Differential Diagnosis for Constant Piloerection, Hair Loss, and Hair Brittleness
Single Most Likely Diagnosis
- Hypothyroidism: This condition is characterized by decreased production of thyroid hormones, which can lead to hair loss, brittle hair, and piloerection (goosebumps) due to cold intolerance. The constant piloerection and moderate diffuse hair loss are common symptoms of hypothyroidism.
Other Likely Diagnoses
- Anxiety or Stress: Prolonged anxiety or stress can cause hair loss (telogen effluvium) and may lead to piloerection due to the body's 'fight or flight' response. Hair brittleness could be secondary to nutritional deficiencies or poor hair care during stressful periods.
- Nutritional Deficiencies: Deficiencies in vitamins and minerals such as vitamin D, iron, zinc, or biotin can lead to hair loss and brittleness. Piloerection could be related to overall health deterioration.
- Alopecia Areata: An autoimmune condition that causes hair loss, which could be accompanied by piloerection in some cases due to the psychological impact or associated stress.
Do Not Miss Diagnoses
- Thyroid Storm or Crisis: Although less likely, a severe and life-threatening complication of untreated or undertreated hyperthyroidism could present with hair loss and piloerection among other symptoms. Early recognition is crucial.
- Cancer (e.g., Thyroid, Skin): Certain cancers can cause hair loss and changes in skin and hair texture. While rare, missing a diagnosis of cancer could have severe consequences.
- Systemic Lupus Erythematosus (SLE): An autoimmune disease that can cause hair loss, skin changes, and potentially piloerection due to its wide range of effects on the body.
Rare Diagnoses
- Hypertrichosis: A condition characterized by excessive hair growth, which might seem contradictory but could be considered if the piloerection is mistaken for hair loss or if there's an unusual pattern of hair growth.
- Porphyria: A group of disorders that can lead to sensitivity to sunlight, blistering, and potentially changes in hair texture or growth patterns. Some forms might cause piloerection due to neurological effects.
- Ehlers-Danlos Syndrome: A genetic disorder affecting the body's connective tissue, which could potentially lead to hair brittleness and other skin and hair changes, though it's less directly associated with piloerection.