Transcript 投影片 1

門診案例討論
Spironolactone Treatment
of Hair Loss
Name : 林玉千
Date : 96. 07. 20
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Hair Growth Cycle:
1. Growth （anagen）
2. involution（catagen）
3. rest（telogen）
Alastair J. J. Wood, M.D.,The New England Journal of Medicine 1999;9;964
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Androgenetic alopecia:
•Higher levels of 5α-reductase .
•More androgen receptors.
•lower levels of cytochrome P-450 aromatase.
Alastair J. J. Wood, M.D.,The New England Journal of Medicine 1999;9;964
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Androgenetic alopecia diagonosis:
Based on visual inspection of the scalp.
•Hair disease : scarring or follicuar plugging.
•Illnesses: hyperthyoidism , hypothyoidism
•Medication side effect: beta blocker, anticonvulsants,
antidepressants, anticoagulants.
Birmingham. AL. Dermatol Clin 24 2006,137-138
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Treatment in women:
（1.）minoxidil
respect to the stimulation of hair growth.
Alastair J. J. Wood, M.D.,The New England Journal of Medicine 1999;9;967-969
（2.） Spironolactone
weak compectitve inhibitor of the binding of androgen
receptor and androgen production.
inhibitor of type 5α-reductase enzyme.
topical dose is 100 to 200 mg per day.
Carlijn Hoedemaker, Sylvia van Egmond and Rodney Sinclairt
Australasian Journal of Dermatology 48 2007,45
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Treatment in men:
（1.）finasteride
inhibitor of type 5α-reductase.
（2.）minoxidil
respect to the stimulation of hair growth.
Alastair J. J. Wood, M.D.,The New England Journal of Medicine 1999;9;964-967
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Mechanism of Spironolactone :
Finasteride , Cyproterone
Spironolactone
5
aromatase
redutase
HO
O
O
OH
OH
OH
H
5 dihydrotestosterone
testosterone
estradiol
5  DHT
Flutamide
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Conclusions:
•Finasteride is a specific inhibiter of 5α-reductase and
approved for the treatment of androgenetic alopecia in
men.
•Minoxidil is a nospecific drug in men, women, and
children with various conditions.
•Spironolactone has been used to treat alopecia in
females.
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