A difference between these two hair disorders is that in loose anagen syndrome there are dystrophic hairs which are absent in patients with short anagen syndrome.Patients with loose anagen syndrome may experience the thinning of their hair which is also a factor of alopecia areata. In order to distinguish between these two conditions, if dots, hairs with tapered roots or vellus hairs are visible in a microscopic examination of the skin this will lead to the diagnosis of alopecia areta rather than loose anagen syndrome.Hair loss can lead to other symptoms and signs such as weight loss, behavioural changes, short temper, abdominal pain and problems with learning. These signs are also observed in children with toxic ingestion which is one of the differential diagnosis.A pull test is also used in the diagnosis of telogen effluvium. The hairs that are removed in a telogen effluvium pull test are telogen staged hairs instead of being at the anagen stage as seen in loose anagen hair syndrome. Associated conditions
Loose anagen syndrome usually appears as an individual condition. Loose anagen syndrome can be present with other conditions related to genetics or developmental conditions. Examples of these conditions include; Coloboma, Noonan syndrome, Hypohidrotic ectodermal dysplasia, EEC (ectrodactyly- ectodermal dysplasia-clefting) syndrome, Neurofibromatosis, Trichorhinophalangeal syndrome, Trichotillomania, Nail-patella syndrome and Woolly hair. Loose anagen hair syndrome has also been associated with AIDS.Alopecia areata patients can also develop loose anagen syndrome. Treatment
Loose anagen syndrome usually does not need treatment as this hair condition tends to improve with age and is self-limited.
An overlap syndrome is a medical condition which shares features of at least two more widely recognised disorders. Examples of overlap syndromes can be found in many medical specialties such as overlapping connective tissue disorders in rheumatology, and overlapping genetic disorders in cardiology. Rheumatology
Examples of overlap syndromes in rheumatology include mixed connective tissue disease and scleromyositis. Diagnosis depends on which diseases the patient shows symptoms and has positive antibodies for in their lab serology. In overlap syndrome, features of the following diseases are found (most common listed):
Systemic lupus erythematosus (SLE)
Systemic sclerosis
Polymyositis
Dermatomyositis
Rheumatoid arthritis (RA)
Sjögrens syndrome
Eosinophilic granulomatosis with polyangiitis (EGPA)
Autoimmune thyroiditis
Antiphospholipid antibody syndromeThe treatment of overlapping connective tissue disorders is mainly based on the use of corticosteroids and immunosuppressants. Biologic drugs, i.e. anti-TNFα or anti-CD20 monoclonal antibodies, have been recently introduced as alternative treatments in refractory cases. There are some concerns with the use of anti-TNF agents in patients with systemic autoimmune diseases due to the risk of triggering disease exacerbations.The term polyangiitis overlap syndrome refers to a systemic vasculitis that shares features with two or more distinct vasculitis syndromes. The most common type of polyangiitis overlap syndrome is microscopic polyangiitis (MPA), which shares features with EGPA, granulomatosis with polyangiitis and panarteritis nodosa. Sometimes polyangiitis overlap syndrome is used as a synonym for MPA. Gastroenterology
In gastroenterology, the term overlap syndrome may be used to describe autoimmune liver diseases that combine characteristic features of autoimmune hepatitis, primary biliary cirrhosis and primary sclerosing cholangitis.