Make the Diagnosis: Increased Hair Loss and “White Bulbs” — What’s Up?



A 55-year-old woman visited her doctor after noticing that the hair on her scalp was falling out at an increased rate over the last 3 months. She had observed that after brushing her hair or showering, hair loss was visible, with small “white bulbs” appearing at the roots of the hairs. On examination, widespread nonscarring alopecia was present. The patient appeared well and had no systemic symptoms. She had been taking metoprolol for over 5 months, which was prescribed for management of hypertension.

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