The differential diagnosis of AGA (male pattern baldness) is important and must be distinguished from other alopecia. Below are the main diseases that should be differentiated from AGA.
Differential Diseases
- Alopecia Areata:
- Characteristics: Sudden, round or oval alopecia patches occur. They may occur not only on the hair of the head, but also on the eyebrows, eyelashes, and body hair.
- Cause: Autoimmune disease is involved, in which the immune system attacks the hair follicle.
- Diagnosis: Visual examination by a dermatologist and possibly biopsy.
- Diffuse Alopecia (Telogen Effluvium):
- Characteristics: Hair thinning is characterized by an overall thinning of the hair, not just in certain areas.
- Causes: Stress, childbirth, surgery, rapid weight loss, nutritional deficiencies, and drugs disrupt the hair cycle and increase dormant hairs.
- Diagnosis: History, blood tests, pull test, etc.
- Demodectic Scarring Hair Bunion (Lichen Planopilaris):
- Characteristics: Inflammation of the scalp and the formation of scars (scars) destroy the hair follicles and cause permanent hair loss.
- Causes: It is believed that abnormalities in the immune system are involved.
- Diagnosis: A biopsy or dermoscopy of the scalp is performed.
- Seborrheic Dermatitis:
- Characteristics: The scalp becomes red and scaling (dandruff) occurs in large quantities. Itching and inflammation often accompany the condition.
- Causes: Malassezia overgrowth, stress, hormonal fluctuations, etc.
- Diagnosis: Visual examination by a dermatologist and microscopic examination of the dandruff.
- Systemic Lupus Erythematosus (SLE):
- Characteristics: A systemic autoimmune disease that may present with circular patches of alopecia as a cutaneous manifestation.
- CAUSE: The immune system attacks its own tissues, causing inflammation in various organs and tissues.
- Diagnosis: Blood tests (e.g., antinuclear antibodies, anti-dsDNA antibodies) and skin biopsy are performed.
- Trichotillomania:
- Characteristics: Hair loss due to the habit of pulling out one’s own hair. Irregular alopecia patches are seen on the scalp.
- CAUSE: Mental stress and obsessive-compulsive disorder are often involved.
- Diagnosis: Patient behavior observation and psychological evaluation are performed.
Importance of differential diagnosis
Differential diagnosis of AGA is very important for proper treatment. Accurate diagnosis by a specialist is necessary because an incorrect diagnosis can lead to the risk of ineffective treatment and progressive hair loss. Diagnosis is based on the patient’s history, clinical symptoms, visual examination, and possibly blood tests and skin biopsies.
