Alopecia areata - Business

Epidemiology The condition affects 0.1%0.2% of humans, occurring in both males and females, though far more females than males.[citation needed] Alopecia areata occurs in people who are apparently healthy and have no skin disorder. Initial presentation most commonly occurs in the late teenage years, early childhood, or young adulthood, but can happen with people of all ages. Types The most common type of alopecia areata involves hair loss in one or more round spots on the scalp. Hair may also be lost more diffusely over the whole scalp, in which case the condition is called diffuse alopecia areata. Alopecia areata monolocularis describes baldness in only one spot. It may occur anywhere on the head. Alopecia areata multilocularis refers to multiple areas of hair loss. The disease may be limited only to the beard, in which case it is called Alopecia areata barbae. If the patient loses all the hair on his/her scalp, the disease is then called Alopecia areata totalis. If all b ody hair, including pubic hair, is lost, the diagnosis then becomes Alopecia areata universalis. Alopecia areata totalis and universalis are rare. Causes Alopecia areata is noncommunicable, or not contagious. It occurs more frequently in people who have affected family members, suggesting that heredity may be a factor. Strong evidence that genes may increase risk for alopecia areata was found by studying families with two or more affected members. This study identified at least four regions in the genome that are likely to contain alopecia areata genes. In addition, it is slightly more likely to occur in people who have relatives with autoimmune diseases. The condition is thought to be an autoimmune disorder in which the body attacks its own hair follicles and suppresses or stops hair growth. There is evidence that T cell lymphocytes cluster around these follicles, causing inflammation and subsequent hair loss. An unknown environmental trigger such as emotional stress or a p athogen is thought to combine with hereditary factors to cause the condition. There are a few recorded cases of babies being born with congenital alopecia areata; however, these are not cases of autoimmune disease because an infant is born without a fully developed immune system. Diagnosis Alopecia areata First symptoms are small, soft, bald patches which can take just about any shape but are most usually round. It most often affects the scalp and beard but may occur on any hair-bearing part of the body. There may be different skin areas with hair loss and regrowth in the same body at the same time. It may also go into remission for a time, or permanently. The area of hair loss may tingle or be very slightly painful. The hair tends to fall out over a short period of time, with the loss commonly occurring more on one side of the scalp than the other. Another presentation of the condition are exclamation point hairs. Exclamation point hairs are hairs that become narrower along the length of the strand closer to the base, producing a characteristic "exclamation point" appearance. One diagnostic technique applied by medical professionals is to gently tug at a handful of hair along the edge of a patch with less strength than would be required to pull out healthy hair. In healthy hair, no hair should fall out or ripped hair should be distributed evenly across the tugged portion of the scalp. In cases of alopecia areata hair will tend to pull out more easily along the edge of the patch where the follicles are already being attacked by the body's immune system than away from the patch where they are still healthy. Professionals usually remind patients that the hair that is pulled out would eventually fall naturally. The test is conducted only once to identify the condition and rule out a simple localized hair loss condition. Nails may have pitting or trachyonychia. Treatment About 50% of patients' hair will regrow in one year without any treatment. If the affected region is small, it is reasonable to observe the progression of the illness as the problem often spontaneously regresses and the hair grows back. In 90% of cases, the hair will, ultimately, grow back. In the other 10%, only some or no hair will regrow.