Why is her hair falling out? – Let’s diagnose

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 non-scarring 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.

What’s the diagnosis?

1. Female pattern alopecia
2. Drug-induced alopecia
3. Alopecia areata
4. Anagen effluvium

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