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Dermatology/Mom's sudden hair loss and dermatitis

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Hi Doc,

My mom is 68, and 1.5 years ago she began losing hair rapidly (from having a full head of hair 1.5 years ago to having much thinner hair now -not bald, but the crown is visible when she does her bangs).

She's got good medical insurance, and she's gone to every dermatologist, endocrinologist and immunologist available. This has caused her enormous mental stress, and she opted for the ridiculous non-solution of hair implants, which didn't make any difference at all, of course - her hair keeps falling, including the ones she got implanted.

She's had every possible blood test taken. All nutrients in range, thyroid in range, etc.

The one thing that's not in range are her eosinophils. She's had this exam done at least 8 times in the last 1.5 years. The last time, a month ago, her white cells were at 6000/mm3, and the eosinophils were at 13.9% (Reference range:0-5 %). As I said, this is the only abnormal result from all the tests she's taken. All that doctors say about this is that eosinophils are usually related to allergies (which she has none and never has) and send her off.

Around the same time (1.5 years ago) she started developing strange rashes/dermatitis in her upper arms and lower legs. Doctors have recommended moisturizing lotion and antihistamines. I've read that sometimes eosinophilia can cause dermatitis, basically because white blood cells start attacking the dermis. Her rashes itch, they're awful looking, and they won't go away with anything - and it's been almost 2 years now with these things in her arms and legs. PIctures attached.

If you could please give this a look, I'd truly appreciate it. I have copies of all the exams in case you need them. I'm thinking the sudden hair loss and the sudden appearance of skin rashes are related, and the eosinophils count is the only abnormal result so far.

Thanks so much. Hope to hear from you soon! (and end my poor mom's anguish!)

Cheers,
Ted.

Answer
Your mother needs a scalp biopsy to determine a possible cause of hair loss. There are genetic causes such as female pattern hair loss. There are other causes such as a telogen effluvium where the hairs are shed. One has to determine the type of hair loss she has. When that is determine then treatment can follow. Another problem is the eosinophilia. Eosinophilia occurs when either a large number of eosinophils are recruited to a specific site in your body or bone marrow produces too many eosinophils. This can be caused by a variety of conditions, diseases and factors, including:

Parasitic and fungal diseases
Allergies (including to medications or food)
Adrenal conditions
Skin disorders
Toxins
Autoimmune diseases
Endocrine disorders
Tumors
Specific diseases and conditions that can result in blood or tissue eosinophilia include:

Ascariasis (a roundworm infection)
Asthma
Atopic dermatitis (eczema)
Chronic myelogenous leukemia
Churg-Strauss syndrome
Crohn's disease
Drug allergy
Eosinophilic leukemia
Hay fever
Hodgkin's lymphoma (Hodgkin's disease)
Idiopathic hypereosinophilic syndrome (HES), an extremely high eosinophil count of unknown origin
Lupus
Lymphatic filariasis (a parasitic infection)
Other cancers
Other parasitic infections
Ovarian cancer
Primary immunodeficiency
Trichinosis (a roundworm infection)
Ulcerative colitis
Parasitic diseases and allergic reactions to medication are among the more common causes of eosinophilia. Hypereosinophilic syndrome tends to have an unknown cause or results from certain types of cancer, such as bone marrow or lymph node cancer.

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Michael S. Fisher, <B>Ph.D., M.D.</B>

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