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- $Unique_ID{BRK03442}
- $Pretitle{}
- $Title{Alopecia Areata}
- $Subject{Alopecia Areata Alopecia Celsi Alopecia Circumscripta Jonston's
- Alopecia Porrigo Decalvans Vitiligo Capitis Cazenave's Vitiligo Celsus'
- Vitiligo Alopecia Universalis (Alopecia Totalis) Alopecia Semiuniversalis
- Trichotillomania Hypotrichiasis (Alopecia Congenitalis, Alopecia Adnata,
- Congenital Baldness, Congenital Alopecia) Alopecia Medicamentosa Alopecia
- Mucinosa Alopecia Neurotica Postpartum Alopecia Premature Alopecia Alopecia
- Presenilis Alopecia Symptomatica Syphilitic Alopecia Alopecia Toxica (Toxic
- Alopecia) Alopecia Triangularis Congenitalis}
- $Volume{}
- $Log{}
-
- Copyright (C) 1987, 1988, 1989 National Organization for Rare Disorders,
- Inc.
-
- 443:
- Alopecia Areata
-
- ** IMPORTANT **
- It is possible the main title of the article (Alopecia Areata) is not the
- name you expected. Please check the SYNONYMS listing on the next page to
- find alternate names, disorder subdivisions, and related disorders covered by
- this article.
-
- Synonyms
-
- Alopecia Celsi
- Alopecia Circumscripta
- Jonston's Alopecia
- Porrigo Decalvans
- Vitiligo Capitis
- Cazenave's Vitiligo
- Celsus' Vitiligo
-
- DISORDER SUBDIVISIONS
- Alopecia Universalis (Alopecia Totalis)
- Alopecia Semiuniversalis
-
- Information on the following diseases can be found in the Related
- Disorders section of this report:
-
- Trichotillomania
- Hypotrichiasis (Alopecia Congenitalis, Alopecia Adnata, Congenital
- Baldness, Congenital Alopecia)
- Alopecia Medicamentosa
- Alopecia Mucinosa
- Alopecia Neurotica
- Postpartum Alopecia
- Premature Alopecia
- Alopecia Presenilis
- Alopecia Symptomatica
- Syphilitic Alopecia
- Alopecia Toxica (Toxic Alopecia)
- Alopecia Triangularis Congenitalis
-
- General Discussion
-
- ** REMINDER **
- The information contained in the Rare Disease Database is provided for
- educational purposes only. It should not be used for diagnostic or treatment
- purposes. If you wish to obtain more information about this disorder, please
- contact your personal physician and/or the agencies listed in the "Resources
- section of this report.
-
-
- Alopecia Areata is a progressive condition characterized by loss of hair.
- The cause is unknown, and unpredictable hair loss is the only noticeable
- symptom. Regrowth of hair may or may not occur. Some cases may be
- associated with endocrine abnormalities, infection of the scalp, or an
- autoimmune reaction. Hair loss is usually confined to the head and face,
- although the entire body may be involved.
-
- Symptoms
-
- Alopecia Areata often begins suddenly with oval or round bald patches
- appearing most commonly on the scalp. Other areas of hairy skin may also be
- involved. Gradually, the affected skin becomes white and smooth. New
- patches may spread by joining existing bald patches. These larger bald areas
- can appear while hair is regrowing in older hairless patches. Loss of hair
- can be permanent in some cases. Hair follicles may deteriorate, but oil
- producing glands in the skin (sebaceous glands) usually change very little.
- The skin does not become hard or atrophied. In a very few cases, all body
- hair may be lost. Cases beginning during childhood tend to be more severe
- than cases with an onset during adulthood.
-
- Causes
-
- The exact cause of Alopecia Areata is not known. An autoimmune mechanism is
- suspected in this disorder. Autoimmune disorders are caused when the body's
- natural defenses (antibodies) against invading organisms suddenly begin to
- attack healthy tissue. Some cases may be linked to abnormal reactions by
- blood cells (serum antibodies) to a thyroid protein (thyroglobulin), stomach
- (parietal) cells, or adrenal cells.
-
- Affected Population
-
- Alopecia Areata affects males and females in equal numbers. Cases may begin
- during childhood or adulthood. According to a 1983 study at the Mayo Clinic
- in Rochester, MN, approximately 2 million cases of this disorder were
- estimated in the United States at that time.
-
- Related Disorders
-
- Loss of hair (alopecia) can occur from a wide variety of causes. Symptoms of
- the following disorders can be similar to those of Alopecia Areata.
- Comparisons may be useful for a differential diagnosis:
-
- Trichotillomania, also known as hair pulling, is a neurotic habit that
- usually appears in children. It may remain undiagnosed for a long time. The
- hairs may be broken off or pulled out. Stubby regrowth may replace damaged
- hair or bald areas. This mental illness may be hard to distinguish from
- Alopecia Areata without careful observation of the affected child's habits.
- Hair can be similarly damaged by permanent wave solutions, softeners or hot
- combs. (For more information on this disorder, choose "trichotillomania" as
- your search term in the Rare Disease Database.)
-
- Hypotrichiasis (Hypotrichosis, Alopecia Congenitalis, Alopecia Adnata,
- Congenital Alopecia, Congenital Baldness) is a condition characterized by the
- absence of hair at birth. This disorder is usually inherited as a dominant
- trait, but can also be due to a recessive gene. It often occurs in
- association with other surface skin layer (ectodermal) defects.
