false alopecia areata
Introduction
Introduction to pseudo-alopecia areata Pseudopelade is a chronic progressive scar-type baldness with no obvious inflammation, and the baldness is permanent. basic knowledge Sickness ratio: 0.05% Susceptible people: no special people Mode of infection: non-infectious Complications: impetigo
Cause
False alopecia areata
Causes:
The cause has not been determined. Some scholars believe that this disease is an independent disease with unknown causes, but there are also contradictions. It is suggested that pseudo-alopecia areata, such as lichen planus, localized scleroderma, can occur in all skin diseases that cause atrophic scars of the scalp. Discoid lupus erythematosus, alopecia folliculitis and Graham-Little syndrome, but in recent years, it is more likely to be considered an independent disease.
Pathogenesis
The pathogenesis is still not very clear. Scholars believe that pseudo-alopecia areata can occur in all skin diseases that cause atrophic scars of the scalp, such as lichen planus, localized scleroderma, discoid lupus erythematosus, and alopecia folliculitis.
In recent years, it has been more inclined to think of it as an independent disease.
Prevention
False alopecia areata prevention
There is no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease.
Complication
False alopecia areata Complications, impetigo
Permanent alopecia with no other complications.
Symptom
False alopecia areata symptoms common symptoms alopecia areata balm pimples scaly tying knot hurricane stagnation
From the beginning, one or several worm-like round, oval or non-plastic alopecia patches on the scalp, which are about the size of coins, can be gradually enlarged and enlarged, scattered everywhere, or merged into large pieces, and the realm is clear. The hair on the edges is not loose. The skin of the affected area is white or slightly reddish. The surface is atrophied and slightly sunken. It is smooth and shiny like thin paper. The hair follicles are destroyed and the hair is never regenerated. Individual hair follicles and hair can also appear in the hair loss area. Seen in women 30 to 50 years old, female: male is greater than 3:1, there is no pustule in the skin of the bald area, scarring, scales and broken hair. The bald spot is generally large and small, unlike alopecia areata. .
Examine
Examination of false alopecia areata
Histopathology: Early manifestations of lymphocytic infiltration at 2/3 of the hair follicle, infiltration gradually enlarged, leading to hair follicle destruction, hair loss, replaced by longitudinal fiber bundles, later epidermal atrophy or normal, fiber bundles can reach the subcutaneous There was no obvious inflammation, scars and follicular horn plugs, hair follicles and sebaceous glands decreased or disappeared. Elastic fiber staining showed permanent elastic fibers around the middle of the hair follicle. This is different from the lichen planus and lupus erythematosus, and most of the immunofluorescence tests are negative.
Diagnosis
Diagnosis of pseudo-alopecia areata
Diagnostic criteria
Braun-Falco et al. (1986) proposed diagnostic criteria.
Clinical standard
Irregular borders, fused alopecia, slight erythema around the hair follicle (early), moderate atrophy (late stage), slow progression over 2 years of disease.
2. Histopathological criteria
There was no obvious inflammation, scars and hair follicle horn plugs, hair follicles and sebaceous glands were reduced or absent, the epidermis was normal or atrophy, and the fiber bundles extended to the subcutaneous tissue.
3. Direct immunofluorescence is negative or only IgM deposition.
Differential diagnosis
Alopecia areata
The number of lesions is small and the range is large, the development is faster, no scars are formed, and the hair can be regenerated.
2. Alopecia folliculitis
There are groups of pustules that are difficult to distinguish at a later stage.
3. Discoid lupus erythematosus or lichen planus
In the scalp damage can cause scarring baldness, but other parts have corresponding skin lesions, biopsy fibril staining can help identify.
4. Huang Wei
There are jaundice, hair is gray stain, there is a special rat smell, microscopy can find spores and hyphae, scars of late-type scars can be confused with this disease, but there is a history of jaundice.
5. syphilitic alopecia
Other manifestations of syphilis, hair loss is more common in the back of the pillow, worm-like incomplete hair loss, no scars, syphilis serum test positive.
