Management of AlopeciaNurul Shuhada bt Mohd Nazari030369

Investigation

1. Serology ▫ANA (to rule out SLE)▫Rapid plasma reagin ( to rule out syphilis )

2. KOH preparation▫Rule out tinea capitis

•Solitary patch or few patches usually do not need treatment.

Solitary lesion of AA in male

Solitary lesion of AA in female.

•If the patches coalesce and become a cosmetic problem or developed into alopecia totalis, treatment is needed.

Alopecia areata universalis•Loss of scalp hair, eyebrown, eyelashes, beard, and all body hair

1. General management

•Treatment directed at inflammatory infiltrate.

•No curative treatment is available•Psychological support from surrounding•Person with extensive scalp involvement

such as AAT may prefer to wear wig or hairpiece

•Application of makeup/ tattoo to eyebrow

2. Glucocorticoids

•Topical ▫Superpotent agents usually not effective

•Intralesional injection ▫Few and small lesions of AA can be treated

with intralesional triamcinolone acetonide▫3-7 mg/ml▫Very effective temporarily

•Systemic glucocorticoid ▫Induced regrowth but AA recurs on

discontinuitaion

Systemic Cyclosporine

•Induced regrowth but AA recurs if drug discontiued.

3. Induction of Allergy Contact Dermatitis•Dinitrodiphencyprone, squaric acid

dibutylester or diphencyprone reported to be succesful

•Local discomfort due to allergic contact dermatitis and swelling of regional lymph nodes poses a problem

4. Oral PUVA ( Photochemotherapy)•Whole body must be exposed•Variably effective as high as 30%.

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