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Alopecia areata associated with other diseases
Most people who have alopecia areata do not have any other medical
condition, but a small proportion of affected individuals may
develop other conditions. Common disease associations with alopecia
areata include allergic rhinitis, asthma, and atopic dermatitis.
The exact nature of the relationship between these other medical
conditions is not clear. The association is considered co-relational – that
is to say there is a link between alopecia areata and other conditions,
but it cannot be assumed that one condition actually causes the
other.
Other unusual associations noted with alopecia areata include
testicular atrophy or dysfunction. Eye abnormalities were reported
to be present in up to 80% of patients with alopecia areata who
otherwise had no ocular symptoms compared with 30% in normal concurrent
controls although this claim is highly controversial. Ophthalmologic
changes noted in those studies that claimed an associateion between
alopecia areata and eye changes include lens opacities, a change
in iris color, or pigment hyperplasia of the choroids and retinal
epithelium.
Atopy and alopecia areata
Atopy is a hereditary disorder marked by the tendency to develop
immediate allergic reactions to substances such as pollen, food,
dander & insect venoms and is manifested by hay fever, asthma,
or similar allergic conditions. Alopecia areata, when associated
with atopy, is reported to occur earlier in life, have a more
severe course and prognosis, and respond less well to treatment.
In some studies, atopy was found in more than 40 percent of alopecia
areata patients, whereas the prevalence of atopic diseases in
the general population is estimated to be 20 percent.
The reason for this apparent increased frequency of atopy in
alopecia areata affected individuals is not clear. It may be that
the genes involved in the inflammatory component of alopecia areata
can also increase the chances of an allergic reaction. In some
respects the inflammation that occurs in allergies is similar
to that seen in autoimmune disease. The difference is that in
autoimmune disease the body’s immune system inappropriately
targets self antigens while with allergies the body inappropriately
targets environmental antigens.
Alopecia
areata and chromosome disorders
Alopecia areata may be seen in association with two chromosome
disorders, Down syndrome and Turner syndrome. Down syndrome is
a congenital disorder, caused by the presence of an extra 21st
chromosome, in which the affected person has mild to moderate
mental retardation, short stature, and a flattened facial profile.
Turner syndrome is a congenital condition of females associated
with a defect or an absence of an X-chromosome, characterized
by short stature, webbed neck, outward-turning elbows, shield-shaped
chest, sexual underdevelopment, and amenorrhea.
In one study, alopecia areata was found in 60 of 1000 Down syndrome
patients compared with 1 of 1000 control subjects with mental
retardation related to other causes. Clinical severity and extent
of alopecia areata lesions appears to correlate with the severity
of mental retardation.
Table
of references on finding alopecia areata in association with
other diseases
Alopecia areata has been reported in association with many other
medical conditions. Most of these complaints are immunologically
mediated. The presence of alopecia
areata plus other immune conditions in individuals has been taken
as indirect, circumstantial evidence that alopecia areata is also
immunologically based. Note: Most medical journal papers below
are case reports on just one or two people and statistical information
was not provided.
| PERCENTAGE WITH AA PLUS CONDITION
| ASSOCIATED CONDITION
| CITATION
|
| *
| Atopy
| Robinson 1948
|
| 18% children, 9% adults
| Atopy
| Muller 1963
|
| 10%
| Atopy
| Ikeda 1965
|
| 52.4%
| Atopy
| Penders 1968
|
| 1%
| Atopy
| Gip 1969
|
| *
| Atopy
| Young 1978
|
| 22%
| Atopy
| De Weert 1984
|
| *
| Atopy
| Shellow 1992
|
| *
| Candida endocrinopathy syndrome
| Stankler 1972
|
| *
| Candida endocrinopathy syndrome
| Boni 1995
|
| 13%
| Down's syndrome
| Wunderlich 1965
|
| *
| Down's syndrome
| Brown 1977
|
| 6%
| Down's syndrome
| Du Vivier 1975
|
| 8.8%
| Down's syndrome
| Carter 1976
|
| *
| Down's syndrome
| Scherbenske 1990
|
| Significant
| Eyes
- cataracts
| Muller 1963
|
| Not significant
| Eyes
| Summerly 1966
|
| 51%
| Eyes - lens opacities
| Recupero 1999
|
| *
| Eyes - cataracts
| Orecchia 1988
|
| *
| HIV/AIDS
| Schonwetter 1986
|
| *
| HIV/AIDS
| Staughton 1990
|
| *
| HIV/AIDS
| Stewart 1993
|
| *
| HIV/AIDS
| Cho 1995
|
| *
| Hodgkins lymphoma
| Chan 1992
|
| *
| Legionaire's disease
| Cook 1993
|
| *
| Intestinal polyposis
| Izumi 1970
|
| *
| Nuchal nevus flammeus
| Camacho 1992
|
| *
| Uticaria
| Kumar 1995
|
Alopecia
areata associated with other diseases references
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An evaluation of 736 patients. Arch Dermatol. 1963
Sep;88:290-7. PMID: 14043621
- Muller SA. Alopecia: syndromes of
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PMID: 4581946
- Ikeda T. A new classification of alopecia
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- Penders AJ. Alopecia areata and atopy.
