Alopecia areata , also known as bald spot , is a condition in which hair disappears from some or all areas of the body. Often produce some bald spots on the scalp, each the size of a coin. Psychological stress can occur. People are generally healthy. In some, all the hair on the scalp or all body hair is lost and the loss can be permanent.
Alopecia areata is believed to be an autoimmune disease. Risk factors include family history of the condition. Among the identical twins if one is affected, others have about 50% possibilities also affected. The underlying mechanism involves failure by the body to recognize its own cells with the subsequent destruction mediated by the hair follicle.
There is no cure for this condition. Efforts can be used to try to accelerate hair regrowth such as cortisone injections. Sunscreen, head covering to protect from cold and sun, and glasses if missing eyelashes are recommended. In some cases, the hair grows back and the condition does not reoccur. In other hair loss and regrowth occurs over the years.
About 2% of people are affected in the United States. Onset is usually in childhood. Men and women have the same number of conditions. The condition does not affect one's life expectancy.
Video Alopecia areata
Signs and symptoms
The first typical symptom of alopecia areata is a small patch that is bald. The underlying skin is unscarred and looks normal shallow. Although these patches can have many shapes, they are usually round or oval. Alopecia areata most commonly affects the scalp and beard, but can occur on any part of the body with hair. Different skin areas can show hair loss and regrowth at the same time. The disease can also be a temporary remission, or it may be permanent. This is common in children.
The area of ​​hair loss can be itchy or painful. Hair tends to fall off in a short time, with losses that usually occur on one side of the scalp than others.
Brushing hair, narrower along the strands near the base, produces a distinctive, typically "exclamation mark" appearance.
When healthy hair is pulled out, at least some must come out, and torn hair should not be distributed evenly throughout the scalp. In the case of alopecia areata, hair will tend to be more easily pulled along the edges of the patch where the follicles have been attacked by the immune system than the far from patch where they are still healthy.
The nails may have spots or trachyonychia.
Maps Alopecia areata
Cause
Alopecia areata is considered a systemic autoimmune disorder in which the body attacks the hair follicles of anagen itself and suppresses or stops hair growth. For example, T cell lymphocytes clump around the affected follicle, causing subsequent inflammation and hair loss. Several cases of infants born with congenital alopecia areata have been reported.
Alopecia areata is not contagious. It happens more often in people who have affected family members, suggesting heredity may be a factor. Strong evidence of a genetic relationship with increased risk of alopecia areata was found by studying families with two or more affected members. The study identified at least four areas in the genome that are likely to contain these genes. In addition, alopecia areata share genetic risk factors with other autoimmune diseases, including rheumatoid arthritis, type 1 diabetes, and celiac disease. This may be the only manifestation of celiac disease.
Endogenous retinoid metabolic defects are a key part of the pathogenesis of alopecia areata.
In 2010, a completed genomic association study identified 129 single nucleotide polymorphisms associated with alopecia areata. Identified genes include those involved in controlling the activation and proliferation of regulatory T cells, associated cytotoxic T lymphocyte antigen 4, interleukin-2, interleukin-2 receptor A, and Eos (also known as the zinc fingers of the Ikaros family 4), as well as human leukocyte antigen. The study also identified two genes, PRDX5 and STX17, which are expressed in hair follicles.
Diagnosis
Alopecia areata are usually diagnosed based on clinical features.
Trichoscopy can help make the diagnosis. In alopecia areata, trichoscopy regularly shows "yellow dots" (hyperkeratosis blockage), small exclamation hair, and "black dots" (smashing hairs in hair follicles).
Biopsy is rarely necessary to make a diagnosis or assistance in the management of alopecia areata. Histologic findings include peribulbar lymphocytic infiltration ("swarm of bees"). Occasionally, in inactive alopecia areata sites, inflammatory infiltrate is not found. Other useful findings include pigment incontinence in hair follicles and follicular stela, and anagen-to-telogen-to-telogen ratio change.
Classification
Generally, alopecia areata involves hair loss in one or more round spots on the scalp.
- Hair can also disappear more diffusely across the scalp, in this case the condition is called diffuse alopecia areata.
- Alopecia areata monolocularis describes baldness in only one place. This can happen anywhere in the head.
- Alopecia areata multilocularis refers to some areas of hair loss.
- Ophiasis refers to hair loss in the form of waves around the head.
- The disease may be restricted to beards, which in this case is called alopecia areata barbae.
- If the person loses all the hair on the scalp, the disease is then called alopecia areata totalis.
- If all body hair, including pubic hair, disappears, the diagnosis becomes alopecia areata universalis.
