Abstract
Primary alopecias of the scalp are divided into scarring and nonscarring types [1]. Scarring alopecias include: (a) lymphocytic (discoid lupus erythematosus [DLE], lichen planopilaris [LPP], pseudopelade of Brocq [PPB], central centrifugal cicatricial alopecia [CCCA]); (b) neutrophilic (dissecting folliculitis/cellulitis, folliculitis decalvans); and (c) combined (acne keloidalis) subtypes. Nonscarring alopecias include alopecia areata (AA), telogen effluvium, trichotillomania, traction alopecia, and androgenetic alopecia (AGA) [1]. The etiology of many of these disorders is unclear; although, a combination of genetic and environmental factors appears to contribute to the pathogenesis of several types of alopecia [2].
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Stefanato CM. Histopathology of alopecia: a clinicopathological approach to diagnosis. Histopathology. 2010;56:24–38.
Alkhalifah A, Alsantali A, Wang E, et al. Alopecia areata update. Part I. Clinical picture, histopathology, and pathogenesis. J Am Acad Dermatol. 2010;62:177–88.
Finner AM, Otberg N, Shapiro J. Secondary cicatricial and other permanent alopecias. Dermatol Ther. 2008;21:279–94.
Dudda Subramanya RLK, Xiang Z, King H, et al. Microarray based gene expression profiling in alopecia areata implicates immune response, cell cycle control, and apoptosis related genes in disease pathogenesis [abstract]. J Invest Dermatol. 2003;121:219.
Carroll JM, McElwee KJ, King LE, et al. Gene array profiling and immunomodulation studies define a cell-mediated immune response underlying the pathogenesis of alopecia areata in a mouse model and humans. J Invest Dermatol. 2002;119:392–402.
Moonkyu K, Young-Hee K, Sang-Ku H, et al. Gene expression profile in dermal papilla cells and construction of hair specific cDNA microarrays. Proceedings of the Third International Meeting of Hair Research Societies, Chinzan-so, Tokyo; 2001. p. 29.
Boone SL, Guitart J, Gerami P. Follicular mycosis fungoides: a histopathologic, immunohistochemical, and genotypic review. G Ital Dermatol Venereol. 2008;143:409–14.
Petukhova L, Duvic M, Hordinsky M, et al. Genome-wide association study in alopecia areata implicates both innate and adaptive immunity. Nature. 2010;466:113–7.
Lueking A, Huber O, Wirths C, et al. Profiling of alopecia areata autoantigens based on protein microarray technology. Mol Cell Proteomics. 2005;4:1382–90.
Coda AB, Hysa VQ, Seiffert-Sinha K, et al. Peripheral blood gene expression in alopecia areata reveals molecular pathways distinguishing heritability, disease and severity. Genes Immun. 2010;11:531–41.
Yu M, Bell RH, Ross EK, et al. Lichen planopilaris and pseudopelade of Brocq involve distinct disease associated gene expression patterns by microarray. J Dermatol Sci. 2010;57:27–36.
Hamilton JB. Patterned loss of hair in man; types and incidence. Ann NY Acad Sci. 1951;53:708–28.
Rhodes T, Girman CJ, Savin RC, et al. Prevalence of male pattern hair loss in 18–49 year old men. Dermatol Surg. 1998;24:1330–2.
Severi G, Sinclair R, Hopper JL, et al. Androgenetic alopecia in men aged 40–69 years: prevalence and risk factors. Br J Dermatol. 2003;149:1207–13.
Norwood OT. Male pattern baldness: classification and incidence. South Med J. 1975;68:1359–65.
Nyholt DR, Gillespie NA, Heath AC, et al. Genetic basis of male pattern baldness. J Invest Dermatol. 2003;121:1561–4.
Hamilton JB. Male hormone stimulation is prerequisite and an incitant in common baldness. Am J Anat. 1942;71:451–80.
Olsen EA. Female pattern hair loss. J Am Acad Dermatol. 2001;45:S70–80.
Birch MP, Lalla SC, Messenger AG. Female pattern hair loss. Clin Exp Dermatol. 2002;27:383–8.
