wstlng2wspy
07-21-2009, 03:26 AM
I just received this from my dermatologist:
Your skin biopsy of the scalp showed a nonscarring alopecia with mild follicular miniaturization. There was no significant evidence of telogen effluvium (despite the overwhelmingly positive history and low ferritin which both support that diagnosis). The changes seen on your biopsy were mild but were most consistent with an early form of female pattern (the female version of male pattern, or androgenetic) alopecia. This type of hair loss is usually much more gradual though and does not usually cause significant shedding. The treatment for androgenetic alopecia in both men and women is rogaine solution daily. This is sometimes effective in preventing further hair loss even if it does not cause complete regrowth of the hair that has already come out. Unfortunately it takes many months for the full effect to be seen and has to be continued indefinitely. In your case I am not convinced by these biopsy results. Sometimes the clinical picture does not agree with the biopsy and in that case we normally base our decisions on the clinical picture (ie what you reported to me and what I saw on exam). I would recommend just using the iron supplement for now and coming back in a few months to discuss whether it is improving and whether we should start rogaine. I am disappointed this test did not prove you had telogen effluvium as I thought it would, but nonetheless I am still inclined to believe this is what you have, and that the mild follicular miniaturization is so mild as to be almost normal, and not indicative of the true cause of your hair loss. Sorry the results wer not more satisfying, especially after the blood spot on your shirt!
So, I don't think that I want to just watch my hair keep falling out for a few more months just to see if the derm was right and not do more.
Advice????
Your skin biopsy of the scalp showed a nonscarring alopecia with mild follicular miniaturization. There was no significant evidence of telogen effluvium (despite the overwhelmingly positive history and low ferritin which both support that diagnosis). The changes seen on your biopsy were mild but were most consistent with an early form of female pattern (the female version of male pattern, or androgenetic) alopecia. This type of hair loss is usually much more gradual though and does not usually cause significant shedding. The treatment for androgenetic alopecia in both men and women is rogaine solution daily. This is sometimes effective in preventing further hair loss even if it does not cause complete regrowth of the hair that has already come out. Unfortunately it takes many months for the full effect to be seen and has to be continued indefinitely. In your case I am not convinced by these biopsy results. Sometimes the clinical picture does not agree with the biopsy and in that case we normally base our decisions on the clinical picture (ie what you reported to me and what I saw on exam). I would recommend just using the iron supplement for now and coming back in a few months to discuss whether it is improving and whether we should start rogaine. I am disappointed this test did not prove you had telogen effluvium as I thought it would, but nonetheless I am still inclined to believe this is what you have, and that the mild follicular miniaturization is so mild as to be almost normal, and not indicative of the true cause of your hair loss. Sorry the results wer not more satisfying, especially after the blood spot on your shirt!
So, I don't think that I want to just watch my hair keep falling out for a few more months just to see if the derm was right and not do more.
Advice????