Alopecia

Alopecia • • • • • • • • •

androgenic congenital endocrine malnutrition chronic diffuse cicatricial chemical areata telogen effluvium

Androgenic • Aetiology both premature and late onset androgenic alopecia with magnitude of change by

genetic predisposition and hormone level in both sexes. •

terminal hair is transformed into vellus hair • miniaturization

incidence • incidence not well reported but it is 100% in caucasian races

classifacation • Hamilton 8 grades - Norwood classification • good as a scaling for topical therapy minoxidil • Ludwig 3 grades- scalling for women venning • traumatic

•

hamilton male- ludwig female is common

pathology b e fo re b a l d n e s s : s h o rte n n e n g o f th e a n a g e n a n d i n c re a s e ta l o g e n p h a s e

b a ld in g

p a th o l o g y b a ld

p e ri v a s c u l a r b a s o p h i l i c d e g e n e ra ti o n l y m p h o c y ti c h i s to c y te i n fi l t ra ti o n o f th e o f th e l o w e r th i r d o f o th e rw i s e s e b a c o u s d u t+ b a s o p h i l i c s c l e ro s i s n o rm a l a n a g e n fo l i c l e i r re v e rs i b l e l o s s s tre a m e rs m u l t i g i a n t c e e l s w i t h h a i r fra g m e n ts th i n e re c to r p i l i m u s c l e s fe w q u i e s e n t fo l i c l e s

p o s t b a ld s o la r d a m m a g e d e c re a s e d b l o o d s u p p l y

clinical • male • female ludwig difuse partial • spare • RAPID ONSET OR lateroposterior sides GRADUAL WITH HIRSUTISM AND • hamilton ACNE • MUST BE INVESTIGATED .

differential diagnosis • increased villus hair in androgenic al. • abcsence villus hair in telogen effluvium

therapy • surgury proper timing and risk of recurrence • wigs‫ البواريك‬، • antandrogen like hirsutism • non hormonal minoxidil 2% vd transform villus to terminal as early as useful • treatment of associated depresion that is mistaken as a cause