Immunity to Hair Follicles in Alopecia Areata

Alopecia areata (AA) is an autoimmune skin disease caused by chronic inflammation of hair follicles. Chronic inflammatory skin diseases such as psoriasis and lupus erythematosus can increase the risk of cardiovascular diseases. However, the relationship between AA and heart diseases (HDs) remains unclear. Therefore, we conducted this retrospective cohort study to evaluate the risk of subsequent HDs in patients with AA. We reviewed 3770 cases of AA and from 18,850 age, sex, and income level-matched controls from the National Health Insurance Service-National Sample Cohort. In the subgroup analysis, patients who suffered from alopecia totalis, alopecia universalis, and ophiasis were designated as patients with severe AA and patients having the disease for over a year were designated as patients with long-standing AA. As a result, we found that AA was not associated with a higher risk of heart failure, angina pectoris, or myocardial infarction. There was no significant increase in the risk of overall HD associated with AA (adjusted hazard ratio: 1.17; 95% confidence interval: 0.93–1.48; p = 0.177). Neither the severity nor the duration of AA was related to an increased risk of HDs. During the study period, AA patients did not show a significantly higher cumulative incidence of HDs than controls (log-rank p = 0.157). In conclusion, AA does not increase the risk of HD.

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The Ultrastructure of the Dermal Papilla-Epithelial Junction in Normal and Alopecia Areata Hair Follicles

Annals of the New York Academy of Sciences ◽

10.1111/j.1749-6632.1991.tb24423.x ◽

2006 ◽

Vol 642 (1) ◽

pp. 476-477

Author(s):

M. NUTBROWN ◽

S. MACDONALD HULL ◽

M. J. THORNTON ◽

W. J. CUNLIFFE ◽

V. A. RANDALL

Keyword(s):

Alopecia Areata ◽

Dermal Papilla ◽

Hair Follicles ◽

Epithelial Junction

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Disorders of Hair

10.2310/fm.1107 ◽

2013 ◽

Author(s):

James Q Del Rosso

Keyword(s):

Hair Loss ◽

Alopecia Areata ◽

Hair Growth ◽

Growth Cycle ◽

Hair Follicles ◽

Common Type ◽

Diagnosis And Treatment ◽

Basic Knowledge ◽

Androgenetic Alopecia ◽

Broad Overview

A basic knowledge of the hair growth cycle is needed to evaluate disorders of hair growth. This chapter presents a broad overview of the physiology and evaluation of hair growth, as well as discussions of specific types of alopecia. The epidemiology, pathogenesis, diagnosis, and treatment of androgenetic alopecia, the most common type of nonscarring hair loss, are covered. Diffuse hair shedding is generalized hair loss over the entire scalp. Diagnosis and treatment of telogen effluvium, anagen arrest (anagen effluvium), and other causes of diffuse hair shedding are covered in detail. Alopecia areata, typically characterized by patchy hair loss; cicatricial alopecia, which results from permanent scarring of the hair follicles; and miscellaneous causes of hair loss are also discussed. Tables list the causes of diffuse and cicatricial alopecia, telogen effluvium, and miscellaneous chemicals and categories of drugs that can cause alopecia, as well as miscellaneous causes of hair loss. Included is an algorithm outlining the approach to diagnosing nonscarring alopecia, as well as a variety of clinical photographs. This review contains 9 highly rendered figures, 6 tables, and 42 references.

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Prevalence and Clinical Characteristics of Alopecia Areata at a Tertiary Care Center in Saudi Arabia

Dermatology Research and Practice ◽

10.1155/2020/7194270 ◽

2020 ◽

Vol 2020 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Aysha A. Alshahrani ◽

Rawan Al-Tuwaijri ◽

Zainah A. Abuoliat ◽

Mesnad Alyabsi ◽

Mohammed I. AlJasser ◽

...

Keyword(s):

Diabetes Mellitus ◽

Saudi Arabia ◽

Alopecia Areata ◽

Clinical Characteristics ◽

Disease Duration ◽

Tertiary Care ◽

Hair Follicles ◽

Atopic Diseases ◽

The Mean ◽

Saudi Patients

Introduction. Alopecia areata (AA) is a common autoimmune disorder of hair follicles characterized by patches on nonscarring hair loss. Reports of prevalence and clinical characteristic of AA in Saudi Arabia are limited. The aim of our study is to describe the prevalence and clinical characteristics of Saudi patients with AA. Materials and Methods. A retrospective cross-sectional study was conducted at King Abdulaziz Medical City in Riyadh, Saudi Arabia. All patients diagnosed with AA between January 2016 and December 2017 were included. Data included patient demographics, type of AA, disease duration, family history of AA, and comorbid autoimmune diseases. Results. A total of 216 patients with AA were included. The overall prevalence of AA was approximately 2.3%. The mean disease duration at the time of presentation was 2 months while the mean age of onset was 25.61 years. The most common type of AA in both adult and pediatric groups was the patchy type involving the scalp. Comorbid diseases were found in 32.41% of patients. Common associated conditions included hypothyroidism, diabetes mellitus, and atopic diseases. Conclusion. The overall prevalence of AA among a population of Saudi patients is 2.3%. AA prevalence is higher in pediatrics than adults. Common comorbid conditions include hypothyroidism, diabetes mellitus, and atopic diseases.