Osborn D. Inheritance of baldness. J Hered. 1916;7:345–55.
Küster W, Happle R. The inheritance of common baldness: two B or not two B? J Am Acad Dermatol. 1984;11(5 Pt 1):921–6.
Ellis JA, Stebbing M, Harrap SB. Genetic analysis of male pattern baldness and the 5alpha-reductase genes. J Invest Dermatol. 1998;110:849–53.
Birch MP, Messenger AG. Genetic factors predispose to balding and non-balding in men. Eur J Dermatol. 2001;11:309–14.
Goodarzi HR, Abbasi A, Saffari M, et al. MicroRNAs take part in pathophysiology and pathogenesis of male pattern baldness. Mol Biol Rep. 2010;37:2959–65.
Kligman AM, Freeman B. History of baldness. From magic to medicine. Clin Dermatol. 1988;6:83–8.
Futterweit W, Dunaif A, Yeh HC, et al. The prevalence of hyperandrogenism in 109 consecutive female patients with diffuse alopecia. J Am Acad Dermatol. 1988;19(5 Pt 1):831–6.
Orme S, Cullen DR, Messenger AG. Diffuse female hair loss: are androgens necessary? Br J Dermatol. 1999;141:521–3.
Randall VA, Hibberts NA, Thornton MJ, et al. The hair follicle: a paradoxical androgen target organ. Horm Res. 2000;54:243–50.
Burton JL, Halim MM, Meyrick G, et al. Male-pattern alopecia and masculinity. Br J Dermatol. 1979;100:567–71.
Phillipou G, Kirk J. Significance of steroid measurements in male pattern alopecia. Clin Exp Dermatol. 1981;6:53–6.
Eicheler W, Dreher M, Hoffmann R, et al. Immunohistochemical evidence for differential distribution of 5 alpha-reductase isoenzymes in human skin. Br J Dermatol. 1995;133:371–6.
Kaufman KD. Androgen metabolism as it affects hair growth in androgenetic alopecia. Dermatol Clin. 1996;14:697–711.
Bayne EK, Flanagan J, Einstein M, et al. Immunohistochemical localization of types 1 and 2 5alpha-reductase in human scalp. Br J Dermatol. 1999;141:481–91.
Sawaya ME, Price VH. Different levels of 5alpha-reductase type I and II, aromatase, and androgen receptor in hair follicles of women and men with androgenetic alopecia. J Invest Dermatol. 1997;109:296–300.
Imperato-McGinley J, Guerrero L, Gautier T, et al. Steroid 5α-reductase deficiency in man: an inherited form of male pseudohermaphroditism. Science. 1974;186:1213–5.
Kaufman KD, Olsen EA, Whiting D, et al. Finasteride in the treatment of men with androgenetic alopecia. Finasteride Male Pattern Hair Loss Study Group. J Am Acad Dermatol. 1998;39(4 Pt 1):578–89.
Price VH, Roberts JL, Hordinsky M, et al. Lack of efficacy of finasteride in postmenopausal women with androgenetic alopecia. J Am Acad Dermatol. 2000;43(5 Pt 1):768–76.
Shum KW, Cullen DR, Messenger AG. Hair loss in women with hyperandrogenism: four cases responding to finasteride. J Am Acad Dermatol. 2002;47:733–9.
Iorizzo M, Vincenzi C, Voudouris S, et al. Finasteride treatment of female pattern hair loss. Arch Dermatol. 2006;142:298–302.
Choudhry R, Hodgins MB, Van der Kwast TH, et al. Localization of androgen receptors in human skin by immunohistochemistry: implications for the hormonal regulation of hair growth, sebaceous glands and sweat glands. J Endocrinol. 1992;133:467–75.
Randall VA. Androgens and hair growth. Dermatol Ther. 2008;21:314–28.
Randall VA, Thornton MJ, Messenger AG. Cultured dermal papilla cells from androgen-dependent human hair follicles (e.g. beard) contain more androgen receptors than those from non-balding areas of scalp. J Endocrinol. 1992;133:141–7.
