Wounds are a symptom. Our job is to find the disease. Here’s a patient with a non-healing abdominal wound after a ruptured aneurysm. He’s lost the outer third of his eyebrows. Today one of his labs came back very high. What lab was it?
If you guessed his TSH, you would be right. He has “Madarosis,” which is loss of the eyebrows. There are many causes, but hypothyroidism is the one that might be most commonly seen. However, some of the other causes might be relevant for this patient who has lost 40 lbs since his hospitalization including Hypoproteinemia, zinc deficiency, and iron deficiency — all of which can certainly be associated with a non-healing wound.
Madarosis can also be caused by leprosy (which we have in Texas; I have seen one), MMR vaccinations, anticoagulants, and Propranolol (to name only two of the many drugs that can cause it). Like many types of hair loss, it can be an indication of an autoimmune disease like Lupus or Scleroderma (we see a lot of those in wound centers), certain types of Carcinomas, Trichotillomania (more common than you think), Psoriasis, and HIV. That’s the short list.
Every single day – a wound center is better than any episode of “House.”