Combination of ER: YAG laser and 5-Fluorouracil versus ER: YAG Laser in Treatment of Alopecia Areata.

Abstract

Alopecia areata is a chronic inflammatory disease which affects the hair follicles and sometimes the nails. The onset may be at any age and there is no known race or sex preponderance. Alopecia areata usually presents as patches of hair loss on the scalp but any hair-bearing skin can be involved. The affected skin may be slightly reddened but otherwise appears normal. Short broken hairs (exclamation mark hairs) are frequently seen around the margins of expanding patches of alopecia areata. Alopecia areata is easily distinguishable from telogen effluvium, androgenetic alopecia, and tinea capitis. About 20% of people with alopecia areata have a family history of the disease, indicating a genetic predisposition. Associations have been reported with a variety of genes, including major histocompatibility complex, cytokine and immunoglobulin genes, suggesting that the genetic predisposition is multifactorial in nature. The hair follicle lesion is probably mediated by T lymphocytes. The autoantigen in alopecia areata remains to be identified, but results from current studies suggest that it may be derived from melanocytes. The association between alopecia areata and other autoimmune diseases suggests that alopecia areata is itself an autoimmune disease. An overriding consideration in the management of alopecia areata is that, although the disease may have a serious psychological effect, it has no direct impact on general health that justifies the use of hazardous treatments, particularly of unproven efficacy. In addition, many patients, although by no means all, experience spontaneous regrowth of hair.