New Onset of Alopecia Areata in a Patient with SARS-CoV-2 Infection: Possible Pathogenetic Correlations

The document reports a case of a 29-year-old female patient who developed alopecia areata (AA) following a SARS-CoV-2 infection. The patient experienced progressive hair loss starting one month after the onset of COVID-19 symptoms, which were treated without hospitalization. Clinical and trichoscopic evaluations confirmed the diagnosis of alopecia areata totalis. The patient's personal and family medical history did not suggest a predisposition to autoimmune or trichological disorders, and laboratory tests were normal. Treatment with triamcinolone acetonide injections, oral vitamin D and probiotics, and topical steroids and bimatoprost for the eyebrows resulted in a good response. The paper discusses the potential pathogenetic correlations between AA and SARS-CoV-2 infection, suggesting that the timing of the AA onset and the infection could be related. It is proposed that stress from the infection, as well as the virus itself, could trigger AA through mechanisms such as the interferon-mediated antiviral response and cytokine cascade activation, particularly involving IL-6, which may inhibit hair follicle proliferation. This case is the third reported instance of new-onset AA following a COVID-19 infection and contributes to the understanding of dermatological manifestations associated with the virus.