Risk Factor Pattern of Ischemic Heart Disease in Young Male Patients with Vertex Baldness

Acute coronary syndrome (ACS) is increasingly evident in all parts of the globe as well in our country. There are accumulating evidences regarding many physical markers, like vertex baldness to predict ACS. This cross sectional study was conducted in the Department of Cardiology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from October 2014 to September 2015. The main objective of the study was to assess the risk factors of premature coronary artery disease (CAD) of male patient of Acute Coronary Syndrome with or without vertex baldness. A total of 100 male patients with age between 25 to 55 years was included as study population. The study population was divided into two groups; each group consisted of 50 patients. Acute coronary syndrome in patients with vertex baldness mentioned as Group A and ACS in patients without vertex baldness mentioned as Group B. All risk factors were higher in group A than group B. But diabetes mellitus, metabolic syndrome and family history of ischemic heart disease (IHD) were significantly higher in group A than in group B (p=0.003, p=0.008, <0.001). Probably as first study in Bangladesh, it may label vertex baldness as a cutaneous marker of premature CAD.

Olmsted syndrome

Olmsted syndrome is a rare disorder characterized by symmetrical sharply marginated mutilating keratoderma of palms & soles & hyperkeratotic plaques around the body orifices, onychodystrophy, ainhum & amputation of digital phalanges, flextion deformities of the fingers, localized alopecia, leukokeratosis of the tongue, shortness of stature & laxity of large joints. Inheritance is autosomal dominant, although sporadic cases have been reported. Here we describe two cases of this rare disorder with thickened hyperkeratotic lesion over palm & soles & along with amputation of 3rd , 4th & 5th toes in one case. In one of our case (case no. 2) the immediate younger brother has got the same disease. Both of them were treated with tab. Neotegason 25 mg orally daily for 3 months & there was significant improvement after treatment.