[Usefulness and limitations of the evaluation of sex-hormone-binding globulin in women with a female pattern of androgen-induced baldness].

Sex-hormone binding globulin (SHBG) and androgen serum levels have been evaluated in a homogeneous group of women with female pattern of androgenetic alopecia (AA), stage II, without any clinical or anamnestic evidence of acne, hirsutism, irregular menses. Results did not show any significant difference between patients and controls. Since SHBG levels are androgen-dependent, the discordant results of previous published series regarding women with AA could be related to the presence of a variable number of patients with clinical and/or anamnestic evidence of a "cryptic" hyperandrogenism in some series, and to their absence in others. Statistically significant low average SHBG values could have been sustained by a mild, heterogeneous and not significant androgen excess. In our opinion the genetically-determined response of the target organ to androgens seems to play the major pathogenetic role in AA, at least when the woman does not reveal any clinical or anamnestic evidence of cryptic or clear hyperandrogenism.