ABD ABD Hair and Nail Disorders 2 — Questions and Answers
Question 1: Which FDA-approved oral JAK inhibitor was first approved specifically for severe alopecia areata in adults?
- Tofacitinib
- Baricitinib (Correct answer)
- Upadacitinib
- Abrocitinib
Correct answer: Baricitinib
Baricitinib (Olumiant) received FDA approval in June 2022 as the first systemic treatment specifically indicated for severe alopecia areata in adults.
Question 2: Lichen planopilaris, a scarring alopecia, characteristically shows which dermoscopic finding?
- Yellow dots and black dots
- Perifollicular scaling and fibrotic white dots (Correct answer)
- Branching vessels and white circles
- Exclamation mark hairs and broken hairs
Correct answer: Perifollicular scaling and fibrotic white dots
Lichen planopilaris shows perifollicular scaling, loss of follicular openings, and fibrotic white dots (stellate scarring) on dermoscopy.
Question 3: Terry's nails (proximal white nail with distal pink band) are most commonly associated with which systemic condition?
- Renal failure
- Iron deficiency anemia
- Liver cirrhosis (Correct answer)
- Congestive heart failure
Correct answer: Liver cirrhosis
Terry's nails, featuring proximal white discoloration with a 0.5-3mm distal pink or red band, are most commonly associated with liver cirrhosis.
Question 4: Hailey-Hailey disease (benign familial pemphigus) is caused by mutations in which gene?
- ATP2A2 (SERCA2)
- ATP2C1 (hSPCA1) (Correct answer)
- DSG3 (desmoglein-3)
- DSP (desmoplakin)
Correct answer: ATP2C1 (hSPCA1)
Hailey-Hailey disease is caused by loss-of-function mutations in ATP2C1 encoding hSPCA1, a Golgi calcium/manganese ATPase pump.
Question 5: Which beta-blocker class medication is a well-established pharmacologic cause of telogen effluvium?
- Methotrexate
- Propranolol (Correct answer)
- Finasteride
- Isotretinoin
Correct answer: Propranolol
Beta-blockers such as propranolol are classic pharmacologic causes of telogen effluvium by shifting hairs prematurely from anagen to telogen phase.
Question 6: A positive hair pull test is defined as extraction of more than how many hairs from a bundle of 50-60 hairs?
- 3 hairs
- 6 hairs (Correct answer)
- 10 hairs
- 15 hairs
Correct answer: 6 hairs
A positive pull test is defined as extraction of more than 6 hairs (or >10% of grasped hairs) from a bundle of approximately 50-60 hairs, indicating active shedding.
ABD ABD Hair and Nail Disorders 2
Which FDA-approved oral JAK inhibitor was first approved specifically for severe alopecia areata in adults?