<div id="pf1" class="pf w0 h0" data-page-no="1"><div class="pc pc1 w0 h0"><img class="bi x0 y0 w1 h1" alt="" src="https://files.passeidireto.com/bd8b623e-aac3-45a2-a28d-90f6d507af40/bg1.png"><div class="t m0 x1 h2 y1 ff1 fs0 fc0 sc0 ls0 ws0">INFORMACIÓN<span class="blank _0"></span></div><div class="t m0 x1 h3 y2 ff1 fs1 fc0 sc0 ls1 ws1">INFORMACIÓN<span class="blank _1"></span></div><div class="t m0 x1 h4 y3 ff1 fs2 fc0 sc0 ls2 ws2">INFORMACIÓN<span class="blank _2"></span></div><div class="t m0 x2 h5 y4 ff2 fs3 fc0 sc0 ls3 ws4">AL<span class="blank _3"></span>OP<span class="blank _4"></span>ECIAS </div><div class="t m0 x3 h5 y5 ff2 fs3 fc0 sc0 ls3 ws4">EN L<span class="blank _5"> </span>A PRÁ<span class="blank _6"></span>CTICA </div><div class="t m0 x4 h5 y6 ff2 fs3 fc0 sc0 ls3 ws4">CLÍNICA DIARIA</div><div class="t m0 x5 h6 y7 ff2 fs4 fc0 sc0 ls3 ws4">Ricardo R<span class="blank _7"></span>uiz <span class="blank _7"></span>Villav<span class="blank _7"></span>er<span class="blank _7"></span>de </div><div class="t m0 x6 h6 y8 ff2 fs4 fc0 sc0 ls3 ws3">(<span class="ff3 ws4">U<span class="blank _7"></span>nidad de Dermatología. Complejo H<span class="blank _7"></span>ospitalario de J<span class="blank _7"></span>aén)</span></div><div class="t m0 x7 h6 y9 ff2 fs4 fc0 sc0 ls3 ws4">Rosa Ortega del Olmo </div><div class="t m0 x8 h6 ya ff2 fs4 fc0 sc0 ls3 ws3">(<span class="ff3 ws4">P<span class="blank _7"></span>rofesora <span class="blank _7"></span>T<span class="blank _8"></span>itular de Dermatología. U<span class="blank _8"></span>niversidad de Granada)</span></div><div class="t m0 x9 h7 yb ff2 fs5 fc1 sc0 ls3 ws4">1. <span class="blank _9"> </span>Intr<span class="blank _7"></span>oducción</div><div class="t m0 x9 h7 yc ff2 fs5 fc1 sc0 ls3 ws4">2. <span class="blank _9"> </span>T<span class="blank _8"></span>ipos de alopecia</div><div class="t m0 xa h8 yd ff3 fs6 fc1 sc0 ls3 ws4">2.1. Alopecias cicatriciales</div><div class="t m0 xa h8 ye ff3 fs6 fc1 sc0 ls3 ws4">2.2. Alopecias no cicatriciales</div><div class="t m0 x9 h7 yf ff2 fs5 fc1 sc0 ls3 ws4">3. <span class="blank _9"> </span>Alopecia androgenética</div><div class="t m0 xa h8 y10 ff3 fs6 fc1 sc0 ls3 ws4">3.1. Etiopatogenia</div><div class="t m0 xa h8 y11 ff3 fs6 fc1 sc0 ls3 ws4">3.2. Epidemiología</div><div class="t m0 xa h8 y12 ff3 fs6 fc1 sc0 ls3 ws4">3.3. Clínica</div><div class="t m0 xa h8 y13 ff3 fs6 fc1 sc0 ls3 ws4">3.4. Clasi\ufb01caciones</div><div class="t m0 xa h8 y14 ff3 fs6 fc1 sc0 ls3 ws4">3.5. Diagnóstico</div><div class="t m0 xa h8 y15 ff3 fs6 fc1 sc0 ls3 ws4">3.6. <span class="blank _8"></span>T<span class="blank _6"></span>ratamiento</div><div class="t m0 x9 h7 y16 ff2 fs5 fc1 sc0 ls3 ws4">4. <span class="blank _9"> </span>Alopecia ar<span class="blank _7"></span>eata</div><div class="t m0 xa h8 y17 ff3 fs6 fc1 sc0 ls3 ws4">4.1. Etiopatogenia</div><div class="t m0 xa h8 y18 ff3 fs6 fc1 sc0 ls3 ws4">4.2. Epidemiología, concepto y clínica</div><div class="t m0 xa h8 y19 ff3 fs6 fc1 sc0 ls3 ws4">4.3. Asociaciones</div><div class="t m0 xa h8 y1a ff3 fs6 fc1 sc0 ls3 ws4">4.4. Diagnóstico</div><div class="t m0 xa h9 y1b ff3 fs6 fc1 sc0 ls3 ws4">4.5. <span class="blank _8"></span>T<span class="blank _6"></span>ratamiento<span class="blank _a"> </span><span class="ff1 fs7 fc0 v1">18</span></div><div class="t m0 xb h7 y1c ff2 fs5 fc1 sc0 ls3 ws4">5. <span class="blank _9"> </span>E\ufb02uvios</div><div class="t m0 xc h8 y1d ff3 fs6 fc1 sc0 ls3 ws4">5.1. E\ufb02uvio telogénico</div><div class="t m0 xc h8 y1e ff3 fs6 fc1 sc0 ls3 ws4">5.2. E\ufb02uvio anagénico</div><div class="t m0 xb h7 y1f ff2 fs5 fc1 sc0 ls3 ws4">6. <span class="blank _9"> </span>¿Qué debemos hacer </div><div class="t m0 xc h7 y20 ff2 fs5 fc1 sc0 ls3 ws4">ante un paciente que acude </div><div class="t m0 xc h7 y21 ff2 fs5 fc1 sc0 ls3 ws4">a nuestra consulta con alopecia? </div><div class="t m0 xc h7 y22 ff2 fs5 fc1 sc0 ls3 ws4">P<span class="blank _7"></span>rotocolo de actuación</div><div class="t m0 xc h8 y23 ff3 fs6 fc1 sc0 ls3 ws4">6.1. Historia clínica</div><div class="t m0 xc h8 y24 ff3 fs6 fc1 sc0 ls3 ws4">6.2. Exploración física</div><div class="t m0 xc h8 y25 ff3 fs6 fc1 sc0 ls3 ws4">6.3. <span class="blank _8"></span>T<span class="blank _6"></span>est diagnósticos</div><div class="t m0 xc h8 y26 ff3 fs6 fc1 sc0 ls3 ws4">6.4. Otras pruebas</div><div class="t m0 xb h7 y27 ff2 fs5 fc1 sc0 ls3 ws4">7. <span class="blank _9"> </span>Bibliografía</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf2" class="pf w0 h0" data-page-no="2"><div class="pc pc2 w0 h0"><img class="bi x0 y0 w1 h1" alt="" src="https://files.passeidireto.com/bd8b623e-aac3-45a2-a28d-90f6d507af40/bg2.png"></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf3" class="pf w0 h0" data-page-no="3"><div class="pc pc3 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x0 y0 w1 h1" alt="" src="https://files.passeidireto.com/bd8b623e-aac3-45a2-a28d-90f6d507af40/bg3.png"><div class="t m0 xd ha y28 ff3 fs8 fc2 sc0 ls3"><span class="fc4 sc0">3</span></div><div class="t m0 xe hb y29 ff4 fs9 fc3 sc0 ls3 ws4"> </div><div class="t m0 xf hc y2a ff5 fsa fc2 sc0 ls3 ws4">Edita: <span class="ff6">Domènec Pujades</span>. © Artículo: <span class="ff6">Ricardo Ruiz Villaverde y Rosa Ortega del Olmo. </span>© Revista <span class="ff6">Laboratorios Thea</span>. </div><div class="t m0 x10 hd y2b ff5 fsa fc2 sc0 ls3 ws4">T<span class="blank _4"></span>odos los derechos reservados. No se permite repr<span class="blank _7"></span>oducir<span class="blank _8"></span>, almacenar en sistemas de recuperación de la información ni </div><div class="t m0 x11 hd y2c ff5 fsa fc2 sc0 ls3 ws4">transmitir alguna parte de esta publicación, cualquiera que sea el medio empleado (electrónico, mecánico, fotocopia, </div><div class="t m0 x12 hd y2d ff5 fsa fc2 sc0 ls3 ws4">grabación, etc.), sin el permiso previo del titular de los der<span class="blank _7"></span>echos de la propiedad intelectual.</div><div class="t m0 x13 hc y2e ff5 fsa fc2 sc0 ls3 ws4">Impresión: <span class="ff6">Eur<span class="blank _7"></span>ogrà\ufb01ca Sant Vicenç<span class="ff5"> - B-20237/2007. ISSN: 1887-679 X</span></span></div><div class="t m0 x14 he y2f ff7 fsb fc2 sc0 ls3 ws4">Labor<span class="blank _7"></span>atorios \ue61fea publica íntegramente los manuscritos r<span class="blank _7"></span>ecibidos de sus legítimos autores, </div><div class="t m0 x6 he y30 ff7 fsb fc2 sc0 ls3 ws4">sin introducir modi\ufb01caciones en los mismos, y por ello no se hace r<span class="blank _7"></span>esponsable de las opiniones </div><div class="t m0 x15 he y31 ff7 fsb fc2 sc0 ls3 ws4">e informaciones contenidas en los artículos. </div><div class="t m0 x16 hf y32 ff8 fsc fc3 sc0 ls3 ws4">1. Intr<span class="blank _7"></span>oducción </div><div class="t m0 x17 h10 y33 ff3 fsd fc2 sc0 ls4 ws4">Existen <span class="blank _b"> </span>muchos <span class="blank _b"> </span>factores <span class="blank _b"> </span>que <span class="blank _b"> </span>contribuyen <span class="blank _b"> </span>a <span class="blank _b"> </span>modular <span class="blank _b"> </span>la <span class="blank _5"> </span>importancia <span class="blank _b"> </span>de <span class="blank _b"> </span>la <span class="blank _b"> </span>imagen <span class="blank _5"> </span>corporal <span class="blank _b"> </span>tanto </div><div class="t m0 x17 h10 y34 ff3 fsd fc2 sc0 ls4 ws4">en <span class="blank _b"> </span>mujeres como <span class="blank _b"> </span>en <span class="blank _b"> </span>hombres, y <span class="blank _b"> </span>uno <span class="blank _b"> </span>de <span class="blank _b"> </span>ellos <span class="blank _b"> </span>es <span class="blank _b"> </span>la <span class="blank _b"> </span>presencia o <span class="blank _b"> </span>no <span class="blank _b"> </span>de <span class="blank _b"> </span>alopecia. <span class="blank _b"> </span>La alopecia <span class="blank _b"> </span>es <span class="blank _b"> </span>por </div><div class="t m0 x17 h10 y35 ff3 fsd fc2 sc0 ls4 ws4">tanto <span class="blank _b"> </span>uno de <span class="blank _b"> </span>los <span class="blank _b"> </span>principales <span class="blank _b"> </span>motivos de <span class="blank _b"> </span>consulta <span class="blank _b"> </span>en la <span class="blank _b"> </span>actualidad <span class="blank _b"> </span>tanto <span class="blank _b"> </span>a nivel <span class="blank _b"> </span>de <span class="blank _b"> </span>la sanidad <span class="blank _b"> </span>pú-</div><div class="t m0 x17 h10 y36 ff3 fsd fc2 sc0 ls4 ws4">blica como privada.</div><div class="t m0 x17 h10 y37 ff3 fsd fc2 sc0 ls3 ws4">Aunque <span class="blank _8"></span>clásicamente la <span class="blank _8"></span>alopecia masculina <span class="blank _8"></span>es socialmente <span class="blank _8"></span>aceptada e <span class="blank _7"></span>in\ufb02uye <span class="blank _7"></span>en <span class="blank _7"></span>menor <span class="blank _7"></span>medida <span class="blank _7"></span>en el </div><div class="t m0 x17 h10 y38 ff3 fsd fc2 sc0 ls3 ws4">mantenimiento de la <span class="blank _7"></span>autoimagen corporal en el <span class="blank _7"></span>varón, suele <span class="blank _7"></span>suponer un factor de <span class="blank _7"></span>importante estrés </div><div class="t m0 x17 h10 y39 ff3 fsd fc2 sc0 ls3 ws4">en <span class="blank _7"></span>la <span class="blank _8"></span>mujer<span class="blank _8"></span>. N<span class="blank _8"></span>o <span class="blank _7"></span>obstante, <span class="blank _7"></span>hemos <span class="blank _7"></span>de <span class="blank _8"></span>precisar <span class="blank _7"></span>que <span class="blank _7"></span>los <span class="blank _7"></span>tratamientos <span class="blank _8"></span>médicos y <span class="blank _8"></span>quirúrgicos <span class="blank _7"></span>que <span class="blank _7"></span>en <span class="blank _7"></span>la <span class="blank _8"></span>ac<span class="blank _b"> </span>-</div><div class="t m0 x17 h10 y3a ff3 fsd fc2 sc0 ls3 ws4">tualidad existen para el tratamiento de los diferentes tipos de alopecia, <span class="blank _b"> </span>en especial la androgenética, </div><div class="t m0 x17 h10 y3b ff3 fsd fc2 sc0 ls3 ws4">hacen <span class="blank _7"></span>del <span class="blank _8"></span>dermatólogo <span class="blank _7"></span>el <span class="blank _7"></span>especialista <span class="blank _7"></span>que <span class="blank _7"></span>mejor <span class="blank _8"></span>puede orientar <span class="blank _8"></span>a <span class="blank _7"></span>los <span class="blank _8"></span>pacientes acer<span class="blank _7"></span>ca <span class="blank _7"></span>del <span class="blank _7"></span>tratamiento </div><div class="t m0 x17 h10 y3c ff3 fsd fc2 sc0 ls3 ws4">más conveniente para su problema.