Diagnosis And Management Of Alopecia Areata: A Saudi Expert Consensus Statement (2023)

The document is a consensus statement by eight experts on the diagnosis and management of Alopecia Areata (AA) in Saudi Arabia, a chronic inflammatory disease causing non-scarring hair loss with a prevalence of 2.3% to 5.2%. The document provides guidance on clinical and diagnostic criteria, disease severity assessment, evaluation of associated comorbidities, and various treatment options. The success of AA treatment is defined by meeting certain criteria at week 24 or 36, depending on the treatment. The document discusses various treatment options, including JAK inhibitors, cosmetic camouflage, photochemotherapy, excimer laser/light, intralesional corticosteroid therapy, topical corticosteroid therapy, minoxidil, topical immunotherapy, anthralin, topical calcineurin inhibitors, and systemic treatment. The document also provides a treatment algorithm for AA and discusses the side effects and contraindications of the various treatments. It concludes by stating that there are no set universal indications for initiating systemic treatment for AA, but provides possible indications such as extensive disease, rapid progression of hair loss, and significant facial involvement. The document also discusses the combination of systemic agents, treatment in special situations like AA in children, AA in the beard area, and AA in the eyelashes and eyebrows. The document concludes by emphasizing the importance of an individualized plan for patients with AA to achieve the best outcomes possible.