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Oiwoh SO, Enitan AO, Adegbosin OT, Akinboro AO, Onayemi EO. Androgenetic Alopecia: A Review. Niger Postgrad Med J 2024; 31:85-92. [PMID: 38826011 DOI: 10.4103/npmj.npmj_47_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 05/16/2024] [Indexed: 06/04/2024]
Abstract
This study reviewed the current knowledge on the epidemiology, pathophysiology, clinical presentations, diagnosis, treatment, quality-of-life assessment and recent trends in androgenetic alopecia (AGA). Relevant articles on AGA from PubMed, Google Scholar, Medline and Scopus from 1950 to 2024 were obtained and scrutinized.. Key search words included each term like 'androgenetic alopecia', 'androgenic alopecia', 'pattern baldness' and 'pattern hair loss' AND each term like 'epidemiology', 'pathophysiology', 'genetics', 'hormones', 'micronutrient', 'stress and inflammation', 'growth factors', 'clinical features', 'staging', 'cardiovascular associations', 'diagnosis' and 'management' were used in the search. AGA is a non-scarring hair loss that is exemplified by a progressive decline of hair follicles, or non-functional or dead hair follicles in the scalp in a defined pattern. It is the most common hair loss, more common in men but can also present in younger age as premature AGA. Hormones, genetics, micronutrient deficiency, microinflammation and stress have been implicated, while psychosocial distress and cutaneous correlate of cardiovascular diseases have become sources of relentless research. AGA is a patterned hair loss that is more prevalent in Men. It results from the interactions between hormonal, genetic and other factors which determine the extent of hair loss and associated disorders (psychosocial and cardiovascular). As results of more research become available, the extent of AGA, its comorbidities as well as the full spectrum of their manifestations will continue to be sources of health education and more holistic examination by dermatologists and patients.
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Affiliation(s)
- Sebastine Oseghae Oiwoh
- Department of Internal Medicine, Dermatology and Venereology Unit, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Ademola Olusegun Enitan
- Department of Dermatology and Venereology, Obafemi Awolowo University Teaching Hospitals Complex, Ile Ife, Osun State, Nigeria
| | | | - Adeolu Oladayo Akinboro
- Department of Medicine, Dermatology and Venereology Unit, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria
| | - Emmanuel Olaniyi Onayemi
- Department of Dermatology and Venereology, Obafemi Awolowo University, Ile Ife, Osun State, Nigeria
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2
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Tawfik C, Tejeda CI, Haughton AM. Case series evaluating the efficacy and safety of platelet-rich plasma for androgenetic alopecia in pediatric patients. JAAD Case Rep 2023; 37:8-12. [PMID: 37332360 PMCID: PMC10275738 DOI: 10.1016/j.jdcr.2023.04.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2023] Open
Affiliation(s)
- Catherine Tawfik
- Liberty University College of Osteopathic Medicine, Lynchburg, Virginia
| | - Christina I. Tejeda
- Department of Dermatology, Stony Brook University Hospital, Stony Brook, New York
| | - Adrienne M. Haughton
- Department of Dermatology, Stony Brook University Hospital, Stony Brook, New York
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3
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Gomes TF, Soares RO. Pediatric androgenetic alopecia: an updated review. J Dtsch Dermatol Ges 2023; 21:19-25. [PMID: 36688435 DOI: 10.1111/ddg.14940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 09/23/2022] [Indexed: 01/24/2023]
Abstract
Pediatric androgenetic alopecia is an underrecognized disorder. A clinical evaluation with trichoscopy should be made in children and adolescents with hair loss and/or reduced hair density. Diagnosis is usually clinical, by observation of the hair loss pattern and performance of trichoscopy. In some cases, hyperandrogenism should be excluded. Although there is no approved therapy for androgenetic alopecia in pediatric age, topical minoxidil, oral minoxidil and topical finasteride may be very useful. Hair transplant may be an option for girls in selected cases. This article is a review of the current state of evidence concerning pediatric androgenetic alopecia.
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4
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Gomes TF, Soares RO. Aktuelle Übersicht zur androgenetischen Alopezie bei Kindern und Jugendlichen. J Dtsch Dermatol Ges 2023; 21:19-26. [PMID: 36721944 DOI: 10.1111/ddg.14940_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 09/23/2022] [Indexed: 02/02/2023]
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5
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Lyakhovitsky A, Tzanani I, Gilboa S, Segal O, Galili E, Baum S, Barzilai A. Changing spectrum of hair and scalp disorders over the last decade in a tertiary medical centre. J Eur Acad Dermatol Venereol 2023; 37:184-193. [PMID: 36066315 DOI: 10.1111/jdv.18570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 07/27/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Hair- and scalp-related disorders (HSRDs) encompass a wide range of conditions that affect people of all ages. OBJECTIVE To evaluate the workload and trends in HSRDs at an outpatient dermatological clinic in a tertiary medical centre over a 10-year period. METHODS Medical records for HSRD visits to the outpatient dermatology clinic at the Sheba Medical Center, an Israeli tertiary care center, were reviewed between 1 January, 2010 and 31 December, 2020. RESULTS There were 10,396 HSRD visits with a new-to-follow-up visit ratio of 1:1.9. The annual number of HSRD visits, as well as their proportion out of all dermatological outpatient visits, have increased from 295 (1.24%) in 2010 to 1726 (9.44%) in 2020. The patients' mean age was 35.3 years (women 39.5 years, men 28.8 years), age range 1-87 years. Over the decade, there was a growing predominance of women with an average female-to-male ratio of 2:1. The winter season accounted for 28.7% of annual visits, followed by the autumn (25.6%), summer (24.3%) and spring (21.4%). The most prevalent HSRDs included androgenetic alopecia (30.6%), alopecia areata (19.3%), telogen effluvium (15.4%), non-scarring folliculitis (15.4%), seborrheic dermatitis (14.9%), lichen planopilaris (7.1%) and folliculitis decalvans (6.6%). Androgenetic alopecia demonstrated the highest increase over the decade examined (from 17% to 32%). CONCLUSION HSRDs account for a significant percentage of visits at a tertiary dermatology outpatient clinic. The number of HSRD visits has increased annually over the past decade. The recent advancement in diagnosis and treatment may account, at least in part, for the growing burden of HSRDs within dermatological ambulatory care.