</div><div class="t m0 x17 h10 y3d ff3 fsd fc2 sc0 ls3 ws4">M<span class="blank _7"></span>uchos <span class="blank _b"> </span>enfermos con <span class="blank _b"> </span>grados <span class="blank _b"> </span>moderados <span class="blank _b"> </span>o <span class="blank _b"> </span>graves de <span class="blank _b"> </span>alopecia <span class="blank _b"> </span>presentan repercusiones <span class="blank _b"> </span>ansiosas y/o </div><div class="t m0 x17 h10 y3e ff3 fsd fc2 sc0 ls3 ws4">depresivas <span class="blank _7"></span>asociadas. <span class="blank _7"></span>Estos pacientes <span class="blank _7"></span>pueden r<span class="blank _7"></span>estringir sus <span class="blank _7"></span>actividades sociales, <span class="blank _7"></span>rechazar <span class="blank _7"></span>la intimidad </div><div class="t m0 x17 h10 y3f ff3 fsd fc2 sc0 ls3 ws4">y <span class="blank _7"></span>el <span class="blank _7"></span>contacto sexual <span class="blank _8"></span>y r<span class="blank _7"></span>estringir <span class="blank _7"></span>también <span class="blank _7"></span>su abanico <span class="blank _8"></span>de posibilidades <span class="blank _8"></span>profesionales. <span class="blank _7"></span>P<span class="blank _8"></span>or eso, <span class="blank _8"></span>y aunque </div><div class="t m0 x17 h10 y40 ff3 fsd fc2 sc0 ls3 ws4">existen <span class="blank _5"> </span>abundantes <span class="blank _b"> </span>textos <span class="blank _5"> </span>y <span class="blank _5"> </span>artículos <span class="blank _5"> </span>en <span class="blank _5"> </span>relación <span class="blank _5"> </span>a <span class="blank _5"> </span>los <span class="blank _b"> </span>diferentes <span class="blank _5"> </span>tipos <span class="blank _5"> </span>de <span class="blank _5"> </span>alopecia, <span class="blank _b"> </span>hemos <span class="blank _5"> </span>querido </div><div class="t m0 x17 h10 y41 ff3 fsd fc2 sc0 ls3 ws4">realizar una r<span class="blank _7"></span>evisión de los principales motivos de <span class="blank _7"></span>consulta por alopecia en la práctica clínica diaria, </div><div class="t m0 x17 h10 y42 ff3 fsd fc2 sc0 ls3 ws4">su orientación diagnóstica y <span class="blank _b"> </span>terapéutica y establecer un protocolo básico <span class="blank _b"> </span>de historia clínica en estos </div><div class="t m0 x17 h10 y43 ff3 fsd fc2 sc0 ls3 ws4">pacientes que pueda ayudarnos a desarrollar mejor nuestra actividad. </div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf4" class="pf w0 h0" data-page-no="4"><div class="pc pc4 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x18 y44 w2 h11" alt="" src="https://files.passeidireto.com/bd8b623e-aac3-45a2-a28d-90f6d507af40/bg4.png"><div class="t m0 x19 h12 y45 ff3 fse fc2 sc0 ls5 ws4">ALOPECIAS EN LA PRÁCTICA CLÍNICA DIARIA<span class="blank _8"></span></div><div class="t m0 x16 hf y46 ff8 fsc fc5 sc0 ls3 ws4">2. Tipos de alopecia</div><div class="t m0 x17 h13 y47 ff2 fsf fc2 sc0 ls3 ws4">2.1. Alopecias cicatriciales</div><div class="t m0 x17 h10 y48 ff3 fsd fc2 sc0 ls3 ws4">Las <span class="blank _5"> </span>que <span class="blank _5"> </span>se <span class="blank _c"> </span>producen <span class="blank _5"> </span>como <span class="blank _5"> </span>consecuencia <span class="blank _5"> </span>de <span class="blank _c"> </span>una <span class="blank _5"> </span>lesión <span class="blank _5"> </span>irreversible <span class="blank _5"> </span>del <span class="blank _5"> </span>folículo, <span class="blank _c"> </span>suelen <span class="blank _5"> </span>asociarse <span class="blank _5"> </span>a </div><div class="t m0 x17 h10 y49 ff3 fsd fc2 sc0 ls3 ws4">alteraciones de la piel afectada.</div><div class="t m0 x17 h14 y4a ff3 fsd fc2 sc0 ls3 ws4">P<span class="blank _7"></span>ueden <span class="blank _d"> </span>presentarse <span class="blank _c"> </span>de <span class="blank _d"> </span>forma <span class="blank _d"> </span><span class="ff2">congénita <span class="blank _d"> </span>en <span class="blank _c"> </span>síndromes <span class="blank _d"> </span>hereditarios: <span class="blank _c"> </span></span>queratosis <span class="blank _d"> </span>pilar <span class="blank _c"> </span>decalvante, </div><div class="t m0 x17 h14 y4b ff3 fsd fc2 sc0 ls3 ws4">atriquia <span class="blank _7"></span>con pápulas; <span class="blank _7"></span><span class="ff2">formas <span class="blank _7"></span>localizadas: <span class="blank _7"></span><span class="ff3">aplasia cutis, <span class="blank _7"></span>nevus <span class="blank _7"></span>organoide y <span class="blank _7"></span><span class="ff2">las <span class="blank _7"></span>formas <span class="blank _7"></span>difusas: <span class="ff3 ws5">ictio-</span></span></span></span></div><div class="t m0 x17 h10 y4c ff3 fsd fc2 sc0 ls3 ws4">sis, enfermedad de Darier<span class="blank _8"></span>, síndrome de Conrado y hamartoma generalizado del folículo piloso.</div><div class="t m0 x17 h14 y4d ff3 fsd fc2 sc0 ls3 ws4">T<span class="blank _6"></span>ambién hay formas <span class="ff2">adquiridas en <span class="blank _7"></span>placas:<span class="ff3"> por traumatismos, <span class="blank _7"></span>radiaciones ionizantes, quemaduras, </span></span></div><div class="t m0 x17 h10 y4e ff3 fsd fc2 sc0 ls4 ws4">infecciones <span class="blank _c"> </span>(bacterianas, <span class="blank _c"> </span>víricas, <span class="blank _c"> </span>micóticas <span class="blank _c"> </span>o <span class="blank _5"> </span>zooparasitarias), <span class="blank _c"> </span>tumores <span class="blank _c"> </span>o <span class="blank _c"> </span>metástasis <span class="blank _c"> </span>cutáneas <span class="blank _c"> </span>de </div><div class="t m0 x17 h10 y4f ff3 fsd fc2 sc0 ls3 ws4">neoplasias <span class="blank _b"> </span>cutáneas <span class="blank _5"> </span>y <span class="blank _b"> </span>por <span class="blank _b"> </span>dermatosis <span class="blank _b"> </span>in\ufb02amatorias <span class="blank _b"> </span>(liquen <span class="blank _b"> </span>plano, <span class="blank _b"> </span>enfermedad <span class="blank _b"> </span>injerto <span class="blank _b"> </span>contra <span class="blank _b"> </span>hués-</div><div class="t m0 x17 h10 y50 ff3 fsd fc2 sc0 ls3 ws4">ped, escler<span class="blank _7"></span>osis en <span class="blank _7"></span>banda, necrobiosis <span class="blank _7"></span>lipoidica, sar<span class="blank _7"></span>coidosis, lupus <span class="blank _7"></span>eritematoso, pen\ufb01goide <span class="blank _7"></span>cicatricial, </div><div class="t m0 x17 h14 y51 ff3 fsd fc2 sc0 ls3 ws4">mucinosis <span class="blank _d"> </span>folicular <span class="blank _e"> </span>y <span class="blank _d"> </span>enfermedad <span class="blank _e"> </span>de <span class="blank _d"> </span>Darier). <span class="blank _e"> </span>F<span class="blank _8"></span>ormas <span class="blank _e"> </span><span class="ff2 ws6">difusas</span>: <span class="blank _e"> </span>dermatosis <span class="blank _d"> </span>pustular <span class="blank _e"> </span>y <span class="blank _d"> </span>erosiva <span class="blank _d"> </span>del </div><div class="t m0 x17 h10 y52 ff3 fsd fc2 sc0 ls3 ws4">cuero cabelludo, ictiosis y por\ufb01ria.</div><div class="t m0 x17 h13 y53 ff2 fsf fc2 sc0 ls3 ws4">2.2. Alopecias no cicatriciales</div><div class="t m0 x17 h10 y54 ff3 fsd fc2 sc0 ls3 ws4">En <span class="blank _7"></span>ellas <span class="blank _7"></span>la <span class="blank _7"></span>alteración <span class="blank _7"></span>del <span class="blank _7"></span>folículo <span class="blank _7"></span>piloso <span class="blank _7"></span>es <span class="blank _7"></span>reversible <span class="blank _8"></span>y no <span class="blank _8"></span>se <span class="blank _7"></span>afecta la <span class="blank _8"></span>piel <span class="blank _7"></span>de <span class="blank _7"></span>alrededor<span class="blank _8"></span>. <span class="blank _4"></span>T<span class="blank _4"></span>ambién <span class="blank _7"></span>pue-</div><div class="t m0 x17 h10 y55 ff3 fsd fc2 sc0 ls3 ws4">den deberse <span class="blank _b"> </span>a lesiones <span class="blank _b"> </span>intrínsecas del <span class="blank _b"> </span>tallo piloso. En <span class="blank _b"> </span>ambos casos <span class="blank _b"> </span>se produce un <span class="blank _b"> </span>desprendimiento </div><div class="t m0 x17 h10 y56 ff3 fsd fc2 sc0 ls3 ws4">del cabello.</div><div class="t m0 x17 h14 y57 ff3 fsd fc2 sc0 ls3 ws4">Como <span class="blank _7"></span>las <span class="blank _7"></span>alopecias <span class="blank _7"></span>cicatriciales, <span class="blank _7"></span>pueden <span class="blank _7"></span>ser <span class="blank _7"></span>en <span class="blank _7"></span><span class="ff2 ws6">placas<span class="ff3 ws4"> <span class="blank _8"></span>(tricotilomanía, alopecia <span class="blank _8"></span>areata <span class="blank _7"></span>focal, <span class="blank _7"></span>tricorre-</span></span></div><div class="t m0 x17 h14 y58 ff3 fsd fc2 sc0 ls3 ws4">xis nodosa proximal y <span class="blank _7"></span>alopecia mecánica o por fricción) o <span class="ff2">difusas </span>(alopecia ar<span class="blank _7"></span>eata total o universal, </div><div class="t m0 x17 h10 y59 ff3 fsd fc2 sc0 ls3 ws4">alopecia <span class="blank _7"></span>androgenética, <span class="blank _7"></span>e\ufb02uvios telogénico <span class="blank _7"></span>y <span class="blank _7"></span>anagénico y <span class="blank _8"></span>alopecias difusas <span class="blank _7"></span>por <span class="blank _7"></span>otras causas <span class="blank _8"></span>\u2013\ufb01ebre o </div><div class="t m0 x17 h10 y5a ff3 fsd fc2 sc0 ls3 ws4">anemia crónicas, senil, colagenosis, sí\ufb01lis y dermatosis localizadas. </div><div class="t m0 x17 h10 y5b ff3 fsd fc2 sc0 ls3 ws4">Ú<span class="blank _7"></span>nicamente nos v<span class="blank _7"></span>amos a referir a <span class="blank _7"></span>los tipos de alopecia clínicamente <span class="blank _7"></span>más frecuentes, por <span class="blank _7"></span>tanto deja-</div><div class="t m0 x17 h10 y5c ff3 fsd fc2 sc0 ls3 ws4">mos aparte las alopecias cicatriciales.