Alopecia Areata Nargess Tavakoli Guilan university of medical sciences

A nonscarring type of alopecia Many different patterns The true cause ?

A nonscarring type of alopecia

Many different patterns

The true cause ?

History Acute onset can affect any hair-bearing area scalp Sigle/multiple Itch?

Acute onset

can affect any hair-bearing area

scalp

Sigle/multiple

Itch?

Physical Exam Alopecia pattern in AA? Other findings?

Alopecia pattern in AA?

Other findings?

Pattern of alopecia Patchy Ophiasis sisaipho (ophiasis spelled backwards) diffuse

Patchy

Ophiasis

sisaipho (ophiasis spelled backwards)

diffuse

Ophiasis

Alopecia Totalis

AT

Alopecia universalis complete loss of hair on all hair-bearing areas Rare

complete loss of hair on all hair-bearing areas

Rare

Nail involvement Pitting Several other abnormalities have been reported

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

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

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?

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

Other autoimmune disease

Changes in Immune system

(cellular/homoral)

Experiments on mice

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

Familial? 4_27%

AD?

HLA

Atopia

Down’s synd.

Infection? CMV? Emotional stress?

Infection? CMV?

Emotional stress?

Diagnosis Clinicaly Biopsy? Thyroid tests?

Clinicaly

Biopsy?

Thyroid tests?

Chronic Regrowth(+/- therapy)  usually How much does it take? Recurrence may occur Prognosis

Chronic

Regrowth(+/- therapy)

 usually

How much does it take?

Recurrence may occur

White hair regrowth in alopecia areata.

Adverse prognosis factors onset at a young age severe forms + FH of AA nail dystrophy Ophiasis

onset at a young age

severe forms

+ FH of AA

nail dystrophy

Ophiasis

Treatment

Treatment No medication? Local steroids  atrophy Antralen Systemic steroids Irritant dermatitis False hair to cover?

No medication?

Local steroids  atrophy

Antralen

Systemic steroids

Irritant dermatitis

False hair to cover?