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NBME 22 Answers

nbme22/Block 4/Question#42

A 31-year-old man comes to the physician because of ...

Dihydrotestosterone

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submitted by gh889(55),

answer is leading you to finasteride - 5alpha-reductase inhibitor for BPH and male patterned baldness - it blocks the conversion of testosterone into DHT





Androgenetic alopecia is a progressive, nonscarring alopecia that affects the regions of the scalp with the most androgen-sensitive hair follicles, resulting in a characteristic pattern of balding (bitemporal scalp in men and vertex and frontal scalp in women).

Follicular miniaturization: Androgen shortens the anagen phase of hair growth → vellus hair formation (thin, short hair)

  • Vellus hair does not cover the scalp adequately. As the anagen phase shortens further, the hair shaft does not grow long enough to reach the scalp.

TL;DR - DHT can lead to baldness