A Clinical Study of Androgenetic Alopecia (3)

(Joo Hyun Shim),(Sung Wook Ro),(Byung In Ro) 대한피부과학회 2002 Annals of Dermatology Vol.14 No.1

N/A 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 alopecia seems to be gradually increasing. Objective: The purpose of this study is to evaluate the family history,clinical and endocrine status of the patients with androgenetic alopecia. Method :1113 patients with androgenetic alopecia who had visited the Department of Dermatology, Yongsan Hospital, College of Medicine,Chung-Ang University during the 3 years (1995.1-1998. 12) have been examined. Results: The results are summarized as follows 1) The incidence of androgenetic alopecia among the total number of alopecia patients was 64.5%, showing recent increment. 2) There were 855 male and 258 female patients being most prevalent in the third decade in both sexes and the patients younger than 30 years old with premature androgenetic alopecia,made up 70.3% of the male patients and 48.8%of the female patients with androgenetic alopecia. 3) While Norwood`s type Iia was the most common and following type II,III vertex,and IV in the male AGA, Ludwig`s type II was the most common in female AGA 4) There was a family history of baldness in 53.5%of first degree relatives in male patients and 51.6%in female patients. 5)Associated diseases were observed in 565(66.8%)of the male patients and 219 (84.8%)of the female patients:diseases associated with androgen such as seborrheic dermatitis and acne vulgaris occupied 39.1%. Conclusion :Based on our findings, those who want to treat androgenetic alopecia at the earlier ages are gradually increasing and it seems to be reasonable to believe that the age, genetic factors, localized effects of androgens on the scalp and the density and/or functional activity of androgen receptors may influence the pathogenesis of androgenetic alopecia. (Ann Dermatol 14(1)11-17,2002).

대학병원 피부과 외래에 내원한 안드로겐 및 원형탈모증 환자에서의 대표적 Trichoscopic Finding에 대한 고찰

임재윤 ( Jae Yun Lim ),민준홍 ( Joon Hong Min ),최영준 ( Young-jun Choi ),남재희 ( Jae Hui Nam ),이가영 ( Ga-young Lee ),김원석 ( Won-serk Kim ),정호주 ( Ho Joo Jung ) 대한피부과학회 2016 大韓皮膚科學會誌 Vol.54 No.9

Background: By magnifying the scalp and structure of hair, trichoscopy enables easy differentiation among various hair loss diseases. Objective: To measure the frequency of representative trichoscopic findings in outpatients with androgenetic alopecia and alopecia areata and the frequency of various trichoscopic findings depending on the disease severity of androgenetic alopecia. Methods: This cross-sectional study included 87 patients with androgenetic alopecia (n=57) and alopecia areata (n=30) treated over a year (2014∼2015). Three dermatologists assessed the trichoscopic findings (hair shaft, hair follicle opening, and perifollicular epidermis) in these patients. Results: Vellus hair was observed in 21 of the 30 patients (70%) with alopecia areata and 20 of the 57 patients (35%) with androgenetic alopecia. Among the patients with androgenetic alopecia, as the disease severity increased, the portion of patients with vellus hair, thickness heterogeneity, and honeycomb pigmentation also increased (p<0.05). Conclusion: Trichoscopy is very useful for the diagnosis of androgenetic alopecia and alopecia areata. Additionally, the severity of androgenetic alopecia can be assessed using trichoscopy. (Korean J Dermatol 2016;54(9):699∼705)

유전성 안드로겐탈모증의 임상적 고찰(제6보)

노용관 ( Yong Kwan Rho ),김범준 ( Beom Joon Kim ),김명남 ( Myeung Nam Kim ),노병인 ( Byung In Ro ) 대한피부과학회 2008 대한피부과학회지 Vol.46 No.6