</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf5" class="pf w0 h0" data-page-no="5"><div class="pc pc5 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x18 y44 w2 h11" alt="" src="https://files.passeidireto.com/bd8b623e-aac3-45a2-a28d-90f6d507af40/bg5.png"><div class="t m0 xd ha y5d ff3 fs8 fc2 sc0 ls3">5</div><div class="t m0 x16 hf y46 ff8 fsc fc6 sc0 ls3 ws4">3. Alopecia andr<span class="blank _7"></span>ogenética</div><div class="t m0 x17 h10 y5e ff3 fsd fc2 sc0 ls3 ws4">La <span class="blank _c"> </span>alopecia <span class="blank _d"> </span>androgenética <span class="blank _d"> </span>(AGA), <span class="blank _c"> </span>o <span class="blank _d"> </span>calvicie <span class="blank _c"> </span>común, <span class="blank _d"> </span>puede <span class="blank _d"> </span>considerarse <span class="blank _c"> </span>como <span class="blank _d"> </span>una <span class="blank _d"> </span>consecuencia </div><div class="t m0 x17 h10 y5f ff3 fsd fc2 sc0 ls3 ws4">del estado <span class="blank _7"></span>\ufb01siológico del <span class="blank _7"></span>cuero cabelludo<span class="blank _7"></span>. P<span class="blank _8"></span>ero <span class="blank _7"></span>según la intensidad <span class="blank _7"></span>y pr<span class="blank _7"></span>ecocidad con la <span class="blank _7"></span>que apar<span class="blank _7"></span>ezca </div><div class="t m0 x17 h10 y60 ff3 fsd fc2 sc0 ls3 ws4">en <span class="blank _5"> </span>el <span class="blank _c"> </span>varón <span class="blank _5"> </span>o <span class="blank _c"> </span>su <span class="blank _c"> </span>aparición <span class="blank _c"> </span>en <span class="blank _5"> </span>la <span class="blank _c"> </span>mujer<span class="blank _8"></span>, <span class="blank _c"> </span>deja <span class="blank _c"> </span>de <span class="blank _5"> </span>ser <span class="blank _c"> </span>considerada <span class="blank _c"> </span>como <span class="blank _5"> </span>tal. <span class="blank _c"> </span>Viene <span class="blank _5"> </span>determinada <span class="blank _c"> </span>por </div><div class="t m0 x17 h10 y61 ff3 fsd fc2 sc0 ls3 ws4">el <span class="blank _5"> </span>impacto <span class="blank _b"> </span>hormonal <span class="blank _5"> </span>andrógeno <span class="blank _5"> </span>dependiente, <span class="blank _b"> </span>en <span class="blank _5"> </span>personas <span class="blank _5"> </span>que <span class="blank _b"> </span>presentan <span class="blank _5"> </span>una <span class="blank _5"> </span>clara <span class="blank _b"> </span>predisposición </div><div class="t m0 x17 h10 y62 ff3 fsd fc2 sc0 ls3 ws4">genética. El cuero <span class="blank _b"> </span>cabelludo es un <span class="blank _b"> </span>importante <span class="blank _b"> </span>órgano diana <span class="blank _b"> </span>de actuación androgénica <span class="blank _b"> </span>y su <span class="blank _b"> </span>porción </div><div class="t m0 x17 h10 y63 ff3 fsd fc2 sc0 ls3 ws4">central <span class="blank _7"></span>es <span class="blank _7"></span>la <span class="blank _8"></span>que pr<span class="blank _7"></span>esenta <span class="blank _7"></span>la <span class="blank _7"></span>enzima <span class="blank _7"></span>5 <span class="blank _7"></span>alfa <span class="blank _7"></span>reductasa <span class="blank _8"></span>que facilita <span class="blank _8"></span>la <span class="blank _7"></span>transformación <span class="blank _7"></span>de <span class="blank _7"></span>testosterona <span class="blank _8"></span>(<span class="blank _b"> </span>T) </div><div class="t m0 x17 h10 y64 ff3 fsd fc2 sc0 ls3 ws4">en dihidrotestosterona (DHT). </div><div class="t m0 x17 h10 y65 ff3 fsd fc2 sc0 ls3 ws4">En la mayoría de los casos las cifras circulantes de andrógenos no experimentan alteraciones signi\ufb01-</div><div class="t m0 x17 h10 y66 ff3 fsd fc2 sc0 ls3 ws4">cativas <span class="blank _b"> </span>y en <span class="blank _b"> </span>la <span class="blank _b"> </span>pubertad <span class="blank _b"> </span>es <span class="blank _b"> </span>cuando <span class="blank _b"> </span>empiezan <span class="blank _b"> </span>a <span class="blank _b"> </span>notarse <span class="blank _b"> </span>las <span class="blank _b"> </span>primeras <span class="blank _b"> </span>manifestaciones <span class="blank _b"> </span>clínicas <span class="blank _b"> </span>de <span class="blank _b"> </span>este </div><div class="t m0 x17 h10 y67 ff3 fsd fc2 sc0 ls3 ws4">tipo <span class="blank _7"></span>de <span class="blank _7"></span>alopecia. <span class="blank _8"></span>El <span class="blank _7"></span>efecto <span class="blank _7"></span>clínico básico <span class="blank _8"></span>es la <span class="blank _8"></span>miniaturización del <span class="blank _8"></span>folículo piloso <span class="blank _7"></span>que <span class="blank _7"></span>se <span class="blank _7"></span>hará <span class="blank _7"></span>efectiva </div><div class="t m0 x17 h10 y68 ff3 fsd fc2 sc0 ls3 ws4">en los <span class="blank _b"> </span>sucesivos ciclos de <span class="blank _b"> </span>crecimiento, produciéndose la <span class="blank _b"> </span>recesión de la <span class="blank _b"> </span>línea frontoparietal y <span class="blank _b"> </span>la acla-</div><div class="t m0 x17 h10 y69 ff3 fsd fc2 sc0 ls3 ws4">ración <span class="blank _b"> </span>del \u201c<span class="blank _7"></span>vertex<span class="blank _7"></span>\u201d <span class="blank _b"> </span>en <span class="blank _b"> </span>el varón <span class="blank _b"> </span>(AGA de <span class="blank _b"> </span>patrón masculino <span class="blank _b"> </span>o <span class="blank _b"> </span>MAGA) o <span class="blank _b"> </span>bien <span class="blank _b"> </span>una <span class="blank _b"> </span>pérdida difusa <span class="blank _b"> </span>en </div><div class="t m0 x17 h10 y6a ff3 fsd fc2 sc0 ls3 ws4">las áreas parietales en la mujer (A<span class="blank _7"></span>GA de patrón femenino o F<span class="blank _7"></span>AGA).</div><div class="t m0 x17 h13 y6b ff2 fsf fc2 sc0 ls3 ws4">3.1. Etiopatogenia</div><div class="t m0 x17 h10 y6c ff7 fsd fc2 sc0 ls4 ws4">a) <span class="blank _f"> </span>P<span class="blank _8"></span>atrón <span class="blank _b"> </span>her<span class="blank _7"></span>editario<span class="ff3">. <span class="blank _b"> </span>Se trata <span class="blank _b"> </span>de una <span class="blank _b"> </span>herencia poligénica <span class="blank _b"> </span>dominante <span class="blank _b"> </span>de penetrancia <span class="blank _b"> </span>variable. <span class="blank _b"> </span>En<span class="blank _7"></span> </span></div><div class="t m0 x1a h10 y6d ff3 fsd fc2 sc0 ls4 ws4">ella <span class="blank _5"> </span>se <span class="blank _5"> </span>codi\ufb01carían <span class="blank _5"> </span>los <span class="blank _5"> </span>receptores <span class="blank _5"> </span>con <span class="blank _5"> </span>mayor <span class="blank _5"> </span>facilidad <span class="blank _5"> </span>para <span class="blank _c"> </span>captar <span class="blank _5"> </span>los <span class="blank _5"> </span>andrógenos <span class="blank _5"> </span>circulantes </div><div class="t m0 x1a h10 y6e ff3 fsd fc2 sc0 ls4 ws4">aunque <span class="blank _5"> </span>se <span class="blank _c"> </span>produzcan <span class="blank _5"> </span>en <span class="blank _c"> </span>cantidad <span class="blank _c"> </span>y <span class="blank _5"> </span>calidad <span class="blank _c"> </span>normal <span class="blank _c"> </span>a <span class="blank _5"> </span>nivel <span class="blank _c"> </span>de <span class="blank _c"> </span>las <span class="blank _5"> </span>diferentes <span class="blank _c"> </span>zonas <span class="blank _5"> </span>del <span class="blank _c"> </span>cuero <span class="blank _7"></span></div><div class="t m0 x1a h10 y6f ff3 fsd fc2 sc0 ls4 ws4">cabelludo susceptibles <span class="blank _8"></span>de producir <span class="blank _7"></span>el proceso <span class="blank _7"></span>de <span class="blank _7"></span>miniaturización del <span class="blank _7"></span>folículo piloso <span class="blank _7"></span>por acción<span class="blank _7"></span> </div><div class="t m0 x1a h10 y70 ff3 fsd fc2 sc0 ls4 ws4">de la dihidrotestosterona.<span class="blank _7"></span> </div><div class="t m0 x17 h10 y71 ff7 fsd fc2 sc0 ls4 ws4">b) <span class="blank _e"> </span>Actividad <span class="blank _c"> </span>hormonal <span class="blank _d"> </span>androgénica<span class="ff3">. <span class="blank _c"> </span>La <span class="blank _c"> </span>respuesta <span class="blank _c"> </span>folicular <span class="blank _d"> </span>al <span class="blank _c"> </span>estímulo <span class="blank _c"> </span>androgénico <span class="blank _c"> </span>es <span class="blank _d"> </span>especí\ufb01ca <span class="blank _7"></span></span></div><div class="t m0 x1a h10 y72 ff3 fsd fc2 sc0 ls3 ws4">de <span class="blank _d"> </span>cad<span class="blank _7"></span>a <span class="blank _5"> </span>reg<span class="blank _7"></span>ión<span class="blank _7"></span> <span class="blank _c"> </span>an<span class="blank _7"></span>atóm<span class="blank _7"></span>ica<span class="blank _7"></span> <span class="blank _c"> </span>y <span class="blank _5"> </span>dep<span class="blank _7"></span>ende<span class="blank _7"></span> <span class="blank _5"> </span>del <span class="blank _5"> </span>sub<span class="blank _7"></span>tip<span class="blank _7"></span>o <span class="blank _5"> </span>de <span class="blank _5"> </span>enzi<span class="blank _7"></span>ma <span class="blank _5"> </span>5-<span class="blank _7"></span>alfa<span class="blank _7"></span>-r<span class="blank _7"></span>educ<span class="blank _7"></span>tas<span class="blank _7"></span>a <span class="blank _5"> </span>y <span class="blank _5"> </span>de <span class="blank _5"> </span>la <span class="blank _5"> </span>can<span class="blank _7"></span>tida<span class="blank _7"></span>d <span class="blank _5"> </span>de </div><div class="t m0 x1a h10 y73 ff3 fsd fc2 sc0 ls4 ws4">te<span class="blank _8"></span>stosterona <span class="blank _b"> </span>libre <span class="blank _b"> </span>(no <span class="blank _5"> </span>unida <span class="blank _5"> </span>a <span class="blank _b"> </span><span class="ff7">Sex <span class="blank _b"> </span>Hormon <span class="blank _5"> </span>Binding</span><span class="ls6"> </span><span class="ff7 ws7">G<span class="blank _7"></span>lobulin<span class="ff3 ws4">-SHBG-) <span class="blank _b"> </span>o <span class="blank _5"> </span>bien <span class="blank _b"> </span>la <span class="blank _5"> </span>producida <span class="blank _b"> </span>en </span></span></div><div class="t m0 x1a h10 y74 ff3 fsd fc2 sc0 ls4 ws4">exceso <span class="blank _7"></span>por <span class="blank _7"></span>alguna causa <span class="blank _8"></span>en la <span class="blank _7"></span>mujer<span class="blank _8"></span>, <span class="blank _7"></span>en los <span class="blank _8"></span>denominados síndromes <span class="blank _8"></span>SAHA de <span class="blank _7"></span>diferente <span class="blank _7"></span>etiolo-</div><div class="t m0 x1a h10 y75 ff3 fsd fc2 sc0 ls4 ws4">gía \u2013Seborr<span class="blank _7"></span>ea, Acné, Hirsutismo y Alopecia.