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"etiology": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Среди основных версий развития рубцующей алопеции рассматриваются наследственная, иммунная, инфекционная теории, но ни одна из них не дает исчерпывающего объяснения всех известных случаев заболевания:</span></p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li><span style=\"font-size: 7pt; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Генетическая. Наличие семейных случаев говорит в пользу возможной роли наследственного фактора в развитии дерматоза. Однако генетические механизмы, вызывающие заболевание, до настоящего времени неизвестны.</span></li>\r\n<li><span style=\"font-size: 7pt; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Иммунная. При исследовании биоптата кожи в поверхностных слоях дермы обнаруживается присутствие иммуноглобулинов класса М (IgM), интерлейкинов, указывающих на вовлеченность иммунных механизмов в развитие псевдопелады Брока.</span></li>\r\n<li><span style=\"font-size: 7pt; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Инфекционная. В клинических наблюдениях выявлена ассоциация дерматоза Брока с клещевым боррелиозом. Это дает основания предполагать, что инфицирование спирохетой Borrelia может вызывать манифестацию облысения.</span></li>\r\n</ul>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Вторичная рубцующая алопеция рассматривается как стадия течения некоторых хронических кожных заболеваний, в первую очередь, дискоидной красной волчанки и фолликулярного красного лишая.</span></p>",
"pathogenesis": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Патогенез рубцующей алопеции, как и этиология, остается неясным. Основные теории связывают дерматоз с гибелью в очаге фолликулярных стволовых клеток и деструкцией сальных желез. Патогистологическое исследование биоптата дермы указывает на наличие перифолликулярной и периваскулярной инфильтрации, состоящей из лимфоцитов, гистиоцитов, плазмоцитов и тучных клеток. Иногда выявляется фолликулярный кератоз.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">В поздних стадиях определяются разрушенные сальные и волосяные фолликулы, атрофия эпидермиса. Присутствие фрагментированных эластиновых и коллагеновых и волокон свидетельствует о склеротических изменениях дермы.</span></p>",
"diagnostics": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Диагноз рубцующая алопеция устанавливается на основании клинических и морфологических критериев. Пациенты с проблемой выпадения волос нуждаются в консультации дерматолога-трихолога и других специалистов: эндокринолога, невролога, инфекциониста. Дальнейшее обследование включает:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Трихоскопию. Осмотр волосяного покрова головы визуально и под увеличением обнаруживает очаги алопеции неправильной формы в лобно-теменной области. В очаге выпадения отсутствуют волосяные фолликулы, отмечается атрофия кожи.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Анализы крови. Для исключения коллагенозов (СКВ, склеродермии) проводится исследование крови на антинуклеарные Ат, Ат к нуклеосомам, антинуклеарный фактор. Также показано определение липидного профиля, глюкозы, тиреоидной панели, противоинфекционных антител.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Биопсию кожи. Окончательная верификация диагноза возможна после гистологического исследования фрагмента кожи, взятого из очага. В исследуемом материале обнаруживаются признаки лимфогистиоцитарной инфильтрации, диффузного склероза дермы, гипотрофия кожных желез.</span></li>\r\n</ul>\r\n<p> </p>\r\n<p><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\"> </span></p>",
"treatment": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">В настоящее время не найдено эффективных препаратов и методик, способных повернуть вспять патологический процесс и восстановить рост волос. Терапия рубцующей алопеции нацелена на предотвращение появления новых участков облысения и стабилизацию имеющихся. Она носит комплексную направленность:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Системная и местная фармакотерапия. Включает прием гормональных (преднизолон), вазоактивных (пентоксифилин), иммуносупрессивных (гидроксихлорохин) препаратов, витаминов А, B1, B6, Е, антиоксидантов. Местно используется втирание кортикостероидных мазей, кремов с пиритионом цинка. Для уменьшения плотности рубцовой ткани применяются внутриочаговые инъекции глюкокортикостероидов.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Физиотерапия. Показаны курсы массажа головы, аппаратные процедуры – дарсонвализация, электрофорез с лидазой, лазеротерапия. В лечении псевдопелады Брока может быть использована селективная фототерапия УФ-лучами.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Косметологические процедуры для волос. Врачом-трихологом подбираются специальные средства ухода за волосами (лечебные маски, шампуни). Показано проведение мезотерапии волос с витаминными и минеральными компонентами.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Методы замещения волос. С целью скрытия косметического дефекта рекомендуется ношение парика. Возможно проведение трансплантации волос путем пересадки полнослойного кожного лоскута, содержащего волосяные фолликулы.</span></li>\r\n</ul>\r\n<p> </p>\r\n<p><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\"> </span></p>",
"prevention": "<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Так как причины заболевания остаются неясными, методы профилактики не разработаны. Рекомендуется санация хронических инфекционных очагов, лечение эндокринных патологий, употребление в пищу достаточного количества витаминов и микроэлементов. При выпадении волос не следует прибегать к самолечению, необходимо незамедлительно пройти полноценное обследование у специалистов.</span></p>",
