Alopecia Areata and Acitretin: A Case Report and Review

In a case report from 2017, a 64-year-old female developed rapid alopecia affecting various parts of her body after starting acitretin therapy for psoriasis vulgaris. The diagnosis of alopecia areata (AA) was favored based on clinical and histopathologic features. Discontinuation of acitretin and treatment with intralesional corticosteroids led to some hair regrowth, suggesting a potential link between systemic retinoids and the pathophysiology of AA. Additionally, a study involving 30 alopecia areata patients found a significantly higher prevalence of vitamin D deficiency compared to controls, indicating a possible association between vitamin D levels and AA severity, although the correlation was not statistically significant. Further research with larger sample sizes was recommended. Another study with 137 AA patients identified patchy, occipital hair loss, female gender, and young age at diagnosis as factors predicting a poor prognosis for AA, while family history of AA, atopy, autoimmune diseases, psychiatric disorders, smoking, and alcohol consumption had less or no impact on the disease's clinical course.