<span class="blank _7"></span></div><div class="t m0 x17 h13 y76 ff2 fsf fc2 sc0 ls3 ws4">3.2. Epidemiología</div><div class="t m0 x17 h10 y77 ff3 fsd fc2 sc0 ls3 ws4">Desde el <span class="blank _b"> </span>punto de <span class="blank _b"> </span>vista <span class="blank _b"> </span>racial es <span class="blank _b"> </span>una afección <span class="blank _b"> </span>predominante en <span class="blank _b"> </span>la raza <span class="blank _b"> </span>caucásica, pudiendo <span class="blank _b"> </span>llegar <span class="blank _b"> </span>a </div><div class="t m0 x17 h10 y78 ff3 fsd fc2 sc0 ls3 ws4">afectar al <span class="blank _7"></span>50 <span class="blank _6"></span>% de <span class="blank _7"></span>la población <span class="blank _7"></span>masculina de <span class="blank _7"></span>50 años <span class="blank _7"></span>o más, <span class="blank _7"></span>mientras que es <span class="blank _7"></span>raro <span class="blank _7"></span>encontrar cifras de </div><div class="t m0 x17 h10 y79 ff3 fsd fc2 sc0 ls3 ws4">prevalencia superior<span class="blank _7"></span>es al 10 <span class="blank _6"></span>% en la población femenina según la serie estudiada.</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf6" class="pf w0 h0" data-page-no="6"><div class="pc pc6 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x18 y7a w2 h15" alt="" src="https://files.passeidireto.com/bd8b623e-aac3-45a2-a28d-90f6d507af40/bg6.png"><div class="t m0 x19 h12 y7b ff3 fse fc2 sc0 ls5 ws4">ALOPECIAS EN LA PRÁCTICA CLÍNICA DIARIA<span class="blank _8"></span></div><div class="t m0 x1b h13 y7c ff2 fsf fc2 sc0 ls3 ws4">3.3. Clínica</div><div class="t m0 x1b h10 y7d ff3 fsd fc2 sc0 ls3 ws4">a) <span class="blank"> </span>Alopecia androgenética femenina (F<span class="blank _7"></span>AGA)</div><div class="t m0 x1c h10 y7e ff3 fsd fc2 sc0 ls3 ws4">N<span class="blank _7"></span>ormalmente <span class="blank _7"></span>se <span class="blank _8"></span>caracteriza por <span class="blank _8"></span>afectar <span class="blank _7"></span>de <span class="blank _7"></span>forma <span class="blank _8"></span>difusa a <span class="blank _8"></span>todo <span class="blank _7"></span>el <span class="blank _8"></span>cuero <span class="blank _7"></span>cabelludo <span class="blank _7"></span>(vértex <span class="blank _7"></span>y <span class="blank _7"></span>sienes) </div><div class="t m0 x1c h10 y7f ff3 fsd fc2 sc0 ls3 ws4">respetando de forma relativ<span class="blank _7"></span>a la región occipital. P<span class="blank _7"></span>uede afectar a la mujer o al varón (F<span class="blank _8"></span>AGA-M). </div><div class="t m0 x1d h16 y80 ff2 fs10 fc2 sc0 ls3 ws4">F<span class="blank _7"></span>igu<span class="blank _7"></span>ra 1<span class="blank _7"></span>.<span class="ff3"> A<span class="blank _7"></span>lope<span class="blank _7"></span>cia<span class="blank _7"></span> and<span class="blank _7"></span>rog<span class="blank _7"></span>enét<span class="blank _7"></span>ica<span class="blank _7"></span> fem<span class="blank _7"></span>eni<span class="blank _7"></span>na (<span class="blank _7"></span>vis<span class="blank _7"></span>ta </span></div><div class="t m0 x1d h17 y81 ff3 fs10 fc2 sc0 ls3 ws4">fr<span class="blank _7"></span>onta<span class="blank _7"></span>l r<span class="blank _7"></span>esp<span class="blank _7"></span>eta<span class="blank _7"></span>ndo <span class="blank _7"></span>líne<span class="blank _7"></span>a d<span class="blank _7"></span>e im<span class="blank _7"></span>pla<span class="blank _7"></span>ntac<span class="blank _7"></span>ión <span class="blank _7"></span>fr<span class="blank _7"></span>onta<span class="blank _7"></span>l).</div><div class="t m0 x1d h16 y82 ff2 fs10 fc2 sc0 ls3 ws4">F<span class="blank _7"></span>igu<span class="blank _7"></span>ra 2<span class="blank _7"></span>. <span class="ff3">A<span class="blank _7"></span>lope<span class="blank _7"></span>cia<span class="blank _7"></span> and<span class="blank _7"></span>rog<span class="blank _7"></span>enét<span class="blank _7"></span>ica<span class="blank _7"></span> fem<span class="blank _7"></span>eni<span class="blank _7"></span>na </span></div><div class="t m0 x1d h17 y83 ff3 fs10 fc2 sc0 ls3 ws4">(di<span class="blank _7"></span>scr<span class="blank _7"></span>eto<span class="blank _7"></span> ac<span class="blank _7"></span>lara<span class="blank _7"></span>mien<span class="blank _7"></span>to <span class="blank _7"></span>pari<span class="blank _7"></span>eta<span class="blank _7"></span>l).</div><div class="t m0 x1b h10 y84 ff3 fsd fc2 sc0 ls3 ws4">b) <span class="blank _e"> </span>Alopecia androgenética masculina (MAGA)</div><div class="t m0 x1c h10 y85 ff3 fsd fc2 sc0 ls3 ws4">La <span class="blank _7"></span>recesión <span class="blank _8"></span>frontoparietal <span class="blank _7"></span>y <span class="blank _7"></span>la <span class="blank _7"></span>afectación <span class="blank _7"></span>del <span class="blank _7"></span>vértex son <span class="blank _8"></span>características <span class="blank _7"></span>en <span class="blank _7"></span>el <span class="blank _7"></span>varón <span class="blank _7"></span>para <span class="blank _7"></span>determinar </div><div class="t m0 x1c h10 y86 ff3 fsd fc2 sc0 ls3 ws4">la denominada calvicie común. P<span class="blank _7"></span>uede afectar al varón y a la mujer (MAGA-F). </div><div class="t m0 x1b h13 y87 ff2 fsf fc2 sc0 ls3 ws4">3.4. Clasi\ufb01caciones</div><div class="t m0 x1b h14 y88 ff2 fsd fc2 sc0 ls3 ws4">T<span class="blank _7"></span>ipos de Hamilton y N<span class="blank _8"></span>or<span class="blank _b"> </span>wood</div><div class="t m0 x1b h14 y89 ff2 fsd fc2 sc0 ls3 ws4">Se clasi\ufb01ca en <span class="blank _b"> </span>7 grados <span class="blank _b"> </span>(del I <span class="blank _b"> </span>al <span class="blank _7"></span>VII)<span class="ff3">. Las <span class="blank _b"> </span>categorías de <span class="blank _b"> </span>Hamilton se han <span class="blank _b"> </span>convertido en <span class="blank _b"> </span>estándares </span></div><div class="t m0 x1b h10 y8a ff3 fsd fc2 sc0 ls3 ws4">para <span class="blank _b"> </span>la <span class="blank _b"> </span>evaluación de <span class="blank _b"> </span>los <span class="blank _b"> </span>varones <span class="blank _b"> </span>con <span class="blank _b"> </span>alopecia androgenética. <span class="blank _b"> </span>En <span class="blank _b"> </span>1975, <span class="blank _b"> </span>N<span class="blank _7"></span>oorwood <span class="blank _b"> </span>actualizó <span class="blank _b"> </span>el <span class="blank _b"> </span>tra-</div><div class="t m0 x1b h10 y8b ff3 fsd fc2 sc0 ls3 ws4">bajo de Hamilton añadiendo cuatro nuevos grados a su clasi\ufb01cación.</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf7" class="pf w0 h0" data-page-no="7"><div class="pc pc7 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x18 y44 w3 h11" alt="" src="https://files.passeidireto.com/bd8b623e-aac3-45a2-a28d-90f6d507af40/bg7.png"><div class="t m0 xd ha y8c ff3 fs8 fc2 sc0 ls3">7</div><div class="t m0 x17 h16 y8d ff2 fs10 fc2 sc0 ls3 ws4">F<span class="blank _7"></span>igu<span class="blank _7"></span>ra 3<span class="blank _7"></span>.<span class="ff3"> A<span class="blank _7"></span>lope<span class="blank _7"></span>cia<span class="blank _7"></span> and<span class="blank _7"></span>rog<span class="blank _7"></span>enét<span class="blank _7"></span>ica<span class="blank _7"></span> mas<span class="blank _7"></span>cul<span class="blank _7"></span>ina </span></div><div class="t m0 x17 h18 y8e ff3 fs10 fc2 sc0 ls3 ws4">en <span class="blank _7"></span>pac<span class="blank _7"></span>ient<span class="blank _7"></span>e d<span class="blank _7"></span>e ed<span class="blank _7"></span>ad m<span class="blank _7"></span>edi<span class="blank _7"></span>a.<span class="blank _10"> </span><span class="ff2 v2">F<span class="blank _7"></span>igu<span class="blank _7"></span>ra 4<span class="blank _7"></span>. <span class="ff3">A<span class="blank _7"></span>lope<span class="blank _7"></span>cia<span class="blank _7"></span> and<span class="blank _7"></span>rog<span class="blank _7"></span>enét<span class="blank _7"></span>ica<span class="blank _7"></span> mas<span class="blank _7"></span>cul<span class="blank _7"></span>ina <span class="blank _7"></span>en <span class="blank _7"></span>paci<span class="blank _7"></span>ente </span></span></div><div class="t m0 x1e h17 y8e ff3 fs10 fc2 sc0 ls3 ws4">de <span class="blank _7"></span>eda<span class="blank _7"></span>d av<span class="blank _7"></span>anz<span class="blank _7"></span>ada<span class="blank _7"></span>.</div><div class="t m0 x17 h14 y8f ff2 fsd fc2 sc0 ls3 ws4">T<span class="blank _7"></span>ipo I:<span class="ff3"> Línea <span class="blank _7"></span>del cabello normal, sin <span class="blank _7"></span>recesión, o r<span class="blank _7"></span>ecesión mínima a <span class="blank _7"></span>lo largo del bor<span class="blank _7"></span>de anterior de <span class="blank _7"></span>la </span></div><div class="t m0 x17 h10 y90 ff3 fsd fc2 sc0 ls3 ws4">línea del pelo en la región frontotemporal.</div><div class="t m0 x17 h14 y91 ff2 fsd fc2 sc0 ls3 ws4">T<span class="blank _8"></span>ipo<span class="blank _7"></span> <span class="blank _8"></span>II:<span class="blank _7"></span><span class="ff3"> <span class="blank _7"></span>E<span class="blank _7"></span>l <span class="blank _8"></span>bor<span class="blank _8"></span>de <span class="blank _8"></span>an<span class="blank _7"></span>te<span class="blank _7"></span>ri<span class="blank _7"></span>or <span class="blank _8"></span>de<span class="blank _7"></span>l <span class="blank _8"></span>ca<span class="blank _7"></span>bel<span class="blank _7"></span>lo<span class="blank _7"></span> <span class="blank _8"></span>en <span class="blank _8"></span>la<span class="blank _7"></span> <span class="blank _7"></span>r<span class="blank _7"></span>egi<span class="blank _7"></span>ón<span class="blank _7"></span> <span class="blank _8"></span>fro<span class="blank _7"></span>nt<span class="blank _7"></span>ot<span class="blank _7"></span>emp<span class="blank _7"></span>or<span class="blank _7"></span>al<span class="blank _7"></span> <span class="blank _7"></span>pr<span class="blank _8"></span>ese<span class="blank _7"></span>nta<span class="blank _7"></span> <span class="blank _8"></span>ár<span class="blank _7"></span>eas<span class="blank _7"></span> <span class="blank _8"></span>tri<span class="blank _7"></span>an<span class="blank _7"></span>gul<span class="blank _7"></span>ar<span class="blank _8"></span>es <span class="blank _8"></span>de<span class="blank _7"></span> <span class="blank _7"></span>r<span class="blank _7"></span>ece<span class="blank _7"></span>si<span class="blank _7"></span>ón </span></div><div class="t m0 x17 h10 y92 ff3 fsd