A. Verma , J. Cargnello
Androgenetic alopecia (AGA) is the most type of hair loss in men thought to have aetiology with a polygenic basis thought to be most likely. This case documents an eleven year old boy presented to a specialist hair clinic complaining of diffuse hair thinning of the scalp. The hair loss began since being diagnosed with adrenoleukodystrophy (ALD) at the age of 6 years, with no associated loss of facial or body hair. There was a family history of ALD but no family history of scalp hair thinning or AGA. ALD is an X linked recessive trait typifi ed by progressive demyelisation of the nervous system. Disturbances of hair growth are frequently mentioned in reports of adrenomyeloneuropathy (AMN, its adult variant) but reports of disturbances in hair growth in the paediatric population are scarce. Patients with AMN may have two distinct types of hair loss – the fi rst being diffuse hair thinning involving the entire scalp and the second being the development of severe AGA more frequently 1 . This case provides evidence of patient with ALD who is too young to develop AGA but it is postulated that this diffuse scalp hair thinning could be a precursor to the development of AGA which may be severer in nature. Given AGA is likely to be a polygenic trait; it is hypothesised that the ALD gene may belong to the polygenic basis of AGA.