Alopecia Areata: news on diagnosis, pathogenesis and treatment. 2014

R D'Ovidio
Trichology Group of Associazione Italiana Dermatologi Ambulatoriali (AIDA), Bari, Italy - r.dovidio@aida.it.

This review focuses on recent changes in the clinical, pathogenetic and therapeutic developments with regards to Alopecia Areata. Some new clinical forms and some phenomena have been described for the first time in recent years. Several phenomena previously observed such as the Renbok, the Koebner and the possibility that an exclamation mark hair can resume its physiological growth have been confirmed. The pathogenetic role of cytotoxic cells is increasingly evident, as well as the deficit of cells and the factors regulating the autoimmune response. The concept of immune privilege of the hair follicle has had further confirmation and have been identified some of the molecular mechanisms such as the expression of the receptors for killer lymphocytes on the trichokeratinocytes of the Outer Root Sheat. There is a renewed interest on the possible role of mast cell as a key element in the acute and chronic phases of the disease. New therapies are focused on the inhibition of the killer cells directed against antigens not yet fully specified of the hair follicle and on the restoration of the immune privilege of this structure. Alopecia Areata is a disease with high emotional impact, able to reduce the quality of life of patients and their family entourage. It is often frustrating for those affected and for the therapists due to its evolution quite unpredictable and the mixed response to the few validated therapies. Investment in research originate almost exclusively from voluntary associations of patients, which need to be known and supported.

UI MeSH Term Description Entries
D006969 Hypersensitivity, Immediate Hypersensitivity reactions which occur within minutes of exposure to challenging antigen due to the release of histamine which follows the antigen-antibody reaction and causes smooth muscle contraction and increased vascular permeability. Atopic Hypersensitivity,Hypersensitivity, Atopic,Hypersensitivity, Type I,IgE-Mediated Hypersensitivity,Type I Hypersensitivity,Atopic Hypersensitivities,Hypersensitivities, Atopic,Hypersensitivities, IgE-Mediated,Hypersensitivities, Immediate,Hypersensitivities, Type I,Hypersensitivity, IgE-Mediated,IgE Mediated Hypersensitivity,IgE-Mediated Hypersensitivities,Immediate Hypersensitivities,Immediate Hypersensitivity,Type I Hypersensitivities
D007167 Immunotherapy Manipulation of the host's immune system in treatment of disease. It includes both active and passive immunization as well as immunosuppressive therapy to prevent graft rejection. Immunotherapies
D007239 Infections Invasion of the host organism by microorganisms or their toxins or by parasites that can cause pathological conditions or diseases. Infection,Infection and Infestation,Infections and Infestations,Infestation and Infection,Infestations and Infections
D008297 Male Males
D009260 Nail Diseases Diseases of the nail plate and tissues surrounding it. The concept is limited to primates. Disease, Nail,Diseases, Nail,Nail Disease
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D011788 Quality of Life A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral, social environment as well as health and disease. HRQOL,Health-Related Quality Of Life,Life Quality,Health Related Quality Of Life
D002386 Cataract Partial or complete opacity on or in the lens or capsule of one or both eyes, impairing vision or causing blindness. The many kinds of cataract are classified by their morphology (size, shape, location) or etiology (cause and time of occurrence). (Dorland, 27th ed) Cataract, Membranous,Lens Opacities,Pseudoaphakia,Cataracts,Cataracts, Membranous,Lens Opacity,Membranous Cataract,Membranous Cataracts,Opacities, Lens,Opacity, Lens,Pseudoaphakias
D003131 Combined Modality Therapy The treatment of a disease or condition by several different means simultaneously or sequentially. Chemoimmunotherapy, RADIOIMMUNOTHERAPY, chemoradiotherapy, cryochemotherapy, and SALVAGE THERAPY are seen most frequently, but their combinations with each other and surgery are also used. Multimodal Treatment,Therapy, Combined Modality,Combined Modality Therapies,Modality Therapies, Combined,Modality Therapy, Combined,Multimodal Treatments,Therapies, Combined Modality,Treatment, Multimodal,Treatments, Multimodal
D003879 Dermatologic Agents Drugs used to treat or prevent skin disorders or for the routine care of skin. Agent, Dermatologic,Agent, Dermatological,Agents, Dermatologic,Dermatologic Agent,Dermatological Agents,Agents, Dermatological,Dermatological Agent

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