Alopecia areata – ein Update

 

 Buy Article Permissions and Reprints

Zusammenfassung

Alopecia areata (AA) – der kreisrunde Haarausfall – stellt nach der androgenetischen Alopezie die zweithäufigste Haarverlusterkrankung weltweit dar. Es wird vermutet, dass es infolge des Verlusts des Immunprivilegs des Haarfollikels zu einer Destruktion der Zellen des Haarfollikels kommt. Der konsekutive Haarausfall geht mit erheblichen Auswirkungen auf die Lebensqualität einher. Die Spontanremission liegt insbesondere bei leichteren Verlaufsformen bei bis zu 80%. Es bestehen topische, injizierbare und systemische immunsupprimierende bzw. -modulierende Behandlungsmöglichkeiten. Vielversprechend scheinen v.a. systemisch verabreichte JAK-Inhibitoren zu sein.

Abstract

Alopecia areata (AA) – circular hair loss – is the second most common hair loss disease worldwide after androgenetic alopecia. It is assumed that the loss of the immune privilege of the hair follicle leads to the destruction of the cells of the hair follicle. The consecutive hair loss is associated with considerable effects on quality of life. The spontaneous remission rate, especially in milder forms, can be up to 80%. There are topical, injectable, and systemic immunosuppressive or immunomodulating treatment options available. Systemically administered JAK inhibitors appear to be particularly promising.

Publication History

Article published online:
13 May 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

• Literatur

• 1 Yousaf A, Lee J, Fang W. et al. Association Between Alopecia Areata and Natural Hair Color Among White Individuals. JAMA Dermatol 2021; e210144
  MissingFormLabel

  PubMedSearch in Google Scholar
• 2 Tu TY, Chang R, Lai JN. et al. Human papillomavirus symptomatic infection associated with increased risk of new-onset alopecia areata: A nationwide population-based cohort study. J Autoimmun 2021; 119: 102618
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 3 Dai YX, Yeh FY, Shen YJ. et al. Cigarette Smoking, Alcohol Consumption, and Risk of Alopecia Areata: A Population-Based Cohort Study in Taiwan. Am J Clin Dermatol 2020; 21: 901-911
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 4 Chelidze K, Lipner SR. Nail changes in alopecia areata: an update and review. Int J Dermatol 2018; 57: 776-783
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 5 Lee DK, Lipner SR. Optimal diagnosis and management of common nail disorders. Ann Med 2022; 54: 694-712
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 6 Ovcharenko Y, Serbina I, Zlotogorski A. et al. Renbök phenomenon in an alopecia areata patient with psoriasis. Int J Trichology 2013; 5: 194-195
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 7 Olsen E, Hordinsky M, McDonald-Hull S. et al. Alopecia areata investigational assessment guidelines. National Alopecia Areata Foundation. J Am Acad Dermatol 1999; 40: 242-246
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 8 Gudobba C, Mane T, Bayramova A. et al. Automating Hair Loss Labels for Universally Scoring Alopecia From Images: Rethinking Alopecia Scores. JAMA Dermatol 2023; 159: 143-150
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 9 Rudnicka L, Olszewska M, Rakowska A. Atlas of Trichoscopy. London: Springer; 2012
  MissingFormLabel

  CrossrefSearch in Google Scholar
• 10 Kempf W, Hantschke M, Kutzner H. et al. Dermatopathologie. Berlin: Springer; 2020
  MissingFormLabel

  CrossrefSearch in Google Scholar
• 11 Nomiyama T, Katoh N. Clobetasol propionate 0.05% under occlusion for alopecia areata: Clinical effect and influence on intraocular pressure. Australas J Dermatol 2021; 62: e262-e264
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 12 Price VH, Willey A, Chen BK. Topical tacrolimus in alopecia areata. J Am Acad Dermatol 2005; 52: 138-139
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 13 Yee BE, Tong Y, Goldenberg A. et al. Efficacy of different concentrations of intral­esional triamcinolone acetonide for alopecia areata: A systematic review and meta-analysis. J Am Acad Dermatol 2020; 82: 1018-1021
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 14 Rastaghi F, Kaveh R, Yazdanpanah N. et al. The Efficacy and Adverse Effects of Corticosteroid Pulse Therapy in Alopecia Areata: A Review Article. Dermatol Pract Concept 2023; 13: e2023255
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 15 Fukumoto T, Fukumoto R, Magno E. et al. Treatments for alopecia areata: A systematic review and network meta-analysis. Dermatol Ther 2021; 34: e14916
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 16 King B, Ohyama M, Kwon O. et al. Two Phase 3 Trials of Baricitinib for Alopecia Areata. N Engl J Med 2022; 386: 1687-1699
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 17 King B, Guttman-Yassky E, Peeva E. et al. A phase 2a randomized, placebo-controlled study to evaluate the efficacy and safety of the oral Janus kinase inhibitors ritlecitinib and brepocitinib in alopecia areata: 24-week results. J Am Acad Dermatol 2021; 85: 379-387
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 18 Peeva E, Guttman-Yassky E, Banerjee A. et al. Maintenance, withdrawal, and re-treatment with ritlecitinib and brepocitinib in patients with alopecia areata in a single-blind extension of a phase 2a randomized clinical trial. J Am Acad Dermatol 2022; 87: 390-393
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 19 Dai Z, Chen J, Chang Y. et al. Selective inhibition of JAK3 signaling is sufficient to reverse alopecia areata. JCI Insight 2021; 6: 142205
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 20 Dhurat R, Sharma R. A Practical Approach to the Treatment of Alopecia Areata. Indian Dermatol Online J 2022; 13: 725-728
  MissingFormLabel

  PubMedSearch in Google Scholar
• 21 Roohaninasab M, Goodarzi A, Ghassemi M. et al. Systematic review of platelet-rich plasma in treating alopecia: Focusing on efficacy, safety, and therapeutic durability. Dermatol Ther 2021; 34: e14768
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 22 Cruciani M, Masiello F, Pati I. et al. Platelet-rich plasma for the treatment of alopecia: a systematic review and meta-analysis. Blood Transfus 2023; 21: 24-36
  MissingFormLabel

  PubMedSearch in Google Scholar