F27 THE X-LINKED GENE DEFECT OF ADRENOLEUKODYSTROPHY IS INVOLVED IN ANDROGENETIC ALOPECIA

¹König A., ¹Happle R., ¹Tchitcherina E., ²Schaefer J.R., ³Sokolowski P., ³Köhler W., ¹Hoffmann R. ¹Dept. of Dermatology, Philipp University, Marburg, Germany; ²Dept. of Internal Medicine, Philipp University, Marburg, Germany; ³Dept. of Neurology, Sächsisches Krankenhaus Hubertusburg, Wermsdorf, Germany.

Adrenoleukodystrophy (ALD) is an X-linked recessive trait characterized by accumulation of very-long-chain fatty acids in the brain and other organs such as the adrenal glands. The ALD gene maps to Xq28 and codes for a peroxisomal membrane protein which is a member of the ATP-binding cassette transporter superfamily. Affected men suffer from progressive demyelinization of the nervous system. Various endocrine and neurological disorders cause a broad spectrum of clinical manifestations.

This study was performed to delineate the hair status and type of hair loss in men with ALD. 16 patients were examined. 12 men had male-pattern androgenetic alopecia, Hamilton grades IV-VIII, 10 of these had reached Hamilton stage VII or VIII. 3 patients showed a female pattern of androgenetic alopecia (Ludwig grade I or II). The remaining scalp hair was unusually scarce and thin, 10 of 16 patients showed pronounced madarosis.

ALD gives rise to two different types of hair loss. Affected men show diffuse hair loss involving the entire scalp and the eyelashes. Secondly they tend to develop androgenetic alopecia more frequently and earlier and in a severer form. The X-linked ALD mutation can be taken as a well-defined gene within the polygenic spectrum of genes responsible for androgenetic alopecia.