We will start with OSDPARA
Onset?
Site? If it’s patch or diffuse hair fall?
Is it getting worse?
Can you think of any thing thay might have caused it?
Ddx
Diffuse hair loss can be due to stress or change in diet, or due to medication ask about that
Ask about change in shampo
Ask about itching, redness etc to r/o fungal infection
Do
Past Med hx : She had a transplant ( this information is already given in stem )
Medication : She will tell you about post transplant medication
Ask psycosocial and impact on daily life
Examination
Alopecia is the S/E of tacrolimus
You will give your provisional Dx
Drug Induced Hair loss due to Side effects of tacrolimus
You will refer to the specialist for re-evaluation of medication, he might change it.
Tell her that it’s temporary hairloss and will comeback once the medication has been changed or stopped
Meanwhile,
Counsell about alternative option like scarves, wigs
Also tell her about support groups
Leaflet about alopecia
Safety net about coming back if severe psychosocial impact because of hair loss
