小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 脱发家族史
- 前额发际线、头皮中央和头顶毛发逐渐后退或减少
- 头皮中央弥漫性毛发稀疏，前额及颞部发际线完整
危险因素
- 脱发家族史
- 老年
- 多囊卵巢综合征
- 白种人
- 胰岛素抵抗
- 前列腺癌
诊断性检查
首要检查
- 拔发试验
- 甲状腺功能检测
- 血清铁蛋白
需考虑的检查
- FBC 和分类计数
- 全套代谢检查组合
- 抗核抗体
- 快速血浆反应素试验
- 游离睾酮
- 血清脱氢表雄酮（dehydroepiandrosterone, DHEA）硫酸盐
- 性激素结合球蛋白
- 皮肤镜/毛发镜检查
- 头皮活检
治疗流程
选择保守治疗的男性
选择药物治疗的男性
选择保守治疗的女性
选择药物治疗的女性
药物治疗失败
撰稿人
作者
Carolyn Goh, MD
Associate Clinical Professor
Department of Medicine
Division of Dermatology
UCLA Medical Center
Los Angeles
CA
利益声明
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.
鸣谢
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.
同行评议者
Marcelo G. Horenstein, MD
Director of Dermatopathology
The Dermatology Group
Verona
NJ
利益声明
MGH declares that he has no competing interests.
Alvin R. Solomon, MD
Professor of Dermatology
Emory University School of Medicine
Atlanta
GA
利益声明
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
利益声明
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.
鉴别诊断
- 弥漫性斑秃
- 急性休止期脱发
- 慢性休止期脱发
更多 鉴别诊断指南
- S3 - 欧洲皮肤病学论坛男性和女性雄激素性脱发治疗指南
- 男性型和女性型脱发的诊断和治疗指南
更多 指南
登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容
内容使用需遵循免责声明