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Affiliation(s)
| | - Ido Tzanani
- Department of Dermatology, Sheba Medical Center, Ramat-Gan, Israel
| | - Sarit Gilboa
- Department of Dermatology, Sheba Medical Center, Ramat-Gan, Israel
| | - Oz Segal
- Department of Dermatology, Sheba Medical Center, Ramat-Gan, Israel
| | - Eran Galili
- Department of Dermatology, Sheba Medical Center, Ramat-Gan, Israel
| | - Sharon Baum
- Department of Dermatology, Sheba Medical Center, Ramat-Gan, Israel
| | - Aviv Barzilai
- Department of Dermatology, Sheba Medical Center, Ramat-Gan, Israel.,Institute of Pathology, Sheba Medical Center, Ramat-Gan, Israel
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6
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Özcan D. Pediatric androgenetic alopecia: a retrospective review of clinical characteristics, hormonal assays and metabolic syndrome risk factors in 23 patients. An Bras Dermatol 2022; 97:166-172. [PMID: 35033390 PMCID: PMC9073250 DOI: 10.1016/j.abd.2021.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/15/2021] [Accepted: 06/28/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Androgenetic alopecia in the pediatric population is rarely discussed in the literature. Although the prevalence of the metabolic syndrome is increased in patients with early-onset androgenetic alopecia, the presence of metabolic syndrome risk factors in pediatric androgenetic alopecia is unknown. OBJECTIVE To evaluate the demographics, medical and family histories, clinical and trichoscopic features, androgenic hormones, and metabolic syndrome risk factors in pediatric androgenetic alopecia. METHODS The medical reports of pediatric patients with androgenetic alopecia were reviewed. RESULTS The study included 23 patients (12 females and 11 males) with a mean age of 15,3 ± 2,1 years. Sixteen patients had adolescent androgenetic alopecia and seven, had childhood alopecia. Nine patients reported a family history, all of whom had adolescent androgenetic alopecia. Hyperandrogenism was noted in three patients with adolescent androgenetic alopecia. The most common hair loss pattern was diffuse thinning at the crown with preservation of the frontal hairline which was noted in 10 patients (43.5%), six of whom were males. Fourteen patients (60.9%) had at least one metabolic syndrome risk factor. The most common risk factor was obesity or overweight (47.8%) followed by insulin resistance (21.7%), high fasting blood glucose (13%), high blood pressure (4.4%) and lipid abnormalities (4.4%). STUDY LIMITATIONS Retrospective study; lack of a control group. CONCLUSION Pediatric androgenetic alopecia is often associated with metabolic syndrome risk factors. Therefore, androgenetic alopecia in the pediatric population may indicate a future metabolic syndrome which warrants an accurate and prompt diagnosis for early screening and treatment.
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Affiliation(s)
- Deren Özcan
- Department of Dermatology, Başkent University Faculty of Medicine, Ankara, Turkey.
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Ohn J, Son HY, Yu DA, Kim MS, Kwon S, Park WS, Kim JI, Kwon O. Early onset female pattern hair loss: a case–control study for analyzing clinical features and genetic variants. J Dermatol Sci 2022; 106:21-28. [DOI: 10.1016/j.jdermsci.2022.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 02/13/2022] [Accepted: 02/27/2022] [Indexed: 11/26/2022]
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8
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Trüeb RM. Understanding Pattern Hair Loss-Hair Biology Impacted by Genes, Androgens, Prostaglandins and Epigenetic Factors. Indian J Plast Surg 2022; 54:385-392. [PMID: 34984074 PMCID: PMC8719969 DOI: 10.1055/s-0041-1739252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Pattern hair loss (PHL) is the most frequent cause of hair loss in men and women, accounting for 65% of consultations in a hair referral center. PHL is understood to represent a hereditary, age-dependent progressive thinning of the scalp hair, which follows distinct clinical patterns with notable differences depending on sex and age of onset. Clinical and investigative advances have helped us to understand some of the pathogenic steps, leading to PHL. Besides genetic factors and peculiarities of androgen metabolism, additional pathogenic factors that are suspected include microbiomata, oxidative stress, and microinflammation. While further suspects are likely to be exposed, individual diversity of causal agents, as well as of the sequence of events, or combined factors, must be kept in mind. A large number of therapeutic molecules claimed to be active and patented in this field, and their limited efficacy in offering a definitive cure of PHL confirm the complexity of PHL. The aim of therapy is to retard progression of hair thinning and increase hair coverage of the scalp. As yet, two FDA-approved drugs are available for this purpose, oral finasteride, and topical solution of minoxidil. Variations in posology and formulation allow for an enhancement of patient comfort and treatment efficacy. Antiandrogen treatments in women with normal androgen levels have questionable efficacy while having health risks.
