Differential Diagnosis for Patchy Hair Loss with Itching
The following conditions can cause patchy hair loss accompanied by itching. It's crucial to approach these symptoms with a broad differential to ensure accurate diagnosis and appropriate treatment.
- Single Most Likely Diagnosis
- Alopecia Areata: This is an autoimmune condition that leads to patchy hair loss, often accompanied by itching or burning sensations before the hair falls out. It's a common cause of hair loss and can be treated with corticosteroids, among other treatments. 1
- Other Likely Diagnoses
- Tinea Capitis (Ringworm of the Scalp): A fungal infection that causes hair loss, itching, and sometimes redness. It's more common in children but can occur in adults. Treatment involves antifungal medications. 2
- Psoriasis: While more commonly associated with skin plaques, psoriasis can cause scalp itching and hair loss. Treatment often involves topical corticosteroids, vitamin D analogs, or systemic therapy for more severe cases. 3
- Seborrheic Dermatitis: This condition causes scaly patches, red skin, and stubborn dandruff, leading to itching and potential hair loss. It's treated with medicated shampoos and topical corticosteroids. 4
- Do Not Miss Diagnoses
- Lymphoma: Certain types of lymphoma, particularly cutaneous T-cell lymphoma (CTCL), can present with skin symptoms including itching and hair loss. Early diagnosis is critical for effective treatment. 5
- Thyroid Disorders: Both hypothyroidism and hyperthyroidism can cause hair loss and itching. These conditions are treatable with thyroid hormone replacement or anti-thyroid medications, respectively. 6
- Rare Diagnoses
- Alopecia Monolocularis: A rare condition causing a single patch of hair loss, which might be accompanied by itching.
- Trichotillomania: A psychological disorder where individuals compulsively pull out their hair, which can lead to patchy hair loss and sometimes itching due to the constant pulling.
- Discoid Lupus Erythematosus: A chronic skin condition of sores with inflammation and scarring favoring the face, ears, and scalp but can cause hair loss and itching. 7
References: 1 Alopecia Areata. (2022). National Institute of Arthritis and Musculoskeletal and Skin Diseases. 2 Tinea Capitis. (2020). Centers for Disease Control and Prevention. 3 Psoriasis. (2022). American Academy of Dermatology. 4 Seborrheic Dermatitis. (2022). Mayo Clinic. 5 Cutaneous T-Cell Lymphoma. (2022). American Cancer Society. 6 Thyroid Disease and Hair Loss. (2020). Endocrine Society. 7 Discoid Lupus Erythematosus. (2022). Lupus Foundation of America.