fc2 sc0 ls3 ws4">qu<span class="blank _7"></span>e <span class="blank _7"></span>ti<span class="blank _7"></span>en<span class="blank _7"></span>den<span class="blank _7"></span> <span class="blank _7"></span>a <span class="blank _7"></span>ser<span class="blank _7"></span> <span class="blank _7"></span>sim<span class="blank _7"></span>ét<span class="blank _7"></span>ri<span class="blank _7"></span>ca<span class="blank _7"></span>s. <span class="blank _8"></span>Est<span class="blank _7"></span>as <span class="blank _8"></span>áre<span class="blank _7"></span>as<span class="blank _7"></span> n<span class="blank _7"></span>o <span class="blank _7"></span>se<span class="blank _7"></span> e<span class="blank _7"></span>xt<span class="blank _7"></span>ie<span class="blank _7"></span>nd<span class="blank _7"></span>en <span class="blank _8"></span>hac<span class="blank _7"></span>ia <span class="blank _8"></span>la <span class="blank _7"></span>pa<span class="blank _7"></span>rte<span class="blank _7"></span> p<span class="blank _7"></span>os<span class="blank _7"></span>te<span class="blank _7"></span>ri<span class="blank _7"></span>or <span class="blank _8"></span>más<span class="blank _7"></span> d<span class="blank _7"></span>e <span class="blank _7"></span>2 <span class="blank _7"></span>cm<span class="blank _7"></span> a<span class="blank _7"></span>nt<span class="blank _7"></span>es<span class="blank _7"></span> d<span class="blank _7"></span>e <span class="blank _7"></span>la </div><div class="t m0 x17 h10 y93 ff3 fsd fc2 sc0 ls3 ws4">lí<span class="blank _7"></span>ne<span class="blank _7"></span>a <span class="blank _8"></span>de<span class="blank _7"></span> <span class="blank _8"></span>la<span class="blank _7"></span>s <span class="blank _8"></span>o<span class="blank _7"></span>re<span class="blank _7"></span>ja<span class="blank _7"></span>s. <span class="blank _6"></span>T<span class="blank _6"></span>am<span class="blank _7"></span>bi<span class="blank _7"></span>én <span class="blank _4"></span>se <span class="blank _4"></span>pie<span class="blank _7"></span>rd<span class="blank _7"></span>e <span class="blank _4"></span>cab<span class="blank _7"></span>ell<span class="blank _7"></span>o,<span class="blank _7"></span> <span class="blank _8"></span>o <span class="blank _8"></span>s<span class="blank _7"></span>e <span class="blank _8"></span>pr<span class="blank _8"></span>ese<span class="blank _7"></span>nt<span class="blank _7"></span>a <span class="blank _8"></span>es<span class="blank _7"></span>ca<span class="blank _7"></span>so<span class="blank _7"></span>, <span class="blank _8"></span>en<span class="blank _7"></span> <span class="blank _8"></span>el<span class="blank _7"></span> <span class="blank _8"></span>bor<span class="blank _8"></span>de <span class="blank _4"></span>fro<span class="blank _7"></span>nt<span class="blank _7"></span>al<span class="blank _7"></span> <span class="blank _8"></span>med<span class="blank _7"></span>io<span class="blank _7"></span> <span class="blank _8"></span>de<span class="blank _7"></span>l <span class="blank _8"></span>cu<span class="blank _7"></span>er<span class="blank _7"></span>o <span class="blank _4"></span>ca-</div><div class="t m0 x17 h10 y94 ff3 fsd fc2 sc0 ls3 ws4">be<span class="blank _7"></span>ll<span class="blank _7"></span>udo<span class="blank _7"></span>, <span class="blank _7"></span>pe<span class="blank _7"></span>ro<span class="blank _7"></span> l<span class="blank _7"></span>a p<span class="blank _7"></span>r<span class="blank _7"></span>ofu<span class="blank _7"></span>nd<span class="blank _7"></span>id<span class="blank _7"></span>ad <span class="blank _7"></span>de<span class="blank _7"></span> l<span class="blank _7"></span>as<span class="blank _7"></span> ár<span class="blank _8"></span>eas<span class="blank _7"></span> a<span class="blank _7"></span>fec<span class="blank _7"></span>ta<span class="blank _7"></span>da<span class="blank _7"></span>s <span class="blank _7"></span>es <span class="blank _7"></span>mu<span class="blank _7"></span>ch<span class="blank _7"></span>o m<span class="blank _7"></span>en<span class="blank _7"></span>or<span class="blank _7"></span> q<span class="blank _7"></span>ue <span class="blank _7"></span>en<span class="blank _7"></span> l<span class="blank _7"></span>a r<span class="blank _8"></span>egi<span class="blank _7"></span>ón<span class="blank _7"></span> f<span class="blank _7"></span>ro<span class="blank _7"></span>nto<span class="blank _7"></span>te<span class="blank _7"></span>mp<span class="blank _7"></span>or<span class="blank _7"></span>al.</div><div class="t m0 x17 h14 y95 ff2 fsd fc2 sc0 ls3 ws4">T<span class="blank _8"></span>ipo I<span class="blank _7"></span>II:<span class="ff3"> G<span class="blank _8"></span>rad<span class="blank _7"></span>o mín<span class="blank _7"></span>imo<span class="blank _7"></span> de c<span class="blank _7"></span>aíd<span class="blank _7"></span>a del<span class="blank _7"></span> pe<span class="blank _7"></span>lo s<span class="blank _7"></span>u\ufb01ci<span class="blank _7"></span>ent<span class="blank _7"></span>e pa<span class="blank _7"></span>ra co<span class="blank _7"></span>nsi<span class="blank _7"></span>der<span class="blank _7"></span>arse<span class="blank _7"></span> cal<span class="blank _7"></span>vic<span class="blank _7"></span>ie. L<span class="blank _7"></span>a ma<span class="blank _7"></span>yor<span class="blank _7"></span> part<span class="blank _7"></span>e de<span class="blank _7"></span> los </span></div><div class="t m0 x17 h10 y96 ff3 fsd fc2 sc0 ls3 ws4">cue<span class="blank _7"></span>ro<span class="blank _7"></span>s cabe<span class="blank _7"></span>llu<span class="blank _7"></span>dos de<span class="blank _7"></span> tipo<span class="blank _7"></span> <span class="blank _b"> </span>II<span class="blank _7"></span>I pr<span class="blank _7"></span>esen<span class="blank _7"></span>tan<span class="blank _7"></span> rece<span class="blank _7"></span>sio<span class="blank _7"></span>nes fr<span class="blank _7"></span>ont<span class="blank _7"></span>ote<span class="blank _7"></span>mpo<span class="blank _7"></span>rale<span class="blank _7"></span>s gen<span class="blank _7"></span>eral<span class="blank _7"></span>men<span class="blank _7"></span>te sim<span class="blank _7"></span>étr<span class="blank _7"></span>icas<span class="blank _7"></span>, sin<span class="blank _7"></span> pelo </div><div class="t m0 x17 h10 y97 ff3 fsd fc2 sc0 ls3 ws4">o <span class="blank _8"></span>con <span class="blank _8"></span>pel<span class="blank _7"></span>o <span class="blank _7"></span>muy<span class="blank _7"></span> <span class="blank _7"></span>esc<span class="blank _7"></span>aso<span class="blank _8"></span>. <span class="blank _7"></span>Est<span class="blank _7"></span>as <span class="blank _8"></span>rec<span class="blank _7"></span>esio<span class="blank _7"></span>nes<span class="blank _7"></span> <span class="blank _7"></span>se <span class="blank _8"></span>exti<span class="blank _7"></span>end<span class="blank _7"></span>en <span class="blank _8"></span>haci<span class="blank _7"></span>a <span class="blank _8"></span>la <span class="blank _7"></span>pa<span class="blank _7"></span>rte <span class="blank _8"></span>post<span class="blank _7"></span>eri<span class="blank _7"></span>or <span class="blank _8"></span>al <span class="blank _8"></span>menos<span class="blank _7"></span> <span class="blank _7"></span>2 <span class="blank _8"></span>cm <span class="blank _8"></span>más <span class="blank _8"></span>que <span class="blank _8"></span>en </div><div class="t m0 x17 h10 y98 ff3 fsd fc2 sc0 ls3 ws4">el <span class="blank _8"></span>tip<span class="blank _7"></span>o <span class="blank _7"></span>II.<span class="blank _7"></span> <span class="blank _7"></span>El<span class="blank _7"></span> <span class="blank _7"></span>tip<span class="blank _7"></span>o <span class="blank _7"></span>II<span class="blank _7"></span>I-co<span class="blank _7"></span>ron<span class="blank _7"></span>ill<span class="blank _7"></span>a <span class="blank _7"></span>se<span class="blank _7"></span> <span class="blank _7"></span>añad<span class="blank _7"></span>ió <span class="blank _8"></span>a <span class="blank _7"></span>la <span class="blank _8"></span>cla<span class="blank _7"></span>si\ufb01c<span class="blank _7"></span>aci<span class="blank _7"></span>ón <span class="blank _8"></span>ya <span class="blank _8"></span>que <span class="blank _8"></span>es <span class="blank _7"></span>má<span class="blank _7"></span>s <span class="blank _7"></span>fr<span class="blank _7"></span>ecu<span class="blank _7"></span>ent<span class="blank _7"></span>e <span class="blank _7"></span>al <span class="blank _8"></span>ava<span class="blank _7"></span>nza<span class="blank _7"></span>r <span class="blank _7"></span>la <span class="blank _8"></span>eda<span class="blank _7"></span>d. <span class="blank _8"></span>En </div><div class="t m0 x17 h10 y99 ff3 fsd fc2 sc0 ls3 ws4">est<span class="blank _7"></span>e t<span class="blank _7"></span>ipo <span class="blank _7"></span>hay<span class="blank _7"></span> po<span class="blank _7"></span>ca r<span class="blank _7"></span>ec<span class="blank _7"></span>esió<span class="blank _7"></span>n f<span class="blank _7"></span>ron<span class="blank _7"></span>tal<span class="blank _7"></span> y l<span class="blank _7"></span>a p<span class="blank _7"></span>ér<span class="blank _7"></span>dida<span class="blank _7"></span> de<span class="blank _7"></span> ca<span class="blank _7"></span>bell<span class="blank _7"></span>o s<span class="blank _7"></span>e lo<span class="blank _7"></span>cal<span class="blank _7"></span>iza<span class="blank _7"></span> pri<span class="blank _7"></span>nci<span class="blank _7"></span>palm<span class="blank _7"></span>ent<span class="blank _7"></span>e en<span class="blank _7"></span> la<span class="blank _7"></span> co<span class="blank _7"></span>ron<span class="blank _7"></span>illa<span class="blank _7"></span>.