Department of Dermatology, University Hospital of Zurich.
J Dtsch Dermatol Ges. 2010 Apr;8(4):284-97, 284-98. doi: 10.1111/j.1610-0387.2010.07261.x. Epub 2010 Jan 22.
Diffuse hair loss is a common complaint and cause of significant emotional distress particularly in women. The best way to alleviate the anxiety is to effectively treat the hair loss. It is paramount to address the symptom systematically. In addition to its psychological impact, hair loss may be a manifestation of a more general medical problem. The diagnosis can be established with a detailed patient history focussing on chronology of events, examination of the scalp and pattern of hair loss, a pull test with examination of bulbs of shed hairs, trichoscopy, and few pertinent screening blood tests. In selected cases a scalp biopsy may be required. The most important differential diagnoses include acute and chronic telogen effluvium, female pattern hair loss, and diffuse alopecia areata. Occasionally, patients seeking advice are not necessarily losing hair. In the absence of convincing evidence of hair loss, they are suffering of psychogenic pseudoeffluvium, and thought should be given to an underlying psychological disorder. Once the diagnosis is established, treatment appropriate for that diagnosis is likely to control the hair loss. Finally, appropriate psychological support and education about the basics of the hair cycle, and why considerable patience is required for effective cosmetic recovery, are essential to help limit patient anxiety.
弥漫性脱发是一种常见的主诉和导致显著情绪困扰的原因，特别是在女性中。缓解焦虑的最佳方法是有效地治疗脱发。系统地解决症状至关重要。除了心理影响外，脱发可能是更普遍的医学问题的表现。通过详细的病史、头皮检查和脱发模式、牵拉试验和检查脱落毛发的毛囊、毛发镜检查以及一些相关的筛选性血液检查，可以确立诊断。在某些情况下可能需要头皮活检。最重要的鉴别诊断包括急性和慢性休止期脱发、女性型脱发和弥漫性斑秃。偶尔，寻求建议的患者不一定在脱发。在没有令人信服的脱发证据的情况下，他们患有精神性假性脱发，应考虑潜在的心理障碍。一旦确立诊断，针对该诊断的适当治疗可能会控制脱发。最后，提供适当的心理支持和有关毛发周期基础知识的教育，以及为什么需要相当长的时间才能有效恢复美容，对于帮助限制患者焦虑至关重要。
