Anatomical Colocalization of Vitiligo and Alopecia Areata~!2010-01-18~!2010-05-21~!2010-07-14~!

Abstract

Alopecia areata (AA) and vitiligo are two common disorders in general population and coincidence of these two diseases is thus to be expected. However, anatomical coexistence of both conditions had rarely been reported. Many different etiological hypotheses have been suggested for both diseases. While alopecia areata is considered a T-cell mediated autoimmune disease, in the pathogenesis of vitiligo, both T cells and autoantibodies may play a role. Here we report a case which supports the hypothesis that vitiligo-induced autoimmunity could trigger AA and bulb melanocytes could act as a possible target in AA.We report the case of a 53-year-old woman which was referred to Dermatology Department for treatment of AA. Twenty years previously, she had developed areas of vitiligo on the face and arms which remained stable for years. She presented with a 1-year history of alopecia on the scalp, with a loss of skin and hair color in the same location during this period. In our case, the chronological appearance, association and co-localization of vitiligo and AA could emphasize the hypothesis that melanocytes-derived antigens released during vitiligo pathogenesis could act as auto-antigens, inducing hair loss.

Adults with a more extensive body involvement, moderate to extremely severe vitiligo and a prolonged clinical course have an early onset in childhood in addition to other prognostic factors as compared to individuals with later‐onset vitiligo

“…Another study also considered onset of vitiligo before the age of 3 years and presence of trichrome vitiligo, confetti‐like lesions and Koebner’s phenomenon as signs of extensive body involvement, progressive disease course and a poor therapeutic outcome/prognosis compared to vitiligo with late onset (3–18 years of age) 13 . The overall distribution of clinical forms of vitiligo in our study corroborates their reported prevalence and variability of distribution frequencies 12,16,17,19 . Although we could not find comparative data, this study shows patients with early onset before 10 years of age are likely to have more severe disease in terms of significantly greater percentage of BSA involvement and a progressive clinical course.…”

Colocalization of vitiligo and alopecia areata presenting as poliosis

“…While concomitant occurrence of vitiligo and alopecia areata in the same patient has been well‐described, only a small number of cases of the occurrence of both disease processes at the same site have been reported. Searches for ‘vitiligo, poliosis and alopecia’ using http://pubmed.gov and http://google.com search engines yielded 10 cases of colocalization published as of April 7, 2014 (Table ) . Patients of both sexes, of various ethnicities and of various age groups were represented.…”

Diphenylcyclopropenone-Induced Vitiligo in a Patient with Alopecia Universalis

“…Studies reporting anatomical colocalization of alopecia areata and vitiligo are displayed in table 1 [5, 6, 7, 8, 9, 10, 11, 12]. The female-to-male ratio was 3:1.…”

“…Colocalization of alopecia areata and vitiligo at the same anatomical site is a more complicated story and has been reported on in many studies. Many hypotheses have been suggested; however, it is actually a rare phenomenon [4, 5, 6, 7, 8, 9, 10, 11, 12]. …”