[citation needed] In cases where there is severe hair loss, there has been limited success treating alopecia areata with clobetasol or fluocinonide, steroid injections, or cream. Steroid injections are commonly used in sites where there are small areas of hair loss on the head or especially where eyebrow hair has been lost. Some other medications used are minoxidil, irritants (anthralin or topical coal tar), and topical immunotherapy cyclosporine, each of which are sometimes used in different combinations. Oral corticosteroids decrease the hair loss, but only for the period during which they are taken, and these drugs have adverse side effects. For small patches on the beard or head it is possible to suppress with topical tacrolimus ointments like Protopic. Symptoms may remain suppressed until aggravated by stress or other factors. Treatment with tacrolimus is recommended only for short periods of time due to adverse side effects.[citation needed] Initial stages may be kept from increasing by applying topical corticosteroids. However, topical corticosteroids frequently fail to enter the skin deeply enough to affect the hair bulbs, which are the treatment target. In terms of adapting to the disease rather than treating in an effort to cure, there are also many options available. Wigs are often used by those with Alopecia, particularly Alopecia Totalis, in which hair is entirely lost from the scalp. Wigs are available at many levels of development and technology, including wigs with suction mechanisms to keep it firmly attached to the scalp. Most of the wigs available are so well made that it is impossible without close investigation to tell whether they are a person's actual hair, or a wig. Prognosis In most cases that begin with a small number of patches of hair loss, hair grows back after a few months to a year. In cases with a greater number of patches, hair can either grow back or progress to alopecia totalis or, in rare cases, universalis. -Effects of alopecia areata are mainly psychological (loss of self image due to hair loss). However, patients also tend to have a slightly higher incidence of asthma, allergies, atopic dermal ailments, and even hypothyroidism. Loss of hair also means that the scalp burns more easily in the sun. Loss of nasal hair increases severity of hay fever and similar allergic conditions. Patients may also have aberrant nail formation because keratin forms both hair and nails. Hair may grow back and then fall out again later. This may not indicate a recurrence of the condition, however, but rather a natural cycle of growth-and-shedding from a relatively synchronised start; such a pattern will fade over time. Episodes of alopec ia areata before puberty predispose chronic recurrence of the condition. Pitting of the fingernails can hint at a more severe or prolonged course.[citation needed] Psychosocial issues Alopecia can certainly be the cause of psychological stress. Because hair loss can lead to significant appearance changes, individuals may experience social phobia, anxiety, and depression. Some psychologists have even gone as far as to describe the feelings of loss and depression felt at the onset of the disease as being similar to those felt by people afflicted with terminal illness. In severe cases where the chance of hair regrowth is slim, individuals need to adapt to the condition, rather than look for a cure. A UK charity named The Little Princess Trust provides wigs to children with hair loss. This has been shown to increase their self-confidence. See also Alopecia totalis Alopecia universalis Noncicatricial alopecia Baldness Locks of Love List of cutaneous conditions References This pag e may also be able to help find problematic links. Several templates are available for formatting. (January 2010) ^ Odom, Richard B.; Davidsohn, Israel; James, William D.; Henry, John Bernard; Berger, Timothy G.; Clinical diagnosis by laboratory methods; Dirk M. Elston (2006). Andrews' diseases of the skin: clinical dermatology. Saunders Elsevier. ISBN 0-7216-2921-0. [page needed] ^ a b c d e f g h i j k Zoe Diana Draelos (August 30, 2007), Alopecia Areata. MedicineNet.com. Retrieved on December 2, 2007 ^ McElwee KJ, Boggess D, Olivry T, et al. (1998). "Comparison of alopecia areata in human and nonhuman mammalian species". Pathobiology 66 (2): 90107. doi:10.1159/000028002. PMID 9645633. ^ a b c d e f g Alopecia Areata at Merck Manual of Diagnosis and Therapy Professional Edition ^ Marks, James G; Miller, Jeffery (2006). Lookingbill and Marks' Principles of Dermatology (4th ed.). Elsevier Inc. ISBN 1-4160-3185-5. ^ a b c d Skin Conditions: Alopecia Areata. WebMD. Retrieved o n December 2, 2007. ^ Martinez-Mir A, Zlotogorski A, Gordon D, et al. (February 2007). "Genomewide scan for linkage reveals evidence of several susceptibility loci for alopecia areata". American Journal of Human Genetics 80 (2): 31628. doi:10.1086/511442. PMID 17236136. ^ Freedberg, Irwin M.; Fitzpatrick, Thomas B. (2003). Fitzpatrick's dermatology in general medicine. New York: McGraw-Hill, Medical Pub. Division. ISBN 