الفهرس 
PATHOGENESIS OF FPHLOnly 14 pages are availabe for public view
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Abstract
Background: Female pattern hair loss (FPHL) is the preferred synonym for androgenetic alopecia in women. It is caused by progressive miniaturization of hair follicles and subsequent reduction of the number of hairs, especially in the central, frontal and parietal scalp regions. These changes are mostly androgen dependent and genetically determined.
Objectives: The present study were clinical, trichoscopic and immunohistochemical evaluation of ADSCs injection in patients with FPHL.
Patients and Methods: Thirty three female patients were recruited from the outpatient clinic of Dermatology, Venereology and Andrology Department, Ain shams University Hospitals; in the period from from December 2016 till June 2017. Patients aged from 20-50 years, and were divided into three groups according to Sinclair’s classification; group 1 included patients with grade II, group 2 and group 3 included patients with grade III and grade IV respectively.
Results: Scalp biopsy was taken for histopathological and immunohistochemical evaluation at baseline and after 12 weeks. Hair follicle miniaturization, in addition to perifollicular inflammation and fibrosis, new blood vessels, and terminal to vellus hair ratio were evaluated by histopathological examination. Immunohistochemical detection of Follistatin (hair follicle stimulatory marker) and DKK-1 (inhibitory marker) was also done before treatment and after 12 weeks. Patients had mean age of 32 ± 8 years and mean duration of hair loss of 5±2 years. Family history was present in 63.6% of patients. Sinclair staging of hair loss positively correlated with patient`s age at presentation and duration of the disease. The observed characteristic trichoscopic features were: - hair shaft diameter diversity and increased miniaturized vellus hairs in all patients 100%, - predominance of single and double hair per follicle in 42.4 % and 57.57% respectively. No significant improvement was seen in the majority (87.8%) of patients, regarding upgrade of Sinclair staging, following ADSCs in the present study; which could be explained that the trichoscopic changes observed weren’t enough to affect the macroscopic appearance of hair fullness.
Conclusion: Clinical stage of female pattern hair loss positively correlates with age at presentation. The dermoscope, which is increasingly used nowadays for diagnosis of hair and skin diseases, is an easy, noninvasive and low cost method of early diagnosis in female pattern hair loss with definitive trichoscopic signs.