Overlapping Features of Atopic Dermatitis and Alopecia Areata: From Pathogenesis to Treatment

In this case report, a 55-year-old woman developed alopecia areata approximately one year into her treatment with upadacitinib for atopic dermatitis, raising questions about a potential drug-induced link that has not been reported before.

This study identified distinct immune differences in patients with alopecia areata, particularly those with atopic backgrounds, and highlighted the OX40 axis as a potential therapeutic target for the condition.

This manuscript reviews the latest understanding of alopecia areata's pathogenesis, highlighting the roles of genetic, immunological, and environmental factors, with a focus on immune responses involving IFN-γ and cytotoxic CD8+ T-cells as key contributors to hair follicle inflammation and function disruption without follicle destruction.

In this study, JAK inhibitors were reported as safe and effective treatments for moderate-to-severe chronic alopecia areata, although the appropriate duration of treatment remains uncertain, as stopping these medications often results in relapse.

This case report describes a 12-year-old boy with severe atopic dermatitis and comorbid alopecia areata who experienced complete hair regrowth and improved skin condition after 3 months of oral abrocitinib treatment, with no adverse reactions observed during a 1-year follow-up period.

This review suggests that the gut microbiome and metabolome may play a significant role in alopecia areata and emphasizes the potential of targeting these factors for improved prevention, diagnosis, and treatment strategies for this skin condition.

In this narrative review, researchers outlined the role of T cells in the autoimmune pathogenesis of alopecia areata and highlighted ongoing research into therapeutic pathways, beyond current JAK inhibitors, aimed at developing new treatments for the disease.

This review reports that alterations in the scalp, hair follicle, and gut microbiome are associated with alopecia, and interventions targeting microbiome dysbiosis may have potential in treating hair loss.

This review explored recent research on the immune mechanisms and potential therapeutic targets for alopecia areata, highlighting the roles of immune-related cells, autocrine and paracrine signaling, as well as factors like adipose-derived stem cells and gut microbiota in disease pathogenesis.

This case report describes a 14-year-old girl with alopecia universalis and mild atopic dermatitis who achieved complete hair regrowth and eczema resolution after three months of treatment with the JAK1 inhibitor upadacitinib.

This case report observed hair regrowth following the treatment of alopecia universalis and atopic dermatitis with tofacitinib, a JAK inhibitor.

This study found that dysregulation of systemic Th1, Th2, and Th17 cytokines is associated with alopecia areata, with specific cytokines linked to disease activity and treatment response.

This study observed that both ritlecitinib and brepocitinib improved scalp biomarkers in patients with alopecia areata, with associations to hair regrowth seen in this phase 2a trial.

JAK inhibitors show promise for treating alopecia areata, but more research is needed.

This review discusses the potential of dupilumab for treating alopecia areata, reporting mixed outcomes with both improvement and new-onset hair loss observed in case reports.

This study found that type 2 immunity may play a role in the development of alopecia areata in patients with extrinsic atopic dermatitis, indicating different immunological states compared to non-atopic patients.

This study reported that some pediatric patients with alopecia areata experienced hair regrowth with dupilumab treatment, particularly those with concomitant atopic dermatitis, suggesting dupilumab may be beneficial when traditional therapies fail.

This review discusses immune privilege in anagen hair follicles and its collapse in alopecia areata, emphasizing the importance of restoring this function for effective management and disease relapse prevention.

In this case report, an 86-year-old man experienced new hair growth and color change in alopecia areata after receiving fecal microbiota transplantation for noninfectious diarrhea.

This study reports two cases of hair loss outcomes in patients using dupilumab for atopic dermatitis, with one showing improvement in alopecia universalis and another experiencing worsening of alopecia totalis.

This background review discusses alopecia areata, highlighting the role of CD8+NKG2D+ T cells in hair follicle pathogenesis, and notes that the exact mechanisms causing hair loss remain unclear.

This review explores the hair follicle microbiome's interaction with the immune system, discussing its potential clinical implications for scalp health and disease but reports no new clinical results.

This study observed a microbial shift on the scalp of Alopecia areata patients, characterized by an increase in Propionibacterium acnes and a decrease in Staphylococcus epidermidis, compared to healthy controls.

This case report suggests potential effectiveness of dupilumab for alopecia areata, though hair regrowth may result from indirect effects on inflammation in atopic dermatitis.

This review discusses genetic and environmental factors contributing to autoimmunity in alopecia areata and reports no new clinical findings, emphasizing the need for further study on its aetiology and pathophysiology.

This study found that among patients with alopecia areata treated with the JAK inhibitor tofacitinib, 34% achieved complete regrowth of eyebrows and 39% achieved complete regrowth of eyelashes, highlighting differences in treatment responses across hair-bearing sites.

This study reviewed recent theories on alopecia areata's pathogenesis, highlighting its autoimmune nature due to immune privilege disruption in hair follicles, and noted current treatments have limited efficacy with high relapse rates, underscoring the need for further research into its mechanisms for better therapies.

This study found that Israeli patients with alopecia areata had a higher prevalence of comorbid conditions, including food allergies and chronic spontaneous urticaria, compared to matched controls.

Alopecia areata patients often have low vitamin D levels.

This article reviews the epidemiology, clinical evaluation, and pathogenesis of alopecia areata and highlights recent advancements, but it does not report new clinical findings.

This review discusses the clinical characteristics, diagnosis, and treatment of alopecia areata, exploring potential environmental, immunological, and genetic factors involved in its development, but reports no new research findings.

This review found that patients with alopecia areata may have lower levels of vitamin D, zinc, and folate, but conflicting evidence precludes definitive clinical recommendations for micronutrient supplementation.

This study found that patients with active severe alopecia areata exhibited decreased CD200 expression on T and B lymphocytes, which may be linked to an imbalance in Th1/Th2 immune equilibrium.

This study found that Th17 lymphocytes may play a more crucial role than cytotoxic T cells in the development of alopecia areata due to their infiltration around the hair bulb/bulge, which exacerbates hair loss as histopathological grade worsens.

This study explored the effectiveness of the oral JAK1/2 inhibitor ruxolitinib in treating patients with moderate-to-severe alopecia areata, building on prior success with JAK inhibitors in mice, but results are not reported in this abstract.

This systematic review of pulse corticosteroid therapy for alopecia areata found relatively low complete response rates, but responders experienced low relapse rates, indicating potential benefits for patients with favorable prognostic factors.

This study observed that applying JAK-STAT pathway inhibitors to mouse and human skin led to rapid hair growth by inducing the anagen phase of hair follicles.

This study found that patients with alopecia areata had higher levels of Th17 cells and lower levels of regulatory T cells compared to healthy controls, suggesting an immune imbalance in these patients.

This review summarizes the current genetic research on alopecia areata, including potential new therapeutic strategies, but reports no new clinical findings.

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.

This study found that intron 3 VNTR polymorphism in the IL-4 gene may be associated with an increased risk of alopecia areata in the Turkish population.

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.