</div><div class="t m0 x17 h14 y9a ff2 fsd fc2 sc0 ls3 ws4">T<span class="blank _7"></span>ipo <span class="blank _7"></span>IV:<span class="ff3"> <span class="blank _8"></span>La <span class="blank _7"></span>recesión <span class="blank _8"></span>frontal <span class="blank _7"></span>y <span class="blank _7"></span>frontotemporal <span class="blank _8"></span>es más <span class="blank _8"></span>profunda <span class="blank _8"></span>que en <span class="blank _8"></span>el <span class="blank _7"></span>tipo <span class="blank _7"></span>III <span class="blank _8"></span>y se <span class="blank _8"></span>obser<span class="blank _b"> </span>va <span class="blank _8"></span>escasez </span></div><div class="t m0 x17 h10 y9b ff3 fsd fc2 sc0 ls3 ws4">o ausencia de <span class="blank _b"> </span>cabello en la <span class="blank _b"> </span>coronilla. Las áreas de <span class="blank _b"> </span>recesión se encuentran separadas <span class="blank _b"> </span>entre sí por una </div><div class="t m0 x17 h10 y9c ff3 fsd fc2 sc0 ls3 ws4">franja de pelo moderadamente <span class="blank _7"></span>denso que se extiende <span class="blank _7"></span>a través de la <span class="blank _7"></span>parte superior del cuero cabellu-</div><div class="t m0 x17 h10 y9d ff3 fsd fc2 sc0 ls3 ws4">do. Esta franja une las dos z<span class="blank _7"></span>onas de cabello poblado a ambos lados de la cabeza.</div><div class="t m0 x17 h14 y9e ff2 fsd fc2 sc0 ls3 ws4">T<span class="blank _7"></span>ipo <span class="blank _7"></span>V:<span class="ff3"> La zona de calvicie en <span class="blank _b"> </span>la coronilla sigue estando separada <span class="blank _b"> </span>de la zona de calvicie frontotem-</span></div><div class="t m0 x17 h10 y9f ff3 fsd fc2 sc0 ls3 ws4">poral, aunque <span class="blank _b"> </span>esta <span class="blank _b"> </span>separación ya <span class="blank _b"> </span>no <span class="blank _b"> </span>es tan <span class="blank _b"> </span>evidente <span class="blank _b"> </span>debido a <span class="blank _b"> </span>que <span class="blank _b"> </span>la franja <span class="blank _b"> </span>de cabello, <span class="blank _b"> </span>a <span class="blank _b"> </span>través de <span class="blank _b"> </span>la </div><div class="t m0 x17 h10 ya0 ff3 fsd fc2 sc0 ls3 ws4">parte <span class="blank _b"> </span>superior <span class="blank _b"> </span>del <span class="blank _b"> </span>cuero <span class="blank _b"> </span>cabelludo, <span class="blank _5"> </span>se <span class="blank _b"> </span>ha <span class="blank _b"> </span>estrechado <span class="blank _b"> </span>y <span class="blank _b"> </span>el <span class="blank _b"> </span>pelo <span class="blank _b"> </span>se <span class="blank _b"> </span>ha <span class="blank _b"> </span>vuelto <span class="blank _b"> </span>más <span class="blank _b"> </span>escaso. <span class="blank _b"> </span>Las <span class="blank _b"> </span>áreas <span class="blank _b"> </span>de </div><div class="t m0 x17 h10 ya1 ff3 fsd fc2 sc0 ls3 ws4">calvicie de la coronilla y de la región fr<span class="blank _7"></span>ontotemporal han aumentado de tamaño.</div><div class="t m0 x17 h14 ya2 ff2 fsd fc2 sc0 ls3 ws4">T<span class="blank _7"></span>ipo VI:<span class="ff3"> <span class="blank _5"> </span>El <span class="blank _5"> </span>puente <span class="blank _5"> </span>de <span class="blank _b"> </span>cabello <span class="blank _5"> </span>que <span class="blank _5"> </span>atravesaba <span class="blank _5"> </span>la <span class="blank _b"> </span>par<span class="blank _b"> </span>te <span class="blank _5"> </span>superior <span class="blank _b"> </span>del <span class="blank _5"> </span>cuero <span class="blank _5"> </span>cabelludo <span class="blank _5"> </span>se <span class="blank _5"> </span>pier<span class="blank _7"></span>de <span class="blank _5"> </span>y <span class="blank _5"> </span>las </span></div><div class="t m0 x17 h10 ya3 ff3 fsd fc2 sc0 ls3 ws4">dos <span class="blank _b"> </span>zonas <span class="blank _5"> </span>de <span class="blank _b"> </span>calvicie <span class="blank _5"> </span>se <span class="blank _5"> </span>han <span class="blank _b"> </span>convertido <span class="blank _5"> </span>en <span class="blank _b"> </span>una <span class="blank _5"> </span>sola. <span class="blank _5"> </span>Además, <span class="blank _b"> </span>el <span class="blank _5"> </span>tamaño <span class="blank _b"> </span>de <span class="blank _5"> </span>la <span class="blank _b"> </span>zona <span class="blank _5"> </span>de <span class="blank _b"> </span>alopecia <span class="blank _5"> </span>ha </div><div class="t m0 x17 h10 ya4 ff3 fsd fc2 sc0 ls3 ws4">aumentado lateral y posteriormente.</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf8" class="pf w0 h0" data-page-no="8"><div class="pc pc8 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x18 y7a w2 h15" alt="" src="https://files.passeidireto.com/bd8b623e-aac3-45a2-a28d-90f6d507af40/bg8.png"><div class="t m0 x19 h12 ya5 ff3 fse fc2 sc0 ls5 ws4">ALOPECIAS EN LA PRÁCTICA CLÍNICA DIARIA<span class="blank _8"></span></div><div class="t m0 x17 h14 ya6 ff2 fsd fc2 sc0 ls3 ws4">T<span class="blank _7"></span>ipo <span class="blank _b"> </span>VII:<span class="ff3"> <span class="blank _b"> </span>Esta <span class="blank _5"> </span>es <span class="blank _5"> </span>la <span class="blank _5"> </span>forma <span class="blank _5"> </span>más <span class="blank _5"> </span>avanzada <span class="blank _b"> </span>de <span class="blank _5"> </span>calvicie <span class="blank _5"> </span>de <span class="blank _5"> </span>patrón <span class="blank _5"> </span>masculino<span class="blank _7"></span>. <span class="blank _5"> </span>Lo <span class="blank _5"> </span>único <span class="blank _5"> </span>que <span class="blank _5"> </span>queda <span class="blank _b"> </span>es </span></div><div class="t m0 x17 h10 ya7 ff3 fsd fc2 sc0 ls3 ws4">una <span class="blank _b"> </span>franja <span class="blank _b"> </span>de <span class="blank _b"> </span>pelo <span class="blank _b"> </span>con <span class="blank _b"> </span>forma <span class="blank _b"> </span>de <span class="blank _b"> </span>herradura <span class="blank _b"> </span>que <span class="blank _b"> </span>comienza <span class="blank _b"> </span>justo <span class="blank _b"> </span>frente <span class="blank _b"> </span>a <span class="blank _b"> </span>la <span class="blank _b"> </span>oreja <span class="blank _b"> </span>y <span class="blank _b"> </span>se <span class="blank _b"> </span>extiende <span class="blank _b"> </span>hacia </div><div class="t m0 x17 h10 ya8 ff3 fsd fc2 sc0 ls3 ws4">la parte posterior del <span class="blank _b"> </span>cuero cabelludo y el cuello. Este pelo no es denso y con frecuencia también es </div><div class="t m0 x17 h10 ya9 ff3 fsd fc2 sc0 ls3 ws4">\ufb01no. <span class="blank _8"></span>T<span class="blank _6"></span>ambién es escaso en la nuca y en un semicírculo por encima de las orejas.</div><div class="t m0 x17 h14 yaa ff3 fsd fc2 sc0 ls3 ws4">En la <span class="ff2">T<span class="blank _6"></span>abla 1<span class="ff3"> que presentamos a continuación se especi\ufb01can las equivalencias entre ambas escalas. </span></span></div><div class="t m0 x1b h14 yab ff2 fsd fc2 sc0 ls3 ws4">T<span class="blank _7"></span>ipos de Ebling </div><div class="t m0 x1b h10 yac ff3 fsd fc2 sc0 ls3 ws4">Esta clasi\ufb01cación (del I al <span class="blank _7"></span>V) facilita más la tipi\ufb01cación de la alopecia. El tipo I incluiría a los tipos I </div><div class="t m0 x1b h10 yad ff3 fsd fc2 sc0 ls3 ws4">y II de <span class="blank _b"> </span>Hamilton, el tipo II a <span class="blank _b"> </span>los tipos II y <span class="blank _b"> </span>III, el tipo III, <span class="blank _b"> </span>los tipos IV <span class="blank _b"> </span>y V<span class="blank _3"></span>, <span class="blank _b"> </span>el tipo IV a <span class="blank _b"> </span>los tipos V y </div><div class="t m0 x1b h10 yae ff3 fsd fc2 sc0 ls3 ws4">VI y el tipo V al tipo <span class="blank _7"></span>VII.</div><div class="t m0 x1b h16 yaf ff2 fs10 fc2 sc0 ls3 ws4">T<span class="blank _6"></span>abla<span class="blank _7"></span> 1.<span class="blank _7"></span><span class="ff3"> Esc<span class="blank _7"></span>alas<span class="blank _7"></span> de<span class="blank _7"></span> Ha<span class="blank _7"></span>milt<span class="blank _7"></span>on <span class="blank _7"></span>y N<span class="blank _8"></span>orwood<span class="blank _7"></span>.</span></div><div class="t m0 x1f h17 yb0 ff3 fs10 fc2 sc0 ls3 ws8">I<span class="blank _11"> </span>II<span class="blank"> </span>IIa</div><div class="t m0 x1f h17 yb1 ff3 fs10 fc2 sc0 ls3 ws9">III<span class="blank _12"> </span>IIIa<span class="blank"> </span>III<span class="blank _7"></span>a-V<span class="blank _4"></span>ertex</div><div class="t m0 x1f h17 yb2 ff3 fs10 fc2 sc0 ls3 wsa">IV<span class="blank _12"> </span>IV<span class="blank _4"></span>a<span class="blank"> </span>V</div><div class="t m0 x1f h17 yb3 ff3 fs10 fc2 sc0 ls3 wsb">V<span class="blank _4"></span>a<span class="blank"> </span>VI<span class="blank"> </span>VII</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf9" class="pf w0 h0" data-page-no="9"><div class="pc pc9 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x18 y44 w2 h11" alt="" src="https://files.passeidireto.com/bd8b623e-aac3-45a2-a28d-90f6d507af40/bg9.png"><div class="t m0 xd ha yb4 ff3 fs8 fc2 sc0 ls3">9</div><div class="t m0 x1b h14 yb5 ff2 fsd fc2 sc0 ls3 ws4">T<span class="blank _7"></span>ipos de Ludwig</div><div class="t m0 x1b h10 yb6 ff3 fsd fc2 sc0 ls3 ws4">P<span class="blank _8"></span>ara <span class="blank _b"> </span>valorar la alopecia de patrón femenino Erich Ludwig, en 1977, consideró tres estadios caracte-</div><div class="t m0 x1b h10 yb7 ff3 fsd fc2 sc0 ls3 ws4">rizados <span class="blank _b"> </span>por <span class="blank _b"> </span>la <span class="blank _5"> </span>pérdida <span class="blank _b"> </span>difusa <span class="blank _b"> </span>en <span class="blank _b"> </span>la <span class="blank _5"> </span>corona <span class="blank _b"> </span>y <span class="blank _b"> </span>la <span class="blank _b"> </span>persistencia <span class="blank _5"> </span>de <span class="blank _b"> </span>la <span class="blank _b"> </span>línea <span class="blank _5"> </span>de <span class="blank _b"> </span>implantación <span class="blank _b"> </span>frontal, <span class="blank _b"> </span>que </div><div class="t m0 x1b h14 yb8 ff3 fsd fc2 sc0 ls3 ws4">podríamos identi\ufb01car como leve, moderada y severa (<span class="ff2">T<span class="blank _6"></span>abla 2<span class="ff3">).</span></span></div><div class="t m0 x20 h16 yb9 ff2 fs10 fc2 sc0 ls3 ws4">T<span class="blank _6"></span>abla<span class="blank _7"></span> 2.<span class="blank _7"></span><span class="ff3"> Esc<span class="blank _7"></span>ala <span class="blank _7"></span>de <span class="blank _7"></span>Lud<span class="blank _7"></span>wig.