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Alopecia Areata

Alopecia Areata. Ciaran Woodman. Background. Partial hair loss: Patchy Extensive > 50% Totalis Universalis 2% dermatology appointments Children and adolescents: 60% before 20 20% < 16 M=F. Causes and Associations. ? T cell immune mediated response Ax: Pernicious Anaemia

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Alopecia Areata

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  1. Alopecia Areata Ciaran Woodman

  2. Background • Partial hair loss: • Patchy • Extensive > 50% • Totalis • Universalis • 2% dermatology appointments • Children and adolescents: • 60% before 20 • 20% < 16 • M=F

  3. Causes and Associations • ? T cell immune mediated response • Ax: • Pernicious Anaemia • Thyroid disorders • Vitiligo • AI/Atopy • Environment: • Virus • Stress

  4. Presentation • Sudden onset +/- pruritus/burning • Circumscribed patches • Nail involvement • Pull Test • Investigations: • TFT • Scalp scrapings

  5. Differential Diagnoses • Tinea Capitis – 4-14y • Trichotillomania • Traction alopecia • SLE • Syphyllis • Telogen Effluvium

  6. Management • <16 – refer • Watchful wait – spontaneous remission • Topical Steroids/Minoxidil • Refer derm – intralesional steroids, topical immunotherapy • Wigs • Counselling

  7. Info for Patient • Unpredictable • Treatment takes time • Sun-cream etc • 34-50% resolve in 1 year • Most have >1 episode • 14-25% - Totalis Universalis

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