Posts Tagged ‘Scales’

Guideline for Diagnostic Evaluation in Androgenetic Alopecia in Men, Women and Adolescents

Sunday, September 18th, 2011

-:: This Abstract is posted here for posterity and archival purposes only ::-

From The British Journal of Dermatology

Guideline for Diagnostic Evaluation in Androgenetic Alopecia in Men, Women and Adolescents

U. Blume-Peytavi; A. Blumeyer; A. Tosti; A. Finner; V. Marmol; M. Trakatelli; P. Reygagne; A. Messenger

Authors and Disclosures

Posted: 01/12/2011; The British Journal of Dermatology. 2011;164(1):5-15. © 2011 Blackwell Publishing

Abstract

Androgenetic alopecia (AGA) is the most common hair loss disorder, affecting both men and women. Due to the frequency and the often significant impairment of life perceived by the affected patients, competent advice, diagnosis and treatment is particularly important. As evidence-based guidelines on hair disorders are rare, a European consensus group was constituted to develop guidelines for the diagnostic evaluation and treatment of AGA. This S1 guideline for diagnostic evaluation of AGA in men, women and adolescents reviews the definition of AGA and presents expert opinion-based recommendations for sex-dependent steps in the diagnostic procedure.
Introduction

Evidence-based guidelines on hair disorders are rare, except for one S2 guideline on alopecia areata by the British Association of Dermatologists.[1] No national, European or international guidelines have been established for the diagnosis and treatment of androgenetic alopecia (AGA). Three different types of evidence-based guidelines (types S1–S3) exist. An S1 guideline is built by an informal consensus of an expert group. The statements for S2 guidelines are formed by a formal consensus process. An S3 guideline is based on a consensus from a systematic literature research with evaluation of evidence levels and a systematic decision process.

A European consensus group was built, consisting of members from different countries, organizations, specialities and interest groups. A detailed literature search on diagnosis and treatment of AGA using Medline, Embase, Cochrane and a hand search was performed. Based on the literature available the group decided to undergo an informal consensus process on an S1 level for the diagnosis of AGA and an S3 guideline process for the therapy of AGA (published separately). A subgroup of this European Consensus Group consisting of the eight authors of this article decided to work on this S1 guideline which was funded by the Verein Pro Haut e.V. Berlin, and is therefore independent and without any commercial conflict of interest.

The European Consensus Group reviewed the definition of AGA and established a consensus for the diagnosis of AGA dealing with the following points: expert opinion-based recommendation for the diagnosis of AGA in female and male patients, as well as in adolescents. The aim was to develop a diagnostic evaluation form and recommendations for diagnostic procedures to assist in the daily work of the practitioner. The questionnaire for daily practice was kept simple and it is planned to be validated during consultation by practising dermatologists experienced in the management of hair disorders.

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Study: Photographic documentation of hair growth in androgenetic alopecia.

Sunday, September 18th, 2011

-:: This Abstract is posted here for posterity and archival purposes only ::-

 

Dermatol Clin. 1996 Oct;14(4):713-21.
Photographic documentation of hair growth in androgenetic alopecia.
Canfield D.
Source

Canfield Scientific, Inc., Cedar Grove, New Jersey, USA.
Abstract

The challenge of useful serial photographic documentation of hair loss can be met by using a regimented approach at each photographic session. Patient outcomes that are better documented allow for more informed decisions to be made about the course of therapy by both the physician and the patient.

PMID:
9238329
[PubMed - indexed for MEDLINE]
Source: http://www.ncbi.nlm.nih.gov/pubmed/9238329

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A bit more text:

The ability to photographically document patient progress is especially useful in recording the subtle changes that a hair loss patient may have between office visits. Serial photography (sequential photographs) can be used by both the physician and the patient to assess these changes. Figures 1A and 1B show the therapeutic benefit a patient has achieved in the vertex area of the scalp from an initial to a 6-month follow-up visit. The physician’s challenge as the photographer is significant: to take photographs that allow for the assessment of change, and not a critique of photographic technique. Variability in technique, including patient preparation, lighting, camera settings, camera to patient registration, film, and processing can all undermine the best intentions of photographic documentation.

