An Overview of Alopecia Areata: Etiopathogenesis, Diagnosis, and Management

Alopecia areata, a chronic inflammatory disorder leading to rapid hair loss, primarily affects the scalp and is characterized by various clinical forms such as patchy alopecia, alopecia totalis, alopecia universalis, and ophiasis. The etiopathogenesis involves genetic, immunological, endocrine, and psychological factors. The review, which considered the most recent and comprehensive studies from October 2003 to January 2023, concludes that CD8 cytotoxic T cells are key in the pathophysiology of the condition, with upregulated Janus kinase (JAK) signaling pathways. JAK inhibitors have emerged as a novel therapeutic approach to block these pathways. Diagnosis of alopecia areata is indicated by the absence of scales, erythema, or exclamation marks on otherwise healthy skin, with hair pull tests usually negative except near the periphery of early active lesions, which signal disease activity and progression.