Alopecia areata in a patient with SARS‐Cov ‐2 infection

Abstract

Dear Editor, SARS-Cov-2 infection has been associated with many dermatologic manifestations, both in symptomatic and asymptomatic patients. 1-3 A 54-year-old Caucasian woman was referred to us because of the rapid-onset of multiple patches of alopecia on her scalp. The patient had been diagnosed with SARS-Cov-2 infection 2 months earlier, thanks to nasal and throat swabs and chest computer tomography. She had been treated for 7 days with hydroxychloroquine therapy, 200 mg twice a day, started 7 days after the onset of mild respiratory symptoms. At the time of our visit the patient was in good health condition and was apyretic. She had recovered from SARS-COv-2 infection 2 weeks before, according to two consecutive negative tests obtained by nasal and throat swabs. Physical examination revealed three asymptomatic patches of alopecia on the right temporo-parietal area of her scalp (Figure 1). The surface of the patches was smooth, without signs of inflammation, and pull test resulted positive from the edges of the patches. Dermatoscopy showed the presence of black dots, yellow dots and vellus hair, allowing the diagnosis of alopecia areata (AA) (Figure 2).

Alopecia areata in a COVID‐19 patient: A case report

“…He referred no other underlying diseases and denied taking any drugs during the last year, except for the paracetamol used as a symp- Only few cases of AA in SARS-CoV-2-infected patients have been reported in the literature. 3 The interplay among genetic factors (ie, HLA-DR, CTLA4 and ULBP3) and environmental factors (ie, emotional/physical stress, hormones and infections) has been shown to play a key role in the AA etiology and progression. 4,5 Although the exact pathophysiology remains unknown, it seems to be related to an autoimmune reaction against the hair follicles.…”

Excessive hair loss as a complication after infection with SARS-CoV-2 virus

“…Cechą wspólną jest również rodzaj łysienia, który ma charakter telogenowy. Problem ten jest również szeroko opisywany w aktualnych międzynarodowych publikacjach naukowych, gdzie dotyczy zarówno łysienia telogenowego (TE -telogen effluvium), plackowatego (AA -alopecia areata) jak i androgenowego (alopecia androgenetica) [5][6][7][8][9][10][11][12][13][14].…”

“…W publikacjach naukowych pojawiają się również informacje na temat występowania łysienia plackowatego po przebiegu zakażania wirusem SARS-CoV-2 [13,14].…”

Prominent Cutaneous Manifestation of COVID-19: A Case Report

“…13 Alopecia areata is also already described. 14 Traditionally, it has been related to immune disorders and stress; the patient reported an intense emotional burden due to the pandemic, the isolation situation, and the discomfort caused by the skin rash. Interestingly, both types of alopecia have been diagnosed more frequently after the peaks of the pandemic compared to previous periods.…”

“…Interestingly, both types of alopecia have been diagnosed more frequently after the peaks of the pandemic compared to previous periods. 14,15…”