</span></div><div class="t m0 x17 h13 yba ff2 fsf fc2 sc0 ls3 ws4">3.5. Diagnóstico </div><div class="t m0 x17 h10 ybb ff3 fsd fc2 sc0 ls3 ws4">Los <span class="blank _b"> </span>exám<span class="blank _7"></span>enes <span class="blank _b"> </span>compl<span class="blank _7"></span>ementar<span class="blank _7"></span>ios <span class="blank _b"> </span>como <span class="blank _b"> </span>hist<span class="blank _7"></span>opatolo<span class="blank _7"></span>gía <span class="blank _b"> </span>o <span class="blank _b"> </span>tricogr<span class="blank _7"></span>ama <span class="blank _b"> </span>rarame<span class="blank _7"></span>nte <span class="blank _b"> </span>son <span class="blank _b"> </span>necesa<span class="blank _7"></span>rios <span class="blank _b"> </span>para el </div><div class="t m0 x17 h10 ybc ff3 fsd fc2 sc0 ls3 ws4">diagn<span class="blank _7"></span>óstico<span class="blank _7"></span>. La b<span class="blank _7"></span>úsqueda<span class="blank _7"></span> de un hip<span class="blank _7"></span>erandr<span class="blank _7"></span>ogenis<span class="blank _7"></span>mo no sue<span class="blank _7"></span>le ser ne<span class="blank _7"></span>cesaria<span class="blank _7"></span>, pues en<span class="blank _7"></span> el hombr<span class="blank _7"></span>e la al<span class="blank _7"></span>o-</div><div class="t m0 x17 h10 ybd ff3 fsd fc2 sc0 ls3 ws4">pecia<span class="blank _7"></span> <span class="blank _7"></span>andro<span class="blank _7"></span>genétic<span class="blank _7"></span>a <span class="blank _7"></span>nunca<span class="blank _7"></span> <span class="blank _7"></span>es <span class="blank _7"></span>signo<span class="blank _7"></span> <span class="blank _7"></span>de <span class="blank _8"></span>exceso <span class="blank _8"></span>de <span class="blank _8"></span>andróge<span class="blank _7"></span>nos <span class="blank _7"></span>desp<span class="blank _7"></span>ués <span class="blank _8"></span>de <span class="blank _7"></span>la <span class="blank _7"></span>pube<span class="blank _7"></span>rtad, <span class="blank _8"></span>como <span class="blank _7"></span>hem<span class="blank _7"></span>os <span class="blank _7"></span>co-</div><div class="t m0 x17 h10 ybe ff3 fsd fc2 sc0 ls3 ws4">menta<span class="blank _7"></span>do <span class="blank _7"></span>en <span class="blank _7"></span>la <span class="blank _7"></span>etiopa<span class="blank _7"></span>togenia<span class="blank _7"></span>, y<span class="blank _7"></span> en<span class="blank _7"></span> la<span class="blank _7"></span> mu<span class="blank _7"></span>jer<span class="blank _8"></span>, <span class="blank _7"></span>sin <span class="blank _7"></span>otr<span class="blank _7"></span>os <span class="blank _7"></span>signos <span class="blank _8"></span>de h<span class="blank _7"></span>iperand<span class="blank _7"></span>rogeni<span class="blank _7"></span>smo <span class="blank _7"></span>como <span class="blank _8"></span>alteracio<span class="blank _7"></span>nes </div><div class="t m0 x17 h10 ybf ff3 fsd fc2 sc0 ls3 ws4">menst<span class="blank _7"></span>ruales, hirs<span class="blank _7"></span>utismo o acné,<span class="blank _7"></span> es excepci<span class="blank _7"></span>onal; sólo<span class="blank _7"></span> <span class="blank _b"> </span>la pr<span class="blank _7"></span>esenci<span class="blank _7"></span>a asociada de esto<span class="blank _7"></span>s signos just<span class="blank _7"></span>i\ufb01ca un </div><div class="t m0 x17 h10 yc0 ff3 fsd fc2 sc0 ls3 ws4">estud<span class="blank _7"></span>io <span class="blank _7"></span>hormo<span class="blank _7"></span>nal. <span class="blank _8"></span>P<span class="blank _8"></span>or <span class="blank _7"></span>eso, <span class="blank _8"></span>en <span class="blank _7"></span>casos <span class="blank _8"></span>con <span class="blank _8"></span>otros <span class="blank _8"></span>signos <span class="blank _8"></span>de <span class="blank _7"></span>hiper<span class="blank _7"></span>androg<span class="blank _7"></span>enismo <span class="blank _8"></span>asocia<span class="blank _7"></span>dos <span class="blank _7"></span>debe<span class="blank _7"></span> <span class="blank _7"></span>descarta<span class="blank _7"></span>r-</div><div class="t m0 x17 h10 yc1 ff3 fsd fc2 sc0 ls3 ws4">se un<span class="blank _7"></span> hipera<span class="blank _7"></span>ndrog<span class="blank _7"></span>enismo <span class="blank _7"></span>tumoral<span class="blank _7"></span>, ov<span class="blank _7"></span>árico<span class="blank _7"></span> o supr<span class="blank _7"></span>arren<span class="blank _7"></span>al. </div><div class="t m0 x17 h13 yc2 ff2 fsf fc2 sc0 ls3 ws4">3.6. <span class="blank _8"></span>T<span class="blank _4"></span>ratamiento</div><div class="t m0 x17 h14 yc3 ff2 fsd fc2 sc0 ls3 ws4">T<span class="blank _6"></span>ratamiento médico</div><div class="t m0 x17 h14 yc4 ff2 fsd fc2 sc0 ls3 ws4">F<span class="blank _7"></span>inasteride oral</div><div class="t m0 x17 h10 yc5 ff3 fsd fc2 sc0 ls3 ws4">El <span class="blank _b"> </span>\ufb01nasteride <span class="blank _5"> </span>es <span class="blank _b"> </span>un <span class="blank _5"> </span>4-azasteroide, <span class="blank _5"> </span>cuya <span class="blank _b"> </span>composición <span class="blank _5"> </span>química <span class="blank _5"> </span>responde <span class="blank _b"> </span>a <span class="blank _5"> </span>la <span class="blank _b"> </span>fórmula <span class="blank _5"> </span>N-(1,1-dime-</div><div class="t m0 x17 h10 yc6 ff3 fsd fc2 sc0 ls3 ws5">til)-3-oxo-4-aza-5-<span class="ff9 wsc">a</span>-androst-1-eno-17-<span class="ff9 wsc">b</span><span class="ws4">-carbo<span class="blank _7"></span>xamida. <span class="blank _5"> </span>El <span class="blank _b"> </span>fármaco <span class="blank _b"> </span>actúa <span class="blank _5"> </span>como <span class="blank _5"> </span>un <span class="blank _b"> </span>inhibidor <span class="blank _5"> </span>com-</span></div><div class="t m0 x17 h10 yc7 ff3 fsd fc2 sc0 ls3 ws4">petitivo y <span class="blank _7"></span>especí\ufb01co de <span class="blank _7"></span>la 5-<span class="ff9 wsc">a</span>-reductasa <span class="blank _7"></span>tipo 2. <span class="blank _7"></span>Su <span class="blank _7"></span>utilización por <span class="blank _7"></span>vía oral <span class="blank _7"></span>está aprobada <span class="blank _7"></span>desde 1997 </div><div class="t m0 x17 h10 yc8 ff3 fsd fc2 sc0 ls3 ws4">por <span class="blank _b"> </span>la <span class="blank _b"> </span>FDA. <span class="blank _b"> </span>Bloquea <span class="blank _b"> </span>de <span class="blank _b"> </span>manera <span class="blank _b"> </span>selectiva la <span class="blank _b"> </span>conversión <span class="blank _b"> </span>de <span class="blank _b"> </span>la <span class="blank _b"> </span>testosterona <span class="blank _b"> </span>a <span class="blank _b"> </span>dihidrotestosterona, <span class="blank _b"> </span>su </div><div class="t m0 x17 h10 yc9 ff3 fsd fc2 sc0 ls3 ws4">metabolito más activo<span class="blank _7"></span>. </div><div class="t m0 x17 h10 yca ff3 fsd fc2 sc0 ls3 ws4">S<span class="blank _7"></span>u especi\ufb01cidad <span class="blank _8"></span>se basa <span class="blank _8"></span>en su <span class="blank _8"></span>mayor a\ufb01nidad <span class="blank _8"></span>por la <span class="blank _8"></span>isoenzima tipo <span class="blank _7"></span>2 <span class="blank _7"></span>frente <span class="blank _7"></span>a <span class="blank _7"></span>la <span class="blank _7"></span>tipo <span class="blank _7"></span>1. S<span class="blank _7"></span>in <span class="blank _7"></span>embargo, </div><div class="t m0 x17 h10 ycb ff3 fsd fc2 sc0 ls3 ws4">posee también <span class="blank _8"></span>un efecto inhibidor <span class="blank _7"></span>competitivo <span class="blank _7"></span>de la <span class="blank _7"></span>isoenzima <span class="blank _7"></span>tipo 1 <span class="blank _7"></span>dependiente del <span class="blank _7"></span>tiempo. <span class="blank _7"></span>Esto </div><div class="t m0 x21 h17 ycc ff3 fs10 fc2 sc0 ls3 wsd">I<span class="blank _13"> </span>II<span class="blank"> </span>III</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pfa" class="pf w0 h0" data-page-no="a"><div class="pc pca w0 h0"><img fetchpriority="low" loading="lazy" class="bi x18 y7a w2 h15" alt="" src="https://files.passeidireto.com/bd8b623e-aac3-45a2-a28d-90f6d507af40/bga.png"><div class="t m0 x19 h12 y7b ffa fse fc2 sc0 ls5 ws4">ALOPECIAS EN LA PRÁCTICA CLÍNICA DIARIA<span class="blank _8"></span></div><div class="t m0 x1b h10 ycd ffa fsd fc2 sc0 ls3 ws4">explica <span class="blank _b"> </span>que <span class="blank _5"> </span>aunque <span class="blank _b"> </span>se <span class="blank _5"> </span>ha <span class="blank _b"> </span>demostrado <span class="blank _5"> </span>que <span class="blank _b"> </span>\ue681nasteride <span class="blank _5"> </span>consigue <span class="blank _b"> </span>disminuir <span class="blank _5"> </span>los <span class="blank _b"> </span>valores <span class="blank _b"> </span>de <span class="blank _b"> </span>dihidrotes-</div><div class="t m0 x1b h10 yce ffa fsd fc2 sc0 ls3 ws4">tosterona entre <span class="blank _b"> </span>un <span class="blank _b"> </span>60 y <span class="blank _b"> </span>un <span class="blank _b"> </span>80 <span class="blank _6"></span>%, nunca <span class="blank _b"> </span>lo <span class="blank _b"> </span>hace <span class="blank _b"> </span>de forma <span class="blank _b"> </span>absoluta <span class="blank _b"> </span>debido <span class="blank _b"> </span>a la <span class="blank _b"> </span>producción <span class="blank _b"> </span>residual </div><div class="t m0 x1b h10 ycf ffa fsd fc2 sc0 ls3 ws4">mantenida por la 5-<span class="ffb">a</span>-reductasa tipo I.</div><div class="t m0 x1b h10 yd0 ffa fsd fc2 sc0 ls3 ws4">Inicialmente estaba indicado sólo en varones, pero en la actualidad se <span class="blank _b"> </span>considera que también puede </div><div class="t m0 x1b h10 yd1 ffa fsd fc2 sc0 ls3 ws4">ser <span class="blank _b"> </span>e\ue681caz en <span class="blank _b"> </span>mujeres posmenopáusicas, <span class="blank _b"> </span>aunque <span class="blank _b"> </span>a dosis <span class="blank _b"> </span>mayores (en <span class="blank _b"> </span>España, <span class="blank _b"> </span>aún no <span class="blank _b"> </span>está <span class="blank _b"> </span>autorizada </div><div class="t m0 x1b h10 yd2 ffa fsd fc2 sc0 ls3 ws4">esta <span class="blank _b"> </span>indicación). <span class="blank _5"> </span>Sigue <span class="blank _b"> </span>desaconsejándose <span class="blank _b"> </span>en <span class="blank _b"> </span>mujeres <span class="blank _5"> </span>en <span class="blank _b"> </span>edad <span class="blank _b"> </span>fér<span class="blank _b"> </span>til. <span class="blank _b"> </span>Su <span class="blank _b"> </span>efecto <span class="blank _b"> </span>a <span class="blank _5"> </span>la <span class="blank _b"> </span>dosis <span class="blank _b"> </span>habitual <span class="blank _5"> </span>de </div><div class="t m0 x1b h10 yd3 ffa fsd fc2 sc0 ls3 ws4">1 <span class="blank _b"> </span>mg/día <span class="blank _b"> </span>parece <span class="blank _b"> </span>depender <span class="blank _b"> </span>de <span class="blank _5"> </span>la <span class="blank _b"> </span>disminución <span class="blank _b"> </span>de <span class="blank _b"> </span>DHT <span class="blank _b"> </span>circulante <span class="blank _5"> </span>y <span class="blank _b"> </span>no <span class="blank _b"> </span>de <span class="blank _b"> </span>una <span class="blank _b"> </span>acción <span class="blank _5"> </span>local <span class="blank _b"> </span>sobre <span class="blank _b"> </span>el </div><div class="t m0 x1b h10 yd4 ffa fsd fc2 sc0 ls3 ws4">folículo, pues la aplicación tópica es poco e\ue681caz.