Differential Diagnosis for Loss of Hair in a 25-year-old Female
Single most likely diagnosis
- Telogen Effluvium: This condition is characterized by a sudden increase in hair shedding, often triggered by stress, hormonal changes, or medical conditions. Given the acute onset (2 weeks) and absence of itching, telogen effluvium is a plausible explanation, especially if the patient has experienced recent stress or hormonal fluctuations.
Other Likely diagnoses
- Androgenetic Alopecia (Female Pattern Hair Loss): Although this condition typically presents with a more gradual onset, it's possible that the patient is experiencing an exacerbation of hair loss due to hormonal influences. The absence of itching does not rule out this diagnosis.
- Alopecia Areata: While alopecia areata can present with itching, its absence does not exclude the diagnosis. This condition is autoimmune in nature and can cause patchy hair loss.
- Thyroid Disorders: Both hypothyroidism and hyperthyroidism can lead to hair loss. The patient's age and the acute onset of symptoms make this a consideration, especially if other symptoms such as weight changes, fatigue, or mood alterations are present.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Systemic Lupus Erythematosus (SLE): Although less common, SLE can cause hair loss as part of its systemic manifestations. Missing this diagnosis could have severe consequences due to the potential for organ damage.
- Cancer (e.g., Hodgkin's Lymphoma): Certain cancers can lead to hair loss, either directly or as a side effect of treatment. While rare, the potential severity of missing a cancer diagnosis warrants its inclusion in this category.
Rare diagnoses
- Trichotillomania: A psychological disorder characterized by compulsive hair pulling, which could lead to noticeable hair loss. The absence of itching and the patient's age make this less likely but not impossible.
- Tinea Capitis (Ringworm of the Scalp): Although typically associated with itching, some cases might not present with this symptom. This fungal infection can cause hair loss and is more common in children, but it should be considered, especially if the patient has been exposed to someone with a similar condition.
- Loose Anagen Syndrome: A rare condition that causes hair to fall out easily, often without any other symptoms. It's more common in children but can occur in adults.