Case Series of Frontal Fibrosing Alopecia and Fibrosing Alopecia in a Pattern Distribution: Is There a Familial Correlation?

Introduction: Frontal Fibrosing Alopecia (FFA) and Fibrosing Alopecia in a Pattern Distribution (FAPD) are two distinct entities of cicatricial pattern hair loss that share histological features of perifollicular lichenoid inflammation associated with concentric fibrosis. Although the pathophysiology of FFA and FAPD are still unknown, recently published reports of familial cases indicate a possible genetic correlation. Case Presentation: We report 6 cases of familial alopecia composed of mothers and daughters: five with FFA and one with FAPD. We describe clinical, trichoscopy and histological correlation in cases of familial alopecia. Conclusions: These cases of mother and daughter disease association suggest a potential benefit of and role for performing systematic scalp examinations of all first-degree relatives of patients with pattern cicatricial alopecia.

Treatment of Male-Pattern Alopecia with Platelet-Rich Plasma.

BACKGROUND: Androgenetic alopecia (AGA) affects up to 80% of men and 50% of women throughout their lifetime, causing significant discomfort. Minoxidil, finasteride, and low-level laser light therapy are the only Food and Drug Administration-approved treatments for AGA, and they have shown positive results in randomized controlled trials and meta-analyses. However, their efficacy is limited, and new therapies are needed. Injection of platelet-rich plasma (PRP), a minimally invasive technique, has been described by several authors as a promising treatment for AGA. Although many studies report beneficial effects of PRP on AGA, there is no standardized practice for PRP preparation and administration or a standard method to evaluate results. OBJECTIVE: The aim of this study was to evaluate the efficacy of manually prepared PRP in the treatment of male AGA. MATERIALS AND METHODS: We treated 20 male patients with AGA with 3 monthly injections of PRP and analyzed results by TrichoScan®. RESULTS: In this study, there was no statistically significant improvement in hair count or proportion of anagen hairs. CONCLUSIONS: This lack of response could be related to any of the variables during PRP preparation described above and also to the limited number of patients in the study.

Physiopathology and current treatments of androgenetic alopecia: Going beyond androgens and anti-androgens.

Androgenetic alopecia (AGA) is the most diagnosed hair loss dysfunction. Its physiopathology comprises a genetic predisposition affording an exacerbated response of the hair follicles cells to androgens aggravated by scalp inflammation and extrinsic factors. This paper presents a review of the mechanisms and extrinsic factors involved in the AGA physiopathology as well as its conventional and emerging treatments. The research focused on reports regarding AGA physiopathology and treatments published between January 2001 and July 2019 in medical and related journals. The most used medical treatments for AGA-minoxidil and finasteride-present non satisfactory results in some cases. Currently, the low-level laser therapy is recognized as a safe and effective treatment for AGA. Some minimally invasive techniques-mesotherapy, microneedling, carboxytherapy, and platelet-rich plasma-are also used to stimulate hair growth. Pharmaceutical substances with mechanisms differing from the anti-androgen activity are under current investigation and many of them have botanical origins; however, formulations with higher performance are required, and the hair follicles ability of being a drug and nanoparticle reservoir has been researched. The association of different strategies, that is, substances with synergic mechanisms and the use of advantageous technologies associated with lifestyle changes could improve the treatment outcomes.

Alopecia androgenética masculina de inicio precoz asociada a cáncer de próstata / Early-onset male androgenetic alopecia associated with prostate cancer

Contexto: La alopecia androgenética masculina es usual en hombres entre 30 a 70 años de edad; su presentación precoz ocurre en varones menores de 31 años, relacionada a andrógenos y herencia, factores importantes en su etiopatogenia. Tiene repercusión estética, sin embargo, se asocia a riesgo cardiovascular y cáncer de próstata; se postula que la influencia hormonal en la alopecia androgenética masculina favorece el desarrollo de cáncer prostático y determina su severidad. Objetivo: determinar la asociación entre alopecia masculina precoz y cáncer de próstata. Sujetos y métodos: hombres mayores a 18 años con cáncer de próstata confirmado; el grupo control lo conforman hombres mayores a 18 años sin neoplasias con determinación negativa de antígeno prostático. El estudio se efectuó en el Hospital Carlos Andrade Marín HCAM, en el periodo mayo a septiembre de 2015. Resultados: relación entre alopecia androgenética antes de los 31 años y cáncer de próstata, con un OR de 4,25 (IC 95% 1,7-10, p=0.001). No se observó diferencia estadística entre la severidad del cáncer prostático y el patrón clínico alopécico. Conclusión: los pacientes con alopecia androgenética masculina precoz (31 años), tienen un mayor riesgo de presentar cáncer de próstata, por lo que podría considerarse a la alopecia androgenética precoz como un indicador de riesgo para cáncer prostático, ameritando su tamizaje en pacientes con esta calvicie precoz (AU)

Context: Male androgenetic alopecia is usual in men between 30 to 70 years of age; Its early presentation occurs in males under 31 years, related to androgens and inheritance, important factors in its etiopathogenesis. It has aesthetic repercussion, however, it is associated with cardiovascular risk and prostate cancer; It is postulated that the hormonal influence in male androgenetic alopecia favors the development of prostate cancer and determines its severity. Objective: To determine the association between early male alopecia and prostate cancer. Subjects and methods: men older than 18 years with confirmed prostate cancer; The control group consists of men older than 18 years without neoplasms with negative determination of prostate antigen. The study was carried out at the Carlos Andrade Marín HCAM Hospital, from May to September 2015. Results: relationship between androgenetic alopecia before 31 years and prostate cancer, with an OR of 4.25 (95% CI 1.7-10, p = 0.001). No statistical difference was observed between the severity of the prostate cancer and the clinical alopecic pattern. Conclusion: patients with early male androgenetic alopecia 31 years, have a higher risk of developing prostate cancer; Early androgenetic alopecia could be considered as an indicator of risk for prostate cancer, deserving its screening in patients with this early baldness. (AU)