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Clinical Reviews in Allergy & Immunology Dec 2021Alopecia areata (AA) is a common chronic tissue-specific autoimmune disease, resulting in hair loss, that affects up to 2% of the general population. The exact... (Review)
Review
Alopecia areata (AA) is a common chronic tissue-specific autoimmune disease, resulting in hair loss, that affects up to 2% of the general population. The exact pathobiology of AA has still remained elusive, while the common theory is the collapse of the immune privilege of the hair follicle caused by immunological mechanism. Multiple genetic and environment factors contribute to the pathogenesis of AA. There are several clinical treatments for AA, varying from one or multiple well-defined patches to more diffuse or total hair loss of the scalp (alopecia totalis) or hair loss of the entire body (alopecia universalis). The available treatments for AA, such as corticosteroids and other immunomodulators, minoxidil, and contact immunotherapy, are of limited efficacy with a high risk of adverse effects and high recurrence rates, especially for patients with severe AA. Recent insights into the pathogenesis of AA have led to the development of new treatment strategies, such as Janus kinase (JAK) inhibitors, biologics, and several small molecular agents. In addition, modern therapies for AA, including antihistamines, platelet-rich plasma (PRP) injection, and other novel therapies have been well explored. In this review, we discussed the recent advances in the pathogenesis, diagnosis, and treatment of AA.
Topics: Alopecia Areata; Humans
PubMed: 34403083
DOI: 10.1007/s12016-021-08883-0 -
Archivos Argentinos de Pediatria Dec 2017Alopecia areata (AA) is a dermatological disease characterized by non-scarring hair loss of the scalp and/or body, with an unpredictable and variable evolution in the... (Review)
Review
Alopecia areata (AA) is a dermatological disease characterized by non-scarring hair loss of the scalp and/or body, with an unpredictable and variable evolution in the patients in which, despite multidisciplinary efforts, its etiology is not entirely known, although some evidence suggests that environmental, immunological and genetic factors could be generating the disease. The aim of this review is to provide an updated panorama of the clinical characteristics, diagnosis and treatment of AA, to analyze the mechanisms that could participate in its etiology, as well as to review some of the most important genetic variants that could confer susceptibility to the development of this disease.
Topics: Adolescent; Alopecia Areata; Child; Child, Preschool; Female; Humans; Male; Prognosis
PubMed: 29087123
DOI: 10.5546/aap.2017.eng.e404 -
Current Pediatric Reviews 2021Alopecia areata (AA) is a non-scarring hair loss disorder of autoimmune etiology. (Review)
Review
BACKGROUND
Alopecia areata (AA) is a non-scarring hair loss disorder of autoimmune etiology.
OBJECTIVE
To familiarize physicians with the clinical presentation, diagnosis, evaluation, and management of pediatric alopecia areata.
METHODS
The search term "Alopecia areata" was entered into a Pubmed search. A narrow scope was applied to the categories of "epidemiology", "clinical diagnosis", "investigations", "comorbidities", and "treatment". Meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews were included. Only papers published in the English language were included. A descriptive, narrative synthesis was provided of the retrieved articles.
RESULTS
AA is an autoimmune disease of unknown etiology. It is the third most common dermatologic presentation in children with a lifetime risk of 1-2%. Diagnosing AA can be made on the basis of the history and clinical findings. Patients will often present with patchy, non-scarring hair loss, generally affecting the scalp. History may reveal a personal or family medical history of autoimmune or atopic disease or a recent stressful event. Tricoscopic examination will classically show "exclamation point hairs" and "yellow dots". Nonspecific nail changes may be present. Other clinical variants include alopecia totalis, alopecia universalis, ophiasis, sisaipho, and Canitis subita. There are multiple treatment options for AA, including conservative treatment, and topical, oral, and injectable medications.
CONCLUSION
AA is an autoimmune disease with a heterogeneous presentation and unpredictable clinical course. Although there is no cure for AA, there are many current treatment options available to help manage this disfiguring disease.
