Alopecia Totalis/Universalis

  • Pooya Khan Mohammad Beigi


Alopecia totalis/universalis is the most severe subset of alopecia areata, which involves total loss of body hair. Approximately 5% of AA cases will progress to alopecia totalis [2].


Puberty Genetic factor CD-8-driven Th1-type autoimmune HLA-DR11 HLA-DR4 HLA-DQ7 Patchy alopecia areata Mild erythema Exclamation point Burning sensation Pruritus Vellus hairs Topical corticosteroids Contact immunotherapy Dinitrochlorobenzene (DNCB) Squaric acid dibutyl ester Diphencyprone (DPCP) Dermatitis JAK inhibitors Ruxolitinib Tofacitinib Clobetasol propionate ointment 


  1. 1.
    Messenger AG, McKillop J, Farrant P, McDonagh AJ, Sladden M. British association of dermatologists’ guidelines for the management of alopecia areata 2012. Br J Dermatol. 2012;166(5):916–26. Scholar
  2. 2.
    Alkhalifah A, Alsantali A, Wang E, McElwee KJ, Shapiro J. Alopecia areata update: part I. Clinical picture, histopathology, and pathogenesis. J Am Acad Dermatol. 2010;62:177–88. quiz 189-190.CrossRefPubMedGoogle Scholar
  3. 3.
    Gilhar A, Etzioni A, Paus R. Alopecia areata. N Engl J Med. 2012;366(16):1515.CrossRefPubMedGoogle Scholar
  4. 4.
    Goh C, Finkel M, Christos PJ, et al. Profile of 513 patients with alopecia areata: associations of disease subtypes with atopy, autoimmune disease and positive family history. J Eur Acad Dermatol Venereol. 2006;20:1055–60.CrossRefPubMedGoogle Scholar
  5. 5.
    Colombe BW, Lou CD, Price VH. The genetic basis of alopecia areata: HLA associations with patchy alopecia areata versus alopecia totalis and alopecia universalis. J Invest Dermatol (Symp Proc). 1999;4:216–9.CrossRefGoogle Scholar
  6. 6.
    Chartier MB, Hoss DM, Grant-Kels JM. Approach to the adult female patient with diffuse nonscarring alopecia. J Am Acad Dermatol. 2002;47(6):809–18.CrossRefPubMedGoogle Scholar
  7. 7.
    Hordinsky MK. Overview of alopecia areata. J Investig Dermatol Symp Proc. 2013;16(1):S13–5. Elsevier.CrossRefGoogle Scholar
  8. 8.
    Happle R, Hausen BM, Wiesner-Menzel L. Diphencyprone in the treatment of alopecia areata. Acta Derm Venereol. 1983;63:49–52.PubMedGoogle Scholar
  9. 9.
    Tosti A, Piraccini BM, Pazzaglia M, Vincenzi C. Clobetasol propionate 0.05% under occlusion in the treatment of alopecia totalis/universalis. J Am Acad Dermatol. 2003;49(1):96–8. Scholar
  10. 10.
    Walker SA, Rothman S. Alopecia Areata1: a statistical study and consideration of endocrine influences. J Investig Dermatol. 1950;14(6):403–13.CrossRefPubMedGoogle Scholar
  11. 11.
    Molin L. Aspects of the natural history of herpes zoster. A follow-up investigation of outpatient material. Acta Derm Venereol. 1969;49(6):569–83.PubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Pooya Khan Mohammad Beigi
    • 1
    • 2
    • 3
  1. 1.Department of Health ManagementNew York Medical CollegeValhallaUSA
  2. 2.University of British ColumbiaVancouverCanada
  3. 3.Misdiagnosis AssociationSeattleUSA

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