0-07-138076-0. [page needed] ^ a b c American Osteopathic College of Dermatology. Alopecia Areata. Dermatologic Disease Database. Aocd.org. Retrieved on December 3, 2007. ^ BBC News article about a girl receiving a wig. External links National Institute of Arthritis and Musculoskeletal and Skin Diseases at NIH DermAtlas 42 Dermpedia Alopecia areata v d e Diseases of the skin and appendages by morphology Growths Epidermal wart callus seborrheic keratosis acrochordon molluscum contagiosum actinic keratosis squamous cell carcinoma basal cell carcinoma merkel cell carcinoma nevus sebaceous trichoepithelioma Pigmented Freckles lentigo melasma nevus melanoma Dermal and subcutaneous epidermal inclusion cyst hemangioma dermatofibroma keloid lipoma neurofibroma xanthoma Kaposi's sarcoma infantile digital fibromatosis granular cell tumor leiomyoma lymphangioma circumscriptum myxoid cyst Rashes With epidermal involvement Eczematous contact dermatitis atopic dermatitis seborrheic dermatitis stasis dermatitis lichen simplex chronicus Darier's disease glucagonoma syndrome langerhans cell histiocytosis lichen sclerosus pemphigus foliaceus Wiskott-Aldrich syndrome Zinc deficiency Scaling psoriasis tinea (corporis cruris pedis manuum faciei) pityriasis rosea secondary syphillis mycosis fungoides systemic lupus erythematosus pityriasis rubra pilaris parapsoriasis ichthyosis Blistering herpes simplex herpes zoster varicella bullous impetigo acute contact dermatitis pemphigus vulgaris bullous pemphigoid dermatitis herpetiformis porphyria cutanea tar da epidermolysis bullosa simplex Papular scabies insect bite reactions lichen planus miliaria keratosis pilaris lichen spinulosus transient acantholytic dermatosis lichen nitidus pityriasis lichenoides et varioliformis acuta Pustular acne vulgaris acne rosacea folliculitis impetigo candidiasis gonococcemia dermatophyte coccidioidomycosis subcorneal pustular dermatosis Hypopigmented tinea versicolor vitiligo pityriasis alba postinflammatory hyperpigmentation tuberous sclerosis idiopathic guttate hypomelanosis leprosy hypopigmented mycosis fungoides Without epidermal involvement Red Blanchable Erythema Generalized drug eruptions viral exanthems toxic erythema systemic lupus erythematosus Localized cellulitis abscess boil erythema nodosum carcinoid syndrome fixed drug eruption Specialized urticaria erythema (multiforme migrans gyratum repens annulare centrifugum ab igne) Nonblanchable Purpura Macular thrombocytopenic purpura actinic purpura Papular disseminated intravascular co agulation vasculitis Indurated scleroderma/morphea granuloma annulare lichen sclerosis et atrophicus necrobiosis lipoidica Miscellaneous disorders Ulcers Hair telogen effluvium androgenic alopecia trichotillomania alopecia areata systemic lupus erythematosus tinea capitis loose anagen syndrome lichen planopilaris folliculitis decalvans acne keloidalis nuchae Nail onychomycosis psoriasis paronychia ingrown nail Mucous membrane aphthous stomatitis oral candidiasis lichen planus leukoplakia pemphigus vulgaris mucous membrane pemphigoid cicatricial pemphigoid herpesvirus coxsackievirus syphilis systemic histoplasmosis squamous cell carcinoma v d e Diseases of the skin and subcutaneous tissue (integumentary system) (L, 680-709) Infections Bacterial skin disease Staphylococcus (Staphylococcal scalded skin syndrome, Impetigo, Boil, Carbuncle) Strep (Impetigo) Corynebacterium (Erythrasma) Viral skin disease Wart Molluscum contagiosum Erythema infectiosum Exanthema subitum Herpes sim plex (Herpetic whitlow, Eczema herpeticum) General Cellulitis (Paronychia) Acute lymphadenitis Pilonidal cyst Pimple (Pustule) Bullous disorders acantholysis (Pemphigus, Transient acantholytic dermatosis) Pemphigoid (Bullous, Cicatricial, Gestational) Dermatitis herpetiformis Inflammatory Dermatitis and eczema Atopic dermatitis Seborrhoeic dermatitis (Dandruff, Cradle cap) Contact dermatitis (Diaper rash, Urushiol-induced contact dermatitis) Erythroderma Lichen simplex chronicus/Prurigo nodularis Itch (Pruritus ani, Pruritus scroti, Pruritus vulvae) Nummular dermatitis Dyshidrosis Pityriasis alba Papulosquamous disorders Psoriasis (Psoriatic arthritis) Parapsoriasis (Pityriasis lichenoides et varioliformis acuta, Pityriasis lichenoides chronica, Lymphomatoid papulosis) other pityriasis (Pityriasis rosea, Pityriasis rubra pilaris) other lichenoid (Lichen planus, Lichen nitidus) Urticaria Dermatographic urticaria Cold urticaria Cholinergic urticaria Solar urticaria Erythema Er ythema multiforme/ drug eruption Stevens-Johnson syndrome Toxic epidermal necrolysis Erythema nodosum Acute generalized exanthematous pustulosis Other eryth