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Affiliation(s)
- Ralph M Trüeb
- Center for Dermatology and Hair Diseases Professor Trüeb, Switzerland
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9
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Trüeb RM, Casañas-Quintana E, Régnier A, Caballero-Uribe N. Prepubertal pattern hair loss. Clin Exp Dermatol 2021; 47:173-175. [PMID: 34347893 DOI: 10.1111/ced.14865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2021] [Indexed: 11/28/2022]
Affiliation(s)
- R M Trüeb
- Center for Dermatology and Hair Diseases Professor Trüeb, University of Zurich, Zurich, Switzerland
| | - E Casañas-Quintana
- Center for Dermatology and Hair Diseases Professor Trüeb, University of Zurich, Zurich, Switzerland
| | - A Régnier
- Center for Dermatology and Hair Diseases Professor Trüeb, University of Zurich, Zurich, Switzerland
| | - N Caballero-Uribe
- Department of Dermatology, Cantonal Hospital Aarau, Aarau, Switzerland
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10
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Boghrati Z, Sabouri-Rad S, Emami SA, Saber MT, Sahebkar A, Tayarani-Najaran Z. The Use of Medicinal Plants for the Treatment of Alopecia in the Canon of Avicenna: An Evidence-Based Review. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1308:291-308. [PMID: 33861452 DOI: 10.1007/978-3-030-64872-5_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Although mostly seen in the scalp, alopecia can occur in any hair- bearing site of the body. In spite of various modern treatments, total cost, efficacy, safety and drug dependency have caused a global willing towards natural remedies. The aim of this chapter is to focus on medicinal plants mentioned in Canon of Avicenna, one of the most primary medicinal books, for the treatment of alopecia. Databases like PubMed, Scopus and Google Scholar were searched for plants mentioned in Canon for managing alopecia to find studies on their clinical efficacy or mechanisms, which may have attributed to the treatment of alopecia. 25 plants belonging to 16 families have been mentioned in Canon. Most of them have a history of use in ethno-medicine and some are used in hair growth products nowadays. Investigating literatures has shown that anti- inflammatory and immunomodulatory properties are the proposed mechanisms for the treatment of some types of alopecia. Islamic traditional medicine can give new insights for development of multiple natural treatment, which their use in human have been tested for thousands of years. By confirming their efficacy and safety, traditional herbal remedies are appropriate alternatives for chemicals mainly used for alopecia.
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Affiliation(s)
- Zahra Boghrati
- Department of Traditional Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sara Sabouri-Rad
- Department of Dermatology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Ahmad Emami
- Department of Traditional Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Mohsen Tahaghoghi Saber
- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. .,Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran. .,School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran. .,Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland.
| | - Zahra Tayarani-Najaran
- Targeted Drug Delivery Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
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11
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Ding Q, Xu YX, Sun WL, Liu JJ, Deng YY, Wu QF, Cao CY, Zhou LB, Lu Y, Fan WX. Early-onset androgenetic alopecia in China: a descriptive study of a large outpatient cohort. J Int Med Res 2020; 48:300060519897190. [PMID: 32188323 PMCID: PMC7105740 DOI: 10.1177/0300060519897190] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective Methods Results Conclusions
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Affiliation(s)
- Qi Ding
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China.,Department of Dermatology, Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Yu-Xuan Xu
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Wei-Ling Sun
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Jing-Jing Liu
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Yu-Yu Deng
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Qiao-Fang Wu
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Chun-Yu Cao
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Lan-Bo Zhou
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Yan Lu
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Wei-Xin Fan
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
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Affiliation(s)
| | - Dawn Marie R Davis
- Department of Dermatology and.,Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Megha M Tollefson
- Department of Dermatology and.,Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
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13
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Perper M, Herskovitz I, Tosti A. Aromatase inhibitor-induced hair loss in two adolescents. Pediatr Dermatol 2020; 37:1125-1127. [PMID: 32869880 DOI: 10.1111/pde.14339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/20/2020] [Accepted: 08/04/2020] [Indexed: 11/28/2022]
Abstract
Hair loss and thinning are possible complications in those undergoing endocrine therapies with aromatase inhibitors. Alopecia in pediatric patients undergoing endocrine therapy has not been previously reported. We describe two adolescents, 14 and 16 years of age, who developed androgenetic alopecia following treatment with anastrozole for idiopathic short stature. Accordingly, the possible adverse event of alopecia should be considered in the pediatric population undergoing treatment with aromatase inhibitors.
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Affiliation(s)
- Marina Perper
- Department of Dermatology and Cutaneous Surgery, University of Miami Hospital, Miami, Florida, USA
| | - Ingrid Herskovitz
- Department of Dermatology and Cutaneous Surgery, University of Miami Hospital, Miami, Florida, USA
| | - Antonella Tosti
- Department of Dermatology and Cutaneous Surgery, University of Miami Hospital, Miami, Florida, USA
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14
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Lemes LR, Melo DF, de Oliveira DS, de La-Rocque M, Zompero C, Ramos PM. Topical and oral minoxidil for hair disorders in pediatric patients: What do we know so far? Dermatol Ther 2020; 33:e13950. [PMID: 32614119 DOI: 10.1111/dth.13950] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 06/26/2020] [Indexed: 12/11/2022]
Abstract
Minoxidil is a strong arterial vasodilator, first introduced as an antihypertensive medication. In dermatology, topical minoxidil (TMX) has been used for many types of alopecia. TMX is not FDA-approved in patients under 18 years old and there are no guidelines for its pediatric use. Low-dose oral minoxidil (OMX) has been used off-label for hair loss treatment in adults expecting to achieve better therapeutic compliance and greater clinical efficacy. However, little is known about TMX and OMX in pediatric population. the literature presented on TMX and OMX in children to date was reviewed. The terms "minoxidil", "child", "children", "childhood", and "infant" were used to perform a literature search in MEDLINE through PubMed. The search was limited to articles about humans and available in English. While 25 relevant articles were selected, duplicate titles were excluded. This article pointed out the use of minoxidil in several pediatric hair diseases. Even when used topically, dermatologists should be aware of potential risks of systemic absorption. In particular situations, OMX in very low doses may be considered. To date, there are no guidelines regarding the ideal dose or minimum age for using the drug topically or systemically.
