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Patients with a large prostate show a higher prevalence of androgenetic alopecia

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Abstract

Androgenetic alopecia (AGA) and benign prostatic hyperplasia (BPH) are both androgen-dependent disorders, displaying in situ high levels of dihydrotestosterone with a good therapeutic response to finasteride. Embryological development of both the hair follicle and the prostate depends on mesenchymal-epithelial interaction, which is influenced by the expression of type 2 5α-reductase. The aim of this study was to elucidate the association between the size of the prostate gland and the prevalence and severity of AGA. A total of 46 patients age between 56 and 87 years were retrospectively recruited. They fulfilling the clinical diagnosis of BPH defined as (1) prostate volume >30 cm3, measured by transrectal ultrasound, (2) maximal urine flow rate <15 ml/s and mean urine flow rate <10 ml/s, and (3) prostate serum albumin <10 ng/ml. The control group comprised 34 patients aged between 49 and 81 years with urogenital infection, cystitis or urolithiasis. The expression and severity of AGA were evaluated by dermatologists using modified Norwood/Hamilton classification. Patients with a prostate volume >30 cm3 had a higher prevalence of AGA than patients with a smaller prostate (<30 cm3) (83.3% vs 61.3%; P<0.05). The prostate size, however, did not correlate with the severity of AGA in either group or in the whole patient group. The prevalence of AGA was not significantly different in patients with or without BPH (85.7% vs 70.6%). The prostate was slightly larger among patients with AGA than among those without AGA (mean±SD 42.7±17.4 vs 35.4±14.9 cm3), but this was not statistically significant. There was no significant correlation between the age of onset of AGA and the development of BPH. Our results suggest that a larger prostate is associated with a higher prevalence of AGA. It remains to be seen if long-term use of finasteride in AGA patients will prophylactically lower the incidence of BPH.

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References

  1. Ellis JA, Sinclair R, Harrap SB (2002) Androgenetic alopecia: pathogenesis and potential for therapy. Expert Rev Mol Med 4:1–11

    Article  Google Scholar 

  2. Hoffmann R (2003) Steroidogenic isoenzymes in human hair and their potential role in androgenetic alopecia. Dermatology 206:85–95

    Article  CAS  PubMed  Google Scholar 

  3. Chen W, Thiboutot D, Zouboulis ChC (2002) Cutaneous androgen metabolism; basic research and clinical perspectives. J Invest Dermatol 119:992–1007

    Article  CAS  PubMed  Google Scholar 

  4. Eaton CL (2003) Aetiology and pathogenesis of benign prostatic hyperplasia. Curr Opin Urol 13:7–10

    Article  PubMed  Google Scholar 

  5. Meigs JB, Mohr B, Barry MJ, Collins MM, McKinlay JB (2001) Risk factors for clinical benign prostatic hyperplasia in a community-based population of healthy aging men. J Clin Epidemiol 54:935–944

    Article  CAS  PubMed  Google Scholar 

  6. Steers WD (2001) 5alpha-reductase activity in the prostate. Urology 58 (6 Suppl 1):17–24

    Article  CAS  PubMed  Google Scholar 

  7. Thigpen AE, Silver RI, Guileyardo JM, Casey ML, McConnell JD, Russell DW (1993) Tissue distribution and ontogeny of steroid 5 alpha-reductase isozyme expression. J Clin Invest 92:903–910

    CAS  PubMed  Google Scholar 

  8. Bartsch G, Rittmaster RS, Klocker H (2002) Dihydrotestosterone and the concept of 5alpha-reductase inhibition in human benign prostatic hyperplasia. World J Urol 19:413–425

    CAS  PubMed  Google Scholar 

  9. Randall VA (1994) Role of 5 alpha-reductase in health and disease. Baillieres Clin Endocrinol Metab 8:405–431

    CAS  PubMed  Google Scholar 

  10. Wilson JD, Griffin JE, Russell DW (1993) Steroid 5 alpha-reductase 2 deficiency. Endocr Rev 14:577–593

    Article  CAS  PubMed  Google Scholar 

  11. Whiting DA (2001) Advances in the treatment of male androgenetic alopecia: a brief review of finasteride studies. Eur J Dermatol 11:332–334

    CAS  PubMed  Google Scholar 

  12. Edwards JE, Moore RA (2002) Finasteride in the treatment of clinical benign prostatic hyperplasia: a systematic review of randomised trials. BMC Urol 2:14

    Article  PubMed  Google Scholar 

  13. Oh BR, Kim SJ, Moon JD, Kim HN, Kwon DD, Won YH, Ryu SB, Park YI (1998) Association of benign prostatic hyperplasia with male pattern baldness. Urology 51:744–748

    Article  CAS  PubMed  Google Scholar 

  14. Irani J, Brown CT, van der Meulen J, Emberton M (2003) A review of guidelines on benign prostatic hyperplasia and lower urinary tract symptoms: are all guidelines the same? BJU Int 92:937–942

    Article  CAS  PubMed  Google Scholar 

  15. Wadie BS, Ibrahim EH, de la Rosette JJ, Gomha MA, Ghoneim MA (2001) The relationship of the International Prostate Symptom Score and objective parameters for diagnosing bladder outlet obstruction. Part I: when statistics fail. J Urol 165:32–34

