Alopecia areata is a presumably immune-mediated disease characterized by patch hair loss that can progress to total scalp hair loss, alopecia areata totalis, or total body hair loss, alopecia areata universalis.
The patch of alopecia is characterized by the presence of exclamation point hairs, stubby hairs broader at the top than the base, and by the absence of scarring.
There is an association of alopecia areata with autoimmune thyroiditis and related conditions, and with stress, although the role of stress is debated.
There can be an associated nail dystrophy.
- Intralesional triamcinolone diacetate, 0.2 ml of a 5 mg/ml solution per cm2 is often very effective.
- AA totalis responds well to topical diphencyprone, or squaric acid dibutytestes, as topical immune stimulants.
- Topical anthralin can also be effective.
- Because of the need for long term therapy, high dose prednisone is rarely indicated.
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