Background: Androgenetic alopecia is the most common form of hair loss in people with a genetic predisposition. It is characterized by the miniaturization of terminal hair follicles and the formation of vellus-like follicles. Objective: The aim of this study was to evaluate the prevalence, clinical manifestation, genetic and endocrine factor, and associated diseases of Korean patients with androgenetic alopecia. Methods: We studied 789 Korean men and women with androgenetic alopecia. A detailed history was taken and their hormonal values were measured. A pelvic ultrasound scan was performed to check for abnormalities the ovaries and uterus of 56 women with androgenetic alopecia. Results: The number of men was 1.9 times more (520) than that of women (269). Most of them were in their twenties (male 223; 42.8%, female 85; 31.5%). In the 520 male patients, Norwood class IIIv was dominant (161 patients; 30.9%). In the 269 female patients, Ludwig class I was superior (218 patients; 81%). 395 (75.9%) of male patients and 198 (73.6%) of female patients had a family history of androgenetic alopecia. The most common associated disorder was seborrheic dermatitis (male 407; 78.2%, female 155; 57.6%). And others included atopic dermatitis, hypertension, thyroid disease, etc. Serum testosterone levels were increased in 92 (17.6%) of the male patients and in 36 (13.3%) of the female patients. Abnormal pelvic ultrasound findings were observed in 10 (18%) of 56 female patients, and the conditions were ovarian cysts (8.9%), Uterine myoma (5.4%), uterine mass (2%), endometrial mass (2%). Conclusion: Androgenetic alopecia is a disease that has genetic and familial tendency and is associated with the androgen level. The number of androgenetic alopecia patients was increasing and type IIIv was most common in the male patients. The pelvic ultrasound showed an increased rate of abnormal findings in the female patients with androgenetic alopecia, but ultrasound is not an appropriate routine test to evaluate. (Korean J Dermatol 2008;46(6):729∼735)

안드로겐성 탈모증의 임상적 고찰

한은실(Eun Sil Han),김명남(Myeung Nam Kim),홍창권(Chang Kwun Hong),노병인(Byung In Ro) 대한피부과학회 1995 대한피부과학회지 Vol.33 No.1

Backpound : Androgenetic alopecia is considered to be a gentially determined disorder influenced by age and andren. The proportion of patients with endrogenetic alopecia among the total number of patients with alpecia seems to be gradually imreasing. Objective : The purpose of this study is to determine the family history, clinical and endocrine status of the patients with androgenetic alopecia. Methods : 387 patients with androgenetic alopecia who had visited the Department of Dermatology, Yongsan Hospital, College of Medicine, Chung-Ang Jniversity during the last 4 years(1990.1-1993.12) were examined. Results : 1) Annual incidence of aodrogenetic alopecia among the to al number of alopecia patients averaged over 4 years was 38.9 having increased recently. 2) There were 286 male and 101 female patients being mosip, evalent in the 3rd decade in both sexes. 3) Patients younger than 30 years old, patients with premat trandrogenetic alopecia, made up 68,5% of the male patients and 56.4% of the female patients with androgenetic alopecia. 4) Of the 73 male patients Hamiltons type III was most cornon (46, 63.0%). 5) Of the 34 female patients Ludwigs type I was most comnorf, 21, 61.2%. 6) There was a family history of baldness in 39.4% of first the gree relatives in male patients and 41.2% 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%/5.9%), atopic dermatitis, thyroid diseasea, pulmonary tuberculosis, depression, and gastrointestinal diseases. In female patients menstrid irregularity, hypertrichosis, and plycystic ovary disease were also observed. 8) Serum testosterone levels were increased in 24 (8.8%) of male patients and in 17 (17.4%) of female patients. Conclusion : Based on our findings, the development of andrignetic alopecia is significantly related to the positive family history of baldness. Serum test as erone levels in most patients were within normal limit and were increased only in a sm 11 number of the patients with androgenetic alopecia. Therefore, it seems reasonable to suggest that the inhibitory effects of androgens on the dermal papilla cells may be mediated by decreased density and/or functional activity of androgen receptors or through an accelera biom the metabolic activity of androgen. (Kor J Dermatol 1995; 33(1): 44-52)

