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P131 Menstrual irregularity in hirsute women
S184
I
P130
Posters -Hair
The densities of T cells, Langerhans cells, and natural killer cells in uninvolved skin of patients with acne vulgaris
A.B. Aksakal ’ , A. Gtllekon ’ , G. Altay ’ , C. Sezer *, M.O. GztaS ’ Gazi University, Faculty of Medicine: ‘Department
of Dermatology:
2Pathology,
Ankara,
Turkey
Acne Vulgaris (AV) is a disease which affects the whole pilosebaseous follicle, and results in the formation of non-inflamed and inflamed lesions. The purpose of the present work was to investigate the inflammatory infiltrating cells in early AV lesions. We examined 25 biopsies, 10 of them were moderate to severe acne cases and 15 of them were healthy control subjects. All specimens evaluated for the density of the CD3+ (total T lymphocyte), CD4+ (helper/inducer T lymphocyte), CD8+ (suppressor/cytotoxic T lymphocyte), CDla+ (Langerhans cells), and CD56+ (Natural Killer cells) in the epidermis and dermis immunocytochemically. Only the CD4+ cells were found to be statistically elevated in dermis of patients with AV when compared to healthy subjects (p < 0.05).
Hair and Nails I PI
31
Menstrual irregularity in hirsute women
A.D. Yticelten ’ , 0. Giirbtiz ’ , F. Durmu~oglu2, M.A. Akman 2, M. Erenus ‘, G. Imir 2. ‘Marmara School of Medicine, Department of Obstetrics and Gynaecology,
of Dermatology; Istanbul, Turkey
University 2Department
Hirsutism is a frequently encountered problem in women of reproductive age group but women with the same degree of hirsutism may have different hormonal features. Menstrual irregularity which is commonly associated with hirsutism is found in several studies to correlate with higher levels of total or free testosterone. To investigate this finding further, age, body mass index (BMI), Ferriman-Gallwey (FG) score, duration of hirsutism, presence of irregular menses and, FSH/LH ratios, total testosterone, dehydroepiandrosterone sulfate, 17-hydroxyprogesterone and prolactin levels in follicular phase of the cycle were evaluated in 215 hirsute patients with FG scores >lO who were referred to a tertiary hirsutism clinic. Patients with menstrual irregularity were compared with those with regular menses in terms of clinical and hormonal parameters. Menstrual irregularity was present in 73 out of 215 patients. BMI was significantly higher in patients with irregular menses while the FSH/LH ratio was significantly higher in patients with regular menses. Testosterone levels were higher in irregular menstruating group but the difference did not achieve significance. Other clinical and hormonal parameters were not different between the two groups. Of 61 patients classified as ovarian sourced hirsutism 39 (63.93%) had irregular menses. Testosterone levels were significantly higher in PC0 patients with irregular menses compared to PC0 patients with regular menses but other clinical and hormonal parameters were not significantly different. 30 (41.10%) out of 133 patients classified as having peripheric hirsutism had irregular menses but had no significant differences in any of the clinical and hormonal parameters. There were 11 late-onset congenital adrenal
and Nails
hyperplasia patients 3 (27.27%) of whom had irregular menses and 1 out of 8 hyperprolactinemia patients had menstrual irregularity. Menstrual irregularity was more commonly associated with ovarian-sourced hirsutism but except for BMI and FSWLH ratios patients with irregular menses did not differ significantly from those with regular menses in terms of clinical and hormonal features.
