Alopecia Areata Possibly Induced by Autoimmune Reaction in a Patient with Human T-Cell Lymphotropic Virus-1-Associated Myelopathy

A 38-year-old female patient experienced alopecia areata totalis followed by human T-cell lymphotropic virus-1-associated myelopathy (HAM), both of which were linked to cell-mediated autoimmune reactions. Immunohistochemistry showed an accumulation of CXCR3+ CD8+ T cells around hair bulbs in alopecic lesions. Flow cytometric analysis revealed elevated CD8+ human leukocyte antigen DR+-activated T cells initially, which declined during hair regrowth with HAM. CD4+ CD25+ adult T-cell leukemia/lymphoma cells were higher during hair loss and decreased after hair improvement. These findings suggested that autoreactive and cytotoxic CD8+ T cells might induce both alopecia areata and HAM in ATL patients, indicating a significant role of autoimmune reactions in their pathogenesis.