Alopecia areata - External and Internal Eye
See also in: Overview,Hair and Scalp,Nail and Distal DigitAlerts and Notices
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Synopsis

Alopecia areata is a T-lymphocyte mediated autoimmune disease of the hair follicle resulting in nonscarring hair loss. Most cases are limited to 1 or 2 small patches of alopecia that involve the scalp, eyebrows, eyelashes, or body hair, but in severe cases, all of the hair on the scalp is lost (alopecia totalis) or all scalp and body hair is lost (alopecia universalis). History of sudden onset is characteristic. Alopecia areata is seen equally in both sexes and in patients of all ages and ethnicities. There is an increased incidence of alopecia areata in patients with Down syndrome as well as those with autoimmune diseases, most commonly thyroid disease.
The course of alopecia areata is unpredictable, with wide variation in duration and extent of disease occurring from patient to patient. In most patients, hair will eventually spontaneously regrow, although recurrences are common. The condition is treatable but cannot be cured.
A 2022 retrospective population-based study in Taiwan showed an increase in retinal diseases among 9909 patients with alopecia areata. The disease extent and prior steroid treatment were not commented on; further studies are needed to confirm an association.
The course of alopecia areata is unpredictable, with wide variation in duration and extent of disease occurring from patient to patient. In most patients, hair will eventually spontaneously regrow, although recurrences are common. The condition is treatable but cannot be cured.
A 2022 retrospective population-based study in Taiwan showed an increase in retinal diseases among 9909 patients with alopecia areata. The disease extent and prior steroid treatment were not commented on; further studies are needed to confirm an association.
Codes
ICD10CM:
L63.9 – Alopecia areata, unspecified
SNOMEDCT:
68225006 – Alopecia areata
L63.9 – Alopecia areata, unspecified
SNOMEDCT:
68225006 – Alopecia areata
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Trichotillomania, from the twisting and pulling of hair, may mimic alopecia areata. Hairs are broken off at varying lengths.
- Telogen effluvium from nutritional, hormonal, and drug etiologies can lead to large clumps of hair loss in a similar fashion to alopecia areata. The loss is diffuse, not localized.
- Tinea capitis
- Secondary syphilis
- Loose anagen syndrome
- Androgenetic alopecia – male or female pattern
- Pseudopelade of Brocq / scarring alopecia
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.
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References
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Last Reviewed:04/10/2017
Last Updated:01/04/2023
Last Updated:01/04/2023

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Alopecia areata - External and Internal Eye
See also in: Overview,Hair and Scalp,Nail and Distal Digit