P8.102 Patients with large prostate size show Higher Prevalence of Androgenetic Alopecia

Chao-Chun Yang¹, Tzong-Shin Tzai², Meng-Chi Wu¹, WenChieh Chen³

¹Department of Dermatology and ²Urology, College of Medicine, National Cheng Kung University, Tainan, Taiwan; * Department of Dermatology, Chang Gung University, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan

Objectives: Androgenetic alopecia (AGA) and benign prostatic hyperplasia (BPH) are both androgen-dependent disorders, displaying in situ high level of dihydrotestosterone with good therapeutic response to finasteride, a specific type II 5-reductase inhibitor. The hair follicle and prostate share similarities in embryological development with mesenchymal-epithelial interaction, influenced by the expression of type II 5- reductase. The present study aims to understand the association between the prostate size and the prevalence and severity of AGA.

Methods: Ninety-seven patients (Mean age 69.8 year-old) were retrospectively recruited from the Urology clinic. BPH was defined and diagnosed by (1) prostate size > 20 cm³, measured by transrectal ultrasound (2) maximal urine flow rate < 15 ml/sec and mean urine flow rate < 10 ml/sec (3) PSA < 10 ng/ml. Included as controls were patients with urogenital infection or urolithiasis. The presence and severity of AGA were evaluated by dermatologists using a modified Norwood/Hamilton classification. The difference of prevalence of AGA was analyzed by Chi-square test. Correlation between severity of AGA and size of prostate was estimated by Spearman’s rank correlation test. Comparison of mean prostate size in AGA vs. non-AGA patients was analyzed by Student’s t-test.

Results: Patients with prostate size larger than 30 cm³ in volume have higher prevalence of AGA than patients with smaller prostate (<30 cm³). (83.3 % vs. 61.3 %; p< 0.05). The prostate size, however, does not correlate with the severity of AGA in either group or in the whole patient group. The prevalence of AGA is not significantly different in patients with or without BPH (85.7 % vs. 70.6 %). The mean prostate size is slightly larger in patients with AGA than those without AGA (42.7±17.4 cm³ vs. 35.4±14.9 cm³), but this is not statistically significant. There is no significant correlation between the onset age of AGA and the development of BPH.

Conclusions: Patients with larger prostate size seem to have higher prevalence of AGA. It remains to see if long-term use of finasteride in AGA patients could prophylactically lower the incidence of BPH.