Loose Anagen Syndrome Differential Diagnoses

Updated: Apr 06, 2021
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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Diagnostic Considerations

Also consider the following:

  • Lichen planopilaris
  • Traction alopecia
  • Hypothyroidism
  • Hyperthyroidism
  • Iron deficiency anemia
  • Medication-induced hair loss (most commonly from chemotherapeutic agents, gout medications, vitamin A, oral contraceptives, and antidepressants)

A strongly positive and painless hair-pull test may represent alopecia areata or loose anagen hair syndrome, the latter diagnosed with a hair mount of the proximal ends of extracted hair, not cut hair, demonstrating misshapen anagen hair bulbs, absent inner root sheath, and the cuticle distal to the bulbs resembling a fallen sock. [21] Normal values for the hair pull test have been suggested as two or fewer hairs. [22]

Loose anagen hair may occasionally be seen with other ectodermal or developmental anomalies. [23]

Differential Diagnoses