042 Morphological Approach To Hair Disorders

R Sinclair. Dept. Dermatology, University of Melbourne, Victoria, Australia

All medical research begins and ends with the patient. Patients present to doctors who by careful observation of the morphology of their complaint establish a diagnosis. Patient needs motivate us to research their disease and find novel therapeutic interventions to take back to the patient to alleviate morbidity. Interaction between clinicians who are hair morphologists and scientific researchers is pivotal. Hair morphology research involves many aspects. Careful observation of the physical presentation of the patient and correlation of these finding with the histological features of biopsy specimens enhances the specificity of both. Many conditions associated with structural abnormalities of the hair fibre are caused by single gene mutations. Cataloguing these conditions based on their clinical presentation and hair microscopy findings allows them to be methodically studied. Kindreds with inherited disorders are amenable to gene discovery procedures. Reverse genetics, whereby the causative mutation is found, the gene product identified and the biological consequences of the altered protein product studied, allows determination of abnormal molecular function on hair biology to be understood. In turn this sheds light on the requirements for normal follicle function. Hair morphology also involves sub-classifying patients who present with multi-factorial diseases on clinical grounds. Female pattern hair loss is an example of a multi-factorial disease whereby careful observation of the patient’s clinical presentation helps predict which patients are likely to respond to therapy. One common problem that confounds all clinical hair research is the difficulty accurately measuring hair growth, monitoring the hair cycle and documenting patient response to therapy. Improvements in photographic methodologies have allowed clinical trials to be conducted into the treatment of androgenetic alopecia but further work is required, particularly in the assessment of scarring alopecia, alopecia areata and the study of normal hair growth and cycling. Just as laboratory research has produced many recent advances in hair biology, clinical research is also continuing at a rapid pace with new clinical insights and new syndromes being regularly described, that will impact on the future direction of hair research.