Alopecia Areata: Overview and Insights from January 2018

December 2017 in “ Journal of The American Academy of Dermatology ”

Lauren C. Strazzulla, Eddy Hsi Chun Wang, Lorena Avila, Kristen Lo Sicco, Nooshin Brinster, Angela M. Christiano, Jerry Shapiro

Studysummary This article reviews the epidemiology, clinical evaluation, and pathogenesis of alopecia areata and highlights recent advancements, but it does not report new clinical findings. Our plain-language summary of this paper — not a Tressless recommendation.

The document from January 2018 provides an overview of Alopecia areata (AA), a common autoimmune hair loss condition affecting both sexes and all age groups, with a prevalence of 0.1% to 0.2%. It is characterized by immune-mediated destruction of hair follicles and inflammatory pathways upregulation. Trichoscopy can be used for diagnosis, showing specific features like exclamation point hairs. The severity of AA correlates with CD8+ T cell density, and genetic studies have implicated various immune-related genes. The C3H/HeJ mouse model has been instrumental in AA research. Factors such as atopy, other autoimmune conditions, stress, and diet may contribute to the risk of developing AA. A high soy oil diet may prevent AA by modulating inflammatory activity. The document also discusses the role of the JAK/STAT pathway in AA and suggests that stress hormones and diet can influence the condition's development.

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research Identification of Differentially Expressed miRNAs in Alopecia Areata That Target Immune-Regulatory Pathways

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Certain microRNAs may help treat alopecia areata by targeting immune pathways.

research SALT II: A New Take on the Severity of Alopecia Tool for Determining Percentage Scalp Hair Loss

44 citations , November 2016 in “Journal of The American Academy of Dermatology”

This article updates a diagnostic tool (SALT II) for assessing hair loss by adding more precise measurements of scalp surface area, particularly useful for various types of alopecia.

research Clinical and Trichoscopic Characteristics of Temporal Triangular Alopecia: A Multicenter Study

32 citations , August 2016 in “Journal of the American Academy of Dermatology”

This letter discusses congenital triangular alopecia (TTA), a non-scarring hair loss condition often seen in children, without reporting new clinical findings.

research CXCR3 Blockade Inhibits T Cell Migration Into the Skin and Prevents Development of Alopecia Areata

64 citations , July 2016 in “Journal of Immunology”

In this study, blocking the CXCR3 receptor in mice prevented the development of alopecia areata by inhibiting the accumulation of specific T cells in the skin, suggesting a potential therapeutic approach for humans.

research Cardiovascular Risk in Patients with Alopecia Areata: A Propensity-Matched Retrospective Analysis

29 citations , May 2016 in “Journal of the American Academy of Dermatology”

This study observed that patients with alopecia areata had decreased odds of developing stroke and a potential decreased risk of acute myocardial infarction, though the latter was not statistically significant.

research Alopecia Areata Is Driven by Cytotoxic T Lymphocytes and Is Reversed by JAK Inhibition

701 citations , August 2014 in “Nature medicine”

This study found that JAK inhibitors promote hair regrowth in both mice and human alopecia areata cases by blocking key immune pathways involved in disease development.

research A New Humanized Mouse Model For Alopecia Areata

25 citations , December 2013 in “Journal of Investigative Dermatology Symposium Proceedings”

In this study, researchers developed a new humanized mouse model for alopecia areata that highlights the role of specific immune cells and may aid in discovering new treatments for the disease.

research Development of Autoimmune Hair Loss Disease Alopecia Areata Is Associated with Cardiac Dysfunction in C3H/HeJ Mice

18 citations , April 2013 in “PLOS ONE”

This study found that in a mouse model, alopecia areata was associated with changes in heart structure, biochemistry, and gene expression linked to cardiac hypertrophy after ACTH exposure.

research British Association of Dermatologists’ Guidelines for the Management of Alopecia Areata 2012

218 citations , April 2012 in “British Journal of Dermatology”

This updated guideline from the British Association of Dermatologists discusses current recommendations for managing alopecia areata but reports no new clinical research findings.

research Abnormal Epigenetic Modifications in Peripheral Blood Mononuclear Cells from Patients with Alopecia Areata

48 citations , September 2011 in “British Journal of Dermatology”

This study found that DNA methylation and histone modification status were altered in peripheral blood mononuclear cells of patients with alopecia areata, suggesting these changes may contribute to the disease's pathological immune responses.

research The Genetics of Alopecia Areata: What's New and How Will It Help Our Patients?

43 citations , May 2011 in “Dermatologic therapy”

This study identified at least eight genetic regions associated with alopecia areata, which may lead to the development of new targeted therapies based on these findings.

research Histopathology of Alopecia Areata, Acute and Chronic: Why Is It Important to the Clinician?

43 citations , May 2011 in “Dermatologic Therapy”

This article discusses the phases and histological features of alopecia areata and reports no new clinical findings; the authors emphasize recognizing these phases for accurate diagnosis.

research Alopecia Areata: Clinical Presentation, Diagnosis, and Unusual Cases

109 citations , May 2011 in “Dermatologic Therapy”

This article reviews the characteristics, associations, and diagnostic criteria for alopecia areata and reports no new clinical findings; the authors note the disease's unpredictable course and variable prognosis.

research Trichohyalin Is a Potential Major Autoantigen in Human Alopecia Areata

66 citations , July 2010 in “Journal of Proteome Research”

This study suggests that an immune response to trichohyalin and keratin 16 may contribute to the pathogenesis of alopecia areata.

research Genome-Wide Association Study in Alopecia Areata Implicates Both Innate and Adaptive Immunity

717 citations , June 2010 in “Nature”

