Alopecia Areata in Latin America: Where are We and Where are We Going?

Abstract

Alopecia areata (AA) represents an underrecognized burden in Latin America (LA), severely impacting quality of life (QoL). This impact is exacerbated by limited access to specialized dermatologic care and therapies for AA within and among nations. Many of the unmet needs for AA globally also exist in LA. The region has geographic, ethnic, cultural, and economic conditions. With new AA medicines targeting immunologic pathways on the horizon, LA must prepare regarding regulatory issues, reimbursement, awareness, and education to give adequate and timely treatment for patients with AA. To address these issues, the Americas Health Foundation convened a panel of six dermatologists from Argentina, Brazil, Colombia, and Mexico who are experts in AA and its comorbidities for a 3-day virtual meeting to discuss AA diagnosis and treatment in LA and create a manuscript offering recommendations to address discussed barriers. This publication examines unmet AA needs in LA, treatment, and innovative therapies and recommends improving AA care. Access constraints to conventional and novel medicines hinder appropriate treatments for patients. Therapy initiation delays can affect QoL, mental health, and disease progression. People with AA face stigmas, discrimination, and misconceptions owing to a lack of disease awareness. With promising new treatments for AA on the horizon, all stakeholders must coordinate efforts to enhance LA’s AA management landscape and improve patient outcomes.

Role of neurogenic inflammation in the pathogenesis of alopecia areata

“…In more severe instances, alopecia may affect the entire scalp or body, known as alopecia totalis (AT) or alopecia universalis (AU) 1 . The prevalence of AA worldwide varies from 0.57% to 3.8% among the general population 3 . Research has suggested that AA arises from an autoimmune attack on hair follicles (HFs), and the loss of immune privilege (IP) within the anagen hair bulb serves as a crucial precursor to the development of AA 4 .…”

“…1 The prevalence of AA worldwide varies from 0.57% to 3.8% among the general population. 3 Research has suggested that AA arises from an autoimmune attack on hair follicles (HFs), and the loss of immune privilege (IP) within the anagen hair bulb serves as a crucial precursor to the development of AA. 4 CD8+ lymphocytes are responsible for follicular damage primarily and dominate the disease activation process, with CD4+ lymphocytes playing an auxiliary role.…”