sharparrow85
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Hi, I have been on finasteride and minoxidil since age 22 (10 years) due to some diffuse thinning. I don't think they really helped to be honest, but within the last 3 years or so, my hair has suddenly been rapidly diffusely thinning to the point where I can see my scalp when my hair is wet or I'm in direct sunlight. My hairline is quite good/no recession. This sudden rapid diffuse thinning alarmed me to the point I decided to see a dermatologist and get a scalp biopsy. I am unsure what to do at this point. I am still on the finasteride/minoxidil.
Any advice would be greatly appreciated. Further lab work showed normal ferritin, vitamin D, zinc, and thyroid panel results...
Age: 32
Surgical Site: Right superior medial forehead
Specimen: Punch x 2
GROSS DESCRIPTION: 3mm cylinder (x2) (blue)
MICROSCOPIC:
Right superior medial forehead: The sections are of scalp skin in horizontal and vertical orientation. The epidermis is intact, without interface changes to suggest connective tissue disease. The dermis is not scarred. The dermal density of anagen follicles seems within normal limits. The hair bulbs visualized have no peribulbar infiltrates to suggest alopecia areata. Dermal inflammation is minimal. The cross sectional view does not display obvious follicle miniaturization to suggest androgenetic alopecia, but sampling artifact or early subtle changes of that condition are not ruled out.
The only other finding is that of a probably increase in dermal and subcutaneous interstitial mucin; while this finding is not specific, it does however raise the possibility of thryoid dysfunction. TSH assay may be helpful, along with serum ferritin. The present findings do not rule out telogen effluvium.
IMPRESSION:
RIGHT SUPERIOR MEDIAL FOREHAD: SCALP BIOPSIES SHOWING POSSIBLE INCREASE IN INTERSTITIAL MUCIN.
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Any advice would be greatly appreciated. Further lab work showed normal ferritin, vitamin D, zinc, and thyroid panel results...
Age: 32
Surgical Site: Right superior medial forehead
Specimen: Punch x 2
GROSS DESCRIPTION: 3mm cylinder (x2) (blue)
MICROSCOPIC:
Right superior medial forehead: The sections are of scalp skin in horizontal and vertical orientation. The epidermis is intact, without interface changes to suggest connective tissue disease. The dermis is not scarred. The dermal density of anagen follicles seems within normal limits. The hair bulbs visualized have no peribulbar infiltrates to suggest alopecia areata. Dermal inflammation is minimal. The cross sectional view does not display obvious follicle miniaturization to suggest androgenetic alopecia, but sampling artifact or early subtle changes of that condition are not ruled out.
The only other finding is that of a probably increase in dermal and subcutaneous interstitial mucin; while this finding is not specific, it does however raise the possibility of thryoid dysfunction. TSH assay may be helpful, along with serum ferritin. The present findings do not rule out telogen effluvium.
IMPRESSION:
RIGHT SUPERIOR MEDIAL FOREHAD: SCALP BIOPSIES SHOWING POSSIBLE INCREASE IN INTERSTITIAL MUCIN.
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