I P132
Quality of life, psychopathologic symptoms and personality disorders in subjects with androgenetic alopecia
C. Rigoni ’ , A. Caputo 2, S. D’ Amico ’ , P. Demichelis ’ , S. Ferri 2, E. Gimosti 2, E. Passoni ’ ‘Istituto di Scienze Dermatologiche, Universito degli Studi di Milano, Ospedale Maggiore Policlinico IRCCS; 21stituto di Clinica Psichiatrica, Universitir degli Studi di Milano, Ospedale Maggiore Policlinico IRCCS, Italy
A situation of psychosocial distress is often present in subjects suffering from dermatological diseases that can affect their body-image and their interpersonal relationships. We administered the Dermatology Life Quality Index, the Symptoms Check-List 90-R and the Personality Disorder Questionnaire-R to 80 subjects (mean age 29.9 & 11.8) with androgenetic alopecia in order to assess their reactive psychopathological features and the impact of the disease on their lives. We found a significantly higher prevalence of personality disorders (mainly paranoid) and of psychopathological symptoms (mainly anxiety) The practitioner and the dermatologist should bear in mind these implications for optimal case-management.
Late onset loose anagen syndrome ElP133 A.M. Peluso, E. Ghetti, G. Parente, N. Venturo, A. Tosti. Department
of Dermatology,
University
of Bologna,
Italy
We report 3 cases of adult onset loose anagen syndrome (LAH). The patients, a 47 year old woman, a 40 year-old woman and a 30 year old man, were the only affected members in their families. They consulted us because of a diffuse hair shedding that had suddenly developed 1 to 3 years before our observation. All these patients had straight light brown hair. In the 2 women the hair barely reached the shoulders and showed uneven ends. They complained that their hair did not grow anymore and showed us some old pictures that revealed the presence of long and dense hair a few years earlier. The 30 year old man, who had by Hamilton III androgenetic alopecia, complained that his hair had become diffusely thinner and more easily plucked. Four years follow-up showed an improvement of the condition in the 47-year-old woman whereas LAH remained stable in the other patient the clinical and pathological features of adult onset LAH are comparable to those of LAH that develops in childhood, adults with acquired LAH usually present with a sudden and diffuse hair loss that resembles a telogen effluvium. The correct diagnosis of these patients requires a microscopic examination of the pulled hairs, since the clinical presentation is not diagnostic. We believe that adult-onset LAH may not be exceptional, but mat it may be easily misdiagnosed as telogen hair loss.
I
P130
Posters -Hair
The densities of T cells, Langerhans cells, and natural killer cells in uninvolved skin of patients with acne vulgaris
A.B. Aksakal ’ , A. Gtllekon ’ , G. Altay ’ , C. Sezer *, M.O. GztaS ’ Gazi University, Faculty of Medicine: ‘Department
of Dermatology:
2Pathology,
Ankara,
Turkey
Acne Vulgaris (AV) is a disease which affects the whole pilosebaseous follicle, and results in the formation of non-inflamed and inflamed lesions. The purpose of the present work was to investigate the inflammatory infiltrating cells in early AV lesions. We examined 25 biopsies, 10 of them were moderate to severe acne cases and 15 of them were healthy control subjects. All specimens evaluated for the density of the CD3+ (total T lymphocyte), CD4+ (helper/inducer T lymphocyte), CD8+ (suppressor/cytotoxic T lymphocyte), CDla+ (Langerhans cells), and CD56+ (Natural Killer cells) in the epidermis and dermis immunocytochemically. Only the CD4+ cells were found to be statistically elevated in dermis of patients with AV when compared to healthy subjects (p < 0.05).