"clinical_picture": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">В большинстве случаев рубцующая алопеция начинает развиваться с небольших зон. Они могут быть скрыты волосами и совершенно незаметны. Со временем очаги расширяются. Этот процесс продолжается длительный период, поэтому обратиться к врачу на начальной стадии бывает довольно сложно. При разных формах недуга верхний слой дермы может оставаться без повреждений или покрываться волдырями. Возможны шелушение кожи, приобретение красноватого оттенка. Основными симптомами болезни считаются:</span></p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li><span style=\"font-size: 7pt; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Увеличение количества выпадающих волос. В очагах поражения начинает просматриваться кожа головы.</span></li>\r\n<li><span style=\"font-size: 7pt; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Образование зон полного облысения. Они имеют круглую или овальную форму и постоянно растут. В более запущенных случаях они сливаются, оголяя все большую площадь.</span></li>\r\n<li><span style=\"font-size: 7pt; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Ощущения в местах поражения зуда, жжения. При этом эпидермис может внешне не отличаться от здоровых участков кожи.</span></li>\r\n<li><span style=\"font-size: 7pt; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Возникновение рубцов в очагах болезни.</span></li>\r\n</ul>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Опасность этой формы алопеции состоит в невозможности восстановить волосы в очагах поражения. Для этого требуется сложная трансплантация. Поэтому в ходе терапии основной целью является прекращение развития недуга, желательно на самых ранних этапах, когда очаги еще очень малы.</span></p>",
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"code": "L64",
"name": "Андрогенная алопеция",
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"lead": "прогрессирующая потеря волос на голове, обусловленная атрофией волосяных луковиц под влиянием мужских половых стероидов",
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"etiology": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Причины андрогенной алопеции у мужчин</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Андрогенная алопеция у мужчин – заболевание, которое встречается среди сильной половины человечества чаще, чем у женщин в силу генетической предрасположенности:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">в мужском организме вырабатывается дигидротестостерон – гормон, который разрушает волосяные фолликулы;</span></li>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">волосяные фолликулы становятся чувствительными к дигидротестостерону;</span></li>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">в организме активизируется фермент – 5-альфа-редуктаза. Он превращает тестостерон в дигидротестостерон.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Это основная причина выпадения волос. Провокаторами появления андрогенного облысения могут быть:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">гормональные сбои;</span></li>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">высокое содержание дигидротестостерона в крови;</span></li>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">патологии внутренних органов;</span></li>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">несбалансированное питание;</span></li>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">опухоль в мужских половых органах;</span></li>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">частые стрессы;</span></li>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">употребление некоторых лекарств – анаболиков, нейролептиков, антидепрессантов и др.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Причины андрогенной алопеции у женщин</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Основная причина андрогенного выпадения волос по мужскому типу у женщин связана с гормональными нарушениями. Если в женском организме наблюдается избыточная выработка тестостерона, то это может привести к алопеции. Причины появления таких гормональных изменений:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">естественные изменения в организме – беременность, лактация, климакс;</span></li>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">болезни эндокринной системы – сахарный диабет, проблемы в работе щитовидной железы;</span></li>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">прием некоторых лекарств – гормональных препаратов, стероидов и др.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Есть еще одна причина появления андрогенной алопеции у женщин – генетическая предрасположенность к облысению. Есть женщины, у которых склонность к алопеции передается по материнской линии.</span></p>\r\n<p><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\"> </span></p>",
"pathogenesis": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">При определенных различиях в механизме развития мужской и женской андрогенной алопеции имеются общие патогенетические звенья: высокая активность 5-альфа-редуктазы, избыток дигидротестостерона (ДГТ) и гиперчувствительность волосяных луковиц к ДГТ.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Под влиянием фермента 5-α-редуктазы, присутствующего в волосяных фолликулах, тестостерон трансформируется в гормон дигидротестостерон, который связывается с андрогенчувствительными рецепторами. Происходит активация генов, которые запускают перерождение волосяных луковиц. Наибольшая плотность андрогеновых рецепторов отмечается в лобно-височной области скальпа и на темени, поэтому алопеция развивается преимущественно в этих зонах.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Фолликулы постепенно уменьшаются в размерах, в результате чего вместо терминальных волос на голове начинают расти пушковые, имеющие меньшую длину и диаметр стержня. Сокращается жизненный цикл волос. Со временем капилляры гиподермы подвергаются облитерации, волосяные сумки склерозируются и атрофируются. Рыхлая волокнистая ткань замещается жировой, происходит гиперплазия сальных желез. Рост волос прекращается, формируется субтотальная или тотальная андрогенетическая алопеция.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Отличия женской алопеции от мужской связаны с ферментом ароматазой. Ароматаза превращает андрогены в эстрогены: тестостерон в эстрадиол, ДГТ – в эстрон. Эта трансформация видоизменяет эффекты андрогенов и обусловливает развитие алопеции по женскому типу.</span></p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Кроме гормональных факторов, в патогенезе андрогенного облысения не исключается роль микровоспаления. В зоне выпадения волос обнаружены пропионовые бактерии, стафилококки, дрожжевые грибки малассезия, вызывающие воспалительную реакцию волосяных фолликулов и развитие перифолликулярного фиброза.</span></p>",
