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P29
PROPOSED MARGINAL TRACTION ALOPECIA SEVERITY (M-TAS) SCORE Traction alopecia (TA) occurs predominantly people of African decent and this has been assumed to be because of the popularity of certain hairstyles in this population. Because some hair styles form an important part of our cultural heritage as Africans, the individual variables that predispose to TA need to be elucidated so that a healthy balance between maintaining culture and preventing pathology can be reached. Without a severity score, it is impossible to objectively assess the effect of causal variables. Method Land marks and Regions The margins of the scalp are divided into an anterior and posterior using a line that joins the tips of both ears. The anterior margin is then divided into three regions using points on hair line at the medial edge of the temporalis muscle, which stands out if jaws are clenched, into a right and left temporalis (i.e. overlying the temporalis muscle on either side) and a central inter temporalis. The posterior margin is also divided into three regions by using a point on the hair line in line with the tip of ear above and behind the lower margin of the mastoid process below, on each side. The area of the hair line (directly behind the ear) overlying the mastoid process on either side form the left and right mastoid areas respectively; and the lower margin in between forms the inter mastoid area. Scoring system. For each of the six areas mentioned above, the affected percentage of the distance between two landmarks is estimated. The maximum possible score is 4 and assessment is as follows: Short/thin hair involving <50% = 1. Short/thin hair involving >50% = 2. Bald patch(es) involving <50% = 3. Bald patch(es) involving >50% = 4. If one area has both short hair and bald patch, the more severe (bald) score is entered. This score allows for quick and easy objective assessment of patients for both clinician and researcher but requires validity and reliability testing.
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