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Alopecia Areata Title Ñ Alopecia Areata Definition Ñ Recurrent non-scarring hair loss that can affect any hair bearing area Aetiology Ñ Not known Ñ Probably autoimmune Pathogenesis Ñ Perifollicular lymphocytic infiltrate around anagen phase hair follicles Ñ Mostly T cells Clinical Features History IS Ñ Hair loss Past Illnesses Ñ Common in Down’s syndrome E&M Ñ Thyrotoxicosis Ñ Myxoedema HS Ñ Pernicious anaemia Examination IS Ñ Localised patches of hair loss with short stubby (exclamation mark) hairs at the edges of the lesions Ñ Loss of hair over the entire scalp: Alopecia totalis Ñ Loss of hair over the entire body: Alopecia universalis Ñ Pitting of the nails Ñ Roughening of the nails Investigations Tissue Diagnosis Skin Biopsy Ñ Seldom required Management Control Drugs Ñ Intralesional steroids Ñ Topical immunotherapy with diphencyprone Ñ Topical 5% minoxidil Ñ PUVA Lifestyle Adjustments Ñ Wig: Camouflage Prognosis Ñ Spontaneous remission may occur Ñ Reversal more likely in those under 30 years
Alopecia Areata
Title
Ñ Alopecia Areata
Definition
Ñ Recurrent non-scarring hair loss that can affect any hair bearing area
Aetiology
Ñ Not known
Ñ Probably autoimmune
Pathogenesis
Ñ Perifollicular lymphocytic infiltrate around anagen phase hair follicles
Ñ Mostly T cells
Clinical Features
History
IS
Ñ Hair loss
Past Illnesses
Ñ Common in Down’s syndrome
E&M
Ñ Thyrotoxicosis
Ñ Myxoedema
HS
Ñ Pernicious anaemia
Ñ Localised patches of hair loss with short stubby (exclamation mark) hairs at the edges of the lesions
Ñ Loss of hair over the entire scalp:
Alopecia totalis
Ñ Loss of hair over the entire body:
Alopecia universalis
Ñ Pitting of the nails
Ñ Roughening of the nails
Investigations
Tissue Diagnosis
Skin Biopsy
Ñ Seldom required
Management
Drugs
Ñ Intralesional steroids
Ñ Topical immunotherapy with diphencyprone
Ñ Topical 5% minoxidil
Ñ PUVA
Lifestyle Adjustments
Ñ Wig:
Camouflage
Prognosis
Ñ Spontaneous remission may occur
Ñ Reversal more likely in those under 30 years
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