남성의 안드로겐성 탈모증에 대한 한의학적 치료 효과

이태후,문정배,김영진,안경애 대한침구의학회 2006 대한침구의학회지 Vol.23 No.1

Background : Recently the demand was increasing on the data describing treatment rates and the outcome of Androgenetic Alopecia using Oriental Medicine. Thus this study was designed to observe androgenetic Alopecia treatment using Oriental Medicine including acupuncture and herb because there has been no such statistics. Objectives : Our purpose was to determine whether oriental medicine treatment leads to clinical improvement in men with androgenetic alopecia. Methods : Eighty two Men, 17 to 53 years of age, with male pattern hair loss according to a modified Norwood/Hamilton classification scale(II to VI) were enrolled in this study. Patients were treated with multidisciplinary Korean oriental medicine treatment (herbal acupuncture, acupuncture, herb, chuna therapy) at twice a week for 6 months to 12 months. Efficacy was evaluated by patient and investigator assessment, and global photographic review. Results : Oriental medicine treatment improved scalp hair by all evaluation. Patient self‐assessment demonstrated that Oriental medicine treatment slowed hair loss, increased hair growth, and improvement appearance of hair. These improvements were corroborated by investigator assessments and assessments of photographs. Conclusion : Oriental medicine treatment has significant effects on the androgenetic alopecia. Longer follow up studies are needed to examine whether its effects last long enough for the patients with androgenetic alopecia.

Scalp Dermatoscopic Findings in Androgenetic Alopecia and Their Relations with Disease Severity

( Melike Kibar ),( ?ebnem Aktan ),( Muzaffer Bilgin ) 대한피부과학회 2014 Annals of Dermatology Vol.26 No.4

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, x2 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. (Ann Dermatol 26(4) 478~484, 2014)

20-30대 성인에게서 안드로겐성 탈모증과 자율신경계 활성도 변화간의 연관성

한애리 ( Ae Ri Han ),이한성 ( Han Sung Lee ),송미연 ( Mi Yeon Song ),신현대 ( Hyun Dae Shin ) 한방재활의학과학회 2007 한방재활의학과학회지 Vol.17 No.4

Objectives :The purpose of this study is to investigate the influence of androgenetic alopecia on autonomic nervous system activity. Methods : The study was performed in total 120 adults consist of 30 men and 30 women group of the patients with androgenetic alopecia from 20 to 39 year-old who visited an oriental medical clinic and the normal control group of 30 men and 30 women from 20 to 39 year-old who didn`t have alopecia. To measure autonomic nervous activity, 5-minute eletrocardiographic recordings were analyzed with time and frequency domain methods of heart rate variability. Results : 1. In male group of the patients with androgenetic alopecia, RMSSD(the square root of the mean squared differences of successive normal-to-normal intervals) and Ln HF(high frequency power) were significantly decreased, and Ln LF(low frequency power) was significantly increased than those of the normal control group. 2. In female group of the patients with androgenetic alopecia, SDNN(the standard deviation of all the normal RR interval) and Ln LF were significantly increased, on the other hand, RMSSD and Ln HF were significantly decreased than those of the normal control group. Conclusions : There was an imbalance of autonomic nervous system activity in the group of the patients with androgenetic alopecia. Especially, sympathetic activity was significantly increased, while parasympathetic activity was significantly decreased

남성혈 탈모증 환자의 질병 행동 특성과 삶의 질에 관한 연구

김휘준(Hwi Jun Kim),심우영(Woo Young Sim),송지영(Ji Young Song) 대한피부과학회 2001 대한피부과학회지 Vol.39 No.10

