et al.). McGraw-Hill, New York [Google Scholar]
  13. ↑ 13.0 13.1 Callender VD, McMichael AJ, Cohen GF (2004). "Medical and surgical therapies for alopecias in black women". Dermatol Ther. 17 (2): 164–76. doi:10.1111/j.1396-0296.2004.04017.x. PMID 15113284.
  14. ↑ Habif TP 2010. Hair diseases. In Clinical dermatology, 5th ed Mosby, Maryland Heights, MO [Google Scholar]
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