This study identified key genetic regions associated with alopecia areata, highlighting both acquired and innate immune involvement, with a novel link to the upregulation of ULBP ligands in autoimmune disease.

research Alopecia Areata Incognita: A Hypothesis

60 citations , October 2009 in “Dermatology”

This article proposes a hypothesis for alopecia areata hair loss patterns and provides epidemiological evidence supporting distinct hair loss characteristics between general cases and those with androgenetic alopecia; it presents no new clinical results.

research Acute Diffuse And Total Alopecia: A New Subtype Of Alopecia Areata With A Favorable Prognosis

64 citations , November 2008 in “Journal of The American Academy of Dermatology”

This study observed that acute diffuse and total alopecia, a subtype of alopecia areata, typically resolves rapidly and spontaneously within about six months, even without treatment, suggesting a favorable prognosis.

research The Role of Scalp Dermoscopy in the Diagnosis of Alopecia Areata Incognita

150 citations , April 2008 in “Journal of The American Academy of Dermatology”

This study found that videodermoscopy reveals distinct dermoscopic features in patients with alopecia areata incognita, aiding in biopsy decisions by identifying the appropriate sampling area and potentially avoiding unnecessary procedures.

research Maintenance of Hair Follicle Immune Privilege Is Linked to Prevention of NK Cell Attack

253 citations , December 2007 in “Journal of Investigative Dermatology”

This study suggests that human hair follicles may actively suppress natural killer cells, which contrasts with the observed defects in NK cell regulation in alopecia areata.

research Lymphocytes, Neuropeptides, And Genes Involved In Alopecia Areata

286 citations , August 2007 in “Journal of Clinical Investigation”

This review examines the interplay of genetics and neuroimmunology in alopecia areata, highlighting its potential to inform broader autoimmunity research, but reports no new findings.

research Genomewide Scan for Linkage Reveals Evidence of Several Susceptibility Loci for Alopecia Areata

143 citations , January 2007 in “The American Journal of Human Genetics”

This study identified four genetic loci on chromosomes 6, 10, 16, and 18 that may contribute to susceptibility for alopecia areata and suggested shared genetic factors with psoriasis.

research Videodermoscopy in the Evaluation of Hair and Scalp Disorders

304 citations , July 2006 in “Journal of The American Academy of Dermatology”

This study found that videodermoscopy enhances diagnostic accuracy for scalp and hair disorders beyond simple clinical inspection and reveals novel disease features that could improve clinical understanding.

research The Hair Cycle

375 citations , February 2006 in “Journal of Cell Science”

This article reviews the stages and regulation of the hair cycle, highlighting molecular regulators involved, but it does not present new research findings.

research Treatment of Alopecia Areata with Anti-Interferon-Gamma Antibodies

16 citations , November 2005 in “Journal of Investigative Dermatology Symposium Proceedings”

This study found that intramuscular anti-IFN-γ significantly stabilized and promoted hair regrowth in alopecia areata patients with patchy, progressive hair loss, whereas those with total baldness showed more limited improvement.

research Guidelines for the Management of Alopecia Areata

182 citations , October 2003 in “British Journal of Dermatology”

These guidelines for alopecia areata management, prepared by the British Association of Dermatologists, provide evidence-based treatment recommendations and insights into the condition's epidemiology, diagnosis, and investigation.

research Dietary Soy Oil Content and Soy-Derived Phytoestrogen Genistein Increase Resistance to Alopecia Areata Onset in C3H/HeJ Mice

61 citations , February 2003 in “Experimental Dermatology”

This study found that increasing dietary soy oil content reduced alopecia areata development in C3H/HeJ mice, though genistein injection showed no significant effect.

research The Pattern and Profile of Alopecia Areata in Singapore: A Study of 219 Asians

275 citations , November 2002 in “International Journal of Dermatology”

This study found that among an Asian population with alopecia areata, commonly first episodes occurred before age 40, with severe cases linked to psychological effects and treatments showing significant regrowth.

research Experimental Induction of Alopecia Areata-Like Hair Loss in C3H/HeJ Mice Using Full-Thickness Skin Grafts

131 citations , November 1998 in “The journal of investigative dermatology/Journal of investigative dermatology”

This study observed that alopecia areata can be induced and serially transferred in C3H/HeJ mice using skin grafts, providing a useful model for studying the disease in humans.

research Sisaipho: A New Form of Presentation of Alopecia Areata

15 citations , October 1996 in “Archives of Dermatology”

This review of alopecia areata cases at Virgen Macarena University Hospital identified a new hair regrowth pattern they term "androgenetic alopecia type" and described a unique inverse form called "sisaipho type" in three cases.

research Alopecia Areata in Aging C3H/HeJ Mice

178 citations , June 1994 in “Journal of Investigative Dermatology”

This study found that a non-scarring alopecia in C3H/HeJ mice resembles human alopecia areata and may serve as a valuable model for studying specific subtypes of the human condition.

research Profile of Alopecia Areata: A Questionnaire Analysis of Patients and Families

161 citations , March 1992 in “International Journal of Dermatology”

This study analyzed survey responses from 800 alopecia areata patients and found a possible genetic association with increased insulin-dependent diabetes mellitus in relatives but not in the patients themselves.

research Juvenile Versus Maturity-Onset Alopecia Areata: A Comparative Retrospective Clinical Study

164 citations , November 1989 in “Clinical and Experimental Dermatology”

This retrospective study found that juvenile alopecia areata is more severe and has a worse prognosis than maturity-onset alopecia areata.

research Structural Abnormalities of the Hair Shaft

126 citations , January 1987 in “Journal of The American Academy of Dermatology”

This article reviews the classification of hair shaft abnormalities, outlining their diagnostic features, but does not present new research findings.