JAAD: Is the androgen hair loss really non -inflammatory hair loss?
Astronomical hair loss (AGA) may affect up to 50%of adults. AGA is a hereditary disease with excessive response to androgen. Aga patients have higher levels of dual-hydrogen testosterone, and 5α-reducing enzymes androgen receptor levels in bald top scalp are also high. The excessive activation of the androgen receptor gradually shortens the miniaturization of follicles through the growth period. In terms of treatment, there are only two types of FDA approved AGA drugs: external minordedor and oral non -Nacheramine. Other therapies (small doses of oral osomal, gauge male amine, snails, platelet rich plasma, red light or 660 nm laser) have shown certain effects.
Although AGA is classified as non -inflammatory and non -scarring hair loss, inflammatory histological evidence has long been recognized. Jaworsky et al. Using ultra -micro -structure studies, of the 4 patients with AGA patients, the outer sheath of the hair follicles of the movement area and hair loss zone increased compared to non -hair follicles outer membranes. Fiber sheaths can see large cells and fibroblasts active. The chemical chemistry of the immunohistochemical tissue shows that there is no foam inflammation in the biopsy tissue, and the movement area is always displayed in the activated T cell infiltration near the lower part of the filter funnel. Inflammation of inflammatory cells infiltration in the bubbles. These data suggest that the peripheral fibrosis of the foaming sheath occurs in the skin lesions of the mode of hair loss, which may begin in the T cell infiltration in the T cells in the olored stem cell epithelium. The thickening of hair follicles stem cells and/or outer membrane sheath can affect normal hair circulation and cause hair loss. Mahéet Al used the term “micro -inflammation” in AGA. They pointed out that in previous studies, it was more effective for patients with Minordel for patients without inflammation. AGA case.
In this issue of the American Society of Dermatology, Plante et al. A retrospective analysis of 96 samples (58 AGA and 38 alopecia areata [AA]). The author found lymphocytes surrounding the lobular lymphocytes (87.9%AGA, 81.6%AA) in most specimens. The AGA specimen is more prone to disclosure (58.6%than 36.8%) and the gorge (79.3%than 55.3%) infiltration, and the permeal infiltration (0.0%to 63.2%) is rarely occur. Most of the two groups of inflammation response slightly. All specimens have miniaturized follicles, 50 cases of AGA (86.2%) and 30 cases of AA (78.9%) have inflammatory reactions near miniaturized follicles. Group 17 cases (29.3%) and 16 cases (42.1%) in group AA. Although the AGA sample shows the overall inflammation rate similar to the AA control group, funnels and gorge suffering are obviously more common in AGA.
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Yale and others observed that the four patients with severe recycles (no AGA medical history) who received the treatment of JANUS kinase inhibitors showed AA improvement, but AGA had hair regeneration. Obviously, the role of inflammation in AGA needs to be further clarified.
Literature source: Heymann WR, The Inflammatic Component of Androidnetic Alopecia, J AM Acad Dermatol 2021 Nov 17;
