There is considerable evidence to suggest that autoimmunity plays a role in the pathogenesis of alopecia areata. Since it is known that T cells regulate the immune system, a study was undertaken to measure T helper (OKT-4) and T suppressor (OKT-8) cells in the peripheral blood of patients with alopecia areata (both active and stable) and in controls. Total T cells, B cells, immunoglobulins, and autoantibodies were also measured. There was a highly significant decrease in the T-suppressor cell population of patients with alopecia areata (P less than 0.001). Two of ten patients had microsomal antibodies and three of ten had elevated IgE levels. Other parameters were not significantly different. The decrease in suppressor cells suggest an impairment of the prime negative regulator of the immune system, with loss of tolerance and resultant autoimmunity.

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We performed myopic keratomileusis on ten patients. Six consecutive patients were treated with our standard postoperative regimen of topical antibiotics and pressure patching. In an attempt to promote a more rapid visual recovery, four consecutive patients were treated with a modified postoperative regimen that consisted of a therapeutic contact lens and intensive topical steroid therapy immediately postoperatively. This regimen did not significantly improve visual recovery or lenticular clarity compared to our standard postoperative treatment. The potential complications associated with contact lenses and topical steroids may not justify their use under these circumstances.