Alopecia areata in atopic dermatitis: coincidence or regularity?

Abstract

Extensive trials have identified a close relationship between atopic dermatitis (AD) and alopecia areata (AA). This review paper summarizes and analyzes available data on the immunological pattern of AD-associated AA. The analysis of scientific findings suggests that epidermal barrier dysfunction in AD promotes AA in the presence of target genes contributing to its development. Both pathological entities negatively affect each other. The results are the reduction in regulatory T cell (Treg) suppression activity and an increase in inflammatory and autoimmune activity of Th-17 cells. Hyperergic Th2 response affects AD-associated AA clinical presentations. The regression of bald patches after IL-4, IL-13, and histamine receptors blockage further establishes the association between AA and AD. The possibility of atopic alopecia requires both skin and hair care products in AD. Dry peeling skin vulnerable to infections should be treated to reduce the risk of autoimmunity in AA. The presence of two family lines of genetic predisposition (atopy and AA) results in severe combined manifestations of these disorders in progeny. Therefore, attention should be paid to early AD signs in children in these families to commence treatment timely. KEYWORDS: atopic dermatitis, аlopecia areata, genetics, autoimmunity, epidermal barrier, regulatory T cells, immune privilege, hair follicle, T helper 17 cells, mast cells. FOR CITATION: Petrova S.Yu., Albanova V.I. Alopecia areata in atopic dermatitis: coincidence or regularity? Russian Medical Inquiry. 2022;6(2):85–91 (in Russ.). DOI: 10.32364/2587-6821-2022-6-2-85-91.