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Affiliation(s)
- Luciana Rodino Lemes
- Department of Dermatology, University of State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Daniel Fernandes Melo
- Department of Dermatology, University of State of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | | | - Paulo Müller Ramos
- Department of Dermatology, São Paulo State University-UNESP, Botucatu, Brazil
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15
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Griggs J, Burroway B, Tosti A. Pediatric androgenetic alopecia: A review. J Am Acad Dermatol 2019; 85:1267-1273. [DOI: 10.1016/j.jaad.2019.08.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 07/24/2019] [Accepted: 08/05/2019] [Indexed: 10/26/2022]
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16
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Rossi A, D'Arino A, Pigliacelli F, Caro G, Muscianese M, Fortuna MC, Carlesimo M. The diagnosis of androgenetic alopecia in children: Considerations of pathophysiological plausibility. Australas J Dermatol 2019; 60:e279-e283. [PMID: 31168786 DOI: 10.1111/ajd.13079] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 04/24/2019] [Indexed: 01/21/2023]
Abstract
Androgenetic alopecia (AGA), one of the most common causes of hair loss in men and women, is an infrequent cause of alopecia in children. In AGA, patients generally start noticing hair thinning after the onset of puberty due to progressive miniaturisation of the hair follicle which leads to vellus transformation of terminal hair. However, the occurrence of prepubertal AGA has rarely been reported in the literature. The pathophysiology of AGA is tightly linked to androgen hormones; prepubertal children do not usually produce significant amounts of adrenal or gonadal androgens. When it does occur, an underlying abnormality should be suspected. Secondary causes of AGA must be excluded when evaluating a patient before the appearance of puberty. Premature puberty, polycystic ovarian syndrome and other causes of hyperandrogenism can present with hair loss in an androgenetic pattern. This article reviews the normal physiology of androgen hormones and their role in the pathophysiology of childhood AGA.
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Affiliation(s)
- Alfredo Rossi
- Department of Internal Medicine and Medical Specialties, UOC Dermatology, University of Rome "Sapienza", Rome, Italy
| | - Andrea D'Arino
- Department of Internal Medicine and Medical Specialties, UOC Dermatology, University of Rome "Sapienza", Rome, Italy
| | - Flavia Pigliacelli
- Department of Internal Medicine and Medical Specialties, UOC Dermatology, University of Rome "Sapienza", Rome, Italy
| | - Gemma Caro
- Department of Internal Medicine and Medical Specialties, UOC Dermatology, University of Rome "Sapienza", Rome, Italy
| | - Marta Muscianese
- Department of Internal Medicine and Medical Specialties, UOC Dermatology, University of Rome "Sapienza", Rome, Italy
| | - Maria Caterina Fortuna
- Department of Internal Medicine and Medical Specialties, UOC Dermatology, University of Rome "Sapienza", Rome, Italy
| | - Marta Carlesimo
- Department of Internal Medicine and Medical Specialties, UOC Dermatology, University of Rome "Sapienza", Rome, Italy
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17
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Trüeb RM, Dutra H, Dias MFRG. Autistic-Undisciplined Thinking in the Practice of Medical Trichology. Int J Trichology 2019; 11:1-7. [PMID: 30820126 PMCID: PMC6385517 DOI: 10.4103/ijt.ijt_79_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Medical trichology is the branch of dermatology that deals with the scientific study of the hair and scalp in health and disease. As any discipline, the practice of medical trichology is not immune to malpractice, either deliberately or carelessly. In his publication "Autistic Undisciplined Thinking in Medicine and How to Overcome It," Swiss psychiatrist Eugen Bleuler describes yet another form of malpractice in medicine reflecting autistic-undisciplined thinking. Autism is not limited to psychopathology, but inherent to the thinking of man throughout history in his drive for knowledge, with thousands of theories lacking any basis in reality. Bleuler recognized the drive character of autistic thinking and how it leads to conclusions that are unshakable because they are determined by, and fulfill, emotional needs, rather than rational argumentation. Even with correct questions, the complexity and incalculability of some problems are often so great that it cannot do justice to realistic thinking and the boundaries between inadequately substantiated hypothesis and autistic sham explanation disappear. Statistics, careful research design, and the attempt to impose stringent methods on our thinking are to be commended. The habituation of the public to useless medicine, to misconceptions, is not hygiene, but negligent endangerment. It has created an industry that largely lives on the autistic thinking of patients and doctors and because it is prosperous, makes propaganda among lay people as well as among doctors that necessarily leads to abuses. This article aims at exposing the most prevalent among abuses in trichological practice due to autistic-undisciplined thinking, specifically: iron supplementation, antiandrogenic treatment, and individualized cell-based therapy in female androgenetic alopecia, treatment of folliculitis decalvans with retinoids, and the value of nutritional therapies.
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Affiliation(s)
- Ralph Michel Trüeb
- Center for Dermatology and Hair Diseases Professor Trüeb, Zurich-Wallisellen, Switzerland
| | - Hudson Dutra
- Department of Dermatology, Alvaro Alvim School Hospital, Campos dos Goytacazes, Brazil
| | - Maria Fernanda Reis Gavazzoni Dias
- Department of Dermatology, Center of Medical Sciences, Fluminense Federal University, Antonio Pedro University Hospital, Rio de Janeiro, Brazil
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18
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Ahmed B, Gritli S. Telogen hair loss and androgenetic-like alopecia in GAPO syndrome. Australas J Dermatol 2018; 60:e142-e144. [PMID: 30255493 DOI: 10.1111/ajd.12937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 08/31/2018] [Indexed: 01/05/2023]
Abstract
Growth retardation, Alopecia, Pseudoanodontia and Optic atrophy (GAPO) syndrome is a rare autosomal recessive condition whose cardinal features include a recognizable craniofacial dysmorphosis, growth retardation, alopecia, pseudoanodontia, and premature aging. We report on a 2-year-old Pakistani man affected with GAPO syndrome who additionally shows an androgenetic-like alopecia with normal testosterone levels and telogen hair loss. These are novel findings in GAPO syndrome.
