Alopecia Areata | Figure 3.51
A: Alopecia areata
B: Trichotillomania
(Courtesy of Dr. Paul Getz)
C: Telogen effluvium |
(Figure 3.51A) - Most common non-scarring alopecia; unknown etiology but likely T cell-mediated autoimmune condition in patients with genetic predisposition
- Presents with round to oval alopecic non-scarring patches on scalp, ‘exclamation mark’ hairs; different patterns include patchy (most common), reticular, diffuse with generalized thinning, alopecia totalis (loss of entire scalp hair), alopecia universalis (loss of scalp and body hair), ophiasis pattern (band-like hair loss at periphery of temporal/occipital scalp)
- May have nail involvement (pitting most common)
- Histology: lymphocytes surrounding lower portion of hair follicle resembling ‘swarm of bees’, ↑ miniature telogen and catagen follicles
- Treatment: topical/intralesional corticosteroid, other topicals (squaric acid, anthralin, minoxidil), excimer laser, systemic corticosteroid or cyclosporine
- Associations: thyroid disease, vitiligo, atopy, IBD, IDDM, polyendocrinopathy
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