Clinical Analysis Of Androgenetic Alopecia

Background:Androgenetic alopecia(AGA)is a common chronic alopecia disease,the main clinical manifestation is progressive hair reduction at the top of the head.Hair is an important manifestation of personal appearance.Alopecia disease brings heavy mental pressure to patients,which leads to negative emotions and seriously affects personal social activities and quality of life.Deepning the understanding of androgenetic alopecia can help us diagnose and treat the disease more effectively,so that patients can recover earlier and effectively improve their quality of life.Therefore,it has important significance to study the clinical characteristics and dermoscopic signs of androgenetic alopecia.Objective:Retrospectively investigate the data of androgenetic alopecia who come to Dermatology Alopecia Department.To explore the epidemiological characteristics,clinical manifestations,disease-related factors and dermoscopic signs of androgenetic alopecia.So as to provide reliable evidence for diagnosis,identification and treatment of AGA in the future.Methods:Retrospectively analyze the data of 2250 patients visited our department from February 2015 to October 2019,with androgenetic alopecia.Patients' gender,age,occupation,education background,living habits,family history,clinical manifestation and dermoscopic signs were collected and analyzed.Results:In the 2250 patients with AGA,78.2% were men and 21.8% were women.There were more unmarried male patients than married males and more married female patients than unmarried females.The age of onset and consultation were mainly 20-29 years old,the average age of onset was 26.3±6.9 years old,the average age of consultation was 29.7±7.5 years old and the average course of disease was 3.4±2.8 years.The occupations of patients were mainly senior intellectuals,staff and students,accounting for 36.0%,31.3%,and 28.1%,respectively.Undergraduate degree and above was the highest in the number of educational level,followed by technical secondary school and junior college.71.6% of patients fell asleep after 23:00,92.9% of patients had sleep less than 8 hours,and 59.6% of patients had poor sleep quality.A family history of AGA was present in 51.3% of men and 23.3% of women with AGA.The average age of onset was 25.7±6.2 years old in male patients with a positive family history and 26.9±6.8 years old in male patients with a negative family history.The average age of onset was 25.9±7.3 years old in female patients with a positive family history and 26.4±7.1 years old in female patients with a negative family history.Compared with those with a negative family history,patients with a positive family history had a higher severity,and most of them had an onset earlier than their patermal or maternal families.The most common types of hair loss were those with mild hair loss,followed by those with moderate hair loss,and thoes with severe hair loss.There were 94.9% of patients with mild to moderate female pattern alopecia and 98.4% of patients with mild to moderate male pattern alopecia.The most significant effct of hair loss on patients was lacking of confidence,accounting for 41.6%.As patients getting older and their disease course increasing,the severity of their hair loss increased.The dermascopic features of androgenetic alopecia in order of appearance frequency from high to low were hair diameter diversity>20%?increased single follicle units?increased vellus hairs?pigmentation?white scales increasing?brown peripilar sigh?telangiectasia?white dots and yellow dots.Besides,the incidence of increased single follicle unit?increased vellus hairs?pigmentation?brown peripilar sigh?white dots and yellow dots increased with the severity of hair loss,and the difference was statistically significant.The incidence of hair diameter diversity>20% was 99.4% in mild patients and 100% in both moderate and severe patients.Conclusion:Patients with androgenetic alopecia in our department is more common in young men and the severity is mainly mild to moderate.AGA was more common in people with mental working,stressful working life and relatively high education.Long-term staying up late,lacking of sleep,or poor sleeping quality may also induce or exacerbate hair loss.Family genetic history is still an important factor in the onset of androgenetic alopecia.Male patients are more affected by genetics than female patients.Patients with a positive family history have an earlier age of onset and a higher severity,and most of them had an onset earlier than their patermal or maternal families.As patients getting older and their disease course increasing,the severity of their hair loss increased.Dermoscope plays an important role in early diagnosis hair loss diseases,and hair diameter diversity more than 20% is the important criteria in the early diagnosis of androgenetic alopecia.