Alopecia Areata

  • Pooya Khan Mohammad Beigi


Alopecia areata (AA) is a type of non-scarring, patterned alopecia that presents in sharply defined circular areas. AA is an autoimmune disease involving T cells, which results in the immune system mistakenly targeting the body’s own hair follicles, resulting in hair loss [1]. AA is characterized by sudden non-scarring hair loss in the form of round or oval patches with spontaneous remissions and exacerbations [2]. The patches are well circumscribed, and they may have a mild peachy hue, occasionally with “exclamation point” hairs around their margin. “Exclamation point” hairs are broken short hairs with a broader distal segment as compared to the proximal end. The involved skin is usually smooth and almost always totally devoid of hair [3].


Autoimmune disease T cells Round patches Oval patches Genetic factors CD-8-driven Th1-type autoimmune reaction Alopecia totalis Alopecia universalis Pigmented hairs Nail changes Nail dystrophy Inner hair sheath Outer hair sheath Dermal papilla Hair bulb Hair bulge Sebaceous gland Arrector pili muscle Stem cells Melanocytic Epithelial Sebaceous glands Interfollicular epithelium Cuticle Cortex Medulla Hair shaft Genetic basis Histocompatibility complex Cytokine Immunoglobulin genes Polygenic disorder Inflammation-induced hair loss Alopecia totalis Alopecia universalis Patchy hair loss Black dots Lack of infection Chronic discoid lupus erythematosus Lichen planopilaris Syphilis Traction alopecia Metastasis to the scalp Mycosis fungoides Alopecia mucinosa Scalp biopsy Telogen effluvium Mild erythema Burning or pruritus Vellus hairs Sisaipho patterns Frontal scalp Temporal scalp Parietal scalp Ophiasis pattern of hair loss Nail involvement Pitting Trachyonychia Onychorrhexis Onycholysis Onychomadesis Atopic dermatitis Psoriasis Vitiligo Lupus erythematosus Thyroid disease Allergic rhinitis Edema Cellular necrosis Pigment incontinence Microvesiculation Tinea capitis Dermatophyte fungi Mild scaliness Inflammatory pustular plaques M. audouinii M. canis T. tonsurans T. violaceum M. audouinii M. canis M. audouinii tonsurans T. violaceum Dihydrotestosterone (DHT) Pull test Congenital triangular alopecia (CTA) Pilosebaceous Cicatricial alopecia Sebaceous glands Inflammatory infiltrate Trichotillomania First-line therapy Intralesional corticosteroids Topical immunotherapy Triamcinolone Doses Side effects Second-line therapies Systemic glucocorticoids Relapse Side effects Refractory cases Children Topical minoxidil Topical immunotherapy 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Pooya Khan Mohammad Beigi
    • 1
    • 2
    • 3
  1. 1.Department of Health ManagementNew York Medical CollegeValhallaUSA
  2. 2.University of British ColumbiaVancouverCanada
  3. 3.Misdiagnosis AssociationSeattleUSA

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