Psoriatic alopecia

The document described psoriatic alopecia as a form of hair loss experienced by patients with psoriasis, which can manifest as localized hair loss within psoriatic plaques or as a more widespread shedding known as telogen effluvium. Although hair typically regrows, severe cases involving scalp psoriasis can lead to permanent hair loss due to scarring. Histological examination reveals features such as psoriasis in the interfollicular skin, inflammation around hair follicles, reduced or absent sebaceous glands, and an increased number of telogen phase hairs, with advanced cases showing follicular destruction and fibrosis. The document also noted that psoriasis patients are at a higher risk for alopecia areata and that certain psoriasis treatments, including topical agents, systemic medications like methotrexate, hydroxyurea, and acitretin, as well as anti-TNF agents, may exacerbate hair loss. This risk of psoriatic alopecia can affect the choice of systemic treatments for psoriasis to avoid permanent alopecia.