Alopecia Areata Research Paper

Independent Capstone Project

Diagnosis and Biochemistry of Alopecia Areata

Kaitlyn Poirier

Student Number: 250673474

MedSci 4200F

Dr. Sarah McLean

Alopecia areata (AA) is a non-scarring, autoimmune, inflammatory disease that can affect any hair-bearing area. Though it carries no actual health concerns as it is often underestimated as a disease, it often has an impact on the quality of life and self-esteem of those affected. As a result, it is a highly recognized autoimmune disease, however, the lack of available therapies is disappointing.

AA is often diagnosed through its clinical features, as there are no biochemical tests at present that can determine its manifestation. AA is most often defined through

At present there is no curative or preventative treatment and there is a lack of controlled trials evaluating therapy targets. Rather, many therapies focus on halting disease activity and addressing immune responses (Wasserman et al., Gilhar, Etzioni and Paus). Corticosteroids are the most commonly used form of treatment due to their anti-inflammatory effects and can be administered through injection, topically, and systemically (Wasserman et al., Gilhar, Etzioni and Paus). However, systemic corticosteroids are not frequently used due to their adverse side effects. Intralesional corticosteroids, preferably triamicinolone acetinoide, are often used when less than 50% of the scalp is affected (Gilhar, Etzioni and Paus) and are administered in 1 cm intervals over the scalp every 4-6 weeks (Wasserman et al.). It is important that the injections are not superficial and penetrates deep into the dermis, which allows its effects to be carried out around the bulb of the hair follicle where inflammatory effects are occurring (Wasserman et al.). If done correctly, localized regrowth can be observed within 1-2 months in anywhere from 60-70% of AA cases (Wasserman et al.) and effects of a single injection can last for up to 9 months. Relapse rates using this method occurred in as little as 29% of AA cases with limited hair loss

This method allows a greater ease of application, and so is more suited for individuals presenting with more widespread hair loss and for children. A study conducted by Mancuso et al. looked at the use of betamethasone valerate foam in the treatment of AA. Their results showed a response rate in 61% of patients, and achieved 75% hair regrowth. In comparison, betamethasone dipropionate lotion only showed responses in 27% of subjects (Mancuso et al.). High-potency topical glucocorticoids in combination with occlusive dressings are most favorable, and can show an improvement in over 25% of affected patients. However, with this method of treatment approximately 37%–63% of responders may experience relapse of AA, and be unable to sustain hair growth (Tosti et