Saç Hastalıkları
Özet
Saç dökülmesi, birinci basamakta sık karşılaşılan ve farklı lokal veya sistemik nedenlere bağlı gelişebilen bir yakınmadır. Tanısal yaklaşımda ilk adım, saç kaybının skatrisyel veya non-skatrisyel olduğunun ve fokal, diffüz ya da paternli dağılım gösterip göstermediğinin belirlenmesidir. Ayrıntılı anamnezde başlangıç ve seyir, tetikleyici olaylar, kullanılan ilaçlar, sistemik hastalıklar, beslenme, aile öyküsü ve saç bakım alışkanlıkları sorgulanmalıdır. Muayenede saç kaybının dağılımı, saçlı deride inflamasyon, foliküler ostiumların varlığı, saç şaftında kırılma ve saç çekme testi değerlendirilmelidir. Alopesi areata tipik olarak iyi sınırlı alopesik yamalarla, telogen effluvium tetikleyici sonrası gelişen diffüz dökülmeyle, androgenetik alopesi progresif paternli incelmeyle, traksiyonel alopesi kronik mekanik çekmeye bağlı saç kaybıyla, trikotillomani farklı uzunluklarda kırık saçlarla ve anagen effluvium sıklıkla kemoterapi sonrası gelişen ani diffüz saç kaybıyla seyreder. Foliküler ostium kaybı, atrofi ve perifoliküler inflamasyon skatrisyel alopesiyi düşündürmeli ve kalıcı saç kaybını önlemek amacıyla erken dermatolojik değerlendirme yapılmalıdır.
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