Hair and Nails I PI
31
Menstrual irregularity in hirsute women
A.D. Yticelten ’ , 0. Giirbtiz ’ , F. Durmu~oglu2, M.A. Akman 2, M. Erenus ‘, G. Imir 2. ‘Marmara School of Medicine, Department of Obstetrics and Gynaecology,
of Dermatology; Istanbul, Turkey
University 2Department
Hirsutism is a frequently encountered problem in women of reproductive age group but women with the same degree of hirsutism may have different hormonal features. Menstrual irregularity which is commonly associated with hirsutism is found in several studies to correlate with higher levels of total or free testosterone. To investigate this finding further, age, body mass index (BMI), Ferriman-Gallwey (FG) score, duration of hirsutism, presence of irregular menses and, FSH/LH ratios, total testosterone, dehydroepiandrosterone sulfate, 17-hydroxyprogesterone and prolactin levels in follicular phase of the cycle were evaluated in 215 hirsute patients with FG scores >lO who were referred to a tertiary hirsutism clinic. Patients with menstrual irregularity were compared with those with regular menses in terms of clinical and hormonal parameters. Menstrual irregularity was present in 73 out of 215 patients. BMI was significantly higher in patients with irregular menses while the FSH/LH ratio was significantly higher in patients with regular menses. Testosterone levels were higher in irregular menstruating group but the difference did not achieve significance. Other clinical and hormonal parameters were not different between the two groups. Of 61 patients classified as ovarian sourced hirsutism 39 (63.93%) had irregular menses. Testosterone levels were significantly higher in PC0 patients with irregular menses compared to PC0 patients with regular menses but other clinical and hormonal parameters were not significantly different. 30 (41.10%) out of 133 patients classified as having peripheric hirsutism had irregular menses but had no significant differences in any of the clinical and hormonal parameters. There were 11 late-onset congenital adrenal
and Nails
hyperplasia patients 3 (27.27%) of whom had irregular menses and 1 out of 8 hyperprolactinemia patients had menstrual irregularity. Menstrual irregularity was more commonly associated with ovarian-sourced hirsutism but except for BMI and FSWLH ratios patients with irregular menses did not differ significantly from those with regular menses in terms of clinical and hormonal features.
I P132
Quality of life, psychopathologic symptoms and personality disorders in subjects with androgenetic alopecia
C. Rigoni ’ , A. Caputo 2, S. D’ Amico ’ , P. Demichelis ’ , S. Ferri 2, E. Gimosti 2, E. Passoni ’ ‘Istituto di Scienze Dermatologiche, Universito degli Studi di Milano, Ospedale Maggiore Policlinico IRCCS; 21stituto di Clinica Psichiatrica, Universitir degli Studi di Milano, Ospedale Maggiore Policlinico IRCCS, Italy
A situation of psychosocial distress is often present in subjects suffering from dermatological diseases that can affect their body-image and their interpersonal relationships. We administered the Dermatology Life Quality Index, the Symptoms Check-List 90-R and the Personality Disorder Questionnaire-R to 80 subjects (mean age 29.9 & 11.8) with androgenetic alopecia in order to assess their reactive psychopathological features and the impact of the disease on their lives. We found a significantly higher prevalence of personality disorders (mainly paranoid) and of psychopathological symptoms (mainly anxiety) The practitioner and the dermatologist should bear in mind these implications for optimal case-management.
Late onset loose anagen syndrome ElP133 A.M. Peluso, E. Ghetti, G. Parente, N. Venturo, A. Tosti. Department
of Dermatology,
University
of Bologna,
Italy
We report 3 cases of adult onset loose anagen syndrome (LAH). The patients, a 47 year old woman, a 40 year-old woman and a 30 year old man, were the only affected members in their families. They consulted us because of a diffuse hair shedding that had suddenly developed 1 to 3 years before our observation. All these patients had straight light brown hair. In the 2 women the hair barely reached the shoulders and showed uneven ends. They complained that their hair did not grow anymore and showed us some old pictures that revealed the presence of long and dense hair a few years earlier. The 30 year old man, who had by Hamilton III androgenetic alopecia, complained that his hair had become diffusely thinner and more easily plucked. Four years follow-up showed an improvement of the condition in the 47-year-old woman whereas LAH remained stable in the other patient the clinical and pathological features of adult onset LAH are comparable to those of LAH that develops in childhood, adults with acquired LAH usually present with a sudden and diffuse hair loss that resembles a telogen effluvium. The correct diagnosis of these patients requires a microscopic examination of the pulled hairs, since the clinical presentation is not diagnostic. We believe that adult-onset LAH may not be exceptional, but mat it may be easily misdiagnosed as telogen hair loss.