Alopecia areata: a review on diagnosis, immunological etiopathogenesis and treatment options

Abstract

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.

Low Level Laser versus Platelet-rich Plasma in Treatment of Alopecia Areata: A Randomized Controlled Intra-patient Comparative Study

“…Different success rates were associated with several treatment options. Although the topical, intralesional and systemic corticosteroids, anthralin, minoxidil, cyclosporine, immunotherapy, phototherapy, antihistaminics, biologic treatment, and superficial cryotherapy for short duration [6], [7], [8], [14] have been applied, but the high cost, the long treatment period, the inconvenience of application, and its invasiveness have delayed the treatment effects as well as patient contentment. Hence, the treatment of AA is still very challenging and it has been a must to find out new effective therapies.…”

Deep Review on Alopecia Areata Diagnosis for Hair Loss-Related Autoimmune Disorder Problem

“…Alopecia areata is an inflammatory condition that causes non-scarring hair to fall in well-defined spots throughout the skull, eventually leading to baldness [6]. Lots of individuals worldwide are affected by the disease [7], particularly those with a hereditary background of alopecia areata [8]. It arises when the body's immunological structure begins to attack hair cells, disrupting their proper activity and limiting hair growth.…”

Diffuse Alopecia Areata and Its Trichoscopic Findings Following COVID-19 mRNA-1273 Vaccination: A Case Report

“…Alopecia Areata (AA) is an autoimmune non-scarring hair loss disease with complex pathogenesis of hair bulb inflammation and the loss of hair follicle immune privilege mediated through Major Histocompatibility Complex (MHC) presentation and interferon-γ (IFN-γ) expression [1][2][3][4]. Increased susceptibility to AA may be associated with genes related to the immune system, structural proteins, and antioxidant enzymes.…”