feedback for an MS1

[Madhatter]

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hi guys,
I'm an MS1 and I need some help with a patient case. She is a 25y/o female, who is experiencing thinning around the crown of her head. She said that her hair was shedding excessively while she was under a prolonged period of stress (over 4 years), but for the past year her hair has decreased shedding but wispy strands are now growing around the crown. There is a hx of male pattern baldness in the family. Am I correct to assume that this hairloss was due to stress and not hereditary hairloss??

Just need some feedback (im kind of stressing about which one it is)

 

[ARealist2]

hi guys,
I'm an MS1 and I need some help with a patient case. She is a 25y/o female, who is experiencing thinning around the crown of her head. She said that her hair was shedding excessively while she was under a prolonged period of stress (over 4 years), but for the past year her hair has decreased shedding but wispy strands are now growing around the crown. There is a hx of male pattern baldness in the family. Am I correct to assume that this hairloss was due to stress and not hereditary hairloss??

Just need some feedback (im kind of stressing about which one it is)

Hmmm....don't know much about male pattern baldness in women,but that could be possible. It seems that 25 is a really young age for any woman to loose their hair. Maybe she has hirsutism. Is she obese, have insulin resistance, polycystic ovary syndrome, does she have normal menses. She could have some kind of adrenal or ovarian tumor. Also sometimes people who have hypothyroidism will loose some hair. If she was my patient I get a testosterone level on her to start with.

 

[Madhatter]

ARealist2, Thank you for your reply! All her bloodwork came back normal; she is very thin, and often has shaky hands, therefore I suspected hyperthyroidism. However, her TSH levels were normal. I'm confused. Although there is a hx of female baldness on her father's side of the family.

 

[ARealist2]

ARealist2, Thank you for your reply! All her bloodwork came back normal; she is very thin, and often has shaky hands, therefore I suspected hyperthyroidism. However, her TSH levels were normal. I'm confused. Although there is a hx of female baldness on her father's side of the family.

Your welcome for the reply! You might also think about tinea capitis ( fungal cause of hair loss). Also some people pull their own hair out when they are stressed, when I was in college a girl in my organic class did this...its's called trichotillomania. I guess there are a lot of things that cause hair loss. Did her labs include a normal testosterone level.

 

[GonnaBeAnMD]

How do MS1's get these cases?

 

[gary5]

"very thin": Anorexics can experience hair loss. They can also stop menstruating (you could ask her). They deny that their eating and exercise behaviors are abnormal in any way, and they vehemently deny being anorexic. It's like trying to help an alcoholic.

 

[Coca Cola]

A patient can have a low TSH level and still have hyperthyroidism, i.e. Graves Dz, How are her Thyroid levels and binding protein?

Late
Cola

 

[wooo]

"Maybe she has hirsutism"

do you know what this is? I don't think it rrelates to thinning hair.