Background: Alopecia areata (AA) is a non-scarring hair loss disorder of autoimmune
Objective: To familiarize physicians with the clinical presentation, diagnosis, evaluation, and management
of pediatric alopecia areata.
Methods: The search term "Alopecia areata" was entered into a Pubmed search. A narrow scope
was applied to the categories of "epidemiology", "clinical diagnosis", "investigations", "comorbidities",
and "treatment". Meta-analyses, randomized controlled trials, clinical trials, observational
studies, and reviews were included. Only papers published in the English language were included.
A descriptive, narrative synthesis was provided of the retrieved articles.
Results: AA is an autoimmune disease of unknown etiology. It is the third most common dermatologic
presentation in children with a lifetime risk of 1-2%. Diagnosing AA can be made on the
basis of the history and clinical findings. Patients will often present with patchy, non-scarring hair
loss, generally affecting the scalp. History may reveal a personal or family medical history of autoimmune
or atopic disease or a recent stressful event. Tricoscopic examination will classically show
“exclamation point hairs” and “yellow dots”. Nonspecific nail changes may be present. Other clinical
variants include alopecia totalis, alopecia universalis, ophiasis, sisaipho, and Canitis subita.
There are multiple treatment options for AA, including conservative treatment, and topical, oral,
and injectable medications.
Conclusion: AA is an autoimmune disease with a heterogeneous presentation and unpredictable
clinical course. Although there is no cure for AA, there are many current treatment options available
to help manage this disfiguring disease.