Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- family history of baldness
- gradual receding of frontal hairline, central, and crown (vertex)
- diffuse thinning of the central scalp with preservation of frontotemporal hairline
Factores de riesgo
- family history of baldness
- advancing age
- polycystic ovary syndrome in women
- white ethnicity
- insulin resistance
- prostate cancer
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- hair-pull test
- thyroid function test
- serum ferritin
Pruebas diagnósticas que deben considerarse
- CBC with differential
- comprehensive metabolic panel
- antinuclear antibodies
- rapid plasma reagin
- free testosterone
- serum dehydroepiandrosterone (DHEA)-sulfate
- sex hormone-binding globulin
- dermatoscopy/trichoscopy
- scalp biopsy
Algoritmo de tratamiento
men who opt for conservative management
men who opt for medical management
women who opt for conservative management
women who opt for medical management
failed medical treatment
Colaboradores
Autores
Carolyn Goh, MD
Associate Clinical Professor
Department of Medicine
Division of Dermatology
UCLA Medical Center
Los Angeles
CA
Divulgaciones
CG has spoken for the International Society of Hair Restoration Surgeons, the American Academy of Dermatology, the Pacific Dermatologic Association, the California Society of Dermatology and Dermatologic Surgery, and has had manuscripts published in a variety of journals. CG has also participated in advisory boards for Pelage Pharmaceuticals and Pfizer, Inc.
Agradecimientos
Dr Carolyn Goh would like to gratefully acknowledge Dr Robert Haber, Dr Christiane Querfeld, and Dr Christopher R. Shea, previous contributors to this topic. RH has an ownership interest in a company that manufactures light-based hair growth devices and receives royalties for the sales of a surgical device used in hair restoration surgery. CQ and CRS declare that they have no competing interests.
Revisores por pares
Marcelo G. Horenstein, MD
Director of Dermatopathology
The Dermatology Group
Verona
NJ
Divulgaciones
MGH declares that he has no competing interests.
Alvin R. Solomon, MD
Professor of Dermatology
Emory University School of Medicine
Atlanta
GA
Divulgaciones
ARS declares that he has no competing interests.
David Whiting, MD, FACP
Medical Director
The Baylor Hair and Skin Research and Treatment Center
Dallas
TX
Divulgaciones
DW is an author of a number of references cited in this topic. We have since been made aware that Dr David Whiting is deceased.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referencias
Artículos principales
Starace M, Orlando G, Alessandrini A, et al. Female androgenetic alopecia: an update on diagnosis and management. Am J Clin Dermatol. 2020 Feb;21(1):69-84. Resumen
European Dermatology Forum. S3 - European Dermatology Forum guideline for the treatment of androgenetic alopecia in women and in men. 2017 [internet publication].Texto completo
Olsen EA, Messenger AG, Shapiro J, et al. Evaluation and treatment of male and female pattern hair loss. J Am Acad Dermatol. 2005 Feb;52(2):301-11. Resumen
Olsen EA, Whiting D, Bergfeld W, et al. A multicenter, randomized, placebo-controlled, double-blind clinical trial of a novel formulation of 5% minoxidil topical foam versus placebo in the treatment of androgenetic alopecia in men. J Am Acad Dermatol. 2007 Nov;57(5):767-74. Resumen
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 Oct;39(4 Pt 1):578-89. Resumen
Lucky AW, Piacquadio DJ, Ditre CM, et al. A randomized, placebo-controlled trial of 5% and 2% topical minoxidil solutions in the treatment of female pattern hair loss. J Am Acad Dermatol. 2004 Apr;50(4):541-53. Resumen
Olsen EA, Hordinsky MK, Price VH, et al. Alopecia areata investigational assessment guidelines: part II. National Alopecia Areata Foundation. J Am Acad Dermatol. 2004;51:440-7. Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Diffuse alopecia areata
- Acute telogen effluvium
- Chronic telogen effluvium
Más DiferencialesGuías de práctica clínica
- S3 - European dermatology forum guideline for the treatment of androgenetic alopecia in women and in men
- Medical guidelines for clinical practice for diagnosis and treatment of hyperandrogenic disorders
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