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The diagnosis of androgenetic alopecia in children: Considerations of pathophysiological plausibility
Author(s) -
Rossi Alfredo,
D'Arino Andrea,
Pigliacelli Flavia,
Caro Gemma,
Muscianese Marta,
Fortuna Maria Caterina,
Carlesimo Marta
Publication year - 2019
Publication title -
australasian journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.67
H-Index - 53
eISSN - 1440-0960
pISSN - 0004-8380
DOI - 10.1111/ajd.13079
Subject(s) - vellus hair , medicine , hyperandrogenism , pathophysiology , hair loss , androgen , abnormality , androgen excess , polycystic ovary , hormone , hirsutism , endocrinology , hair follicle , physiology , dermatology , diabetes mellitus , psychiatry , insulin resistance , scalp
Androgenetic alopecia ( AGA ), one of the most common causes of hair loss in men and women, is an infrequent cause of alopecia in children. In AGA , patients generally start noticing hair thinning after the onset of puberty due to progressive miniaturisation of the hair follicle which leads to vellus transformation of terminal hair. However, the occurrence of prepubertal AGA has rarely been reported in the literature. The pathophysiology of AGA is tightly linked to androgen hormones; prepubertal children do not usually produce significant amounts of adrenal or gonadal androgens. When it does occur, an underlying abnormality should be suspected. Secondary causes of AGA must be excluded when evaluating a patient before the appearance of puberty. Premature puberty, polycystic ovarian syndrome and other causes of hyperandrogenism can present with hair loss in an androgenetic pattern. This article reviews the normal physiology of androgen hormones and their role in the pathophysiology of childhood AGA .