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Affiliation(s)
- Burhan Ahmed
- Department of Dermatology and Dermatological Surgery, Jinnah Hospital, Lahore, Pakistan
| | - Sami Gritli
- Department of Developmental Biology, Harvard School of Dental Medicine and Harvard Medical School, Boston, Massachusetts, USA
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Wang X, Xiong C, Zhang L, Yang B, Wei R, Cui L, Xing X. Psychological assessment in 355 Chinese college students with androgenetic alopecia. Medicine (Baltimore) 2018; 97:e11315. [PMID: 30075498 PMCID: PMC6081179 DOI: 10.1097/md.0000000000011315] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Although the association of the psychological problems and androgenetic alopecia (AGA) gained the increasing attention, the psychosocial state in college students with AGA remains unknown. We recruited a total number of 355 college students with AGA from 18 universities in Southern China for interview. The Symptom Checklist-90-R (SCL-90-R) survey was used to assess the psychological state of these students. There were significant differences in somatization, obsessive-compulsive, interpersonal sensitivity, depression, phobic anxiety, psychoticism, and global severity index (GSI) between college students with AGA and the controls. Moreover, regarding the impact of specialty, scores for the interpersonal sensitivity, depression, and phobic anxiety in medical students and art students with AGA were significantly higher than other professions. In addition, obsessive-compulsive and GSI in art students with AGA were significantly higher compared with other professions. These findings suggested that the therapeutic approach for the psychological problems should be considered in the tailored treatment for AGA in the college students.
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Affiliation(s)
- Xia Wang
- Department of Dermatology, the First Affiliated Hospital of Jinan University
- Department of Dermatology, the First Affiliated Hospital of Guangzhou Medical University
| | - Chunping Xiong
- Department of Dermatology, the First Affiliated Hospital of Guangzhou Medical University
| | - Li Zhang
- Department of Dermatology, the First People's Hospital of Lanzhou City, Lanzhou
| | - Bin Yang
- Department of Dermatology, the First Affiliated Hospital of Jinan University
- Dermatology Hospital of Southern Medical University, Guangzhou, P.R. China
| | - Rongfang Wei
- Department of Dermatology, the First Affiliated Hospital of Guangzhou Medical University
| | - Liqian Cui
- Department of Dermatology, the First Affiliated Hospital of Guangzhou Medical University
| | - Xiangbin Xing
- Department of Gastroenterology, the First Affiliated Hospital of Sun Yat-sen University
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Peña AS, Metz M. What is adolescent polycystic ovary syndrome? J Paediatr Child Health 2018; 54:351-355. [PMID: 29280221 DOI: 10.1111/jpc.13821] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 09/29/2017] [Accepted: 10/17/2017] [Indexed: 12/28/2022]
Abstract
The diagnostic criteria for adolescent polycystic ovary syndrome (PCOS) has been derived from adult criteria, which makes diagnosis challenging as criteria include normal physiological events that occur during puberty such as acne, hirsutism, menstrual irregularities, high androgen levels and polycystic ovarian morphology on pelvic ultrasound. The only criteria that applies from the adult criteria is exclusion of other conditions that mimic PCOS. Clinical findings consistent with hyperandrogenaemia during adolescence include inflammatory acne, hirsutism, alopecia and/or menstrual irregularities, which are severe and present 2 years after menarche. The measurement of androgen levels during adolescence should take into account age, puberty, type of androgen measured, assay used and diurnal rhythm. Multiple measurements are useful to demonstrate hyperandrogenaemia. The combination, severity and persistence of the hyperandrogenic symptoms and hyperandrogenaemia in girls 2 years or more post-menarche support the diagnosis of adolescent PCOS. Adolescent girls with these findings should be followed up into adulthood.
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Affiliation(s)
- Alexia S Peña
- Discipline of Paediatrics, Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia.,Department of Endocrinology and Diabetes, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Michael Metz
- SA Pathology, Women's and Children's Hospital, Adelaide, South Australia, Australia
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Abstract
Inflammatory dermatoses encompass a variety of histologic patterns that affect different portions of the skin. In spongiotic, psoriasiform, lichenoid, pityriasiform, and blistering disorders, there are predominately epidermal and junctional activities with variable superficial dermal inflammation. Hypersensitivity reactions can show either epidermal or mostly dermal changes depending on whether the exposure of the exogenous allergen occurs through an external or internal route, respectively. Exceptions include erythema multiforme and Stevens-Johnson syndrome/toxic epidermal necrolysis, where the etiology is often due to infection or ingested medications, but the histologic features are almost exclusively confined to the epidermis and dermoepidermal junction. Autoimmune disorders are unique in that lesions typically incorporate a mixture of epidermal and dermal inflammatory patterns with periadnexal inflammation, while the vast majority of vasculitis/vasculopathy and alopecia have changes limited to only the vessels and hair follicles, respectively. It is critical to recognize that a relatively limited number of histologic patterns are seen in a large array of clinical entities. Therefore, clinicopathologic correlation and careful examination of histologic details are of the utmost importance when evaluating skin biopsies for inflammatory disorders.
