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Alopecia areata is a sudden happen limitations patchy areas of sex hair hair loss disease. Its characteristic is the blockage scalp normal, no inflammation and self-conscious symptom, often in had found his head round or oval, hair loss spot, bald hair fringe hair is loose, very easy to pull out Alopecia areata, of course of course after a slow, sustainable for months to for years. The disease to ease and often have repeated attacks. Alopecia areata about 5-10% of cases in a few days or months off and become the hair all bald Alopecia, a few serious totalis patients can be involving the eyebrows, beard, armpit hair, pubic hair, etc, all stripped Alopecia universalis said.
etiology
Now cause is still unknown. Nervous spirit factors is considered to be one of the important factors. Many cases before the neural mental trauma such as long-term anxious, anxiety, grief, mental tension and emotional upset wait for a phenomenon. Sometimes the patient in the course of these mental factors, can make the disease worse quickly.
In recent years, Alopecia areata study the etiology of the following factors: with
1. About 10% ~ 20% genetic allergic cases have family history. A report about the identical twins and Alopecia areata occur in the same position, and report a 4 Alopecia areata generations, think is genetic defects sexual diseases. From clinical accumulation of disease saw that, with genetic allergic constitution of comorbid Alopecia areata easily. The United States with Alopecia areata statistics of children in patients with asthma, eczema or 18% or both; Adult Alopecia areata accounts for about 9% of patients; Alopecia totalis children patients than is even higher, at 23%. Alopecia areata patients of Japanese statistics have accounted for 10% of the genetic allergic constitution, the Netherlands is as high as 52.4%. But the Dutch establish genetic allergic constitution is the basis for the positive skin test, and genetic family history also includes the allergy. So the countries and regions of genetic allergic constitution diagnosis standard is different, also can’t data comparison. China’s ChenCheng strong Alopecia areata a white blood cells and the related research shows that: antigen Alopecia areata patient HLA antigen-A9 frequency (16.67%) than normal (32.65%) was significantly lower, from the point of view of experiment Alopecia areata support the genetic allergy factors.
2. Their immune Alopecia areata patients with some autoimmune disease than those with normal rate. As with the thyroid disease of 0 ~ 8%; With the vitiligo 4% (normal 1%). And Alopecia areata patients about antibodies research report is differ, has said there, also have said not found. China’s ZhangXinJiang a about T cells subsets and beta 2 micro globulin study suggests Alopecia areata patients exist T cell network disorders and humoral immune disorders.
3. Down syndrome in Down syndrome, often for increase rate bald spot alopecia universalis totalis or alopecia. These patients antibodies exists significant increased.
At present still not sure Alopecia areata is autoimmune diseases, but its comorbid autoimmune diseases, such as a temporary relief for cortical hormone, tip tend to their own immune theory.
Japan Ikeda after long-term research think Alopecia areata can be divided into four type, each of the onset ages, clinical manifestations and prevention are different.
Ⅰ type, genetic allergic (10%) : the early, the course of a long, 75% for alopecia totalis development.
Ⅱ type, autoimmune (5%) : often in 40 years old of after.
Ⅲ type, hypertension, former sex (4%), the young adult onset one or both parents to one of the patients with high blood pressure. The illness quickly, alopecia totalis incidence of 39%.
Ⅳ type, unusual type (83%) : do not belong to Ⅰ ~ Ⅲ type person. Develop in the late children or young people, the total course in three years, a single often Alopecia areata can be in 6 months long hair. 6% happen totalis alopecia.
Pathological changes
Hair follicles and the surrounding a lymphocytes, part can be hair follicle walls, and into the hair matrix cells degeneration. In the fall of the hair follicle has a new form of hair. The new long hair lack of pigment. The late hair follicles are narrow, leather nipple location is also up. Matrix, decrease around around vascular disease, so the blood vessels are connective tissue thrombosis. A long time also reduce the number of hair follicle cells infiltrating at this time, no obvious also.
Clinical manifestations
Alopecia areata can occur at any from infants to old age, but with more gender differences, middle-aged man is not clear.
The disease is longer than had found or by others found that no self-conscious symptom, a few cases coming on earlier place can have a mildly abnormal feeling.
For the beginning of one or several borders round or oval alopecia, straight play about 1 ~ 2 cm more. The edge of the hair loss in some very loose and easy to take off hair, some have broken near side, the hair often atrophy. If the hair pulled up, can see the thick hair on the bottom of the small and the hair loss and pigment. This phenomenon is the sign of progress. Continue to increase, hair loss phenomenon each piece, can also expand the fusion form irregular shape. If continue to progress can be totalis alopecia. Serious brow, eyelash, armpit hair, pubic hair and body hair also fall off, namely for alopecia universalis.
Hair loss also can stop hair loss, this time no longer expand the range of edge, a firm, not easy hair out several big, edge, a firm, not easy hair pull out, several months, hair can gradually or quickly grow. Also some patients to grow white pastel, later gradually become the thick black long hair, be normal,.
The normal scalp hair loss, smooth, without inflammation phenomenon, sometimes look thinner slightly concave, this is because the hair and hair root disappear, the reason and not a scalp thin.
Children occur in the bald hair hair pillow called ophiasis.
Alopecia areata can and the following disease happening at the same time:
1. Armour lesions can the drip is sunken, longitudinal crest and irregular thickening. Also can have the opacity, crisp and change. Alopecia alopecia universalis totalis and a change of more obvious.
2. Leucoderma or white hair about 4% with leucoderma, black hair off cases after a new long are white hair. Vogt Koyanagi syndrome-about half have Alopecia areata cases.
3. Cataract may be associated with posterior capsule back under catarracts subcapsular.
Differential diagnosis
According to happen suddenly round or oval, hair loss, alopecia scalp normal, it’s not difficult to diagnosis. With the following disease shall be identified:
1. Tinea alba don’t fully take off method, hair not easily broken, most residual hair roots was uprooted, with squames. Easy to check mold broken hair. Good hair in children.
2. Though a syphilitic alopecia and erythema shape bald hair, the hair without scar formation, but the edge, a bug eat by moth, irregular. Alopecia hair loss is not entirely, the number is numerous, good hair at rear. Accompanied by other symptoms, syphilis syphilis serologic testing positive.
3. Pseudopelade place atrophy, smooth and scalp glossy hair follicles, see open, the edge of a supreme rough spot in the fine hair loss.