Alopecia areata and Down syndrome

Abstract

The skin of 214 institutionalized patients with the Down syndrome was carefully examined. There were 19 cases of alopecia areata and four cases of vitiligo. Since persons with the Down syndrome are predisposed to immunological deficiency in thymus-dependent (T-cell) function, findings from the skin examinations suggest that immunologic factors might contribute to the increased incidence of vitiligo and alopecia areata seen in the Down syndrome. Syringoma was also common and affected female patients twice as frequently as male patients.

Dermatological Manifestations of Down's Syndrome

“…16 The incidence of AA is between 6% and 10% in the DS population compared with approximately 1.7% of the general population. 2,8,17 There is an increased incidence in both sexes; however, unlike the general population in which the rate does not vary with gender, it is more common in females with DS (17.4% vs. 3.1%). 8 As in the general population, it may coexist with vitiligo.…”

“…20 While some studies have suggested an increased prevalence of >50% of atopic dermatitis in patients with DS, 8,21 others have shown it to be decreased. Using the criteria of Hanifin and Rajka, Schepis et al 22 noted only a 3% prevalence.…”

“…7 The high incidence of alopecia areata, vitiligo, and atopic dermatitis may be related to immunological deficiency in thymus-dependent (T-cell) function which exists in DS. 8,9 The literature on the humoral or cellular immune system alterations in DS has been met with mixed results. Studies show both reduced number and function of both B-and T-lymphocytes, with thymusdependent function and morphology (T-cell) most consistently affected.…”

“…Studies show both reduced number and function of both B-and T-lymphocytes, with thymusdependent function and morphology (T-cell) most consistently affected. 2,8,10 Phagocytosis also appears to be impaired. 10 In general, people with DS have a high incidence of mortality caused by infection, 5,10 increased incidence of malignancies such as leukemia, and are more likely to develop autoimmune conditions such as thyroiditis and alopecia areata.…”

“…2 DS is also associated with accelerated aging and an increased incidence of acne vulgaris, anetoderma, cheilitis, cutis marmorata, elastosis perforans serpiginosa, fissured and geographic tongue, onychomycosis, palmoplantar hyperkeratosis, pityriasis rubra pilaris, psoriasis, seborrheic dermatitis, syringoma, tinea pedis, and xerosis. 3,8,[11][12][13] Syringoma, alopecia areata, elastosis perforans serpiginosa, and vitiligo usually present in adulthood. 3 …”