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- Gip L, Lodin A, Molin L. Alopecia
areata. A follow-up investigation of outpatient material. Acta
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- Young E, Bruns HM, Berrens L. Alopecia
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- De Weert J, Temmerman L, Kint A. Alopecia
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- Hara M, Hunayama M, Aiba S, Suetake T, Watanabe M, Tanaka
M, Tagami H. Acrokeratosis paraneoplastica (Bazex syndrome)
associated with primary cutaneous squamous cell carcinoma of
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- Stankler L, Bewsher PD. Chronic mucocutaneous
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- Boni R, Trueb RM, Wuthrich B. Alopecia
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PMID: 8589491
- Wunderlich C, Braun-Falco O. [MONGOLISM AND ALOPECIA AREATA.]
Med Welt. 1965 Mar 6;10:477-81. PMID: 14276234
- Brown AC, Olkowski ZL, McLaren JR, Kutner MH. Alopecia areata
and vitiligo associated with Down's syndrome. Arch Dermatol.
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- Du Vivier A, Munro DD. Alopecia areata,
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PMID: 122906
- Carter DM, Jegasothy BV. Alopecia
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PMID: 134671
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and ocular manifestations of Down syndrome. J Am Acad Dermatol.
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PMID: 5862630
- Recupero SM, Abdolrahimzadeh S, De Dominicis M, Mollo R, Carboni
I, Rota L, Calvieri S. Ocular alterations
in alopecia areata. Eye. 1999 Oct;13 ( Pt 5):643-6.
PMID: 10696317
- Orecchia G, Bianchi PE, Malvezzi F, Stringa M, Mele F, Douville
H. Lens changes in alopecia areata.
Dermatologica. 1988;176(6):308-9. PMID:
3402643
- Schonwetter RS, Nelson EB. Alopecia
areata and the acquired-immunodeficiency-syndrome-related complex.
Ann Intern Med. 1986 Feb;104(2):287. PMID: 3946974
- Staughton R.Skin manifestations in
AIDS patients. Br J Clin Pract Suppl. 1990 Sep;71:109-13. PMID:
2091731
- Stewart MI, Smoller BR. Alopecia universalis
in an HIV-positive patient: possible insight into pathogenesis.
J Cutan Pathol. 1993 Apr;20(2):180-3.
PMID: 8100574
- Chan PD, Berk MA, Kucuk O, Singh S. Simultaneously occurring
alopecia areata and Hodgkin's lymphoma: complete remission of
both diseases with MOPP/ABV chemotherapy.
Med Pediatr Oncol. 1992;20(4):345-8.
PMID: 1376855
- Cook D, Georgouras K. Alopecia areata
associated with Legionnaires' disease. Australas J Dermatol.
1993;34(3):137. PMID: 8080419
- Izumi AK, Rosato FE, Shelley WB. Alopecia
areata in association with intestinal polyposis. The relationship
of two syndromes- Gardner's and Cronkhite-Canada. Acta Derm
Venereol. 1970;50(5):381-4. PMID: 4099144
- Camacho F, Navas J. Nuchal nevus flammeus
in alopecia areata. Dermatology. 1992;184(2):158. PMID: 1498382
- Kumar B, Sharma VK, Sehgal S. Antismooth
muscle and antiparietal cell antibodies in Indians with alopecia
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