Female androgenetic alopecia

Androgenetska alopecija u žena je česta bolest koja pogađa milijune žena diljem svijeta. Ubraja se u neožiljkaste alopecije. Početni simptomi se mogu javiti već u tinejdžerskoj dobi, a prevalencija je najveća u postmenopauzi. Bijela rasa je najviše pogođena bolešću. ----- Etiopatogeneza bolesti je vrlo složena i još nije u potpunosti razjašnjena. Najvažniju ulogu u nastanku imaju muški spolni hormoni (testosteron i dihidrotestosteron), ali i brojni drugi čimbenici kao što su genetski i okolišni čimbenici. Vezanjem dihidrotestosterona, metabolita testosterona, za androgeni receptor započinje proces folikularne minijaturizacije. Ovaj proces je najvažniji događaj u nastanku androgenetske alopecije. Terminalne dlake koje su pigmentirane, duge i debele, transformiraju se u velus dlake koje su kratke i tanke. Genetska podloga bolesti je slična u muškaraca i žena. ----- Bolest karakterizira postupno progresivno prorjeđivanje kose najčešće na parijetalnoj i frontalnoj regiji vlasišta, a okcipitalna regija i frontalna linija kose su očuvane. Dijagnoza se postavlja na temelju karakteristične kliničke slike. Za postavljanje dijagnoze i praćenje učinka terapije primjenjuje se više klasifikacija pri čemu je najčešća Ludwigova klasifikacija koja bolest dijeli u tri stupnja. ----- Terapija androgenetske alopecije u žena je lokalna i zasad jedini odobreni lijek je minoksidil. Osim medikamentozne terapije i transplantacija kose i niskoenergetski laseri mogu biti korisni. Androgenetska alopecija je estetski nedostatak koji žene može psihološki opteretiti, poglavito u socijalnim kontaktima. Zato je važno pravodobno otkrivanje i liječenje ove bolesti.Female androgenetic alopecia is a common disease that affects millions of women around the world. Androgenetic alopecia belongs to the group of nonscarring alopecia. Initial symptoms can appear as early as the teenage years, and the prevalence is greatest among postmenopausal women. Caucasian women are mostly affected by this disease. ----- Etiopathogenesis of the disease is very complex and still hasn’t been fully understood. The most important role in the development belongs to male sex hormones - testosterone and dihydrotestosterone (DHT), but also many other factors such as genetic and environmental factors are included. ----- Dihydrotestosterone, metabolite of testosterone, binds to androgen receptor and then begins the process of follicular miniaturization. Follicular miniaturization is the most important feature of female androgenetic alopecia. Pigmented, long and thick terminal hairs are transformed into short and thin vellus hairs. Genetic background is similar among men and women. ----- The disease is characterized by progressive thinning of the hair, usually in the parietal and frontal regions of the scalp. Occipital region and frontal hair line are usually spared. The diagnosis is made on the basis of clinical picture. Three-point Ludwig scale is most commonly used classification together with few other classifications. ----- Therapy for female androgenetic alopecia is topical and today the only approved medication is minoxidil. Hair transplantation and low-energy lasers can be useful too. Female androgenetic alopecia is a cosmetic defect and women may be psychologically affected, especially in social contacts. Therefore early diagnosis and treatment are very important