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Affiliation(s)
- Andy C Hsi
- 1 Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
| | - Ilana S Rosman
- 1 Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri.,2 Division of Dermatology, Washington University School of Medicine, St. Louis, Missouri
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Redler S, Messenger AG, Betz RC. Genetics and other factors in the aetiology of female pattern hair loss. Exp Dermatol 2017; 26:510-517. [DOI: 10.1111/exd.13373] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2017] [Indexed: 12/19/2022]
Affiliation(s)
- Silke Redler
- Institute of Human Genetics; University Clinic Düsseldorf; Heinrich-Heine-University; Düsseldorf Germany
| | | | - Regina C. Betz
- Institute of Human Genetics; University of Bonn; Bonn Germany
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Martínez-Velasco MA, Vázquez-Herrera NE, Maddy AJ, Asz-Sigall D, Tosti A. The Hair Shedding Visual Scale: A Quick Tool to Assess Hair Loss in Women. Dermatol Ther (Heidelb) 2017; 7:155-165. [PMID: 28220468 PMCID: PMC5336434 DOI: 10.1007/s13555-017-0171-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Hair shedding is a common consequence of the normal hair cycle that changes with internal and external factors. Female pattern hair loss (FPHL) is difficult to assess in terms of shedding severity as the conscious perception of hair shedding varies according to each individual, and most utilized methods are semi-invasive or very time consuming. In this study, we establish and validate a hair-shedding scale for women with thick hair of different lengths. METHODS A visual analog scale was developed for thick hair of short, medium, and long lengths by dividing a bundle of hairs of each length into nine piles of increasing hair amount that were then photographed and arranged in order of size. Twenty women with no FPHL with each length of hair (60 total) were asked to select the photographed hair bundle that best correlated with the amount of hair they shed on an average day. A total of 94 women with FPHL with excessive shedding were then asked to repeat the same process. RESULTS Women with no FPHL and short, medium and long hair had mean shedding scores of 2.5, 2.35 and 2.4, respectively. Women with FPHL and short, medium and long hair had mean shedding scores of 7.25, 7.0 and 7.14, respectively. Statistically significant Spearman's ρ coefficient and κ coefficient demonstrated correlation and inter-observer reliability. CONCLUSION Our results show that women with FPHL not only shed considerable hair more than women with no FPHL, but that this hair-shedding visual scale is a fast and effective method of evaluating hair-shedding amounts in an office setting.
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Affiliation(s)
- María Abril Martínez-Velasco
- Universidad Nacional Autonoma de Mexico Clínica de Oncodermatología, Circuito Escolar S/N, Col. UNAM C.U., Del Coyoacán, Mexico City, Mexico
| | | | - Austin John Maddy
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1475 NW 12th Avenue Suite 2175, Miami, FL, USA
| | - Daniel Asz-Sigall
- Universidad Nacional Autonoma de Mexico Clínica de Oncodermatología, Circuito Escolar S/N, Col. UNAM C.U., Del Coyoacán, Mexico City, Mexico
| | - Antonella Tosti
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1475 NW 12th Avenue Suite 2175, Miami, FL, USA.
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Hair loss among a group of Egyptian children. JOURNAL OF THE EGYPTIAN WOMEN’S DERMATOLOGIC SOCIETY 2017. [DOI: 10.1097/01.ewx.0000489879.88799.28] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Siah TW, Muir-Green L, Shapiro J. Female Pattern Hair Loss: A Retrospective Study in a Tertiary Referral Center. Int J Trichology 2016; 8:57-61. [PMID: 27601857 PMCID: PMC4989388 DOI: 10.4103/0974-7753.188033] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: Female pattern hair loss (FPHL) is a very common problem in women. The underlying pathophysiology remains unclear, and there are no universally agreed treatment guidelines. Objective: We explored the clinical features, relevant medical and family history, laboratory evaluation, and treatment and compliance of 210 patients with FPHL. Methods: Data analysis from case notes was performed on 210 patients with a diagnosis of FPHL seen from January 2011 to December 2011. Results: The youngest individual was 8 years old and the oldest was 86 years old. Nearly, 85% of the patients had a family history of androgenetic alopecia. Hypothyroidism and hypertension are the most common medical problems. Telogen effluvium (TE) is the most common concurrent hair loss condition. Only 38% of the patients were found to have normal Vitamin D level, 71% had ferritin level above 30 μg/L, and 85% had normal zinc level at the first consultation. Fifty-nine percent of the patients failed to attend any follow-up appointments. Limitations: One of the limitations of this study is its retrospective nature. Moreover, the severity of FPHL in terms of Ludwig score was not routinely documented in the medical charts. Conclusion: History of TE, hypothyroidism and hypertension, and low serum Vitamin D is common in our patients with FPHL.
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Affiliation(s)
- Tee Wei Siah
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC V5Z 4E8, Canada
| | - Llorenia Muir-Green
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC V5Z 4E8, Canada
| | - Jerry Shapiro
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC V5Z 4E8, Canada; Department of Dermatology, New York University Langone Medical Center, New York City, New York, USA
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Kibar M, Aktan S, Bilgin M. Scalp dermatoscopic findings in androgenetic alopecia and their relations with disease severity. Ann Dermatol 2014; 26:478-84. [PMID: 25143677 PMCID: PMC4135103 DOI: 10.5021/ad.2014.26.4.478] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Revised: 09/09/2013] [Accepted: 09/14/2013] [Indexed: 11/17/2022] Open
Abstract
Background Clinicians are searching for new methods to diagnose and predict the course of androgenetic alopecia noninvasively. Objective Our aim is to evaluate trichoscopic findings and their relations with disease severity in androgenetic alopecia. Methods The videodermatoscopic findings of 143 female and 63 male patients with androgenetic alopecia were compared with each other, with those of healthy subjects (n=100), and with those of patients with other nonscarring alopecias (n=208). Mann-Whitney U-test, χ2 analyses, and logistic regression analysis were used for statistical analysis. Results No statistically significant relation was found between trichoscopic findings and severity in male androgenetic alopecia (MAGA) on the basis of the modified Hamilton Norwood scale (among 7 degrees); however, multihair follicular unit and perifollicular pigmentation were related to low severity whereas white dots, honeycomb pattern pigmentation, and brown dots were related to high severity. On the other hand, according to the Ludwig classification, arborizing red lines were related to low severity and brown dots were related to high severity, whereas there was no difference in stages between the Ebling and Olsen classifications in female androgenetic alopecia (FAGA). In the characteristic trichoscopic findings in this study, perifollicular pigmentation was found as a normal feature of the scalp, whereas multihair follicular unit and honeycomb pigment pattern, which were previously considered as normal features, were observed to be related to androgenetic alopecia. Conclusion No relation was found between MAGA severity and trichoscopic findings, as well as between FAGA severity according to different disease severity classifications and trichoscopic findings.
