Alopecia Areata

Greenberg, Samuel I.

doi:10.1001/archderm.1955.03730350056010

Cited by 34 publications

(10 citation statements)

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“…[3132] The present study confirms these findings: anxiety (62%) and depression (38%) were significantly higher in the patient group in comparison with controls ( P = 0.005 and P = 0.047). This implies that the effect of AA on patients is psychologically distressing.…”

Section: Discussionsupporting

confidence: 87%

The relationship between alopecia areata and alexithymia, anxiety and depression: A case-control study

et al. 2014

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Background:Alopecia areata (AA) is a skin disease characterized by the sudden appearance of areas of hair loss on the scalp and other hair-bearing areas, but its aesthetic repercussions can lead to profound changes in patient's psychological status and relationships.Aim:The goal was to investigate a possible relationship between AA and alexithymia as well as two other emotional dimensions, anxiety and depression.Materials and Methods:Fifty patients with AA seen in the Department of Dermatology of Hedi Chaker University Hospital, Sfax were included in this study. Anxiety and depression were evaluated by Hospital Anxiety and Depression scale questionnaire, alexithymia was assessed by Toronto Alexithymia scale 20, and severity of AA was measured by Severity of Alopecia Tool.Results:Patient's mean age was 32.92 years. 52% of patients were females. Depression and anxiety were detected respectively in 38% and 62% of patients. There was statistically significant difference between patients and control group in terms of depression (P = 0.047) and anxiety (P = 0.005). Forty-two percent of patients scored positive for alexithymia. No significant difference was found between patient and control groups (P = 0.683) in terms of alexithymia. Anxiety was responsible for 14.7% of variation in alexithymia (P = 0.047).Conclusions:Our study shows a high prevalence of anxiety and depressive symptoms in AA patients. Dermatologists should be aware of the psychological impact of AA, especially as current treatments have limited effectiveness.

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Section: Discussionsupporting

confidence: 87%

The relationship between alopecia areata and alexithymia, anxiety and depression: A case-control study

et al. 2014

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“…[15] Selye's observation led to multiple investigations of the link between stress and sudden hair loss, many of which date back to the 1950s. [1617] Although a medically benign condition, alopecia can have a significant negative impact on one's self-image, leading to a decreased quality of life. [1819] Despite the fact that an association between hair loss and stress is readily acknowledged by patients and physicians, a clear-cut pathophysiological mechanism explaining the connection between psychoemotional stress and hair loss in humans remains to be demonstrated.…”

Section: Discussionmentioning

confidence: 99%

Presence of mast cells and mast cell degranulation in scalp biopsies of telogen effluvium

et al. 2017

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Background:Telogen effluvium (TE) is a type of acquired, diffuse alopecia that occurs due to an abnormal shift of scalp hair follicles from anagen to telogen, leading to premature shedding of hair. Previous studies have suggested the existence of a neuroimmunologic “brain-hair follicle” axis, in which mast cells have been implicated as an important link between the nervous system and immunologic system.Objective:The current study sought to investigate the role of mast cell presence and mast cell degranulation in the pathogenesis of TE.Materials and Methods:Mast cells were counted using Giemsa and tryptase immunohistochemical stains in scalp biopsy specimens with the pathologic diagnosis of TE (TE, n = 10), alopecia areata (AA, n = 7), and androgenic alopecia (ANDRO, n = 9).Results:We found significant (P < 0.001) group-level differences between the mean mast cell counts per high-power fields for each type of alopecia studied. Tukey post hoc analysis showed the mean mast cell count for TE to be significantly larger than AA for both Giemsa (P = 0.002) and tryptase (P = 0.006); significantly larger than ANDRO for both Giemsa (P < 0.001) and tryptase (P < 0.001); and significantly larger when compared to normal scalp skin for both Giemsa (P < 0.001) and tryptase (P < 0.001). No significant difference of mean mast cell counts was observed for AA compared to ANDRO for Giemsa (P = 0.373) or tryptase (P = 0.598) stains.Conclusion:Our findings suggest that mast cells could play a role in mediating stress-induced hair loss seen in TE.

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“…Irwin's (1953) series of 55 cases contained 23% in which mental trauma was considered to have caused the condition, and a further 63 % classified as neurotic. Greenberg (1955) reported 44 cases, of which only 7% were free from mental illness. Recently, however, Macalpine (1958) has caried out an extensive psychiatric study of 125 selected cases, and could find no evidence that mental illness, anxiety, or mental shock plays a significant part in causing alopecia areata.…”

Section: Discussionmentioning

confidence: 99%

Relationship of Stress to the Development of Symptoms in Alopecia Areata and Chronic Urticaria

Reinhold¹

1960

BMJ

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Agreementhas not yet been reached on the part played by emotional disturbance in the development of two common disorders, alopecia areata and chronic urticaria. In an attempt to assess the relationship of psychological stress to symptoms, a study was made of patients suffering from these two conditions in the out-patient department of St. John's Hospital for Diseases of the Skin. The effects of adeqiuate psychotherapy on symptoms were also studied. The study depended on the taking of a very long and detailed history of every case (when necessary, over several interviews of an hour each), together with a careful follow-up of patients, each of whom was seen at short, regular intervals over a period varying from 3 to 18 months, during interviews which lasted from 45 to 15 minutes. Most patients were followed up for more than one year.The time devoted to the patients seemed to he of extreme importance. Many were not able to discuss their difficulties in the first few interviews, but as time went on they were able to talk more freely. From the therapeutic point of view also, the time devoted to each pat;ent was of major importance. In many studies of this kind the psychotherapy offered may consist of brief interviews spaced widely over a varying period. In the present study it was, in certain cases, not possible to give adequate psychotherapy for the condition, the psychological disturbance being too profound.

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Alopecia Areata

Cited by 34 publications

References 4 publications

The relationship between alopecia areata and alexithymia, anxiety and depression: A case-control study

The relationship between alopecia areata and alexithymia, anxiety and depression: A case-control study

Presence of mast cells and mast cell degranulation in scalp biopsies of telogen effluvium

Relationship of Stress to the Development of Symptoms in Alopecia Areata and Chronic Urticaria

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