A Clinical Study of Androgenetic Alopecia

Han, Eun Sil; Kim, Myeung Nam; Hong, Chang Kwun; Ro, Byung In

Abstract

BACKGROUND: Androgenetic alopecia is considered to be a genetically determined disorder influenced by age and androgen. The proportion of patients with androgenetic alopecia among the total number of patients with alpecia seems to be gradually increasing.
OBJECTIVE
The purpose of this study is to determine the family history, clinical and endocrine status of the patients with androgenetic alopectia.
METHODS
387 patients with androgenetic alopecia who had visited the Department of Dermatology, Yongsan Hospital, College of Medicine, Chung-Ang University during the last 4 years (1990.1-1993.12)were examined.
RESULTS
1) Annual incidence of androgenetic alopecia among the total number of alopecia patients averaged over 4 years was 38.95 having increased recently. 2) There were 286 male and 101 female patients being most prevalent in the 3rd decade in both sexes. 3) Patients younger than 30 years old, patients with premature androgenetic alopecia, made up 687.5% of the male patients and 56.4 of the female patients with androgenetic alopecia. 4) Of the 73 male patients Hamilton's type III was most common (46, 63.0%). 5) Of the 34 female patients Ludwig's type I was most common (21, 61.2%). 6) there was a family history of baldness in 39.4% of first degree relatives in male patients and 41.25 of first degree relatives in female patients. 7) Associated diseases were observed in 152 (53.1%) of the male patients and 63(62.4%) of the female patients : seborrheic dermatitis (36.7%/35.7%), acne vulgaris (5.2%/5.95), atopic dermatitis, thyroid diseases, pulmonary tuberculosis, depression, and gastrointestinal diseases. In female patients menstrual irregularity, hypertrichosis, and polycystic ovary disease were also observed. 8) Serum testosterone levels were increased in 24 (8.8%0 of male patients and in 17 (17.45) of female patients.
CONCLUSION
Based on our findings, the development of androgenetic alopecia is significantly related to the positive family history of baldness. Serum testosterone levels in most patients were within normal limit and were increased only in a small number of the patients with androgenetic alopecia. Therefore, it seems reasonable to suggest that the inhibitory effecfts of androgens on the dermal papilla cells may be mediated by an increased density and/or functional activity of androgen receptors or through an acceleration in the metabolic activity of androgen.