Alopecia Areata

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Alopecia Areata

• Ciaran Woodman

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Background

• Partial hair loss
• Patchy
• Extensive gt 50
• Totalis
• Universalis
• 2 dermatology appointments
• Children and adolescents
• 60 before 20
• 20 lt 16
• MF

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Causes and Associations

• ? T cell immune mediated response
• Ax
• Pernicious Anaemia
• Thyroid disorders
• Vitiligo
• AI/Atopy
• Environment
• Virus
• Stress

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Presentation

• Sudden onset /- pruritus/burning
• Circumscribed patches
• Nail involvement
• Pull Test
• Investigations
• TFT
• Scalp scrapings

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Differential Diagnoses

• Tinea Capitis 4-14y
• Trichotillomania
• Traction alopecia
• SLE
• Syphyllis
• Telogen Effluvium

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Management

• lt16 refer
• Watchful wait spontaneous remission
• Topical Steroids/Minoxidil
• Refer derm intralesional steroids, topical
  immunotherapy
• Wigs
• Counselling

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Info for Patient

• Unpredictable
• Treatment takes time
• Sun-cream etc
• 34-50 resolve in 1 year
• Most have gt1 episode
• 14-25 - Totalis Universalis