The first account of alopecia areata is usually ascribed to Celsus. Writing in the first century AD, he described two patterns of hair loss under the heading ‘Areae’1. The first, known as alopecia (from the Greek alopekia meaning ‘fox-mange’) ‘... spreads in no certain form. It is found in the hair of the head and in the beard.’ The second type, known as ophiasis, ‘... begins at the hinder part of the head... it creeps with two heads to the ears...’ However, it was not until the latter half of the nineteenth century that alopecia areata was clearly delineated from tinea capitis, and claims that alopecia areata was caused by various microorganisms continued to appear into the early years of the present century. A variety of theories as to the cause of alopecia areata have been proposed since that time. These have included endocrine dysfunction, reflex irritation and trophoneurosis. Currently, the most popular view is that alopecia areata is an autoimmune disease but, although there are grounds for believing that immunological mechanisms are involved in the disease, most of the evidence that alopecia areata is caused by autoimmunity is circumstantial. A particular problem, both in terms of understanding the aetiology and in the development of better forms of treatment, has been our poor understanding of the pathogenesis.
KeywordsHair Follicle Hair Growth Alopecia Areata Dermal Papilla Tinea Capitis
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- 1.Celsus, A. C. (1838). In Of Medicine, Book VI, pp. 292–293 (translated by James Grieve), (London: H. Renshaw)Google Scholar
- 4.Rosen, E. (1945). Uveitis with poliosis, vitiligo, alopecia and dysacousia (Vogt-Koyanagi-Harada syndrome). Arch. Ophthalmol, 33, 281–292Google Scholar
- 7.Jelinek, J. E. (1972). Sudden whitening of the hair. Bull. NY Acad. Med., 48, 1003–1013Google Scholar
- 9.Valsecchi, R., Vicari, O., Frigeni, A., Foiadelli, L., Naldi, L. and Cainelli, T. (1985). Familial alopecia areata—genetic susceptibility or coincidence? Acta Dermatol; Venereol., (Stockh.) 65, 175–177Google Scholar
- 11.Van Scott, E. J. and Ekel, T. (1958). Geometric relationships between the matrix of the hair bulb and its dermal papilla in normal and alopecic scalp. J. Invest. Dermatol., 31, 281–287Google Scholar
- 12.Editorial (1984). Alopecia areata—an autoimmune disease? Lancet, 1, 1335–1336Google Scholar
- 23.Headington, J. T., Mitchell, A. and Swanson, N. (1981). New histopathologic findings in alopecia areata studied in transverse section. J. Invest. Dermatol., 76, 325Google Scholar
- 25.Van Scott, E.J. (1958). Morphologic changes in pilosebaceous units and anagen hairs in alopecia areata. J. Invest. Dermatol., 31, 35–43Google Scholar
- 26.Perret, C, Wiesner-Menzel, L. and Happle, R. (1984). Immunohistochemical analysis of T-cell subsets in the peribulbar and intrabulbar infiltrates of alopecia areata. Acta Dermatol. Veriereol. (Stockh.) 64, 26–30Google Scholar
- 44.Home, K.A., Jahoda, C.A.B., Johnson, B.E., Michie, H.J. and Oliver, R. F. (1987). An animal model for alopecia. J. Invest. Dermatol., 89, 316Google Scholar