138 Androgenetic Alopecia in Adolescence

Wilma Bergfeld, Fabiane Mulinari–Brenner Department of Dermatology, The Cleveland Clinic Foundation, Cleveland, Ohio - USA

Androgenetic alopecia (AGA) is an autosomal dominant condition with variable penetrance that affects about 50% of men and women. AGA is androgen mediated with puberty onset (early teens or twenties) in both sexes and frequently being fully expressed by the fourties. Early identification of this condition leads to better treatment results. A review of patients under 18 years old with clinical diagnosis of AGA was performed. These patients were seen from 1997 to 2000 on the Department of Dermatology – The Cleveland Clinic Foundation. Clinical presentation, family history of AGA, laboratory tests and scalp biopsies were reviewed. Twenty-one patients (4 female and 17 male) were in the young cohort. Age range was 13-17 years (mean 15,4 years). Frontal, vertex or both areas were affected. Family history of AGA was present in 18 patients. Androgen excess signs such as acne (7 patients), hirsutism (4 patients) and seborrheic dermatitis (7 patients) were also associated with alopecia. Hormone levels suggested androgen excess only in 6 patients (2 female and 4 male) of 16 tested. Scalp biopsies were performed in 3 patients and confirmed the presence of hair follicle miniaturization. AGA may start early in the adolescence, especially when the patient has family history of AGA. It can be associated with other signs of androgen excess, however laboratory tests are not always helpful. AGA should be remembered as a cause of hair loss in adolescence.