Motofei Ion G, Rowland David L, Georgescu Simona R, Tampa Mircea, Paunica Stana, Constantin Vlad D, Balalau Cristian, Manea Mirela, Baleanu Bogdan C, Sinescu Ioanel
Department of Surgery/Dermatology, Carol Davila University, Bucharest, Romania.
Skin Pharmacol Physiol. 2017;30(1):42-45. doi: 10.1159/000455972. Epub 2017 Feb 22.
Finasteride has proved to be relatively safe and effective in the therapeutic management of male androgenic alopecia. However, literature data report several endocrine imbalances inducing various adverse effects, which often persist after treatment cessation in the form of post-finasteride syndrome. Here we present the case of a 52-year-old man receiving finasteride (1 mg/day) who developed an uncommon adverse effect represented by generalized vitiligo 2 months after finasteride discontinuation. Associated adverse effects encountered were represented by mild sexual dysfunction (as determined by the International Index of Erectile Function, IIEF) and moderate depressive symptoms (according to DSM-V criteria), all of these manifestations aggregating within/as a possible post-finasteride syndrome. Further studies should develop and compare several therapeutic approaches, taking into account not only compounds that decrease the circulating dihydrotestosterone level but also those that could block the dihydrotestosterone receptors (if possible, compounds with selective tropism towards the skin). In addition, the possibility of predicting adverse effects of finasteride (according to hand preference and sexual orientation) should be taken into account.
非那雄胺已被证明在男性雄激素性脱发的治疗管理中相对安全有效。然而，文献数据报道了几种导致各种不良反应的内分泌失调，这些不良反应在停药后常以非那雄胺后综合征的形式持续存在。在此，我们报告一例52岁男性患者，他接受非那雄胺（1毫克/天）治疗，在停药2个月后出现了一种罕见的不良反应，表现为全身性白癜风。同时出现的不良反应包括轻度性功能障碍（根据国际勃起功能指数，IIEF测定）和中度抑郁症状（根据DSM-V标准），所有这些表现均聚集在一起，作为一种可能的非那雄胺后综合征。未来的研究应开发并比较多种治疗方法，不仅要考虑降低循环二氢睾酮水平的化合物，还要考虑那些能够阻断二氢睾酮受体的化合物（如果可能，对皮肤具有选择性趋向性的化合物）。此外，应考虑根据用手偏好和性取向预测非那雄胺不良反应的可能性。
