Some other diseases are more common in people with alopecia areata

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  Association of Alopecia Areata With Other Diseases
 
Association of alopecia areata with other diseases is well documented, though occurrence is rare. But it should not be assumed that there is a direct link between alopecia areata and other diseases i.e. one is not the cause of the other. It would be more correct to say that there is a co-relation or an indirect link between alopecia and other diseases.

Only a small proportion of people affected by alopecia areata are victims of other disorders. The details of some of these diseases are as follows:

Thyroid Diseases

Diseases of the thyroid gland are often seen associated with alopecia areata. While most investigators are certain about the association between alopecia and thyroid disease, curing one has not been a remedy for the other.

In one study, 59 out of 736 patients affected with alopecia areata also had a clinical thyroid disorder. Out of these 59 patients, 14 were cases of exopthalmic goiter, 27 were cases of simple goiter, 7 were cases of myxedema, 6 were affected by Hashimoto’s thyroiditis, and 5 were cases of previous thyroidectomy. It was noted that the same thyroid disorders occurred more frequently in patients who had alopecia areata.

In another study 19 of the 64 patients were found, carrying thyroid macrosomal antibodies as against only an incidence of 7.7% found in a separate study on an East Indian population. Neither of these studies conducted a screening for thyroid functioning but focused on physical examination, history and /or the presence of thyroid antibodies and thyroglobulin. However, confirmation of the presence of thyroid auto antibodies has not come from other studies.

Many hold the view that the incidence of clinically acceptable thyroid disorders such as Hashimoto’s chronic lymphocytes thyroiditis, thyrotoxicosis, exopthalmic goiter, and myxedema does not differ significantly from that in historical controls. As the matter stands today, the association between alopecia areata and thyroid diseases is not conclusively established.

Chromosome Disorders

Alopecia areata is also associated with two chromosome disorders – Down’s and Turner’s syndrome.

Downs syndrome is a disorder caused by functional deficiencies in T-cell mediated immune response and reductions in serum IgG levels. It is a congenital disorder caused by the presence of an extra 21st chromosome and causes mild to moderate mental retardation, short stature and a flat facial profile. Patients with Downs’s syndrome appear to have an increased incidence of alopecia areata. On average, 5% of patients with Down syndrome have alopecia areata, whereas it is only around 0.1% in concurrent control mentally retarded patients. Observations indicate a correlation between the severity and extent of the alopecia areata lesions and the severity of the mentally retarded cases.

Turner’s syndrome is a congenital disorder found only in females. It occurs due to the absence or defect of an X-chromosome. People affected by it have a short stature, webbed neck, outward turning elbows, shield shaped chest, sexual underdevelopment and amenorrhea.

Glandular syndrome: Alopecia areata has a stronger association with the autosomal recessive disorder called autoimmune glandular syndrome which leads to insufficiency of the glandular cortex, the parathyroid glands and /or the gonads. 30% of people affected by this disorder are likely to have alopecia areata.

Allergies

Atopy is a hereditary disease where the individual has the tendency to develop immediate allergic reactions to substances such as pollen, food, dander & insect venoms and is manifested by hay fever, asthma, or similar allergic conditions. It has been observed that people with atopy are affected by alopecia areata early in life and in due course a more severe form of alopecia areata develops. Prognosis is bad in such patients and they do not respond well to treatment. In some studies, atopy was found in more than 40 percent of alopecia areata patients, whereas the prevalence of atopic diseases in the general population is estimated to be 20 percent.

Vitiligo

In this disease, commonly known as leukederma, the skin loses its pigment in patches and affects various parts of the body. Some studies show the incidence of vitiligo as higher in alopecia areata patients than in the general population. Recent studies however do not show any significant correlation between alopecia areata and vitiligo or the family history of vitiligo patients. The view, now, is that there could be rare cases of co-localization of vitiligo and alopecia areata.

Because vitiligo affects the skin and causes irritation, patients affected by both diseases may not be able to undergo certain conventional therapies for alopecia areata.

Diabetes Mellitus

There are increasing reports of an increase of incidence of diabetes mellitus, particularly the type I insulin-dependent diabetes in relatives of patients with alopecia areata. However, the alopecia patients themselves were not affected. Such findings point to a genetic connection between alopecia areata and insulin-dependent diabetes. They further suggest that the incidence of alopecia areata acts against the development of diabetes mellitus.

Other Diseases

These are:

  • Lupus erythematosus, a chronic disorder of unknown origin marked by red scaly lesions or patches on the face or the upper trunk.
  • Rheumatoid arthritis, a painful inflammatory disease, leading to loss of mobility due to pain and joint destruction.
  • Pernicious anemia, a serious autoimmune disease caused by deficiency of vitamin B-12.
  • Scleroderma, a rare, chronic disease marked by excessive deposits of collagen, the main protein of connective tissue.
  • Alopecia areata has also been reported in patients seropositive for the human immunodeficiency virus.
  • Some unusual cases are association of testicular atrophy or dysfunction with alopecia areata.

Conclusion

In conclusion it must be said that there is sufficient proof of association of alopecia areata with only two diseases – Atopy and Down’s syndrome. Association with other diseases is more an exception than a rule. Only 3% to 5% alopecia areata patients have autoimmune or other diseases.



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