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Affiliation(s)
- Melike Kibar
- Department of Dermatology, Beypazarı Public Hospital, Ankara, Turkey
| | - Sebnem Aktan
- Department of Dermatology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Muzaffer Bilgin
- Department of Biostatistics, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
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The female pattern hair loss: review of etiopathogenesis and diagnosis. BIOMED RESEARCH INTERNATIONAL 2014; 2014:767628. [PMID: 24812631 PMCID: PMC4000932 DOI: 10.1155/2014/767628] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 01/14/2014] [Indexed: 11/24/2022]
Abstract
Female pattern hair loss (FPHL) is the most common hair loss disorder in women. Initial signs may develop during teenage years leading to a progressive hair loss with a characteristic pattern distribution. The condition is characterized by progressive replacement of terminal hair follicles over the frontal and vertex regions by miniaturized follicles, that leads progressively to a visible reduction in hair density. Women diagnosed with FPHL may undergo significant impairment of quality of life. FPHL diagnosis is mostly clinical. Depending on patient history and clinical evaluation, further diagnostic testing may be useful. The purpose of the paper is to review the current knowledge about epidemiology, pathogenesis, clinical manifestations, and diagnosis of FPHL.
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Khodaeiani E, . SB, . MJA, . ERK, . DFF, . MG. Changes of Hair Diameter after Treatment of Androgenic Alopecia; the First Case-control Study. JOURNAL OF MEDICAL SCIENCES 2014. [DOI: 10.3923/jms.2014.97.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Abstract
Hair and scalp disorders in children may originate from the hair itself, scalp skin, or infectious causes and be congenital or acquired. The most common sign is alopecia, frequently brought on by tinea capitis, patchy alopecia areata, or trichotillomania. Sometimes less frequent and clinically more elusive conditions such as initial androgenetic alopecia, congenital triangular alopecia, or alopecia areata incognita may be responsible for hair loss. The noninvasive technique known as trichoscopy is being used more frequently, aiding in the prompt differential diagnosis and follow-up of many of these diseases, oftentimes providing further examination before a treatment decision is made. This review of trichoscopy of the main scalp and hair disorders afflicting children and adolescents discusses the most important dermoscopic criteria and the usefulness of this technique.
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Affiliation(s)
- André Lencastre
- Serviço de Dermatologia, Hospital de Santo António dos Capuchos, Centro Hospitalar de Lisboa Central Lisbon, Portugal
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Abstract
Hair loss and alopecia occur frequently in children. The prevalence of the underlying causes and conditions, treatment options and prognosis differ in part significantly from adulthood. This article focuses on frequent forms of acquired alopecia which are not associated with inflammation or scarring of the scalp. Special attention is given to alopecia areata as the most important entity and to trichotillomania as its most difficult differential diagnosis. Significant forms of diffuse hair loss include anagen-dystrophic and telogen effluvium, androgenetic alopecia and loose anagen hair.
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Miteva M, Tosti A. Hair and scalp dermatoscopy. J Am Acad Dermatol 2012; 67:1040-8. [DOI: 10.1016/j.jaad.2012.02.013] [Citation(s) in RCA: 201] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Revised: 01/29/2012] [Accepted: 02/03/2012] [Indexed: 12/19/2022]
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Zhang X, Caulloo S, Zhao Y, Zhang B, Cai Z, Yang J. Female pattern hair loss: clinico-laboratory findings and trichoscopy depending on disease severity. Int J Trichology 2012; 4:23-8. [PMID: 22628986 PMCID: PMC3358934 DOI: 10.4103/0974-7753.96082] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Female pattern hair loss (FPHL) is a progressive hair loss disorder with unclear triggering and supporting factors. Trichoscopic features of each stage of FPHL have not been specifically elaborated previously. AIMS To analyze characteristics and investigate associations of clinico-laboratory and trichoscopic features of female patients in regard to the severity of hair loss in FPHL and to facilitate its diagnosis using noninvasive scalp dermoscopy (trichoscopy) in Fitzpatrick skin type III patients. MATERIALS AND METHODS Clinico-laboratory and trichoscopic data from 60 patients with FPHL were analyzed using Spearman's correlation test. RESULTS Patients had mean age of 34.4±10.6 years and mean duration of hair loss of 4.49±3.76 years. Of all, 45% (27/60) had a family history of pattern hair loss (PHL) and had an earlier onset of hair loss. Stage of hair loss positively correlated with duration and age at presentation. No association was found between the severity of FPHL and laboratory values including anemic and gonadal hormone profiles. Characteristic trichoscopic features (at 10-fold magnification) of FPHL were peripilar signs (PPS) (brown, BPPS and white, WPPS), white dots, scalp pigmentation, and focal atrichia. WPPS, scalp pigmentation, and focal atrichia positively correlated with the stage and duration of hair loss. CONCLUSIONS Family history of PHL causes an earlier onset of hair loss but does not influence its course or severity. The latter is also not affected by abnormal anemic profile or hormonal levels. PPS, scalp pigmentation, focal atrichia, and white dots are characteristic of PHL. WPPS, scalp pigmentation, and focal atrichia reflect advanced PHL.
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Affiliation(s)
- Xingqi Zhang
- Department of Dermatology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Vozza A, Piccolo V, Russo T, Vozza G. Familial androgenetic alopecia in siblings with normal endocrinological status. Pediatr Dermatol 2012; 29:534-5. [PMID: 21906153 DOI: 10.1111/j.1525-1470.2011.01528.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Androgenetic alopecia (AGA) is the most common type of hair loss in adults, but it has been rarely reported in children. We report two cases of AGA in two siblings, aged 6 and 8, whose mother had the same condition, without any association with other skin diseases or abnormalities in endocrinologic examinations.
