Alopecia Areata: Clinical Presentation, Pathogenesis, and Treatment Options

    June 2018 in “ Journal of the American Academy of Dermatology ”
    Shari R. Lipner, Richard K. Scher
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    TLDR Alopecia areata causes varying hair loss and nail changes, and treatments include topical, systemic, and injectable therapies.
    The document discussed the clinical presentation, pathogenesis, and treatment options for alopecia areata (AA), highlighting the variability in its clinical manifestations, from small patches of hair loss to complete hair loss on the body and scalp. It emphasized the importance of trichoscopy and scalp biopsy in diagnosing AA and noted that nail changes, present in up to 66% of patients, could indicate more severe disease progression. The review also covered various treatment approaches, including topical, systemic, and injectable therapies, with a focus on the potential of Janus kinase inhibitors. The importance of a thorough nail examination in AA patients was stressed, as nail changes, though often subtle and asymptomatic, could significantly impact quality of life and suggest disease progression.
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      The user experienced hair loss despite using Fin and Min for 12 years and switched to Dutasteride, RU58841, and Keto scalp serum, but shedding and itch persist. They are considering increasing Dutasteride to 2.5mg and questioning the necessity of a scalp biopsy, with mixed opinions on its usefulness.

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      in Progress Pictures  86 upvotes 8 months ago
      A person with hair loss since COVID-19 is considering treatments like finasteride and minoxidil but is hesitant due to potential side effects. Suggestions include visiting a dermatologist, using a ketoconazole shampoo, and considering that post-COVID hair loss might be an autoimmune response.

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      in Chat  46 upvotes 1 year ago
      How diffuse unpatterned alopecia (DUPA) is not an invitation to self-diagnose oneself with aggressive AGA and that seeking a specialized dermatologist may help people experiencing hair loss. Treatment options discussed include topical clobetasol propionate, oral minoxidil, and discontinuing finasteride.

      community 2.5 years Minoxidil and HRT, CPA->Lupron +Minox 5%

      in Transgender  611 upvotes 1 week ago
      The user experienced significant hair regrowth after 2.5 years of using Minoxidil 5% and hormone replacement therapy (HRT) with Lupron, despite initial scalp irritation. Finasteride was ineffective for them.
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      in Research  692 upvotes 3 months ago
      Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.

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      in Chat  15 upvotes 7 months ago
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