Topics: Alopecia Areata; Autoimmune Diseases; Child; Combined Modality Therapy; Humans
PubMed: 32351186
DOI: 10.2174/1573396316666200430084825 -
International Journal of Molecular... Jan 2022Alopecia areata is a representative inflammatory skin disease that is associated with various environmental stimuli. While psychological stress is believed to be a major... (Review)
Review
Alopecia areata is a representative inflammatory skin disease that is associated with various environmental stimuli. While psychological stress is believed to be a major pathogenetic trigger in alopecia areata, infants and newborns also suffer from the disease, suggesting the possible presence of other environmental factors. Daily lifestyle is well known to be involved in various inflammatory diseases and influences the severity of inflammatory skin diseases. However, only a limited number of studies have summarized these influences on alopecia areata. In this review article, we summarize lifestyle factor-related influences on the pathogenesis of alopecia areata and focus on environmental factors, such as smoking, alcohol consumption, sleep, obesity, fatty acids, and gluten consumption.
Topics: Alopecia Areata; Autoantigens; Humans; Life Style
PubMed: 35162962
DOI: 10.3390/ijms23031038 -
Clinical and Experimental Medicine May 2021Patients suffering from alopecia areata (AA) can lose hair in focal regions, the complete scalp, including eyelashes and eyebrows, or even the entire body. The exact... (Review)
Review
Patients suffering from alopecia areata (AA) can lose hair in focal regions, the complete scalp, including eyelashes and eyebrows, or even the entire body. The exact pathology is not yet known, but the most described theory is a collapse of the immune privilege system, which can be found in some specific regions of the body. Different treatment options, local and systemic, are available, but none of them have been proven to be effective in the long term as well for every treatment there should be considered for the possible side effects. In many cases, treated or non-treated, relapse often occurs. The prognosis is uncertain and is negatively influenced by the subtypes alopecia totalis and alopecia universalis and characteristics such as associated nail lesions, hair loss for more than 10 years and a positive familial history. The unpredictable course of the disease also makes it a mental struggle and AA patients are more often associated with depression and anxiety compared to the healthy population. Research into immunology and genetics, more particularly in the field of dendritic cells (DC), is recommended for AA as there is evidence of the possible role of DC in the treatment of other autoimmune diseases such as multiple Sclerosis and cancer. Promising therapies for the future treatment of AA are JAK-STAT inhibitors and PRP.
Topics: Adrenal Cortex Hormones; Alopecia Areata; Dendritic Cells; Humans; Immunotherapy; Janus Kinase Inhibitors; Minoxidil; PUVA Therapy; Platelet-Rich Plasma; Prognosis; STAT Transcription Factors
PubMed: 33386567
DOI: 10.1007/s10238-020-00673-w -
Alopecia areata: Disease characteristics, clinical evaluation, and new perspectives on pathogenesis.Journal of the American Academy of... Jan 2018Alopecia areata (AA) is a common, inflammatory, nonscarring type of hair loss. Significant variations in the clinical presentation of AA have been observed, ranging from... (Review)
Review
Alopecia areata (AA) is a common, inflammatory, nonscarring type of hair loss. Significant variations in the clinical presentation of AA have been observed, ranging from small, well-circumscribed patches of hair loss to a complete absence of body and scalp hair. Patients affected by AA encompass all age groups, sexes, and ethnicities, and may experience frustration with the unpredictable nature of their disease for which there is currently no definitive treatment. The cause of AA remains incompletely understood, though it is believed to result-at least in part-from a loss of immune privilege in the hair follicle, autoimmune-mediated hair follicle destruction, and the upregulation of inflammatory pathways. Patients with AA frequently experience marked impairment in psychological well-being, self-esteem, and may be more likely to suffer from psychiatric comorbidities. Part one of this two-part continuing medical education series describes the epidemiology, clinical evaluation, prognosis, and recent advancements in the understanding of the pathogenesis of AA.
