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SUMMARY

SUMMARY

  • Telogen effluvium is one of the most common forms of non-scarring alopecia; it can occur in both adults and children, males and females, with no racial predilection.

  • Telogen effluvium can be a challenging disease because numerous causes and triggering factors can be associated.

  • Despite its high rate of remission, as in all the scalp diseases, the hair loss can be very worrisome and upsetting for affected individuals and may significantly impact their quality of life, causing stress, depression, and anxiety.

TIPS FOR DIAGNOSIS

  • Clinical presentation of telogen effluvium (TE) is an increased hair shedding.

  • Main differential diagnosis is represented by androgenetic alopecia, alopecia areata diffuse and incognita and anagen effluvium.

  • Pull tests shows increased loss of telogen hair.

  • Trichoscopy is useful, while a scalp biopsy is reserved for patients whose diagnosis is uncertain.

TIPS FOR TREATMENT

  • The most important aspect in the management of telogen effluvium is counseling the patient about the natural history and the benign course of the disease.

  • In most cases, telogen effluvium resolves within 6 months.

  • The first approach is a local steroid, gradually reduced.

DON’T FORGET

  • The collection of the medical history is mandatory to make a diagnosis.

  • Laboratory testing may be helpful for identifying an etiology when the inciting factor for telogen effluvium is unknown.

  • Often, only clinical examination permits correct diagnosis of the hair disease and evaluation of its severity and progression.

PITFALLS AND CAUTIONS

  • The diagnosis of telogen effluvium includes two separate entities, distinguished in acute and chronic, with different causes, onset, symptoms and outcome.

  • Due to the multifactorial causes of TE, it is often challenging to diagnose and treat.

  • Sometimes telogen effluvium is associated to paresthesia on the scalp with painful sensation (trichodinya).

EXPERT PEARLS

  • It is the most common cause of diffuse hair loss in females.

  • Diagnosis includes history of the hair loss, pull test, trichoscopy, and, in doubtful cases, scalp biopsy.

  • The disease is usually self-limiting, and therapies include cosmetic or medical ones.

PATIENT EDUCATION POINTS

  • Acute telogen effluvium occurs three months after a triggering event, and resolves within 6 months.

  • Patients affected by telogen effluvium may complain of psychological distress, as hair is very important in the communication of beauty, attractiveness, and self-esteem.

  • Acute telogen effluvium usually undergoes spontaneous resolution and, if the causative event is identified by history and has been adequately treated, there is no further treatment required.

INTRODUCTION

The term telogen effluvium (TE), coined by Kligman in 1961,1 defines a diffuse and profuse non-scarring loss of hair in the telogen phase. It is the most common cause of diffuse hair loss in females.

The diagnosis of telogen effluvium includes two separate entities, distinguished as acute and chronic, with different causes, onset, symptoms, and outcome. Acute telogen effluvium occurs 3 months after a triggering event, and ...

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