Hair and Nail Manifestations of Systemic Disease

    January 2017 in “ Current Dermatology Reports
    Sally Tan, Maryanne M. Senna
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    TLDR Early baldness in men may indicate risks for obesity, metabolic syndrome, insulin resistance, and heart disease, similar to women with PCOS. Alopecia areata is often linked with autoimmune diseases and mental health issues. Certain hair disorders are due to genetic issues, and chemotherapy can cause hair loss through specific biological pathways. Iron deficiency's link to hair loss is still disputed.
    The 2017 document "Hair and Nail Manifestations of Systemic Disease" explored the connection between systemic diseases and changes in hair and nails. It found that men with early onset androgenetic alopecia have similar hormonal profiles to women with Polycystic Ovary Syndrome (PCOS), indicating a potential risk for similar systemic complications like obesity, metabolic syndrome, insulin resistance, and cardiovascular disease. The document also noted common comorbidities in patients with alopecia areata, including autoimmune diseases, atopy, and mental health issues. It also discussed the molecular basis for several congenital hair shaft disorders and the pathophysiology of chemotherapy-induced alopecia, highlighting the role of p53-dependent apoptosis pathways and chemotherapy-induced hair cycle abnormalities. A study on hair loss from cytotoxic drugs was mentioned, but pre-treatment with calcipotriol did not prevent hair loss. The document also discussed the controversial link between iron deficiency anemia and hair loss, with one study finding no difference in iron deficiency prevalence between pre- or post-menopausal women with female pattern hair loss, chronic telogen effluvium, and control subjects.
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