Topics: Adult; Age Factors; Age of Onset; Alopecia Areata; CD4-Positive T-Lymphocytes; Education, Medical, Continuing; Female; Genetic Predisposition to Disease; Hair Follicle; Humans; Incidence; Male; Prognosis; Quality of Life; Severity of Illness Index; Sex Factors
PubMed: 29241771
DOI: 10.1016/j.jaad.2017.04.1141 -
The New England Journal of Medicine Apr 2012
Review
Topics: Alopecia Areata; Dermatitis, Contact; Hair; Hair Follicle; Humans; Immunosuppressive Agents; Immunotherapy; Injections, Intralesional
PubMed: 22512484
DOI: 10.1056/NEJMra1103442 -
Journal of Dermatological Science Dec 2023Alopecia areata (AA) is a common, acquired, and nonscarring type of hair loss that affects people of every generation and is intractable in severe and relapsing cases.... (Review)
Review
BACKGROUND
Alopecia areata (AA) is a common, acquired, and nonscarring type of hair loss that affects people of every generation and is intractable in severe and relapsing cases. Patients with AA, especially those with greater scalp involvement, have poor health-related quality-of-life scores.
PURPOSE
Following our previous review article in the April 2017 issue of the Journal of Dermatological Science, we aim to provide a pair of review articles on recent progress in multidisciplinary approaches to AA.
MAIN FINDINGS
We found more than 1800 publications on AA from July 2016 to December 2022.
CONCLUSIONS
In this review, we focused on the latest information on the epidemiology, comorbidities, and pathogenesis of AA.
Topics: Humans; Alopecia Areata; Alopecia; Comorbidity; Quality of Life; Recurrence
PubMed: 37833164
DOI: 10.1016/j.jdermsci.2023.09.008 -
Journal of Cosmetic Dermatology Jun 2022Alopecia Areata (AA) is an autoimmune dermatological disease that could be influenced by psychological factors as part of the pathophysiology of the illness. (Review)
Review
BACKGROUND
Alopecia Areata (AA) is an autoimmune dermatological disease that could be influenced by psychological factors as part of the pathophysiology of the illness.
AIMS
This review article aims to report on psychodermatological and psychopathological aspects involved in the etiopathogenesis and comorbidities of AA, as well as on the psychiatric and psychological management of affected patients.
METHODS
We conducted a literature search on PubMed and Google Scholar from January 1980 to May 2021 employing the search terms of alopecia areata, psychological factors, psychological impact, psychodermatology, and psychopathology. All lists of references from the identified articles were screened for further relevant studies. The search was limited to English and Spanish language articles and was supplemented with themed books and book chapters. No specific quality criteria were used for the studies selection.
RESULTS
Several authors have found a high comorbidity rate between AA and mental disorders, concluding that stress and psychological factors are involved in both the development and exacerbation of the illness. More evidences are needed in order to describe the associations between the immune response, stress, and the physiological factors observed in AA patients.
CONCLUSION
AA is a complex illness characterized by multifactorial etiology. An interaction between genetic, autoimmune, hormonal, neural, and psychological factors is supposed. Psychopathological aspects of illness need to be better described and considered in the clinical setting.
Topics: Alopecia Areata; Comorbidity; Humans; Mental Disorders
PubMed: 34449973
DOI: 10.1111/jocd.14416 -
Journal of Drugs in Dermatology : JDD Oct 2023Alopecia areata (AA), an autoimmune disorder of hair follicles, results in varying degrees of scalp, facial, and body hair loss. In addition, it is associated with... (Review)
Review
Alopecia areata (AA), an autoimmune disorder of hair follicles, results in varying degrees of scalp, facial, and body hair loss. In addition, it is associated with profound psychosocial and quality-of-life impairments, which can lead to anxiety and depression. The clinical course is unpredictable, with spontaneous remissions and relapses. There is no cure, and current treatments are limited by their efficacy, safety, and high relapse rates after discontinuation. This article reviews clinician and patient perspectives on AA, based on clinician and physician surveys, and discusses the unmet needs and gaps in care. J Drugs Dermatol. 2023;22(10 Suppl):s5-10.
Topics: Humans; Alopecia Areata; Alopecia; Hair Follicle; Autoimmune Diseases; Scalp; Recurrence
PubMed: 37801523
DOI: 10.36849/JDD.SF396143