Alopecia areata totalis and universalis rare.
Treatment
Objective assessment of the efficacy of treatment is very difficult and spontaneous remission is unpredictable, but if the affected area is patched, the hair can grow back spontaneously in many cases. None of the existing therapeutic options is curative or preventive.
In the case of severe hair loss, limited success has been achieved by using corticosteroid klobetasol or fluocinonide, corticosteroid injections, or cream. Cream is ineffective and takes longer to see the results. Steroid injections are commonly used in places where areas of hair fall out on a small head or especially where eyebrow hair has disappeared. Are they effectively uncertain. Some other medications that have been used are minoxidil, Elocon ointment (mometason) (steroid cream), irritation (anthralin or topical coal tar), and topical ciclosporin immunotherapy, sometimes in different combinations. Topical corticosteroids often fail to penetrate the skin deep enough to affect the hair ball, which is the treatment target, and small lesions usually also grow spontaneously. Oral corticosteroids can decrease hair loss, but only for the period when they are taken, and these drugs can cause serious side effects. There is no effective treatment in all cases, and some individuals may not respond to any treatment. Some treatments have been well evaluated. A meta-analysis of 2008 oral and topical corticosteroids, topical ciclosporin, photodynamic therapy, and topical minoxidil showed no benefit from hair growth compared to placebo, especially with regard to long-term benefits.
When alopecia areata is associated with celiac disease, treatment with a gluten-free diet allows for complete and permanent growth of scalp and body hair in many people, but in others there is remission and recurrence. This increase may be due to the normalization of the immune response as a result of the withdrawal of gluten from the diet.
Prognosis
In many cases starting with a small amount of hair loss, hair grows back after a few months to a year. In cases with a large number of patches, hair may grow back or develop into alopecia areata totalis or, in rare cases, universalis alopecia areata.
There is no loss of body function, and the effects of alopecial areata especially psychological (loss of self-image due to hair loss), although this can be severe. The loss of hair also means the scalp is more easily burned in the sun. The patient may also have a distorted nail formation because keratin forms hair and nails.
Hair can grow back and then fall again later. This may not indicate a recurrence of conditions, but rather a relatively synchronized growth-and-shedding natural cycle from the start; Such patterns will fade over time. The episode of alopecia areata before puberty affects the chronic recurrence of this condition.
Alopecia can be a cause of psychological stress. Because hair loss can cause significant changes in appearance, the individual with it may experience social phobia, anxiety, and depression.
Epidemiology
This condition affects 0.1% -0.2% of the population, and occurs equally in men and women. Alopecia areata occurs in healthy people and has no other skin disorders. Initial presentation most often occurs in late adolescence, early childhood, or young adulthood, but can occur at any age. Patients also tend to have a slightly higher incidence of conditions associated with the immune system, such as asthma, allergies, atopic dermatitis, and hypothyroidism.
Research
Many drugs are being studied, including abatacept, MEXIS/M6S, triamcinolone, secukinumab, tralonkinumab, apremilast, botulinum toxin, INCB018424, bimatoprost, clobetasol, AS101, autologous platelet rich plasma, topical minoxidil, and nitric oxide gel. Some of these drugs are approved for other diseases, others are not available outside the study.
In 2014, preliminary findings indicate that oral ruxolitinib, a drug approved by the US Food and Drug Administration (FDA) for myeloid bone marrow mielofibrosis, restores hair growth in three individuals with long-standing and severe disease. The drug costs almost $ 10,000 a month.
History
Alopecia areata and alopecia barbae have been identified by some as the biblical condition of nethek which is part of a larger family of skin disorders tzaraath ; these disorders are said to be discussed in the Book of Leviticus, chapter thirteen.
See also
- nonkrikatrik Alopecia
- Trichotillomania
References
![Pam vs. Alopecia Areata [Pam - 1, Alopecia - 0!]](https://lh3.googleusercontent.com/blogger_img_proxy/AEn0k_vQiIlULvUFuQFnis5-afLE8FPkGJ3NhvWpnO8vwRixQrZcjEqueoQCb8-xI5McyimBGDccyR8ekhHf1E8BNtVO8BRbRDIkTqWGOZvVFsS-0A05o4eoOBKWBltHUcqUC6RWFuz7ZAygcQ=s0-d "Pam vs. Alopecia Areata [Pam - 1, Alopecia - 0!]")
External links
directory
- National Institute of Arthritis and Musculoskeletal Day Penyakit Kulit di NIH
- DermAtlas 42
- National Alopecia Areata Foundation
- Canadian Alopecia Areata Foundation
Source of the article : Wikipedia
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