"diagnostics": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">В план диагностического обследования пациентов с андрогенной формой алопеции входит консультация дерматолога-трихолога, проведение инструментально-лабораторного комплекса исследований:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Фототрихограмма. Компьютерная видеодиагностика помогает выявить андрогенную алопецию еще на субклинической стадии, определить соотношение волос в разных фазах, вычислить скорость их роста. На дистрофию волосяных луковиц указывает уменьшение их размеров, деформация, гипопигментация.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Лабораторный комплекс. В крови определяют содержание лютеинизирующего и фолликулостимулирующего гормонов (у женщин), тестостерона (общего и свободного), ДГТ, пролактина, тиреоидных гормонов, в моче – 17-КС, . В биохимическом анализе исследуют сывороточное железо, ферритин, ОЖСС.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Биопсия. Забор кожного биоптата из очагов облысения позволяет проследить гистопатологические изменения: оценить плотность фолликулов на см2, выяснить количество различных типов волос, выявить участки перифолликулярного фиброза.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Прочие исследования. Для выявления эндокринных нарушений выполняется УЗИ яичников, щитовидной и паращитовидных желез, надпочечников. Женщинам требуется консультация гинеколога-эндокринолога.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>",
"treatment": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Лечение андрогенной алопеции у мужчин может проводиться разными методами (конкретный способ терапии определяет врач с учетом анамнеза пациента):</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Трансплантация волосяных фолликулов – радикальный, но эффективный способ решения проблемы облысения. Операция позволяет восстановить волосяной покров.</span></li>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Мезотерапия – введение специальных мезококтейлей, задача которых заключается в нормализации баланса андрогенов в крови, снижении их негативного воздействия на фолликулы.</span></li>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Физиотерапия – ионофорез, дарсонвализация, массажи. Цель этих методов – улучшить кровообращение в кожных покровах, тем самым, способствовать ускорению процесса роста новых волос.</span></li>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Медикаментозное лечение – прием препаратов, которые препятствуют процессу превращения тестостерона в дигидротестостерон.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Лечение андрогенной алопеции у женщин в основном заключается в назначении специальных лекарственных препаратов. Дело в том, что женщины реже подвержены генетической предрасположенности к облысению. Но не всегда после медикаментозной терапии удается вернуть былую густоту волос. Для возвращения волосам объема или при наличии проплешин/залысин врачи могут посоветовать такие способы для восстановления волос:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Пересадка волос – изъятие фолликулов из области затылка и вживление их в проблемные зоны.</span></li>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Физиотерапевтические методы – микротоковое лечение, криотерапия.</span></li>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Косметологические процедуры – озонотерапия, аутоплазмотерапия.</span></li>\r\n</ul>\r\n<p><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\"> </span></p>",
"prevention": "<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">корректный уход за волосами (использование профессиональных шампуней, отказ от использования фена, красок для волос);</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">сбалансированное питание;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">предотвращение развитие стрессов (при необходимости, естественно, и сеансы психотерапии);</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">профилактические приемы витаминных комплексов в осенне-весенний период.</span></li>\r\n</ul>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Основная профилактическая мера развития андрогенной алопеции – своевременное обращение к врачу-трихологу.</span></p>",
"clinical_picture": "<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Основной симптом андрогенной алопеции – прогрессирующее истончение и выпадение волос. Название патологии обусловлено особенностями облысения при данной патологии. </span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Мужской («андрогенный») тип облысения характеризуется потерей волос в теменной и лобной областях. Волосы выпадают постепенно (от лба к области затылка). Процесс протекает в течение нескольких лет. У мужчин андрогенная алопеция приводит к полному и бесповоротному облысению при отсутствии своевременного лечения. </span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">У женщин выпадение волос затрагивает только лобную и теменную области. В остальных зонах волосы сохраняют свою структуру и густоту.</span></p>",
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]
}
