Alopecia Areata. Current situation and perspectives

Abstract

Alopecia areata (AA) is a dermatological disease characterized by non-scarring hair loss of the scalp and/or body, with an unpredictable and variable evolution in the patients in which, despite multidisciplinary efforts, its etiology is not entirely known, although some evidence suggests that environmental, immunological and genetic factors could be generating the disease. The aim of this review is to provide an updated panorama of the clinical characteristics, diagnosis and treatment of AA, to analyze the mechanisms that could participate in its etiology, as well as to review some of the most important genetic variants that could confer susceptibility to the development of this disease.

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“…The factors that may implicate such an autoimmunity in AA, however, remain still unknown. [1920] Despite more and more evidences demonstrate that human microbiome plays a key role in human health and diseases, to the best of our knowledge, no study has been conducted to analyze an implication of microbiome in the pathogenesis of AA. There is only one case report describing hair growth in two patients suffering from AA after fecal microbiota transplant, which may suggest the potential role of gut microbiota in the disease mechanism.…”

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“…However, HLA contribution alone could not be enough for the explanation of the entire genetic basis of AA 16. Several studies found that AA has a polygenic origin where multiple genes intertwine causing a greater susceptibility to develop the disease 17. A recent genome-wide association (GWAS) study revealed the association of HLA in addition to new loci outside the MHC including ACOXL/BCL2L11 and GARP with a nominal association of SH2B3(LNK)/ATXN2 18…”

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“…Alopecia areata (AA) is an extremely common autoimmune condition affecting hair characterized by patches of nonscarring alopecia affecting scalp and body hair that can be psychologically exterminating. [ 1 ] Despite multidisciplinary endeavour, its aetiology is not entirely known, and AA is natural history is unpredictable, although some evidence suggests that genetic factors, immunological and environmental could be generating the disease. [ 2 ]…”

“…In China, AA prevalence approximately.27% of the population presents this disease [ 3 ] ; In the United Kingdom, 2% of its population; In the United States, AA affects between 0.7% and 3% of the individual; In Mexico, the reported affects between 0.2% and 3.8%; In Korea, it has been estimated that AA prevalence between 0.9% and 6.9% of the individuals. [ 1 ] At the same time, AA does not distinguish men or women, although some study suggest a slight inferior in men. [ 4 ] While AA affects both sexes equally, data from the Rochester Epidemiology Project showed that men tended to be diagnosed earlier compared with women (mean age at diagnosis, 31.5 vs 36.2 years).…”