N/A Background: Androgenetic alopecia is a common, genetically predisposed condition among men and women, which commences at any age after puberty. It may significantly affect a variety of psychological and social experiences and the individuals quality of life(QOL). Objective: The purpose of this study was to investigate the impact of androgenetic alopecia on patients illness behavior and quality of life. Methods: A total of 192 male patients with androgenetic alopecia were enrolled and interviewed with structured questionnaire which contained 26 items including personal information, social, psychological questions and the patients knowledge of androgenetic alopecia. Results: 1. The mean age of the patients was 27 years old. The proportion of patients under 30 years old was 79.7%. 2. The mean age of onset in the patients was 24 years old. 3. Using the Norwood's classification, the proportion of type IIIa, type III, type IIIvertex and female pattern was 76.1%. And that of type I and II was 16.1%. 4. The 177 patients (92.2%) showed dissatisfaction about their hair states and 116 patients (60.5%) made efforts to conceal and compensate for their alopecia. The peer teasing about their condition was reported by 134 patients (69.8%). 5. Most unmarried patients (S9.3%) thought that hair loss would erode their chances for romance. 6. Only 33 patients (17.2%) had experiences of professional treatments. Conclusion: This study confirms that androgenetic alopecia has significant impact on the overall QOL of patients. (Korean J Dermatol 2001;39(10): 1094-1099)

탈모의 한의학적 치료에 대한 국내 현황 : 증례보고를 중심으로

권소현,홍석훈 대한한방안이비인후피부과학회 2019 한방안이비인후피부과학회지 Vol.32 No.3

Objectives : This study is carried out to analyze the use of Korean medical treatments on alopecia in Korean medicine clinical studies published in South Korea. Methods : Based on OASIS and KTKP with the keyword ‘alopecia’, published in 1996-2019.4.23., total 23 studies have been found and analyzed. We analyzed Korean medical treatment used in each cases, and investigated the tendency of use for each treatment. Results : 369 cases in 23 research papers were selected. Herbal medicine, acupuncture, pharmacopuncture, external medicine and other therapy were used as treatment for Alopecia. Herbal medicine with a cooling effect was mainly used. The acupoints mainly used were GV20, ST8, GB5, ST36, HT8, PC6, BL66. Pharmacopunctures used to treat alopecia were CF, HP, HH, BV, etc. The average duration of Korean medicine treatment was 144 days. After Korean medicine treatment, 292 cases presented improvement or complete recovery. Conclusions : According to the results, we were able to discover the current status of Korean medicine treatment of alopecia. Based on this result, further studies will be needed to establish the primary treatment direction of alopecia.

남성형 탈모증 환자에서 시행한 모속이식술 52예에 대한 치료효과 분석

민복기,황성주,김도원,정상립,김정철,나건연 ( Pok Kee Min,Sung Joo Hwang,Do Won Kim,Sang Lip Chung,Jung Chul Kim,Gun Yoen Na ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.5

Background: There have been numerous methods to treat androgenetic alopecia but few methods to treat it effectively and permanently. Objective : The purpose of this study was to evaluate bundle hair grafting as an effective treatment for patients with androgenetic alopecia. Methods : Bundle hair grafiing was performed on 52 patients with androgenetic alopecia who had visited the department of dermatology, Kyungpook National University Hospital and Fatima Hospital. Questionaires regarding cosmetic satisfaction, side effects and general efficacy were recorded by patients themselves one year after hair grafting. Results : The results are as follows : 1. The loss of transplanted hair was most common during the third week(48.1%) after hair grafting. 2. The regrowth of the hair on the recipient site was most common during the 4th month(59.6 %) after the hair graft. 3. Bundle grafting afforded excellent cosmetic satisfaction even after one session in the alopecic area, 4. Facial edema, temporary sensory loss on the donor site, folliculitis and small pitted scarring were seen 19.2%, 5.8%, 1.9% and 3.8% of patients, respectively. 5. The disadvantages were the time necessary to carry out the procedure and the need for an experienced operator and assistants. Conclusion : We concluded that bundle hair grafting was an effective and safe therapeutic method for patients with androgenetic alopecia. (Korean J Dermatol 1997;35(5): 893-901)