Alopecia areata Signs and Diagnosis

Alopecia areata
Signs and Diagnosis
Alopecia areata can occur at any age from birth until the distant decade of life. Congenital cases have been reported. The maximum incidence occurs between 15-29 years. Over 44% of people with alopecia areata have an onset before 20 years. Natural History of alopecia areata is unpredictable. There are wide variations in the extent and duration from patient to patient condition. Alopecia areata is most often asymptomatic, but some patients experience burning or itching in the affected areas. The condition is located at the onset. 80% of patients have a single stain. Alopecia areata affects scalpel but can affect any hair-bearing area.
Alopecia areata located. Episodes are self-limited localized alopecia, spontaneous regeneration of hair occurs over several months intro patients with or without treatment.
Extensive alopecia areata. It represents over 50% of affected scalp. It's rare. 30% of patients involved a total loss of hair six months after onset. Evolution is unpredictable but admits relapse.
Alopecia areata universalis. Characterizes the total loss of hair on all body areas.
Pathological conditions associated with alopecia areata: -Atopic dermatitis is observed in 9-25% of patients -Vitiligo has an incidence of 2-3% -Thyroid disease varies from 1-14% Collagen-vascular diseases are described in 2% Diabetes mellitus-0. 4% Down-syndrome, anxiety, personality disorders, depression, paranoid disorders, stressful events.
Precipitating factors include: -Major stressful events -Drugs, pregnancy, trauma, febrile diseases.
Physical examination. The spots feature the presence of a peach color or normal, smooth, slightly erythematous and hairless. The hair cut is tangential to the skin but not always patognominica described. Test positive light hair removal hair on the outskirts of drift indicate active disease. Hairless areas in other parts of the body indicate the diagnosis. No epidermal changes are associated. The presence of yellow spots of alopecia areata appears to be specific and is present in 95% of patients, depending on the stage of disease. They are degenerate follicular keratinocytes and sebum in hair follicle ostium. Black dots are observed dependent hair torn, broken hairs, hairs contained in the epidermis, velus.
Nail. It is present in 6-50% of patients especially those with severe forms. Describe trachionichia, Beau lines, onicorexis, onicomadesis, coilonichia, leuconichia, lunue red.
Diagnosis.
Histological examination. Peribulbar lymphoma infiltrates characteristic is present. Usually only a few scattered sia efcteaza hairs. It described the reduction of mature hair follicles and increase velusului. There is a change in the rate of anagen phases: telogen hair follicles. Normal 90% of follicles are in anagen phase and 10% in telogen phase. In alopecia areata 70% are in anagen phase and 30% in telogen phase. In cases of alopecia lasting up to 100% of follicles are in telogen. The differential diagnosis is made with the following conditions: androgenetic alopecia, syphilis, telogen effluvium, tinea capitis, trichotilomania.