Background:
Alopecia areata (AA) is a non-scarring hair loss disorder of autoimmune
etiology.
Objective:
To familiarize physicians with the clinical presentation, diagnosis, evaluation, and
management of pediatric alopecia areata.
Methods:
The search term "Alopecia areata" was entered into a Pubmed search. A narrow
scope was applied to the categories of "epidemiology", "clinical diagnosis", "investigations",
"comorbidities", and "treatment". Meta-analyses, randomized controlled trials, clinical trials,
observational studies, and reviews were included. Only papers published in the English
language were included. A descriptive, narrative synthesis was provided of the retrieved
articles.
Results:
AA is an autoimmune disease of unknown etiology. It is the third most common
dermatologic presentation in children with a lifetime risk of 1-2%. Diagnosing AA can be
made on the basis of the history and clinical findings. Patients will often present with patchy,
non-scarring hair loss generally affecting the scalp. History may reveal a personal or family
medical history of autoimmune or atopic disease or a recent stressful event. Tricoscopic
examination will classically show “exclamation point hairs” and “yellow dots”. Nonspecific
nail changes may be present. Other clinical variants include alopecia totalis, alopecia
universalis, ophiasis, sisaipho, and Canitis subita. There are multiple treatment options for
AA including conservative treatment, and topical, oral, and injectable medications.
Conclusion:
AA is an autoimmune disease with a heterogenous presentation and
unpredictable clinical course. Although there is no cure for AA, there are many current
treatment options available to help manage this disfiguring disease.