    Article  CAS  PubMed  Google Scholar 

  16. Stenn KS, Paus R (2001) Controls of hair follicle cycling. Physiol Rev 81:449–494

    CAS  PubMed  Google Scholar 

  17. Greenwald P, Damon A, Kirmss V, Polan AK (1974) Physical and demographic features of men before developing cancer of the prostate. J Natl Cancer Inst 53:341–346

    CAS  PubMed  Google Scholar 

  18. Demark-Wahnefried W, Schildkraut JM, Thompson D, Lesko SM, McIntyre L, Schwingl P, Paulson DF, Robertson CN, Anderson EE, Walther PJ (2000) Early onset baldness and prostate cancer risk. Cancer Epidemiol Biomarkers Prev 9:325–328

    PubMed  Google Scholar 

  19. Hawk E, Breslow RA, Graubard BI (2000) Male pattern baldness and clinical prostate cancer in the epidemiologic follow-up of the first National Health and Nutrition Examination Survey. Cancer Epidemiol Biomarkers Prev 9:523–527

    CAS  PubMed  Google Scholar 

  20. Hsieh CC, Thanos A, Mitropoulos D, Deliveliotis C, Mantzoros CS, Trichopoulos D (1999) Risk factors for prostate cancer: a case-control study in Greece. Int J Cancer 80:699–703

    Article  CAS  PubMed  Google Scholar 

  21. Giles GG, Severi G, Sinclair R, English DR, McCredie MR, Johnson W, Boyle P, Hopper JL (2002) Androgenetic alopecia and prostate cancer: findings from an Australian case-control study. Cancer Epidemiol Biomarkers Prev 11:549–553

    PubMed  Google Scholar 

  22. Demark-Wahnefried W, Lesko SM, Conaway MR, Robertson CN, Clark RV, Lobaugh B, Mathias BJ, Strigo TS, Paulson DF (1997) Serum androgens: associations with prostate cancer risk and hair patterning. J Androl 18:495–500

    CAS  PubMed  Google Scholar 

  23. Drake L, Hordinsky M, Fiedler V, et al (1999) The effects of finasteride on scalp skin and serum androgen levels in men with androgenetic alopecia. J Am Acad Dermatol 41:550–554

    CAS  PubMed  Google Scholar 

  24. Roberts JL, Fiedler V, Imperato-McGinley J, et al (1999) Clinical dose ranging studies with finasteride, a type 2 5alpha-reductase inhibitor, in men with male pattern hair loss. J Am Acad Dermatol 41:555–563

    CAS  PubMed  Google Scholar 

  25. Frankel S (1999) Study of the Food and Drug Administration files on Propecia: dosages, side effects, and recommendations. Arch Dermatol 135:257–258

    Article  CAS  PubMed  Google Scholar 

  26. Cote RJ, Skinner EC, Salem CE, Mertes SJ, Stanczyk FZ, Henderson BE, Pike MC, Ross RK (1998) The effect of finasteride on the prostate gland in men with elevated serum prostate-specific antigen levels. Br J Cancer 78:413–418

    CAS  PubMed  Google Scholar 

  27. Vaughan D, Imperato-McGinley J, McConnell J, Matsumoto AM, Bracken B, Roy J, Sullivan M, Pappas F, Cook T, Daurio C, Meehan A, Stoner E, Waldstreicher J (2002) Long-term (7 to 8-year) experience with finasteride in men with benign prostatic hyperplasia. Urology 60:1040–1044

    Article  CAS  PubMed  Google Scholar 

  28. Sullivan MJ, Geller J (2002) The effectiveness of reducing the daily dose of finasteride in men with benign prostatic hyperplasia. BMC Urol 2:2

    Article  PubMed  Google Scholar 

  29. Yoshida O, Oishi K, Okada Y, Mizutani Y, Itokawa Y, Tomoyoshi T, Okada K, Komatz Y, Matsuda T, Takeuchi H (1996) Effect of long-term administration of finasteride (MK-906), an inhibitor of 5 alpha-reductase, in patients with benign prostatic hyperplasia. Hinyokika Kiyo 42:323–331

    CAS  PubMed  Google Scholar 

  30. Kaplan SA, Holtgrewe HL, Bruskewitz R, Saltzman B, Mobley D, Narayan P, Lund RH, Weiner S, Wells G, Cook TJ, Meehan A, Waldstreicher J (2001) Proscar Long-Term Efficacy and Safety Study Group. Comparison of the efficacy and safety of finasteride in older versus younger men with benign prostatic hyperplasia. Urology 57:1073–1077

    Article  CAS  PubMed  Google Scholar 

  31. Anderson WR, Harris NM, Holmes SA (2002) Hormonal treatment for male-pattern hair loss: implications for cancer of the prostate? BJU Int 90:682–685

    Article  CAS  PubMed  Google Scholar 

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Correspondence to WenChieh Chen.

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Chen, W., Yang, CC., Chen, GY. et al. Patients with a large prostate show a higher prevalence of androgenetic alopecia. Arch Dermatol Res 296, 245–249 (2004). https://doi.org/10.1007/s00403-004-0514-z

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  • DOI: https://doi.org/10.1007/s00403-004-0514-z

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