Immunohistochemical characterization of elastofibroma and exclusion of ABCC6 as a predisposing gene

double-blind, placebo-controlled study of postmenopausal women treated with finasteride 1 mg daily showed no improvement in increasing hair growth or slowing the progression of hair thinning. In contrast, in 2001 a noncontrolled study of 42 preand postmenopausal women with female-pattern hair loss and SAHA syndrome (seborrhoea, acne, hirsutism and alopecia) revealed that finasteride 2Æ5 mg daily effectively increased hair growth. Recently, another study supported the efficacy of mediumhigh doses of finasteride in the treatment of female-pattern hair loss. Approximately two-thirds of the 37 women without clinical evidence of hyperandrogenism responded well to a medium-high dose of finasteride (2Æ5 mg daily). The authors stated that the concomitant use of the oral contraceptive drospirenone may also have contributed to the hair growth due to its antiandrogenic effect. Marked efficacy was also observed for higher doses of finasteride (1Æ25–5Æ0 mg daily) in women with normoor hyperandrogenism in recent reports. As these higher doses of finasteride differ from the standard male androgenetic alopecia dose of 1Æ0 mg daily, an important unanswered question arises: whether androgenetic alopecia in women demonstrates a dose-dependent therapeutic response or whether some patients respond due to their relative androgen levels. Indeed, in one case report, a woman with androgenetic alopecia had limited response to finasteride 0Æ5 mg daily and benefited well from dutasteride, a more potent 5a-reductase inhibitor. In our case, we cannot rule out that a lower dose of finasteride may have been effective. Further study is necessary to establish the optimal dose regimen for finasteride in female androgenetic alopecia due to androgen supplementation. Practitioners need to be aware that Hamilton type hair loss can occur in women given androgen supplementation, especially at higher doses. In our patient, androgen-induced alopecia was effectively treated with a medium-high dose of finasteride (2Æ5 mg daily) despite her continued androgen supplementation. Taking her surgically menopausal status into account, the testosterone adjunct to oestrogen replacement therapy may benefit our patient by reducing anxiety and depression, protecting against breast cancer and delaying Alzheimer’s disease. We recommend that hormonal supplementation with androgen be appropriately reduced and maintained at a reasonable dose when iatrogenic androgenetic alopecia is found.