Alopecia Areata

Nargess Tavakoli

Guilan university of medical sciences

• A nonscarring type of alopecia

• Many different patterns

• The true cause ?

HistoryAcute onset

can affect any hair-bearing area

scalp

Sigle/multiple

Itch?

Physical Exam

• Alopecia pattern in AA?

• Other findings?

Pattern of alopecia

• Patchy• Ophiasis• sisaipho (ophiasis spelled

backwards) • diffuse

Ophiasis

Alopecia Totalis

AT

Alopecia universalis

complete loss of hair on all hair-bearing areas

Rare

Nail involvement

• Pitting

• Several other abnormalities have been reported

Epidemiology• Prevalence: 0.1-0.2% in the

general population• Sex: F = M• Age: can occur at any age / more

common before 40yo,esp. childhood & adolescence

physiopathology

• AA progresses as a wave of follicles which enter telogen prematurely

• Autoimmune/T_cell mediated/genetic

Etiology

• The true cause: unknown

• autoimmune?• Genetic?• Infection?• Emotional stress?

Evidence supports the autoimmune hypothesis

• Other autoimmune disease

• Changes in Immune system

(cellular/homoral) • Experiments on mice

Genetic

• Familial? 4_27%• AD?• HLA• Atopia• Down’s synd.

•Infection? CMV?

•Emotional stress?

Diagnosis•Clinicaly•Biopsy?•Thyroid tests?

ChronicRegrowth(+/- therapy) usuallyHow much does it take?

Recurrence may occur

Prognosis

White hair regrowth in alopecia areata.

Adverse prognosis factors

onset at a young age severe forms + FH of AAnail dystrophy Ophiasis

Treatment

Treatment

• No medication?• Local steroidsatrophy• Antralen• Systemic steroids• Irritant dermatitis• False hair to cover?