SLR - September 2010 - Rachel Johnson

Lack of Lower Extremity Hair Not a Predictor for Peripheral Artierial Disease

Reference: Brueske T.J., Macrino S., Miller J.J.(2009) Lack of lower extremity hair not a predictor for perpherial arterial disease. Archives of Dermatology, 145(12),1456-1457.

Scientific Literature Reviews

Reviewed by:  Rachel Johnson, RN, DPM
Residency Program: OCPM/University Hospitals-Richmond Hts. Hospital, Cleveland, OH

Podiatric Relevance:
When evaluating a patient for a diabetic foot exam or podiatric surgery, the physical exam plays an important role.  Vascular status of a patient is a necessity whether healing an ulcer or scheduling a surgical procedure. Podiatrists are taught many different visual inspection techniques for the feet, and hair growth is noted in a physical exam.  Most physicians are taught that lack of hair growth could be an indicator of PAD, along with many other assessments made by the physician.  This article indicates that hair growth should not be weighed as heavily as other indicators of PAD.

The study involved 50 subjects from the Hersey Medical Center.  Two control groups were formed with 25 subjects with a documented normal ABI (>0.9) and 25 subjects from the vascular clinic with either an ABI lower than normal 0.9 or abnormal arterial duplex findings. Patients with lower ABIs due to disease other than PAD were excluded. Lower extremity hair was counted on all patients in a specific defined area.  Photographs of the areas were taken on each patient with magnified digital photography.  Hair count analysis was performed and categorized in either present hair (1 or more) or  no hair present.  Statistical analysis was then performed.

Mean age of the  healthy control group was 65 years and the PAD group mean age was 75 years.  No statistical significance was found between disease presence and absence of lower extremity hair (p=0.09). Sixty-four percent of patients with PAD had absent leg hair growth and 40 % of patients without PAD had absent leg hair growth.

Although as a podiatric student we are taught during our physical exam to look for hair growth as one of the indicators for PAD, however, this study reveals that hair growth may be a weak and unreliable indicator. 

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