The Role Of Dermoscopy And Clinical Characteristics Analysis In Male Androgenetic Alopecia

Androgenetic alopecia(AGA)is the most common disorder of chronic hair loss and often presented as a typical male pattern hair loss in men.In addition to the clinical manifestations,AGA can make an impact on psychological health and social relations of patients.The condition can be improved by correct diagnosis and treatment.In the first part of this study,an observational study was conducted to observe the dennoscopic findings of male patients with AGA and evaluate the relationship between the dennoscopic findings and the traditional clinical classification in order to discuss the role of dennoscopy in the diagnosis and treatment of male AGA.In the second part of the study,an investigation was conducted to obtain clinical information of male AGA patients through a questionnaire and analyze the results statistically so that we could get more information about the epidemiological characteristics,clinical manifestations,disease related factors,influence on patients and treatment of the disease.Part1:The role of dermoscopy in male androgenetic alopeciaObjective To observe the characteristics of male patients with AGA with a dermoscope and evaluate the relationship between dermoscopic findings and clinical classification in order to discuss the role of dermoscopy in the diagnosis and treatment of male AGA.Methods 187 patients were divided into seven groups according to the Hamilton-Norwood(H-N)classification system.Hair density and hair diameter in the crown regions and the occipital regions of patients and controls were investigated respectively by a handheld dermoscope and the results were statistically analyzed.Results In cases of male AGA,proportion of vellus hairs was significantly different between the crown regions and the occipital regions(P<0.001).In patients with different grades,proportion of vellus hairs in the crown regions and in the occipital regions were both significantly different.Proportion of vellus hairs in the crown regions was positively related to H-N classification(P<0.001).Density in both regions of male AGA and proportion of vellus hairs in the occipital regions were not related to H-N classification(P>0.05).The proportion of the hair of which the diameter was less than 0.06mm reached 20%in 95.2%of the patients.The proportion of the hair of which the diameter was less than 0.3mm reached 20%in 47.1%of the patients.In controls,proportion of vellus hairs was significantly different between the crown regions and the occipital regions(P<0.001)and there was no difference in hair density between the two regions(P>0.05).Compared with controls,proportion of vellus hairs in the crown regions and the occipital regions was significantly higher in patients(P<0.001)and the hair density in both regions of patients was significantly different from controls(P<0.05).In cases of grade I,proportion of vellus hairs in the crown regions was significantly different between patients and controls.And proportion of vellus hairs in the occipital regions was significantly different between patients and controls as well(P<0.001).Conclusions Proportion of vellus hairs in the crown regions increases with H-N classification,implying that the dermoscopic findings and clinical classification are consistent.The proportion of the hair of which the diameter is less than 0.06mm is more sensitive in diagnosis of early male AGA.In controls,proportion of vellus hairs is different between the crown regions and the occipital regions.Proportion of vellus hairs and hair density in the crown regions and the occipital regions of AGA patients are significantly different from controls.The dermoscopic findings of the patients are significantly changed before the typical appearance of male AGA so that dermoscopy examination is helpful for the early diagnosis of male AGA.Part2:Clinical characteristics analysis in male androgenetic alopeciaObjective To analyze the clinical characteristics in male AGA.Methods The survey was completed by investigator through asking patients of male AGA for information about demographic data,epidemiological characteristics,clinical manifestations,disease related factors,the impact on patients and the treatment.Results The study enrolled 156 male AGA patients and the age of patients ranged 18 to 48 years old including 19 cases of grade I,71 cases of grade II,34 cases of grade Ⅲ,17 cases of grade Ⅳ,11 cases of grade V and 4 cases of grade VI on the basis of the Hamilton-Norwood(H-N)classification.62%of the patients were in their twentiesand and the proportion of gradeⅡ reached 45%of all cases.Male AGA most often manifested gradual recession in the crown regions and the most shape of hairline is "M" type.21.2%of patients appeared with "O" type of hair loss over the vertex regions.16.7%of patients had positive pull tests.76.3%of patients observed change of hair texture such as becoming softer and thinner.Stress and lack of sleep were mostly considered as factors related to male AGA.The age of onset and H-N classification were not related to family history(P>0.05).Past treatment was attempted in 74 cases and condition improved in 26 cases.The combination of oral and topical treatment achieved the highest efficiency and the effective rate of oral finasteride combined with minoxidil topical solution was up to 73.3%.Conclusions Most of male AGA patients are presented as a typical male pattern hair loss.The age of onset and severity of disease are not related with family history.The therapeutic effect of oral finasteride combined with minoxidil topical solution is the best.Male AGA has a negative effect on mental health in majority of the patients.