Posts Tagged ‘Tests’

Study: Androgenetic alopecia in children: report of 20 cases.

Saturday, October 8th, 2011

Br J Dermatol. 2005 Mar;152(3):556-9.
Androgenetic alopecia in children: report of 20 cases.
Tosti A, Iorizzo M, Piraccini BM.
Source

Department of Dermatology, University of Bologna, Via Massarenti 1, 40138 Bologna, Italy. tosti@med.unibo.it
Abstract

Androgenetic alopecia (AGA) is the most common type of hair loss in adults. Although there are differences in the age at onset, the disease starts after puberty when enough testosterone is available to be transformed into dihydrotestosterone.

We report 20 prepubertal children with AGA, 12 girls and eight boys, age range 6-10 years, observed over the last 4 years. All had normal physical development. Clinical examination showed hair loss with thinning and widening of the central parting of the scalp, both in boys and girls. In eight cases frontal accentuation and breach of frontal hairline were also present. The clinical diagnosis was confirmed by pull test, trichogram and dermoscopy in all cases, and by scalp biopsy performed in six cases.

There was a strong family history of AGA in all patients. The onset of AGA is not expected to be seen in prepubertal patients without abnormal androgen levels. A common feature observed in our series of children with AGA was a strong genetic predisposition to the disease. Although the pathogenesis remains speculative, endocrine evaluation and a strict follow-up are strongly recommended.

PMID:
15787828
[PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/15787828

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

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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

 

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.

 

How is Patterned Baldness Tested for?

Monday, January 3rd, 2011

Evaluation for causative disorders should be done based on clinical symptoms. A mainstream physician wont do much if any testing once they’ve determined their patient has male-pattern and female-pattern hair loss. Many readily available blood, urine and saliva tests could be done to understand metabolic, hormonal and nutritional issues in the body. Other articles will discuss these further.

These are hair tests that could be done on the scalp/hair itself:

The pull test: to evaluate diffuse scalp hair loss. Gentle traction is exerted on a group of hair (about 40–60) on three different areas of the scalp. The number of extracted hairs is counted and examined under a microscope. Normally, <3 hairs per area should come out with each pull. If >10 hairs are obtained, the pull test is considered positive.

The pluck test: In this test, the individual pulls hair out “by the roots.” The root of the plucked hair is examined under a microscope to determine the phase of growth and used to diagnose a defect of telogen, anagen, or systemic disease. Telogen hairs are hairs that have tiny bulbs without sheaths at their roots. Telogen effluvium shows an increased percentage of hairs upon examination. Anagen hairs are hairs that have sheaths attached to their roots. Anagen effluvium shows a decrease in telogen-phase hairs and an increased number of broken hairs.

Hair mineral analysis: Tests for minerals and heavy metals.

Scalp biopsy: This test is done when alopecia is present, but the diagnosis is unsure. The biopsy allows for differing between scarring and nonscarring forms. Hair samples are taken from areas of inflammation, usually around the border of the bald patch.

Daily Hair Counts: This is normally done when the pull test is negative. It is done by counting the number of hairs lost. The hair that should be counted are the hairs from the first morning combing or during washing. The hair is collected in a clear plastic bag for 14 days. The strands are recorded. If the hair count is >100/day is considered abnormal except after shampooing, where hair counts will be up 250 and be normal.

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Women’s Ludwig & Other Hair Loss Classification Scales

Thursday, December 30th, 2010

In women, the hair loss progresses as a diffused thinning of hair all over the top areas and crown of the head (i.e. parietal region). [5] [13] In this case, this hair loss is either referred to as male-pattern baldness, or as female-pattern baldness. [13]


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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Prostate Health and Hair Loss

Wednesday, December 29th, 2010

Research has found a link between men’s prostate health and a healthy full head of hair.

The prostate is a cluster of small glands found only in men surrounding the urethra, located just below the bladder. We don’t fully understand everything the prostate probably does, we know it serves to squeeze seminal fluid into and through the urethra during ejaculation.

Many older men, and younger ones thanks to excessive pharmaceutical TV ads, know that prostate problems can cause annoying issues with urination if the prostate becomes enlarged; sometimes the prostate becomes cancerous. The non-cancerous enlargement of the prostate is known as benign prostatic hyperplasia (BPH).

DHT is responsible for the division of cells in the prostate, DHT is expelled by the prostate normally however, if the prostate fails to expel DHT, it builds up and causes enlargement.

Studies have shown that modern diets are a culprit in prostate dysfunction and disease. Whether you call it a civilized diet, the North American diet, the West European diet or the Standard American Diet (SAD), these diets increase the cases of male pattern baldness (and female pattern baldness) and prostate cancers in men. Such symptoms where much less common or uncommon at all in other lands and people that lived and consumed a less civilized lifestyle and diet.

The link between diet and prostate (and hair loss) disease is thought to be the diet.  Our civilized and over processed diets lead to an overproduction of DHT causing BPH and prostate cancers.

The actionable takeaway here is that a change in diet is absolutely a must to lower your chances of of these conditions and improve overall health.An improved diet and lifestyle can prevent a myriad of disease, from migraines to cardiovascular and cancer diseases.

For men over 40 years of age, check with your physician about a prostate-specific antigen (PSA) test for prostate health and have regular check-ups. Avoid pharmaceuticals and look for natural nutrients that are not synthetic.

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