Hibberts NA, Howell AE, Randall VA. Balding hair follicle dermal papilla cells contain higher levels of androgen receptors than those from non-balding scalp. J Endocrinol. 1998;156:59–65.
Ellis JA, Stebbing M, Harrap SB. Polymorphism of the androgen receptor gene is associated with male pattern baldness. J Invest Dermatol. 2001;116:452–5.
Sawaya ME, Shalita AR. Androgen receptor polymorphisms (CAG repeat lengths) in androgenetic alopecia, hirsutism, and acne. J Cutan Med Surg. 1998;3:9–15.
Hillmer AM, Hanneken S, Ritzmann S, et al. Genetic variation in the human androgen receptor gene is the major determinant of common early-onset androgenetic alopecia. Am J Hum Genet. 2005;77:140–8.
Levy-Nissenbaum E, Bar-Natan M, Frydman M, et al. Confirmation of the association between male pattern baldness and the androgen receptor gene. Eur J Dermatol. 2005;15:339–40.
Ellis JA, Scurrah KJ, Cobb JE, et al. Baldness and the androgen receptor: the AR polyglycine repeat polymorphism does not confer susceptibility to androgenetic alopecia. Hum Genet. 2007;121:451–7.
el-Samahy MH, Shaheen MA, Saddik DE, et al. Evaluation of androgen receptor gene as a candidate gene in female androgenetic alopecia. Int J Dermatol. 2009;48:584–7.
Ali I, Dawber RPR, Wojnarowska FT. The role of the androgen receptor gene CAG repeat polymorphism and X-chromosome inactivation pattern in postmenopausal female pattern hair loss [abstract]. Br J Dermatol. 2008;159 Suppl 1:8–9.
Wakisaka N, Taira Y, Ishikawa M, et al. Effectiveness of finasteride on patients with male pattern baldness who have different androgen receptor gene polymorphism. J Investig Dermatol Symp Proc. 2005;10:293–4.
Prodi DA, Pirastu N, Maninchedda G, et al. EDA2R is associated with androgenetic alopecia. J Invest Dermatol. 2008;128:2268–70.
Hillmer AM, Brockschmidt FF, Hanneken S, et al. Susceptibility variants for male-pattern baldness on chromosome 20p11. Nat Genet. 2008;40:1279–81.
Hillmer AM, Flaquer A, Hanneken S, et al. Genome-wide scan and fine-mapping linkage study of androgenetic alopecia reveals a locus on chromosome 3q26. Am J Hum Genet. 2008;82:737–43.
Tang L, Bernardo O, Bolduc C, et al. The expression of insulin-like growth factor 1 in follicular dermal papillae correlates with therapeutic efficacy of finasteride in androgenetic alopecia. J Am Acad Dermatol. 2003;49:229–33.
Sato A, Arima Y, Kojima Y, et al. Correlation between polymorphic CAG-repeats in the androgen receptor gene and therapeutic efficacy of finasteride in androgenetic alopecia. Skin Surg. 2008;17:80–6.
HairDx. Available at http://www.hairdx.com Accessed Jan 10, 2010.
Goh C, Zippin JH. Androgenetic alopecia: diagnosis and treatment with a focus on recent genetic implications. J Drugs Dermatol. 2009;8:185–92.
Kaufman KD, Rotonda J, Shah AK, et al. Long-term treatment with finasteride 1 mg decreases the likelihood of developing further visible hair loss in men with androgenetic alopecia (male pattern hair loss). Eur J Dermatol. 2008;18:400–6.
Acknowledgment
We would like to thank Andy Goren, HairDx, LLC, for his helpful discussions.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Hoss, D.M., Murphy, M.J. (2011). Alopecias. In: Murphy, M. (eds) Molecular Diagnostics in Dermatology and Dermatopathology. Current Clinical Pathology. Humana Press. https://doi.org/10.1007/978-1-60761-171-4_18
Download citation
DOI: https://doi.org/10.1007/978-1-60761-171-4_18
Published:
Publisher Name: Humana Press
Print ISBN: 978-1-60761-170-7
Online ISBN: 978-1-60761-171-4
eBook Packages: MedicineMedicine (R0)