Comorbidity in patients with alopecia areata

Abstract

BACKGROUND: Alopecia areata (AA) is a non-scarring hair loss characterized by the immune intolerance of hair follicles, leading to the development of T-cell-mediated inflammation and subsequent hair loss. Different ages of onset, repeated relapses, and changes in the appearance of patients lead to psychoemotional distress and contribute to AA and socially significant skin diseases. Scientific data based on the effect of comorbid disorders in the course of alopecia (atopy, autoimmune diseases, and endocrinopathies) should be considered by dermatologists. This publication contains data of own research.
 AIM: The study aimed to determine the concomitant pathology and its effect on the course of AA, especially on the content of vitamin D, to optimize further treatment.
 MATERIALS AND METHODS: The research was based on the clinical materials of 132 patients with different severities of AA and concomitant nosologies. Several allergic (atopic dermatitis) and other autoimmune diseases (vitiligo and autoimmune thyroiditis) present similar pathogenetic mechanisms of development to AA. An ultrasound investigation was carried out, and a number of autoimmune and allergic nosologies accompanying the course of AA and the level of vitamin D in blood serum depending on the disease severity were revealed.
 RESULTS: The analysis of results of ultrasound investigation of the inner organs was presented and revealed comorbid autoimmune and allergic nosologies affecting the course or associating with AA. The moderate (32.67 0.91 nmol/l; р 0.5) and severe clinical forms (32.9 0.84 nmol/l) of AA vitamin D significantly decreased compared with the mild course of the disease (56.75 0.62 nmol/l). Two clinical cases of patients with AA and concomitant diseases were presented.
 CONCLUSION: The results revealed that the concomitant pathology of AA correlates with the literature source data and suggest their correction by doctors of narrow specialties. Vitamin D in the blood serum of patients was examined as a possible comorbid factor and predictor of disease activity. The role of trichoscopy as an investigation tool for the visualization and verification of the diagnosis and determination of the activity of AA was outlined.