Alopecia areata Flashcards
Define alopecia areata.
Alopecia areata (AA) is an autoimmune disease that causes inflammation of the hair follicles resulting in non-scarring hair loss, affecting scalp and body hair.
What is the aetiology of alopecia areata?
The aetiology of AA has not been determined. However, it is hypothesised to be an organ-specific autoimmune disease mediated by T-lymphocytes directed at hair follicles.
With respect to the genetics of AA, there seem to exist both susceptibility and severity genes.
What are risk factors for alopecia areata?
Autoimmune disease
Family history of autoimmune disease
Summarise the epidemiology of alopecia areata.
Relatively common
Worldwide lifetime incidence 2%
What are the signs and symptoms of alopecia areata?
Hair loss
Non-scarring alopecia
Exclamation mark hairs
Normal underlying skin in bare areas
What investigations should be performed for alopecia areata?
Clinical diagnosis
Positive hair pull test (more than 5 hairs pulled away from a group of 50 hairs)
What is the management for alopecia areata?
Topical corticosteroids (immunotherapy if severe)
Cosmetic camouflage
What are the complications of alopecia areata?
Topical minoxidil-induced skin irritation and hypertrichosis
Intralesional corticosteroid-induced adverse effects
Oral corticosteroid-induced adverse effects
Topical immunotherapy-induced sensitisation
Topical corticosteroid-induced adverse effects
Psychological distress
Topical immunotherapy-induced dyspigmentation
What is the prognosis of alopecia areata?
The natural history of alopecia areata (AA) is that of unpredictable episodes of relapsing and remitting disease. Within 2 years, 90% of the patients with limited scalp involvement will have spontaneous regrowth.
