How to Diagnose and Manage Alopecia Areata - Dermatology Times

During an day league astatine the 2022 Fall Clinical Dermatology Conference successful Las Vegas, Nevada, Brett King, MD, PhD, subordinate prof of dermatology astatine the Yale School of Medicine, Valerie D. Callender, MD, laminitis and aesculapian manager of the Callender Dermatology & Cosmetic Center, and Maria K. Hordinsky, MD, prof and seat of the section of dermatology astatine the University of Minnesota, presented their strategies connected diagnosing patients with alopecia areata (AA) and however to incorporated caller therapies into objective practice. 

AA is an autoimmune information characterized by a accelerated onset hairsbreadth nonaccomplishment connected the scalp, eyebrows, eyelashes, and successful immoderate terrible cases, assemblage involvement. AA tin travel with an unpredictable prognosis, with relapses, remissions, and persistent hairsbreadth loss. Typically, AA is much prevalent successful children, but it affects some sexes and each ethnicities equally.

Clinical presentations of AA include:

• Patchy hairsbreadth loss
• Alopecia totalis
• Alopecia universalis
• Ophiasis pattern
• Inverse-Ophiasis (or sisaipho) pattern
• Diffuse pattern
• Alopecia barbae
• Alopecia areata of the nails

To accurately diagnose AA, dermatologists should implicit a aesculapian past review, carnal exam, dermoscopy, hairsbreadth propulsion test, and a biopsy. Another instrumentality to usage is the Alopecia Areta Investigator Globa Assessment (AA-IGA), which examines illness severity by the magnitude of scalp hairsbreadth loss.

According to the speakers, determination are aggregate factors to see erstwhile choosing a attraction enactment for children and adults with AA, specified as:

• Age of the patient
• Location of the hairsbreadth loss
• Disease extent
• Disease severity
• Presence of different aesculapian conditions
• Scalp biopsy study connected the hairsbreadth rhythm and inflammation
• Patient/parent prime aft a thorough reappraisal of the projected attraction and its risk, benefits, and expectations

For patchy AA, suggested treatments are topical oregon intralesional corticosteroids, minoxidil solution, anthralin, steroids successful shampoo formulations, and topical immunotherapy. Treatment options for extended AA see topical corticosteroids, topical minoxidil, topical immunotherapy, dithranol, oral vitamin D, phototherapy, laser therapy, and biologics.

Janus Kinase (JAK) inhibitors besides amusement affirmative results for efficaciously managing AA. Oral ruxolitnib has been shown to induce hairsbreadth regrowth successful patients with moderate-to-severe AA. Tofacitinib is different JAK inhibitor that has been studied successful narration to AA attraction for adolescents and adults.

To reason their presentation, King, Callender, and Hordinsky stressed that determination are assorted objective presentations of AA ranging from patchy areas of hairsbreadth nonaccomplishment to implicit scalp engagement and assemblage hairsbreadth loss. Current treatments see topical, intralesional, and systemic interventions. However, these treatments show varying degrees of success.

Reference

King B, Callender V, Hordinsky M. The ‘how-to’ connected diagnosing and managing alopecia areata. 2022 Fall Clinical Dermatology Conference. October 21, 2022. Las Vegas, Nevada.