Wu Sam
Department of Dermatology - University of North Carolina School of Medicine, 410 Market St Suite 400, Chapel Hill, NC 27516.
FP Essent. 2022 Jun;517:11-16.
Alopecia affects men and women and can result in significant distress for patients. Alopecias can be categorized as nonscarring or scarring. Nonscarring alopecias include male and female pattern alopecias, alopecia areata, telogen effluvium, traction alopecia, trichotillomania, and tinea capitis. Scarring alopecias include central centrifugal cicatricial alopecia, lichen planopilaris, frontal fibrosing alopecia, discoid lupus erythematosus, dissecting cellulitis of the scalp, folliculitis decalvans, and acne keloidalis nuchae. Evaluation of patients with alopecia involves assessment of the duration and distribution of hair loss, associated scalp symptoms, and associated conditions. Clinical examination of the hair and scalp may include a hair pull test, tug test, hair mount (ie, trichogram), dermoscopy, laboratory tests, and/or scalp biopsy, depending on the suspected etiology. Hair regrowth cannot occur in established lesions of scarring alopecia, so early identification and prompt initiation of treatment are critical in these cases. Patients with suspected or confirmed alopecias, alopecia areata, or alopecias refractory to treatment may benefit from referral to a dermatologist.
脱发影响男性和女性，会给患者带来极大困扰。脱发可分为非瘢痕性脱发和瘢痕性脱发。非瘢痕性脱发包括男性型脱发、女性型脱发、斑秃、休止期脱发、牵引性脱发、拔毛癖和头癣。瘢痕性脱发包括中央离心性瘢痕性脱发、扁平苔藓性毛囊病、额部纤维性脱发、盘状红斑狼疮、头皮穿掘性蜂窝织炎、脱发性毛囊炎和项部瘢痕疙瘩性痤疮。对脱发患者的评估包括对脱发的持续时间和分布、相关头皮症状以及相关疾病的评估。根据怀疑的病因，对头发和头皮的临床检查可能包括拔发试验、牵拉试验、毛发镜检（即毛发图谱）、皮肤镜检查、实验室检查和/或头皮活检。瘢痕性脱发的既定病变中无法发生毛发再生，因此在这些病例中早期识别并及时开始治疗至关重要。疑似或确诊患有脱发、斑秃或治疗无效的脱发患者转诊至皮肤科医生处可能会受益。
