Correlation between clinical features, biochemical parameters, and histopathological findings in women with patterned baldness: Study from North India

Background: Androgenetic alopecia (AGA) is a non-scarring alopecia with a characteristic pattern in genetically predisposed men and women. Hormonal abnormalities namely hyperandrogenism, hair cycle defects, genetic predisposition, and follicular miniaturization have been implicated as the causative factors for AGA. Aim: To analyze women with patterned hair loss and correlate their clinical findings with the histopathology and biochemical parameters. Materials and Methods: Female patients between 18 and 45 years of age with a history of hair loss on the crown, temporal area, and recession of hairline were clinically examined. These patients were then subjected to histopathological examination, and on confirmation of diagnosis of female pattern hair loss (FPHL), they were included in the study. Their morning blood sample was taken on 3rd–5th day of the menstrual cycle for hormonal analysis. The study was carried out on 30 patients and 30 age- and sex-matched controls. Results: A statistically significant difference was observed between the mean values of dehydroepiandrosterone sulfate, prolactin, androstenedione, and free triiodothyronine of cases and controls. The most common histopathological finding in our study was an increase in the percentage of telogen hair. Conclusion: The biochemical findings in our study corroborate the role of hyperandrogenism as one of the major etiological factors in FPHL with the role of adrenal androgens being central, and therefore all female patients with FPHL should be evaluated for underlying hormonal imbalances. The role of histopathology in FPHL can be used as a prognostic marker