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Title: Analysis of laboratory parameters, clinical factors, and impact of scalp vascularization on the clinical response in patients with androgenetic alopecia treated with minoxidil
Abstract:
The aim of this paper was to conduct a series of laboratory tests in order to assess the rationality behind their broad clinical use as well as to assess the selected clinical parameters, including exposure to psychological stress, disease progression based on the Ludwig scale, and the therapies applied in patients diagnosed with androgenetic alopecia. Moreover, we looked into whether the degree of scalp vascularization has an impact on the efficacy of topical treatment with 5% minoxidil. Material and Methods: The study was carried out at the Department and Clinic of Dermatology with the use of Medicam 800 video dermatoscope manufactured by FotoFinder (Bad Birnbach, Germany). The physicians involved in the study are specialists in dermatology and venereology. Analysis of trichoscopic images was carried out at the TrichoLAB laboratory (Warsaw, Poland). Histological specimens were examined by a specialist in pathomorphology. To render the analyses objective, the results of histological examinations and video trichoscopy assessments were blinded for the investigators involved. Moreover, the commonly applied Ludwig scale was used to assess the progression of androgenetic alopecia. An original scale, developed by the authors, was used to assess the intensity of the subjectively experienced psychological stress. Laboratory tests were carried out at the analytical laboratory of the Un ; iversity Hospital in Krakow, with the use of standard measurement units. Results: In the studied population, the most commonly observed hormonal disorders included elevated levels of SHBG (38.8%), low levels of total testosterone (25.4%), elevated levels of ATPO (17.3%), low levels of DHEAS (15.6%), and elevated levels of insulin (12.6%). High levels of free testosterone were observed in only 6.8 % of the subjects, and 6.7% of the patients had high cortisol levels. Menstruation disorders, hirsutism and acne were reported in the histories of 40% of the study subjects. However, sex hormone levels were not found to correlate with the symptoms reported by the patients, and were not significantly different from those measured in the remaining study subjects, who did not complain about symptoms of hyperandrogenism. Patients presented with very high scores of stress exposure – 7 and 8 (on a scale of 1 to 10). The type of treatment applied (topical vs. systemic) was of no significance in terms of stress alleviation. Disease progression did not correlate with the stress level either. In terms of disease progression, most patients were classified as Ludwig grade I-2 (24.74%). Having compared the applied methods of treatment in the studied population, we established that a great majority of the patients had been treated with topical solutions (80.00%), amongst which the 5% minoxidil sol ; ution prevailed (51.19%), followed by a solution of minoxidil combined with prednisolone and estradiol (35.71%). 17.14% of the patients received systemic treatment. A small percentage of patients opted for aesthetic medicine procedures (3.81%). 22.86% of the patients also applied dietary supplements or over-the-counter topical products. For patients whose scalp vascularization was assessed with respect to the efficacy of 5% minoxidil solution, a significant increase in the total count was observed 6 months into the treatment, and a reduction in the number of single-hair follicular units as compared to baseline. A reduction in the number of single-hair follicular units was observed in 50.67% of the patients. At the same time, an increase in the total hair count was observed in 57.33% of the patients, and a lack of reduction in the total hair count was reported for 68% of the patients 6 months into the treatment. Conclusions: Even though nearly half of the patients complained about symptoms indicative of hormonal disorders, no significant deviations from normal ranges were observed in the studied population. The high scores of stress exposure reported by the patients most likely stemmed from the very symptoms of the disease, as the patients represented diverse professional backgrounds and had different levels of professional activity. The patients responded equally well to topic ; al minoxidil treatment, irrespectively of the scalp vessel count.
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Last modified:
Aug 11, 2023
In our library since:
Apr 5, 2022
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2
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http://dl.cm-uj.krakow.pl:8080/publication/4626
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| Edition name | Date |
|---|---|
| ZB-133862 | Aug 11, 2023 |
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