Short Commentary - (2023) Volume 13, Issue 1
Alopecia Areata (AA) is a common autoimmune disorder that often results in unpredictable hair loss. It affects roughly 6.8 million people in the United States and 147 million people worldwide. In most cases, hair falls out in small patches around the size of a quarter. There may be only a few patches, but alopecia areata can affect wider areas of the scalp. If there is a complete loss of hair on the scalp, doctors diagnose alopecia totalis. If there is hair loss throughout the entire body, the condition is called alopecia universalis. Alopecia can affect anyone, regardless of age, gender, or race, though most cases develop before the age of 30. In this article, we look at the causes and symptoms of alopeciaareata, its diagnosis.and (AA) potential treatment. Skin-related immune manifestations such as trichodynia, telogen effluvium, and Alopecia Areata have recently been reported following COVID-19 infection and vaccination. The latter is primarily observed in patients with pre-existing AA. [1, 2]. Cases of new-onset AA following COVID-19 infection have been reported in the literature, with only one case describing a pediatric patient in his or her adolescent years [3]. We describe three school-aged patients who developed AA following COVID-19 infection. Given this condition's scarcity of pediatric reports, this series is of particular interest. Two boys and one girl, ages 8, 9, and 8, were referred to the Pediatric Dermatology Department due to the sudden appearance of patches of balding hair loss. The alopecic areas appeared 7, 4, and 3 weeks after symptomatic COVID-19 infection, which resulted in 2 weeks of high fever (39°C), cough, fatigue, and general malaise in the girl, but only mildly in the boys. Molecular testing of viral RNA on a nasopharyngeal swab during COVID-19 illness confirmed COVID-19 infection. Clinical scalp examination revealed well-defined oval patches of smooth, completely bald skin on the girl's vertex and posterior hairline, one boy's parietal area, and the other boy's vertex. The pull test was positive at the borders of all patches, indicating that the disease was still active. Trichoscopy examination revealed exclamation-mark hairs and black dots, indicating acute hair loss, particularly around patches, while short vellus hairs were retrieved centrally, confirming the diagnosis of AA. Fasting blood glucose, thyroid, liver, and kidney functionality were all within normal ranges, and the patients were treated with topical corticosteroids daily. AA is a common non-scarring hair loss condition with a 0.1%-0.2% prevalence and a 2% cumulative lifetime incidence4, primarily affecting the first four decades of life, particularly the first two (48%). Because AA is characterized by acute onset, usually in sharply defined oval-to-round patches of completely bald skin, the diagnosis is usually established clinically.The patch usually widens centrifugally, eventually leading to longstanding alopecic areas with yellow dots, which represent dilated follicular infundibula filled with keratinous and sebaceous material [4].
AA pathogenesis is currently understood to be an organ-specific autoimmunity against hair follicles, possibly caused by a loss of immune privilege of hair follicles. Indeed, in genetically predisposed individuals, viral infections such as COVID-19 infection can cause oxidative stress, which leads to an increase in the expression of MHC-I ligands on hair follicles. Upregulated MHC-I ligands may cause T cell activation, hair follicle cell destruction, and the release of perifollicular IFN- and TNF-, perpetuating the vicious inflammatory cycle [5]. Furthermore, the high association rate of AA with immune-mediated diseases such as thyroiditis, type I diabetes, and vitiligo, which have all been linked to COVID-19 infection, lends support to the theory of an immune pathogenesis of AA [4, 5].
Though a just casual association must be considered, the temporal association demonstrated between COVID-19 infection and our patients' new onset of AA reflects the temporal line of events described in other literature reports and speaks in favor of a causative link. Recently, the increased focus on COVID-19 infection has allowed researchers to identify a plethora cutaneous of possible associations with autoimmune manifestations. Perhaps AA has always been virally triggered, but increased awareness of the COVID-19 infection may have allowed for the discovery of previously unknown associations.
Citation: Henderson, G. Alopecia Areata in Children after COVID-19 infection. Prim Health Care, 2023, 13(1), 483.
Received: 07-Jan-2023, Manuscript No. JPHC-23- 87988 ; Editor assigned: 10-Jan-2023, Pre QC No. JPHC-23- 87988 (PQ); Reviewed: 24-Jan-2023, QC No. JPHC-23- 87988 (Q) ; Revised: 26-Jan-2023, Manuscript No. JPHC-23- 87988 (R); Published: 29-Jan-2023, DOI: 10.35248/2376-0389.23.13.1.484
Copyright: ©2023 Henderson, G. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