High-quality clinical photography can be accomplished in the examination room. With the 35-mm camera equipment you may already have in your office, you can structure a methodic approach for taking reproducible serial photographs. Controlled reproducible serial photographs should read like a time-lapse movie, allowing for only the change in a patient’s condition over time. Clinical researchers studying androgenetic alopecia worldwide use controlled photography for primary and secondary endpoints of protocols to determine the efficacy of therapies.

 

Study: Male Pattern Baldness: classification and Incidence – by NORWOOD, O’TAR T. MD

Sunday, September 18th, 2011

-:: This Abstract is posted here for posterity and archival purposes only ::-

Title:

Male Pattern Baldness: classification and Incidence NORWOOD, O’TAR T. MD – Southern Medical Journal

Abstract:

The need for a widely accepted, accurate, and reproducible standard of classification for male pattern baldness has increased with the advent and increasing popularity of hair transplant surgery. This report establishes such a classification, and reports its use in determining the incidence of male pattern baldness at various ages in 1,000 white adult male subjects. The action of testosterone as an incitant in male pattern baldness is well known, but this study points out the continued effect of time, even in later years. Since most hair transplant surgery is performed on subjects with male pattern baldness, and because the success of hair transplant surgery is largely dependent on proper patient selection, a complete understanding of male pattern baldness is essential for consistently good results with hair transplantation.

(C) 1975 Southern Medical Association

 

Find the attached document for the Norwood scalre and the full text of the Norwood study “Male Pattern Baldness: classification and Incidence” by Norwood. Click HERE

Is Self Diagnosis of MPB Possible?

Wednesday, December 29th, 2010

Can a man diagnose himself of having MPB?

Yes! In men, male pattern baldness (MPB) or Androgenic Alopecia (AGA) can be identified and defined visually. The use of the Hamilton Norwood Classification scale or other scales aids in this process and offers a more accurate classification.

Let me repeat: Self diagnosis for MPB is possible. I diagnosed myself, I then went to see the family doctor and asked him “what’s happening to my hair” he answered “male pattern baldness”. Don’t take my word for it, a study published in December, 2004 entitled “Validity of self reported male balding patterns in epidemiological studies” examined and compared the accuracy and reliability of the assessment of balding patterns when conducted by “trained observers” verses assessments of balding patterns conducted by “men” who are experiencing the balding themselves.

In this study, the trained observers and “men” used a classification system known as the “Hamilton-Norwood classification system” (shown below). This study found while it was best to have a trained observer assess the balding pattern, it found that “men’s self evaluation is accurate enough to ensure reliability and validity of results.” In other words, a man should be able to assess his own hair loss pattern using this scale reliably. [*1]

How to identify?

MPB causes a gradual thinning of the hair on the scalp, following a certain pattern. With MPB, the hair line either recedes uniformly from the forehead (this is known as frontal hair loss or frontal balding) or it recedes in a manner that follows an “M” shape (known as vertex hair loss). Vertex hair loss is also accompanied by hair loss at the crown or back of the head. [21] [23]

Both patterns could progress to partial baldness that leave hair around the sides of the head (resembling a “U” shape) or even to total baldness. The Hamilton Norwood scale is used by researchers and individuals to access or quantify their baldness pattern. [21] [23]

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Men’s Hamilton Norwood & Other Hair Loss Classification Scales

Wednesday, December 29th, 2010

In men, male pattern baldness (MPB) or Androgenic Alopecia (AGA) can be identified and defined visually.

A study published in December, 2004 entitled “Validity of self reported male balding patterns in epidemiological studies” examined and compared the accuracy and reliability of the assessment of balding patterns when conducted by “trained observers” verses assessments of balding patterns conducted by “men” who are experiencing the balding themselves.

In this study, the trained observers and “men” used a classification system known as the “Hamilton-Norwood classification system” (shown below). This study found while it was best to have a trained observer assess the balding pattern, it found that “men’s self evaluation is accurate enough to ensure reliability and validity of results.” In other words, a man should be able to assess his own hair loss pattern using this scale reliably. [*1]

 

A related article posted today 9/18/2011 Male Pattern Baldness: classification and Incidence – by NORWOOD, O’TAR T. MD features a PDF document with the full text by Dr Norwood himself and his scale.

 

The Hamilton Norwood Classification Scale was created in 1975 and is shown next.


Figure 1. Hamilton Norwood Classification Scale (OT Norwood, 1975)

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