PC
Explore hair loss:
Since when? How many strands? Ever take a picture? Is it patchy or generalised? Any rash?
Any recent infection? Any change in haircare routine? Traction alopecia? Any fungal infection? Flakes of dandruffs? Any exclamation marks (short hairs, alopecia arreta)? Any change in nail structure? Sun exposure?
DDs:
Dermatitis, Traction alopecia, Tinea capitis, Telogen effluvium (any stress), Male pattern baldness
PMAFTOSA
-Ask about family history of hairloss
-Any medical condition? Autoimmune disorder?
-Any medications? (tacrolimus)
-If they give you hx of tacrolimus use thn explore why using it? If for transplant how its going?
-Any complications? Any other sideeffects of tacrolimus (tremor,GI upset) regular with follow ups?
Psycosocial hx
-Its very important to ask how its effecting them (life, job) and what they have done so far!
DESA
Examination:
-Examine the scalp and observations Look for nail change and eyelashes
-Also look for any gedema
Daignosis:
-Unfortunately hairloss is due to tacrolimus
-It is an immunosuppressant drug you are taking this medicine so that the body doesn’t not reject the kidney transplant. It is an important medicineso it could not be stop immediately
Management:
-Refer to the specialist so that they can review the Medication and try different medications
-Please continue taking medicine untill reviewed my specialist
-Inform patient about different options that what they think they would prefer
-Advice technique to camouflage areas of hair loss e.g by Using cosmetic hair styling
-Use a hat or head scarves to protect hair loss patches from sun damage
-Always use sunblock
-Advice on using hair pieces and wigs(synthetic or real hair)
-Advice not to stop taking the medications because it is very important that she does not suffer organ rejection
-Counselling (CBT) if its effecting them emotionally
-Alopecia UK (for support)
-Provide with leaflets