INTRODUCTION
Alopecia areata (AA) is a distinct pathological condition characterized by non-scarring hair loss due to autoimmune processes and inflammation.1 It can present as patchy alopecia, alopecia totalis (AT), or alopecia universalis (AU).2 About 2% of the population experiences AA at some point, predominantly as patchy alopecia on the scalp.3 The clinical spectrum of AA varies from isolated patches of hair loss to complete baldness on the scalp (AT) or the entire body (AU), leading to psychological distress, especially in severe or chronic cases.4
Although a cause was suggested in the 1970s, it has not been substantiated. A genetic study by Yang et al showed 8.4% of patients had a family history of AA, indicating a polygenic additive mode of inheritance. AA is now considered an organ-specific autoimmune disorder with a genetic predisposition triggered by environmental factors.5 It can affect individuals of any age or gender, sometimes occurring alongside other autoimmune disorders like vitiligo or thyroid disease.4,5 Diagnosis is primarily clinical, based on distinct circular, non-scarring areas of hair loss with "exclamation mark" hairs at the periphery.5 Skin biopsy shows increased telogen follicles and an inflammatory lymphocytic infiltrate in the peribulbar region.6
Although AA is mainly a cosmetic concern, it causes significant emotional distress, particularly in children and women. Up to 80% of localized AA cases spontaneously remit within a year.7 A Cochrane review highlighted the lack of randomized controlled studies on effective treatments for AA.8 Treatments
Although a cause was suggested in the 1970s, it has not been substantiated. A genetic study by Yang et al showed 8.4% of patients had a family history of AA, indicating a polygenic additive mode of inheritance. AA is now considered an organ-specific autoimmune disorder with a genetic predisposition triggered by environmental factors.5 It can affect individuals of any age or gender, sometimes occurring alongside other autoimmune disorders like vitiligo or thyroid disease.4,5 Diagnosis is primarily clinical, based on distinct circular, non-scarring areas of hair loss with "exclamation mark" hairs at the periphery.5 Skin biopsy shows increased telogen follicles and an inflammatory lymphocytic infiltrate in the peribulbar region.6
Although AA is mainly a cosmetic concern, it causes significant emotional distress, particularly in children and women. Up to 80% of localized AA cases spontaneously remit within a year.7 A Cochrane review highlighted the lack of randomized controlled studies on effective treatments for AA.8 Treatments
