Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- presença de fatores de risco
- história familiar de alopécia
- regressão gradual da linha capilar frontal, central e da coroa (vértice)
- afinamento difuso da parte central do couro cabeludo com preservação da linha capilar frontotemporal
Fatores de risco
- história familiar de alopécia
- idade avançada
- síndrome do ovário policístico nas mulheres
- etnia branca
- resistência insulínica
- câncer de próstata
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- teste de tração do cabelo
- teste da função tireoidiana
- ferritina sérica
Investigações a serem consideradas
- Hemograma completo com diferencial
- perfil metabólico completo
- fator antinuclear
- reagina plasmática rápida
- testosterona livre
- sulfato de prasterona (DHEA) sérico
- globulina ligadora de hormônios sexuais
- dermatoscopia/tricoscopia
- biópsia do couro cabeludo
Algoritmo de tratamento
homens que optam pelo tratamento conservador
homens que optam pelo tratamento clínico
mulheres que optam pelo tratamento conservador
mulheres que optam pelo tratamento clínico
tratamento clínico malsucedido
Colaboradores
Autores
Carolyn Goh, MD
Associate Clinical Professor
Department of Medicine
Division of Dermatology
UCLA Medical Center
Los Angeles
CA
Declarações
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.
Agradecimentos
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
Marcelo G. Horenstein, MD
Director of Dermatopathology
The Dermatology Group
Verona
NJ
Declarações
MGH declares that he has no competing interests.
Alvin R. Solomon, MD
Professor of Dermatology
Emory University School of Medicine
Atlanta
GA
Declarações
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
Declarações
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.
Referências
Principais artigos
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. Resumo
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. Resumo
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. Resumo
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. Resumo
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. Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Alopécia areata difusa
- Eflúvio telógeno agudo
- Eflúvio telógeno crônico
Mais Diagnósticos diferenciaisDiretrizes
- S3 - European dermatology forum guideline for the treatment of androgenetic alopecia in women and in men
- Guidelines for the diagnosis and treatment of male-pattern and female-pattern hair loss
Mais DiretrizesConectar-se ou assinar para acessar todo o BMJ Best Practice
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