Alopecia Areata: A Comprehensive Review of Pathogenesis and Management

    Ralph M. Trüeb, Maria Fernanda Reis Gavazzoni Dias
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    TLDR New treatments for Alopecia Areata show promise but need to be more effective and affordable.
    The document from 2017 reviews the pathogenesis and management of Alopecia Areata (AA), an autoimmune condition leading to hair loss. It explains that AA has a genetic basis and is associated with other autoimmune conditions. Genome-wide association studies have implicated an IFN-y-driven immune response in AA's pathogenesis. Treatments such as corticosteroids and topical immunotherapy are the mainstay, but their effectiveness is limited, and novel therapies are being explored. A study involving 45 patients showed that Platelet-Rich Plasma (PRP) treatment was effective in promoting hair regrowth in AA patients. Another retrospective study of 90 patients treated with the JAK inhibitor tofacitinib showed promising results, with 77% of potential responders achieving a clinical response. However, the document notes the need for treatments to have better remission rates than spontaneous remission, proven efficacy, and a good safety profile, while also acknowledging the high cost and off-label use as barriers to the widespread adoption of new treatments like JAK inhibitors.
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