169 Chronic Diffuse Alopecia in Japanese Females

R Ueki, R Tsuboi, H Ogawa. Dept. of Dermatology, Juntendo University School of Medicine, Tokyo, Japan.

Until recently, there has been a great reluctance on the part of many Japanese women afflicted with chronic diffuse alopecia to come forward for diagnosis and treatment. Lately, however, the mass media have brought more publicity to the issue, and it was consequently reported that the number of women complaining of hair loss has increased 4-5% every year. Interestingly, the majority of the patients were younger than a decade ago. Chronic diffuse alopecia in women is caused by various factors including female androgenetic alopecia (FAGA), chronic telogen effluvium (CTE), nutritional deficiency and systemic disorders. The differential diagnosis of FAGA and CTE, especially in cases with mild changes, is sometimes difficult. Hairs of Japanese female subjects are usually black, straight and grow less densely than those of Caucasians. These racial considerations, as well as the inadequacy of the oversimplified Ludwig classification system, have made the development of a new, more rigorous quantitative method for dividing female alopecia patients into more specific categories necessary. Hair growth patterns in healthy Japanese female subjects as well as those with chronic diffuse alopecia, of various ages, were examined by using phototrichogram analysis and the measurement of excised hair diameter. The hair growth pattern of Japanese female subjects complaining of diffuse hair loss was divided into six abnormal groups, two borderline groups and one normal group. It was further found that hair density, hair diameter, short hair ratio and hair growth rate, but not anagen hair ratio, were the most critical factors, in the order of decreasing significance, for grading the severity of female diffuse alopecia.