Androgenetic alopecia in males: a histopathological and ultrastructural study.
BACKGROUND
Androgenetic alopecia is a common cosmetic hair disorder, resulting from interplay of genetic, endocrine, and aging factors leading to a patterned follicular miniaturization. Microinflammation seems to be a potential active player in this process.


OBJECTIVE
To study the histopathological and ultrastructural changes occurring in male androgenetic alopecia (AGA). Patients/methods Fifty-five subjects were included in this study (40 with AGA and 15 as normal age-matched controls). Skin biopsies from frontal bald area and occipital hairy area were subjected to histopathological examination, immunohistochemical staining for collagen I and ultrastructural study.


RESULTS
The frontal bald area of patients showed highly significant increase in telogen hairs and decrease in anagen/telogen ratio and terminal/vellus hair ratio (P < 0.001). Perifollicular inflammation was almost a constant feature in early cases and showed a significant inverse correlation with perifollicular fibrosis (P = 0.048), which was more marked with thickening of the follicular sheath in advanced cases.


CONCLUSIONS
Follicular microinflammation plays an integral role in the pathogenesis of AGA in early cases. Over time, thickening of perifollicular sheath takes place due to increased deposition of collagen, resulting in marked perifollicular fibrosis, and sometimes ends by complete destruction of the affected follicles in advanced cases.
El-Domyati
Moetaz
M
Department of Dermatology, Al-Minya University, 2 Obour Buildings, Salah Salem St, Apt. 53, Nasr City, Cairo 11371, Egypt. moetazeldomyati@yahoo.com
Attia
Sameh
S
Saleh
Fatma
F
Abdel-Wahab
Hossam
H
D000328:Adult; D000367:Age Factors; D000368:Aged; D000505:Alopecia / Q000473:pathology*; D001706:Biopsy / Q000379:methods; D016022:Case-Control Studies; D003094:Collagen / Q000648:ultrastructure; D005355:Fibrosis / Q000473:pathology; D018859:Hair Follicle / Q000473:pathology / Q000648:ultrastructure*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D012535:Scalp / Q000473:pathology*; D012720:Severity of Illness Index; D012737:Sex Factors
D003094:Collagen