Nargess Tavakoli

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alopecia areata

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Nargess Tavakoli

  1. 1. Alopecia Areata Nargess Tavakoli Guilan university of medical sciences
  2. 2. <ul><li>A nonscarring type of alopecia </li></ul><ul><li>Many different patterns </li></ul><ul><li>The true cause ? </li></ul>
  3. 3. History <ul><li>Acute onset </li></ul><ul><li>can affect any hair-bearing area </li></ul><ul><li>scalp </li></ul><ul><li>Sigle/multiple </li></ul><ul><li>Itch? </li></ul>
  4. 4. Physical Exam <ul><li>Alopecia pattern in AA? </li></ul><ul><li>Other findings? </li></ul>
  5. 5. Pattern of alopecia <ul><li>Patchy </li></ul><ul><li>Ophiasis </li></ul><ul><li>sisaipho (ophiasis spelled backwards) </li></ul><ul><li>diffuse </li></ul>
  6. 9. Ophiasis
  7. 11. Alopecia Totalis
  8. 12. AT
  9. 13. Alopecia universalis <ul><li>complete loss of hair on all hair-bearing areas </li></ul><ul><li>Rare </li></ul>
  10. 20. Nail involvement <ul><li>Pitting </li></ul><ul><li>Several other abnormalities have been reported </li></ul>
  11. 23. Epidemiology <ul><li>Prevalence : 0.1-0.2% in the general population </li></ul><ul><li>Sex: F = M </li></ul><ul><li>Age: can occur at any age / more common before 40yo,esp. childhood & adolescence </li></ul>
  12. 24. physiopathology <ul><li>AA progresses as a wave of follicles which enter telogen prematurely </li></ul><ul><li>Autoimmune/T_cell mediated/genetic </li></ul>
  13. 25. Etiology <ul><li>The true cause: unknown </li></ul><ul><li>autoimmune? </li></ul><ul><li>Genetic? </li></ul><ul><li>Infection? </li></ul><ul><li>Emotional stress? </li></ul>
  14. 26. Evidence supports the autoimmune hypothesis <ul><li>Other autoimmune disease </li></ul><ul><li>Changes in Immune system </li></ul><ul><li>(cellular/homoral) </li></ul><ul><li>Experiments on mice </li></ul>
  15. 27. Genetic <ul><li>Familial? 4_27% </li></ul><ul><li>AD? </li></ul><ul><li>HLA </li></ul><ul><li>Atopia </li></ul><ul><li>Down’s synd. </li></ul>
  16. 28. <ul><li>Infection? CMV? </li></ul><ul><li>Emotional stress? </li></ul>
  17. 30. Diagnosis <ul><li>Clinicaly </li></ul><ul><li>Biopsy? </li></ul><ul><li>Thyroid tests? </li></ul>
  18. 31. <ul><li>Chronic </li></ul><ul><li>Regrowth(+/- therapy) </li></ul><ul><li> usually </li></ul><ul><li>How much does it take? </li></ul><ul><li>Recurrence may occur </li></ul>Prognosis
  19. 32. White hair regrowth in alopecia areata.
  20. 33. Adverse prognosis factors <ul><li>onset at a young age </li></ul><ul><li>severe forms </li></ul><ul><li>+ FH of AA </li></ul><ul><li>nail dystrophy </li></ul><ul><li>Ophiasis </li></ul>
  21. 34. Treatment
  22. 35. Treatment <ul><li>No medication? </li></ul><ul><li>Local steroids  atrophy </li></ul><ul><li>Antralen </li></ul><ul><li>Systemic steroids </li></ul><ul><li>Irritant dermatitis </li></ul><ul><li>False hair to cover? </li></ul>

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