</div><div class="t m0 x1b h10 yd5 ffa fsd fc2 sc0 ls3 ws4">En <span class="blank _b"> </span>hombres <span class="blank _b"> </span>detiene <span class="blank _5"> </span>la <span class="blank _b"> </span>caída <span class="blank _5"> </span>en <span class="blank _b"> </span>el <span class="blank _5"> </span>80-90 <span class="blank _6"></span>% <span class="blank _b"> </span>de <span class="blank _5"> </span>los <span class="blank _b"> </span>pacientes <span class="blank _5"> </span>y <span class="blank _b"> </span>existe <span class="blank _5"> </span>repoblación <span class="blank _b"> </span>a <span class="blank _5"> </span>los <span class="blank _b"> </span>2 <span class="blank _5"> </span>años <span class="blank _b"> </span>en <span class="blank _5"> </span>el </div><div class="t m0 x1b h10 yd6 ffa fsd fc2 sc0 ls3 ws4">66 <span class="blank _6"></span>%, sobre <span class="blank _7"></span>todo en la <span class="blank _7"></span>zona del v<span class="blank _7"></span>értex. Las alteraciones eréctiles <span class="blank _7"></span>o de la <span class="blank _7"></span>libido son escasas <span class="blank _7"></span>y similares </div><div class="t m0 x1b h10 yd7 ffa fsd fc2 sc0 ls3 ws4">a placebo<span class="blank _7"></span>. En mujer<span class="blank _7"></span>es posmenopáusicas parece ser <span class="blank _7"></span>menos e\ue681caz que en <span class="blank _7"></span>el hombre, aunque <span class="blank _7"></span>en algún </div><div class="t m0 x1b h10 yd8 ffa fsd fc2 sc0 ls3 ws4">estudio <span class="blank _7"></span>reciente <span class="blank _7"></span>ha <span class="blank _7"></span>mostrado e\ue681cacia <span class="blank _8"></span>a dosis <span class="blank _8"></span>superiores (2,5 <span class="blank _8"></span>mg/día). Existe <span class="blank _8"></span>cierta discrepancia <span class="blank _8"></span>sobre </div><div class="t m0 x1b h10 yd9 ffa fsd fc2 sc0 ls3 ws4">si la asociación con minoxidil al 5 <span class="blank _6"></span>% tiene efecto sinérgico<span class="blank _7"></span>. </div><div class="t m0 x1b h14 yda ffc fsd fc2 sc0 ls3 ws4">Mino<span class="blank _7"></span>xidil tópico</div><div class="t m0 x1b h10 ydb ffa fsd fc2 sc0 ls3 ws4">El minoxidil tópico <span class="blank _b"> </span>aumenta la <span class="blank _b"> </span>síntesis de <span class="blank _b"> </span>ácido desoxirribonucleico <span class="blank _b"> </span>en las <span class="blank _b"> </span>células foliculares, entre </div><div class="t m0 x1b h10 ydc ffa fsd fc2 sc0 ls3 ws4">otras acciones. Su efectividad consiste más en <span class="blank _b"> </span>detener la evolución de la <span class="blank _b"> </span>alopecia androgenética que </div><div class="t m0 x1b h10 ydd ffa fsd fc2 sc0 ls3 ws4">en <span class="blank _7"></span>recuperar el <span class="blank _8"></span>cabello perdido <span class="blank _7"></span>de <span class="blank _7"></span>una forma <span class="blank _7"></span>cosméticamente <span class="blank _7"></span>evidente. En <span class="blank _8"></span>la actualidad <span class="blank _7"></span>está comer-</div><div class="t m0 x1b h10 yde ffa fsd fc2 sc0 ls3 ws4">cializado a dosis del 2 y el 5 <span class="blank _6"></span>% y se administra dos veces al día (normalmente 1cc cada 12 horas).</div><div class="t m0 x1b h10 ydf ffa fsd fc2 sc0 ls3 ws4"> </div><div class="t m0 x1b h10 ye0 ffa fsd fc2 sc0 ls3 ws4">Los <span class="blank _c"> </span>estudios <span class="blank _d"> </span>que <span class="blank _c"> </span>tratan <span class="blank _c"> </span>de <span class="blank _d"> </span>establecer <span class="blank _c"> </span>diferencias <span class="blank _c"> </span>entre <span class="blank _d"> </span>ambas <span class="blank _c"> </span>concentraciones <span class="blank _c"> </span>abogan <span class="blank _d"> </span>más <span class="blank _c"> </span>por <span class="blank _d"> </span>el </div><div class="t m0 x1b h10 ye1 ffa fsd fc2 sc0 ls3 ws4">uso <span class="blank _b"> </span>de <span class="blank _b"> </span>la <span class="blank _5"> </span>dosis <span class="blank _b"> </span>del <span class="blank _b"> </span>5 <span class="blank _6"></span>% <span class="blank _5"> </span>aun <span class="blank _b"> </span>a <span class="blank _b"> </span>riesgo <span class="blank _5"> </span>de <span class="blank _b"> </span>incrementar <span class="blank _b"> </span>los <span class="blank _b"> </span>efectos <span class="blank _5"> </span>secundarios <span class="blank _b"> </span>tópicos. <span class="blank _b"> </span>Debe <span class="blank _b"> </span>aplicarse </div><div class="t m0 x1b h10 ye2 ffa fsd fc2 sc0 ls3 ws4">en <span class="blank _5"> </span>el <span class="blank _5"> </span>cuero <span class="blank _5"> </span>cabelludo <span class="blank _5"> </span>y <span class="blank _5"> </span>con <span class="blank _5"> </span>el <span class="blank _c"> </span>pelo <span class="blank _5"> </span>seco. <span class="blank _5"> </span>Hay <span class="blank _5"> </span>que <span class="blank _5"> </span>advertir <span class="blank _5"> </span>al <span class="blank _5"> </span>paciente <span class="blank _5"> </span>que <span class="blank _5"> </span>debe <span class="blank _c"> </span>lavarse <span class="blank _5"> </span>las <span class="blank _5"> </span>manos </div><div class="t m0 x1b h10 ye3 ffa fsd fc2 sc0 ls3 ws4">después de <span class="blank _b"> </span>su <span class="blank _b"> </span>aplicación porque <span class="blank _b"> </span>el contacto <span class="blank _b"> </span>con <span class="blank _b"> </span>otras zonas <span class="blank _b"> </span>de <span class="blank _b"> </span>la cara <span class="blank _b"> </span>puede llevar <span class="blank _b"> </span>a <span class="blank _b"> </span>la producción </div><div class="t m0 x1b h10 ye4 ffa fsd fc2 sc0 ls3 ws4">de hipertricosis. </div><div class="t m0 x1b h10 ye5 ffa fsd fc2 sc0 ls3 ws4">Los <span class="blank _e"> </span>principales <span class="blank _e"> </span>efectos <span class="blank _e"> </span>secundarios <span class="blank _e"> </span>suelen <span class="blank _e"> </span>estar <span class="blank _e"> </span>relacionados <span class="blank _e"> </span>con <span class="blank _e"> </span>el <span class="blank _e"> </span>propilenglicol <span class="blank _e"> </span>asociado <span class="blank _e"> </span>a <span class="blank _e"> </span>su </div><div class="t m0 x1b h10 ye6 ffa fsd fc2 sc0 ls3 ws4">formulación <span class="blank _b"> </span>y <span class="blank _5"> </span>que <span class="blank _b"> </span>causa <span class="blank _b"> </span>picor<span class="blank _8"></span>, <span class="blank _5"> </span>enrojecimiento <span class="blank _b"> </span>e <span class="blank _b"> </span>intensa <span class="blank _5"> </span>xer<span class="blank _7"></span>osis, <span class="blank _5"> </span>motivos <span class="blank _b"> </span>por <span class="blank _b"> </span>los <span class="blank _5"> </span>cuales <span class="blank _b"> </span>el <span class="blank _b"> </span>paciente </div><div class="t m0 x1b h10 ye7 ffa fsd fc2 sc0 ls3 ws4">puede llegar <span class="blank _7"></span>a abandonar <span class="blank _7"></span>el tratamiento<span class="blank _7"></span>. E<span class="blank _7"></span>n ocasiones <span class="blank _7"></span>se ha <span class="blank _7"></span>descrito dermatitis <span class="blank _7"></span>de contacto <span class="blank _7"></span>asociada </div><div class="t m0 x1b h10 ye8 ffa fsd fc2 sc0 ls3 ws4">a <span class="blank _7"></span>su <span class="blank _8"></span>uso <span class="blank _7"></span>prolongado. <span class="blank _8"></span>Es <span class="blank _7"></span>un <span class="blank _7"></span>tratamiento <span class="blank _7"></span>muy <span class="blank _8"></span>seguro, <span class="blank _7"></span>pero <span class="blank _7"></span>existe <span class="blank _8"></span>una mínima <span class="blank _8"></span>absorción <span class="blank _8"></span>sistémica que </div><div class="t m0 x1b h10 ye9 ffa fsd fc2 sc0 ls3 ws4">podría causar palpitaciones o hipotensión.</div><div class="t m0 x1b h10 yea ffa fsd fc2 sc0 ls3 ws4">La disminución de la caída <span class="blank _b"> </span>se inicia a partir <span class="blank _b"> </span>del tercer mes, y a partir <span class="blank _b"> </span>del cuarto mes puede iniciarse </div><div class="t m0 x1b h10 yeb ffa fsd fc2 sc0 ls3 ws4">una <span class="blank _b"> </span>repoblación <span class="blank _b"> </span>que <span class="blank _b"> </span>primero <span class="blank _b"> </span>es <span class="blank _b"> </span>lineal <span class="blank _b"> </span>en <span class="blank _b"> </span>su <span class="blank _5"> </span>intensidad <span class="blank _b"> </span>pero <span class="blank _b"> </span>a <span class="blank _b"> </span>partir <span class="blank _b"> </span>de <span class="blank _b"> </span>los <span class="blank _5"> </span>12 <span class="blank _b"> </span>meses <span class="blank _b"> </span>aumenta <span class="blank _b"> </span>len-</div><div class="t m0 x1b h10 yec ffa fsd fc2 sc0 ls3 ws4">tamente <span class="blank _b"> </span>hasta <span class="blank _5"> </span>estabilizarse <span class="blank _5"> </span>entre <span class="blank _b"> </span>1 <span class="blank _5"> </span>y <span class="blank _b"> </span>3 <span class="blank _5"> </span>años <span class="blank _5"> </span>después. <span class="blank _b"> </span>La <span class="blank _5"> </span>aplicación <span class="blank _b"> </span>debe <span class="blank _5"> </span>ser <span class="blank _5"> </span>de <span class="blank _b"> </span>por <span class="blank _5"> </span>vida, <span class="blank _5"> </span>pues <span class="blank _b"> </span>si <span class="blank _5"> </span>se </div><div class="t m0 x1b h10 yed ffa fsd fc2 sc0 ls3 ws4">suspende el tratamiento el pelo que <span class="blank _7"></span>ha rebrotado cae en <span class="blank _7"></span>unos tres meses, regr<span class="blank _7"></span>esando el paciente a su </div><div class="t m0 x1b h10 yee ffa fsd fc2 sc0 ls3 ws4">estado inicial.</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div>
