Alopecia areata

Alopecia areata is a disorder with an estimated lifetime risk of 1 to 2%. The prevalence is the highest in the age group of 10 to 25 years. The exact aetiopathogenesis of alopecia areata is not precisely known, however, some factors that seem to play an important role in the development of the condition include autoimmune processes, stress or genetic vulnerability. Also, alopecia areata often coexists with depressive or anxiety disorders. The clinical presentation of alopecia areata includes sharply demarcated patches of hair loss, though the skin remains otherwise unaffected by any pathological changes. The severity of the condition varies greatly, and symptoms may range from isolated areas of hair loss on the scalp to total hair loss of the scalp - or even total loss of body hair. The most important differential diagnosis to consider in patients with suspected alopecia areata is androgenetic alopecia, i.e. the most common form of hair loss. The course of alopecia areata remains difficult to predict. In the majority of cases, the hair grows back spontaneously, but relapses are common. Treatment involves a variety of drugs, mainly immunomodulatory agents - either the types generating an allergic reaction or producing immunosuppressive effects. There are, however, no established treatment regimens for alopecia areata. It is worthwhile to note that antidepressants and non-pharmacologic interventions such as psychotherapy are also frequently used for treatment. Patients with alopecia areata often experience an impaired quality of life secondary to the disease. This fact, combined with the potential contribution of stress to the development of the condition, seems important from the viewpoint of considering psychological support in this group of patients.