Selected Disorders of Skin Appendages: Acne, Alopecia, Hyperhidrosis

September 2015 in “ Medical Clinics of North America ”

James C. Vary

TLDR The conclusion is that acne, alopecia, and hyperhidrosis are common skin issues with various treatments available, and accurate diagnosis is key for effective management.

The document from November 1, 2015, provides an overview of common skin appendage disorders, including acne, various forms of alopecia, and hyperhidrosis. It details the prevalence, pathogenesis, and treatment options for acne, which affects 35% to 90% of adolescents and can persist into adulthood, leading to psychological distress. Acne treatments target overproduction of keratinocytes, sebaceous gland production, bacteria, and androgens, with options like tea tree oil, salicylic acid, benzoyl peroxide, topical retinoids, antibiotics, isotretinoin, and hormonal treatments. The document also covers the diagnosis and management of non-scarring alopecias such as Alopecia Areata (AA), Androgenetic Alopecia (AGA), Female Pattern Hair Loss (FPHL), and Telogen Effluvium (TE). AA treatments include topical steroids and immunomodulatory agents, while AGA and FPHL may be treated with minoxidil, antiandrogens, and hair transplantation. TE, a common cause of diffuse hair shedding, is usually self-resolving but can lead to significant thinning. Diagnosis of TE involves a history of sudden hair shedding with a clear trigger or by exclusion, and a positive hair pull test. The document emphasizes the importance of thorough examination and history-taking for accurate diagnosis and management of these conditions.

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