Telogen Hair Loss and Androgenetic-Like Alopecia in GAPO Syndrome

The case report describes a 2-year-old Pakistani boy with GAPO syndrome, a rare autosomal recessive condition characterized by growth retardation, alopecia, pseudoanodontia, and optic atrophy. The boy exhibited an androgenetic-like alopecia pattern, classified as Hamilton–Norwood type VII, despite having normal testosterone levels, and his hair loss was identified as occurring in the telogen phase of the hair cycle. These findings are novel for GAPO syndrome. The report suggests that while androgens are typically involved in androgenetic alopecia, other non-hormonal mechanisms may be contributing to the hair loss pattern seen in this patient with GAPO syndrome. The authors propose that excess extracellular matrix protein deposition in the skin or ischemia due to vascular anomalies could affect hair follicle development and cycling, leading to hair loss. Further studies are needed to understand the mechanisms of hair follicle development and hair loss in GAPO syndrome.