Hypertrichosis Lanuginosa Associated With Diazoxide Therapy in Prepubertal Children: A Clinicopathologic Study*

Abstract

In 1963, Okun and coworkers' reviewed their 30 cases in which diazoxide had been used as an antihypertensive agent, and noted that hypertrichosis had occurred in six female patients. Hyperglycemia had occurred in 15 of the 30 patients and in 5 of the 6 patients who demonstrated "hirsutism". The hypertrichosis** appeared to be drug-dependent, and disappeared several weeks after the drug was discontinued.' The overall incidence of hypertrichosis during the field trials of diazoxide as an antihypertensive drug appeared to be one percent.2 However, when diazoxide came into increasing use for the treatment of hypoglycemic states, hypertrichosis was again noted as a prominent and more frequent side effecP5 (FIGURES 1 and 2).Since July of 1965, eight children with idiopathic hypoglycemia of infancy have been treated with diazoxide at The Children's Hospital of Philadelphia. Hypertrichosis occurred in all cases. Some preliminary attempts were made to investigate this action of diazoxide in the hope that it would provide basic information concerning the physiology of hair growth as well as some insight into the mechanism of action of this drug. Physiologic ReviewIt is difficult to discuss, even in outline form, the physiology of so complex an organ as the pilary system without oversimplifying and entering into controversial areas. However, the following broad generalizations are usually accepted : The pilary complex is an epidermal appendage. It is a holocrine gland, the hair being the secretory product. The size and shape of the hairs are determined by the size and shape of the root sheaths. The length of each hair is determined by the duration and velocity of its growth. The organ has an inherent rhythmicity, cycling from resting (telogen) through growth (anagen) and then back to telogen through involution (catagen) (FIGURE 3 ) . Hair grows in length only during anagen; therefore, factors that promote and extend this phase also promote an increase in length.Hair follicles have been shown to have a high degree of autonomous rhythmicity in animals and in man. Hair transplant experiments have shown that the transplanted hair will grow in accordance with the cycle and pattern of the donor animaL7 Another characteristic is the way in which hair cycles are propagated. In certain rodents, hair cycles occur with great regularity and are propagated in a

Evidence that Diazoxide Promotes Calcium Influx in Mouse Keratinocyte Cultures by Membrane Hyperpolarization

“…A number o f potassium channel openers (PCOs), including diazoxide, minoxidil and pinacidil, have been shown to stimulate hair growth in man and monkeys [1][2][3][4], We have recently shown that these structurally unre lated P C O s stimulate the proliferation of mouse epidermal kératinocytes in primary culture [5], extending previous findings of minoxidil effects on mouse [6] and human [7] kératinocytes. In addition, a number o f P C O s, including diazoxide, have been shown to stimulate proliferation o f mouse hair follicle cultures [ In the present study we have used the cal cium indicator dye fura-2 to show that diazoxide induces both a transient and a sustained increase in Caj, as a result of increased calcium influx.…”

Novel and Established Potassium Channel Openers Stimulate Hair Growth In Vitro: Implications for their Modes of Action in Hair Follicles

“…The stronger response to minoxidil than diazoxide by deer follicles also reflects human hair growth in vivo, since hypertrichosis in adults treated with oral minoxidil is much more frequent than with oral diazoxide (Koblenzer and Baker, 1968;Burton and Marshall, 1979;Zins, 1988). Topical minoxidil also appears to be slightly more effective than diazoxide (Olsen et al, 1985;Olsen and Weiner, 1987;Roenigk, 1988).…”

“…Minoxidil, diazoxide, and pinacidil are all drugs that stimulate human hair growth, although none were designed to do so (Koblenzer and Baker, 1968;Burton et al, 1975;Burton and Marshall, 1979;Goldberg, 1988;Price et al, 1999). Minoxidil, currently the main topical treatment for hair loss (Olsen et al, 2002;Dawber and Rundegren, 2003), was originally developed as an anti-hypertension therapy.…”

Medical treatments for male and female pattern hair loss

“…Diazoxide is another antihypertensive potassium channel opener which increases blood flow and is reputed to increase hair growth. 14,15 Laser Doppler velocimetry studies showed an increase in cutaneous blood flow after applying 1%, 3%, and 5% minoxidil solutions to the scalps of 16 balding men. 16 All three groups showed increases compared to a control group, and the 5% group showed the greatest increase.…”