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Cytokines and Other Mediators in Alopecia Areata

Mediators of Inflammation ◽

10.1155/2010/928030 ◽

2010 ◽

Vol 2010 ◽

pp. 1-5 ◽

Cited By ~ 46

Author(s):

Stamatis Gregoriou ◽

Dafni Papafragkaki ◽

George Kontochristopoulos ◽

Eustathios Rallis ◽

Dimitrios Kalogeromitros ◽

...

Keyword(s):

Alopecia Areata ◽

Stress Hormones ◽

Disease Onset ◽

Hla Antigens ◽

Hair Follicles ◽

Strong Component ◽

Underlying Mechanisms ◽

As Stress ◽

Shed Light

Alopecia areata, a disease of the hair follicles with multifactorial etiology and a strong component of autoimmune origin, has been extensively studied as far as the role of several cytokines is concerned. So far, IFN-, interleukins, TNF-, are cytokines that are well known to play a major role in the pathogenesis of the disease, while several studies have shown that many more pathways exist. Among them, MIG, IP-10, BAFF, HLA antigens, MIG, as well as stress hormones are implicated in disease onset and activity. Within the scope of this paper, the authors attempt to shed light upon the complexity of alopecia areata underlying mechanisms and indicate pathways that may suggest future treatments.

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Transient Efficacy of Tofacitinib in Alopecia Areata Universalis

Case Reports in Dermatology ◽

10.1159/000445182 ◽

2016 ◽

Vol 8 (1) ◽

pp. 102-106 ◽

Cited By ~ 32

Author(s):

Florian Anzengruber ◽

Julia-Tatjana Maul ◽

Jivko Kamarachev ◽

Ralph M. Trüeb ◽

Lars E. French ◽

...

Keyword(s):

Treatment Option ◽

Alopecia Areata ◽

Kinase Inhibitors ◽

Autoimmune Disorder ◽

Immunosuppressive Drugs ◽

Hair Follicles ◽

Janus Kinase ◽

Individual Treatment ◽

Immune Therapies ◽

New Treatment

Alopecia areata is a common autoimmune disorder that targets hair follicles. Swarms of lymphocytes surround the basis of the follicles, inducing loss of pigmented terminal hair and subsequently inhibit further hair growth. Depending on the extent of involvement, alopecia areata can be associated with a dramatic reduction of quality of life. Currently, no targeted treatment option is available, and topical immune therapies or immunosuppressive drugs are typically used with mixed success. Recently, several cases of alopecia areata responding to Janus kinase inhibitors were published. Here, we report on a businessman with alopecia areata universalis who was treated with tofacitinib. We observed initial signs of hair regrowth in the same timeframe as previously reported, but efficacy quickly waned again, leading to renewed effluvium. Thus, even though tofacitinib and ruxolitinib are a promising new treatment option, we have yet to learn more about their potential role in each particular patient's individual treatment strategy.

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Hair Follicles from Alopecia Areata Patients Exhibit Alterations in Immune Privilege-Associated Gene Expression in Advance of Hair Loss

Journal of Investigative Dermatology ◽

10.1038/jid.2010.180 ◽

2010 ◽

Vol 130 (11) ◽

pp. 2677-2680 ◽

Cited By ~ 50

Author(s):

Hoon Kang ◽

Wen-Yu Wu ◽

Blanche K.K. Lo ◽

Mei Yu ◽

Gigi Leung ◽

...

Keyword(s):

Gene Expression ◽

Hair Loss ◽

Alopecia Areata ◽

Hair Follicles ◽

Immune Privilege

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Videocapillaroscopic Alterations in Alopecia Areata

BioMed Research International ◽

10.1155/2013/160203 ◽

2013 ◽

Vol 2013 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Agnieszka Gerkowicz ◽

Dorota Krasowska ◽

Aldona Pietrzak ◽

Anna Michalak-Stoma ◽

Joanna Bartosińska ◽

...

Keyword(s):

Alopecia Areata ◽

Hair Follicles ◽

Control Group ◽

Skin Microcirculation ◽

Nailfold Videocapillaroscopy ◽

Noninvasive Technique ◽

Efferent Limb ◽

Unknown Disturbances

Alopecia areata (AA) is a common hair disorder observed in dermatological practice; however, the exact mechanisms that lead to the hair loss are still unknown. Disturbances in the blood supply of hair follicles may be one of the elements in the complex pathogenesis of AA. Nailfold videocapillaroscopy is a noninvasive technique that allows analysis of skin microcirculation in vivo. The aim of the study was the videocapillaroscopic assessment of skin microcirculation in AA patients. The study included 44 patients with patchy alopecia areata, 27 with alopecia universalis or totalis, and 40 healthy volunteers. Nailfold videocapillaroscopy was performed in all participants according to a standard protocol. Obtained images were assessed qualitatively and quantitatively. Two types of videocapillaroscopic images were distinguished in the study. Abnormal videocapillaroscopic images were found in 42% of patients. Tortuous and branching capillaries (, ), decreased density of capillaries (), enlargement of the efferent limb (), or top part of the loop () were observed significantly more often than in the control group. Only some patients with AA presented with microvascular abnormalities characterised by altered videocapillaroscopic images. More studies, including larger group of patients with AA, are required to determine the role of observed videocapillaroscopic alterations in AA.

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