alopecia areata

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Introduction

A sudden loss of hair.

Etiology

Epidemiology

  • generally occurs in young, otherwise health persons
    • generally presents befor 30 years of age

Pathology

Clinical manifestations

  • often abrupt onset
  • painless loss of hair in patches
  • complete loss of hair
  • no visible effect on skin (non-scarring)
  • easily extracted hairs at the periphery
    • hairs may narrow close to skin at periphery
  • nail pitting may be present
  • ophiasis is a loss of hair in the shape of a wave at the circumference of the head

* images[9][10][11]

Complications

Differential diagnosis

Management

Clinical trials

Comparative biology

More general terms

References

  1. DeGowin & DeGowin's Diagnostic Examination, 6th edition, RL DeGowin (ed), McGraw Hill, NY 1994, pg 862
  2. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 916-18
  3. 3.0 3.1 3.2 Medical Knowledge Self Assessment Program (MKSAP) 15, 16, 17, 18, 19. American College of Physicians, Philadelphia 2009, 2012, 2015, 2018. 2022.
  4. Messenger AG et al British Association of Dermatologists' guidelines for the management of alopecia areata 2012. Br J Dermatol 2012 May;166(5):916-26 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22524397 (corresponding NGC guideline withdrawn Dec 2017)
  5. Wikipedia: Ophiasis http://en.wikipedia.org/wiki/Ophiasis
  6. Alkhalifah A, Alsantali A, Wang E, McElwee KJ, Shapiro J. Alopecia areata update: part I. Clinical picture, histopathology, and pathogenesis. J Am Acad Dermatol. 2010 Feb;62(2):177-88 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20115945
  7. 7.0 7.1 7.2 Xing L et al. Alopecia areata is driven by cytotoxic T lymphocytes and is reversed by JAK inhibition. Nat Med 2014 Sep; 20:1043. PMID: https://www.ncbi.nlm.nih.gov/pubmed/25129481
  8. 8.0 8.1 Callen JP Methotrexate for Alopecia Areata NEJM Journal Watch. Feb 11, 2015 Massachusetts Medical Society (subscription needed) http://www.jwatch.org
    Hammerschmidt M and Mulinari Brenner F. Efficacy and safety of methotrexate in alopecia areata. An Bras Dermatol 2014 Sep/Oct; 89:729. PMID: https://www.ncbi.nlm.nih.gov/pubmed/25184911
  9. 9.0 9.1 Alopecia areata (image) American Academy of Dermatology https://www.aad.org/public/diseases/hair-and-scalp-problems/alopecia-areata
  10. 10.0 10.1 Bolduc C, Elston DM (images) Medscape: Alopecia Areata http://emedicine.medscape.com/article/1069931-overview
  11. 11.0 11.1 DermNet NZ. Alopecia areata (images) http://www.dermnetnz.org/hair-nails-sweat/alopecia-areata.html
  12. Gilhar A, Etzioni A, Paus R Alopecia Areata N Engl J Med 2012; 366:1515-1525. April 19, 2012 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22512484 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMra1103442
  13. King B et al. Two phase 3 trials of baricitinib for alopecia areata. N Engl J Med 2022 Mar 26; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/35334197 https://www.nejm.org/doi/10.1056/NEJMoa2110343
  14. 14.0 14.1 King B et al. Two phase 3 trials of baricitinib for alopecia areata. N Engl J Med 2022 Mar 26; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/35334197 https://www.nejm.org/doi/10.1056/NEJMoa2110343
    Frellick M FDA OKs First Systemic Treatment for Alopecia Areata, Medscape. June 13, 2022 https://www.medscape.com/viewarticle/975487
  15. Strazzulla LC, Wang EH, Avila L, et al. Alopecia areata: disease characteristics, clinical evaluation, and new perspectives on pathogenesis. J Am Acad Dermatol. 2018;78:1-12. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29241771
  16. 16.0 16.1 Mateos-Haro M, Novoa-Candia M, Sanchez Vanegas G et al Treatments for alopecia areata: a network meta-analysis. Cochrane Database Syst Rev. 2023 Oct 23;10(10):CD013719. PMID: https://www.ncbi.nlm.nih.gov/pubmed/37870096 Review.
  17. Alopecia Areata https://www.niams.nih.gov/health-topics/alopecia-areata
    National Alopecia Areata Foundation http://www.naaf.org
  18. National Alopecia Areata Foundation http://www.naaf.org/site/PageServer

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