What is the cause of persistent horripilation (piloerection) for over a week, unilateral acne on the left side of the face, poor hair quality, and moderate alopecia (hair fall)?

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Differential Diagnosis

  • Single most likely diagnosis
    • Polycystic Ovary Syndrome (PCOS): This condition is characterized by hormonal imbalance, which can lead to acne, hair loss, and changes in hair quality. The constant piloerection could be related to hormonal fluctuations or stress associated with PCOS. The unilateral acne could be due to localized factors such as skin care routine or environmental exposures.
  • Other Likely diagnoses
    • Thyroid disorders: Hypothyroidism can cause hair loss, dry skin, and piloerection. Acne can also be a symptom of thyroid disorders, although it's less common.
    • Stress and anxiety: Chronic stress can lead to hormonal imbalances, causing acne, hair loss, and piloerection. Poor hair quality could be related to stress-induced changes in hair growth cycles.
    • Hormonal imbalances: Other hormonal imbalances, such as those caused by adrenal gland disorders or pituitary tumors, could lead to similar symptoms.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Cushing's syndrome: This rare endocrine disorder can cause acne, hair loss, and changes in hair quality. Piloerection could be a symptom of the underlying hormonal imbalance. Although rare, Cushing's syndrome can be life-threatening if left untreated.
    • Pheochromocytoma: This rare tumor of the adrenal gland can cause hormonal imbalances, leading to symptoms such as acne, hair loss, and piloerection. It's essential to rule out this condition due to its potential to cause life-threatening hypertension.
  • Rare diagnoses
    • Hypertrichosis lanuginosa: This rare condition causes excessive hair growth, which could be mistaken for piloerection. However, it's unlikely to cause acne or poor hair quality.
    • Ehlers-Danlos syndrome: This genetic disorder can cause skin and hair changes, including poor hair quality and easy bruising. Although it's a rare condition, it could be considered in the differential diagnosis if other symptoms are present.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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