ABSTRACT
Alopecia areata (AA) is a common, non-scarring, organ-specific, autoimmune, chronic inflammatory disease that can affect hair follicles and sometimes nails. The course of the disease is unpredictable, spontaneous recovery and relapse can be seen in 80% of the patients. Although the formation mechanism of AA has not been fully elucidated, It is thought that it is a T cell-mediated autoimmune disease triggered by certain environmental factors in individuals with genetic predisposition. The lifetime development risk of AA is 0.1-0.2%, all over the world 1.7%. It occurs equally in both sexes, has been reported to be more common in early ages. AA family history in affected individuals has been found between 10-20%. 20% of patients are children and 50% of all patients experience their first attack under the age of 20. Lifetime recurrence rate is estimated as 50%.
One of the finding that supports AA is an autoimmune disease is other accompanying autoimmune diseases such as thyroiditis, atopy, vitiligo, psoriasis, lupus erythematosus, celiac disease, diabetes mellitus, myasthenia gravis, Addison’s disease, pernicious anemia, autoimmune hepatitis, lichen planus and Down syndrome like genetic diseases.
Poor prognostic factors are early onset age, positive family history, atopy, autoimmune diseases, nail involvement in the patient, ophiasis, diffuse involvement and disease over five years.
The disease which may be progresive, show relapses and recovery attacks, occurs as a result of the organ-specific autoimmune reaction of the hair follicles mediated by T lymphocyte. Few evidence-based datas are available for treatment and treatment approaches are generally based on case series and clinical experience. Most of the treatments are palliative. Factors such as extent and duration of the disease, age and gender, pregnancy and breastfeeding conditions and compliance with drugs are important in treatment planning. According to those information, AA treatment schemes have been developed.
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