Male pattern androgenetic alopecia in an Indian context: a perspective study.

BACKGROUND: Androgenetic alopecia (AGA) has received scant attention, despite it being a common entity that may result in significant psychosocial morbidity. There are some patients who do not fit into any of the proposed types. Moreover, there have been no published studies of pattern and prevalence of AGA in males in an Indian context. Hence, the present study was an attempt to classify AGA in males with the aim of producing a simple, effective and easily reproducible classification. METHODS: In total, 150 male patients were clinically diagnosed as AGA. After obtaining informed consent from all patients, a detailed history/examination was carried out, including a hair pull test, a trichogram investigation and a biopsy. Classification of AGA was subsequently attempted across Norwood guidelines. RESULTS: A gradual shift in the type of AGA from the earlier types (II and III) to more severe types (VI) with increasing age was significant. Twenty-seven patients did not fit into specific patterns according to Hamilton and Norwood classifications. In addition, type 'a' variant was recorded in 20% of patients, clearly indicating limitations of the existing classifications. CONCLUSIONS: It was possible to classify 80% of the AGA, with II (28%) and III (15%) being the most common types of AGA. Twenty-seven patients (18%) could not be classified as a significant finding. There was considerable overlap in types IV, V and VI in the Norwood classification with the 'a' variants further confusing the picture.

Autologous thin thiersch's grafts in vitiligo: experience of 8000 cases, 50000 grafts (1959-98) with modified technique in 198 cases in the year 1997-98.

The present study, spread over past four decades of experience gathered after operating 8000 stable vitiligo patients, reaffirms the value of thin Thiersch's grafts in treating this disfiguring disease. Under experienced hands, the success rate can be over 95%. However, selection of the patient, quality of the graft and the state of the donor and recipient sites can affect the final outcome.