-
- Alopecia Medicamentosa is characterized by widespread hair loss, most
- commonly of the scalp, caused by a reaction to various types of drugs in
- sensitive or allergic individuals. It may also be a result of chemotherapy
- used in treating various disorders (e.g., cancer).
-
- Alopecia Mucinosa, also known as Follicular Mucinosis, occurs in children
- and young adults. Hard, reddish, well defined plaques underlie the areas of
- hair loss. A fine scaling may develop on the face, scalp, trunk, arms or
- legs. A loss of sensation may occur as the plaques develop. The exact cause
- of this form of hair loss in not known, although a skin inflammation is
- suspected. Symptoms often spontaneously resolve after a few months in many
- cases.
-
- Alopecia Neurotica is characterized by hair loss caused by injury to the
- nerves in the area where balding occurs.
-
- Postpartum Alopecia is characterized by temporary loss of hair at the
- termination of a pregnancy. The cause is not known.
-
- Premature Alopecia is characterized by male pattern baldness occurring at
- an abnormally early age.
-
- Alopecia Presenilis is characterized by ordinary or common baldness
- occurring in early or middle life without any apparent disease of the scalp.
- This condition is very common in males, but rare in females.
-
- Alopecia Symptomatica is characterized by hair loss associated with other
- illnesses or conditions, most commonly following prolonged illnesses marked
- by high fever.
-
- Alopecia Toxica, also known as Toxic Alopecia, is characterized by hair
- loss thought to be caused only by fever.
-
- Alopecia Triangularis Congenitalis is a congenital defect consisting of a
- triangular patch of baldness on the front of the scalp.
-
- Therapies: Standard
-
- Treatment of Alopecia Areata is directed at producing regrowth of hair.
- Drugs such as systemic corticosteroids may cause the hair to grow, but long-
- term treatment may have undesirable side effects. Triamcinolone acetonide
- suspension may be beneficial but the effect is often temporary.
-
- For cosmetic reasons, wigs and hairpieces may be necessary, especially
- for affected women and children.
-
- Therapies: Investigational
-
- Treatment of Alopecia Areata involving a combination of 8-methoxypsoralen
- ointment and ultraviolet light exposure is being attempted experimentally,
- and may not be successful in all cases. More research is necessary to
- determine other treatment combinations to prolong beneficial effects in
- patients. Some researchers believe ultraviolet light may trigger a change in
- the immune system (immunomodulation) which might control hair loss in
- Alopecia Areata. Synthetic immunomodulator drugs such as Isoprinosine and
- diphencyprone are also under investigation as possible treatments for this
- disorder. A clinical trial involving low doses of the drug spironolactone,
- also used to treat excessive hair growth in females due to hormonal
- imbalances, is under way. A trial of the drug minoxidil indicated no benefit
- for severe Alopecia Areata patients. Other tests involve the drug
- dinitrochlorobenzene (in ointment form) as compared with squaric acid
- dibutylester. This is not recommended due to adverse side effects in some
- test participants. More extensive research is necessary before the
- therapeutic value of these drugs can be evaluated.
-
- Cyclosporine (Sandimmune) may be of potential benefit for treating a
- number of dermatologic diseases. These include Pemphigus and Bullous
- Pemphigoid, Posterior Uveitis and Behcet's Syndrome, collagen vascular
- disorders such as severe Dermatomyositis, Sjogren's Syndrome, and
- Scleroderma, Mycosis Fungoides, and Alopecia Areata. However, this drug may
- also be associated with severe and life-threatening side effects which would
- limit its use in many patients.
-
- Careful monitoring of this drug by a physician is necessary to guard
- against possible toxic side effects. Relapses can occur when the drug is
- discontinued. More research is needed before cyclosporine can be recommended
- as a treatment for all but the most severe cases of the disorders listed
- above. Even for the most severe cases its use is still experimental, and
- long-term effects are unknown.
-
- This disease entry is based upon medical information available through
- November 1988. Since NORD's resources are limited, it is not possible to
- keep every entry in the Rare Disease Database completely current and
- accurate. Please check with the agencies listed in the Resources section for
- the most current information about this disorder.
-
- Resources
-
- For more information on Alopecia Areata, please contact:
-
- National Organization for Rare Disorders (NORD)
- P.O. Box 8923
- New Fairfield, CT 06812-1783
- (203) 746-6518
-
- National Alopecia Areata Foundation
- P.O. Box 15076
- San Rafael, CA 94901-0760
- (415) 456-4644
-
- The National Arthritis and Musculoskeletal and
- Skin Diseases Information Clearinghouse
- Box AMS
- Bethesda, MD 20892
- (301) 495-4484
-
- References
-
- TOPICAL PHOTOCHEMOTHERAPY FOR ALOPECIA AREATA: A.J. Mitchell, et al.; J Am
- Acad Dermatol (April 1985, issue 12(4) ). Pp. 644-649.
-
- CLINICAL AND IMMUNOLOGIC RESPONSE TO ISOPRINOSINE IN ALOPECIA AREATA AND
- ALOPECIA UNIVERSALIS: ASSOCIATION WITH AUTOANTIBODIES: M. Lowy, et al.; J
- Am Acad Dermatol (January 1985, issue 12(1 Pt 1). Pp. 78-84.
-
- LOW-DOSE SPIROMOLACTONE IN THE TREATMENT OF FEMALE HIRSUTISM: Int J
- Fertil (Jan-Feb 1987, issue 32(1)). Pp. 41-45.
-
-