Abstract | Dlake prekrivaju cijelo naše tijelo, a na nekim dijelovima tijela, usnama, dlanovima, stopalima, glansu, klitorisu i malim stidnim usnama, dlake ne rastu. Alopecije se dijele prema etiologiji na primarne i sekundarne, prema razvitku na kongenitalne i stečene, prema distribuciji na lokalizirane, androgeno lokalizirane i difuzne te prema histopatologiji na ožiljkaste i neožiljkaste alopecije. U ovom radu glavni osvrt je na androgenetsku alopeciju (AGA). AGA je sekundarna, stečena, androgeno lokalizirana (rijetko difuzna) i neožiljkasta alopecija. Vidi se u 80% muškaraca i 40% žena i najčešći je oblik alopecije kod muškaraca. Etiopatogeneza AGA je genetska, hormonalna uz mikroupalne procese, promjene u prostaglandinskm putovima i Wnt/betaCatenin putovima. Radi se opoligenetskom nasljeđivanju u kojem sudjeluje oko 200 gena i najvažniji su vezani za androgeni receptor, ectodysplasin 2, TWIST i Wnt put. Androgeni, posebno dihidrotestosteron, koji nasataje iz testosterona putum 5-alfareduktaza enzime, utječu na minijaturizaciju dlačnih folikula i skraćuju anagenu fazu kod muškara i žena koji su većinom genetski predisponirani. AGA se različito manifestira kod žena i muškaraca te je stoga i različito klasificirana i stupnjevana. Počinje najčešće u dobi između 16 i 30 godina, premda može početak može biti i u kasnijoj dobi. Progresija AGA je individualna. Dosadašnje studije su pokazale da rani razvitak AGA može biti u asocijaciji s benignom hiperplazijom prostate i metaboličkim sidromom. Imajući u vidu utjecaj gubitka kose na pojedinca, androgena alopecija sa sobom nosi i šansu za razvijanje psiholoških poteškoća, čemu su žene i mlađi, neoženjeni muškarci podložniji u odnosu na ostatak oboljelih. Cilj ovoga rada je definirati androgenu alopeciju, objasniti njezinu etiologiju, opisati kliničku sliku androgene alopecije kod muškaraca i žena zasebno, objasniti metode i postupke dijagnosticiranja, navesti važnost poznavanja bolesti u asocijaciji s AGA, navesti i i objasniti farmakoterapijske i druge oblike liječenja te ulogu medicinske sestre u skrbi za oboljele od alopecije. |
Abstract (english) | Hair covers our entire body, and on some parts of the body, lips, palms, feet, glans, clitoris and labia minora, hair does not grow. Alopecias are divided according to etiology into primary and secondary, according to development into congenital and acquired, according to distribution into localized, androgenically localized and diffuse, and according to histopathology into scarring and non-scarring alopecia. In this paper, the main focus is on androgenetic alopecia (AGA). AGA is a secondary, acquired, androgenic localized (rarely diffuse) and non-scarring alopecia. It is seen in 80% of men and 40% of women and is the most common form of alopecia in men. Etiopathogenesis of AGA is genetic, hormonal with micro-inflammatory processes, changes in prostaglandin pathways and Wnt/beta-Catenin pathways. It is a polygenetic inheritance involving about 200 genes, the most important of which are related to the androgen receptor, ectodysplasin 2, TWIST and the Wnt pathway. Androgens, especially dihydrotestosterone, which is formed from testosterone via the 5- alpha-reductase enzyme, influence the miniaturization of hair follicles and shorten the anagen phase in men and women who are mostly genetically predisposed. AGA manifests itself differently in women and men and therefore it is classified and graded differently. It starts most often between the ages of 16 and 30, though it can start at a later age. The progression of AGA is individual. Previous studies have shown that early development of AGA may be associated with benign prostatic hyperplasia and metabolic syndrome. Bearing in mind the impact of hair loss on the individual, androgenetic alopecia also carries with it the chance for developing psychological difficulties, to which women and younger, unmarried men are more susceptible than the rest of the patients. The aim of this paper is to define androgenic alopecia, explain its etiology, describe the clinical picture of androgenic alopecia in men and women separately, explain the methods and procedures used for its diagnosis, state the importance of knowing the disease in association with AGA, state and explain pharmacotherapeutic and other forms of treatment and describe the role of the nurse in the care of patients with alopecia. |