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Affiliation(s)
- Antonio Vozza
- Department of Dermatology and Venereology, Second University of Naples, Naples, Italy
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Chen WC, Zouboulis CC. Hormones and the pilosebaceous unit. DERMATO-ENDOCRINOLOGY 2011; 1:81-6. [PMID: 20224689 DOI: 10.4161/derm.1.2.8354] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2009] [Accepted: 03/09/2009] [Indexed: 01/14/2023]
Abstract
Hormones can exert their actions through endocrine, paracrine, juxtacrine, autocrine and intracrine pathways. The skin, especially the pilosebaceous unit, can be regarded as an endocrine organ meanwhile a target of hormones, because it synthesizes miscellaneous hormones and expresses diverse hormone receptors. Over the past decade, steroid hormones, phospholipid hormones, retinoids and nuclear receptor ligands as well as the so-called stress hormones have been demonstrated to play pivotal roles in controlling the development of pilosebaceous units, lipogenesis of sebaceous glands and hair cycling. Among them, androgen is most extensively studied and of highest clinical significance. Androgen-mediated dermatoses such as acne, androgenetic alopecia and seborrhea are among the most common skin disorders, with most patients exhibiting normal circulating androgen levels. The "cutaneous hyperandrogenism" is caused by in stiu overexpression of the androgenic enzymes and hyperresponsiveness of androgen receptors. Regulation of cutaneous steroidogenesis is analogous to that in gonads and adrenals. More work is needed to explain the regional difference within and between the androgn-mediated dermatoses. The pilosebaceous unit can act as an ideal model for studies in dermato-endocrinology.
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Tosti A, Torres F. Dermoscopy in the diagnosis of hair and scalp disorders. ACTAS DERMO-SIFILIOGRAFICAS 2010; 100 Suppl 1:114-9. [PMID: 20096205 DOI: 10.1016/s0001-7310(09)73176-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Dermoscopy is a non-invasive, in vivo technique that has been recently utilized for the diagnosis and management of hair and scalp disorders. In the last few years many studies have been published in this field; this review will describe the dermoscopic patterns observed in the most common hair and scalp disorders and discuss their diagnostic relevance.
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Affiliation(s)
- A Tosti
- Department of Dermatology, University of Bologna, Bologna, Italy.
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Gonzalez ME, Cantatore-Francis J, Orlow SJ. Androgenetic alopecia in the paediatric population: a retrospective review of 57 patients. Br J Dermatol 2010; 163:378-85. [PMID: 20346026 DOI: 10.1111/j.1365-2133.2010.09777.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hair loss is an unwelcome event at any age, but it can be particularly distressing for adolescents and their families. While androgenetic alopecia (AGA) is the most common form of hair loss in adults, little is known about its prevalence, clinical features and response to treatments in the paediatric population. OBJECTIVES To better characterize the causes of alopecia in a paediatric population. METHODS We performed a retrospective chart review to identify all patients with hair loss seen in an academic paediatric dermatology practice at New York University over a 12-year period to better characterize the causes of alopecia in this population. We review the clinical and histological features, natural progression and associated laboratory abnormalities of AGA in 57 paediatric patients. RESULTS AGA was identified as the most frequent cause of hair loss in adolescents and the second most common diagnosis overall. The male to female ratio was 2 : 1 and the average age at initial presentation with AGA was 14.8 years. Adolescent girls had diffuse thinning or thinning at the crown, and boys frequently presented with female pattern hair loss. When biopsies were performed, perifollicular inflammation was a common finding. A family history of AGA was reported in 83% of patients. Laboratory evaluation for androgens revealed polycystic ovarian syndrome in three girls and late-onset congenital adrenal hyperplasia in one boy. CONCLUSIONS AGA is the most common form of hair loss in adolescents, and can be the presenting sign of an underlying endocrine disorder. An accurate and timely diagnosis is essential for appropriate medical and psychosocial intervention when warranted.
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Affiliation(s)
- M E Gonzalez
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY, USA
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Yazdabadi A, Green J, Sinclair R. Successful treatment of female-pattern hair loss with spironolactone in a 9-year-old girl. Australas J Dermatol 2009; 50:113-4. [DOI: 10.1111/j.1440-0960.2009.00517.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Taylor PJ. Big head? Bald head! Skull expansion: alternative model for the primary mechanism of AGA. Med Hypotheses 2009; 72:23-8. [DOI: 10.1016/j.mehy.2008.07.048] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2008] [Revised: 07/17/2008] [Accepted: 07/21/2008] [Indexed: 10/21/2022]
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Abstract
Androgenetic alopecia (AGA) is the most common type of hair loss in adults, but it also occurs in adolescents, though its prevalence among this younger population is not well established. The purpose of this study was to evaluate the clinical manifestations and endocrine status of adolescent patients with AGA in Korea. This 5-year (January 2001-August 2005) clinical study involved 43 adolescent patients with AGA. Testosterone and dehydroepiandrosterone sulfate (DHEA-S) laboratory studies were undertaken to investigate androgenic hormonal effects. Hair loss severity was categorized using the Hamilton-Norwood and Ludwig classifications. Gender ratio showed a male predominance (M : F, 35:8), and a mean age at onset of 16.8 years. These adolescent patients showed milder symptoms than adults, and a family history of alopecia was found in 72.1%, which is greater than that reported in adults, which ranges 30.9-64.5%. Seborrheic dermatitis (27.9%) was the condition most commonly associated with AGA among our study subjects, followed in descending order by acne vulgaris and atopic dermatitis. Serum levels of testosterone and DHEA-S were within normal limits, except in one subject. Our study shows the clinical characteristics of AGA in Korean adolescents.
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Affiliation(s)
- Beom Joon Kim
- Department of Dermatology, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744, Korea
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