Effect of dutasteride 0.5 mg/d in men with androgenetic alopecia recalcitrant to finasteride.

BACKGROUND: Finasteride at a dose of 1 mg/d has been reported to show no significant improvement in 30-50% of patients with androgenetic alopecia (AGA). Dutasteride, a dual inhibitor of both type I and type II 5 alpha-reductase, inhibits the conversion of testosterone to dihydrotestosterone, which is the key contributor of AGA. MATERIALS AND METHODS: Our aim is to evaluate clinical efficacy and tolerability of dutasteride in men with AGA who do not show clinical improvement to the conventional finasteride treatment. A total of 35 Korean men with AGA who had not shown significant clinical improvement when treated with finasteride 1 mg/d for at least six months received dutasteride at a dose of 0.5 mg/d for six months. Efficacy was evaluated by global photograph assessment and phototrichogram. Safety assessment was performed through physical examination and adverse event report. RESULTS: Of the 31 patients who completed the treatment, 24 patients (77.4%) were improved by the global photography (17 were slightly, six moderately, and one markedly improved) compared with the post-finasteride treatment. There was no significant change in seven patients (22.6%), and aggravation was not reported. Hair density and thickness significantly increased by 10.3% (87 ± 12-96 ± 12/cm(2)) and 18.9% (0.053 ± 0.012-0.063 ± 0.011 mm), respectively, in phototrichogram assessment. Side effects included transient sexual dysfunction in six patients (17.1%). CONCLUSIONS: Dutasteride is suggestive to be an alternative treatment option to patients with AGA who do not clinically respond to finasteride in six months.

Gene mapping study for constitutive skin color in an isolated Mongolian population.

To elucidate the genes responsible for constitutive human skin color, we measured the extent of skin pigmentation in the buttock, representative of lifelong non-sun-exposed skin, and conducted a gene mapping study on skin color in an isolated Mongolian population composed of 344 individuals from 59 families who lived in Dashbalbar, Mongolia. The heritability of constitutive skin color was 0.82, indicating significant genetic association on this trait. Through the linkage analysis using 1,039 short tandem repeat (STR) microsatellite markers, we identified a novel genomic region regulating constitutive skin color on 11q24.2 with an logarithm of odds (LOD) score of 3.39. In addition, we also found other candidate regions on 17q23.2, 6q25.1, and 13q33.2 (LOD ≥ 2). Family-based association tests on these regions with suggestive linkage peaks revealed ten and two significant single nucleotide polymorphisms (SNPs) on the linkage regions of chromosome 11 and 17, respectively. We were able to discover four possible candidate genes that would be implicated to regulate human skin color: ETS1, UBASH3B, ASAM, and CLTC.

Linkage and association scan for tanning ability in an isolated Mongolian population.

Tanning ability is important, because it represents the ability of the skin to protect itself against ultraviolet (UV) radiation. Here, we sought to determine genetic regions associated with tanning ability. Skin pigmentation was measured at the outer forearm and buttock areas to represent facultative and constitutive skin color, respectively. In our study population consisting of isolated Mongolian subjects, with common histories of environmental UV exposure during their nomadic life, facultative skin color adjusted by constitutive skin color was used to indicate tanning ability. Through linkage analysis and family-based association tests of 345 Mongolian subjects, we identified 2 potential linkage regions regulating tanning ability on 5q35.3 and 12q13.2, having 6 and 7 significant single nucleotide polymorphisms (SNPs), respectively. Those significant SNPs were located in or adjacent to potential candidate genes related to tanning ability: GRM6, ATF1, WNT1, and SILV/Pmel17.

Efficacy, safety, and tolerability of dutasteride 0.5 mg once daily in male patients with male pattern hair loss: a randomized, double-blind, placebo-controlled, phase III study.

BACKGROUND: Dutasteride (Avodart) is a dual inhibitor of both type I and type II 5 alpha reductases, and thus inhibits conversion of testosterone to dihydrotestosterone, a key mediator of male pattern hair loss. OBJECTIVES: The aim of this randomized double-blind phase III study was to compare the efficacy, safety, and tolerability of dutasteride (0.5 mg) and placebo for 6 months of treatment in male patients with male pattern hair loss. METHODS: A total of 153 men, 18 to 49 years old, were randomized to receive 0.5 mg of dutasteride or placebo daily for 6 months. Efficacy was evaluated by the change of hair counts, subject assessment, and photographic assessment by investigators and panels. RESULTS: Mean change of hair counts from baseline to 6 months after treatment start was an increase of 12.2/cm(2) in dutasteride group and 4.7/cm(2) in placebo group and this difference was statistically significant (P = .0319). Dutasteride showed significantly higher efficacy than placebo group by subject self-assessment and by investigator and panel photographic assessment. There was no major difference in adverse events between two groups. LIMITATIONS: The study was limited to 6 months. CONCLUSIONS: This study clearly showed that 0.5 mg of dutasteride improved hair growth and was relatively well tolerated for the treatment of male pattern hair loss.

Case of congenital esophageal stricture by ganglioneuroma and acro-flexural hyperpigmentation: a coincidence?

Congenital hyperpigmentation in the acro-genital area and simultaneous occurrence of ganglioneuroma in the esophagus have yet to be reported. Herein, we report a 4-month-old girl presenting with feeding difficulty by esophageal ganglioneuroma and symmetrically distributed brown pigmented patches on the lips, axillae, dorsa of fingers and toes, and genital area. Although the esophageal stricture was resolved by surgical removal of ganglioneuroma, her skin manifestations remained for over 2 years.