Morales-Sánchez M A, Domínguez-Gómez M A, Jurado-Santa Cruz F, Peralta-Pedrero M L
Centro Dermatológico Dr. Ladislao de la Pascua, México Distrito Federal, México.
Actas Dermosifiliogr. 2010 Jun;101(5):437-43.
Alopecia areata is an autoimmune inflammatory disease affecting the hair follicles. Researchers are currently interested in whether the presence of bacterial pathogens and/or a history of immunization can trigger an autoimmune response in patients who are genetically predisposed.
This study aimed to determine whether there is an association between the development of alopecia areata and throat carriage of bacterial pathogens or a history of immunization.
Sixty-five men and women with alopecia areata and 65 control patients with other skin diseases were studied at the Dr Ladislao de la Pascua Dermatology Clinic between September 2008 and February 2009. The patients ranged in age from 18-59 years. Patients with scalp diseases were excluded from the control group. In all cases, the patient was questioned about immunizations received in the previous 6 months, and a throat swab was cultured.
A history of immunization (odds ratio [OR], 3.3; 95% confidence interval [CI], 1.6-6.7; P=.001), the presence of bacterial pathogens in the oropharynx (OR, 2.6; 95% CI, 1.1-6.2; P=.033), and being a carrier of Streptococcus pyogenes (OR, 2.1; 95% CI, 1.7-2.5; P=.042) were risk factors for alopecia areata. Klebsiella pneumoniae, S. pyogenes, Pseudomonas aeruginosa, Streptococcus pneumoniae, Serratia marcescens and Escherichia coli were isolated from cultures.
This is the first study to show an association between alopecia areata and throat carriage of bacterial pathogens or history of immunization, as risk factors for development of the disease. Given the characteristics of our study population, the association appears valid for patients with less than 25% hair loss and a course of disease under 1 year.
斑秃是一种影响毛囊的自身免疫性炎症性疾病。目前研究人员感兴趣的是，在具有遗传易感性的患者中，细菌病原体的存在和/或免疫接种史是否会引发自身免疫反应。
本研究旨在确定斑秃的发生与细菌病原体的咽部携带或免疫接种史之间是否存在关联。
2008年9月至2009年2月期间，在拉迪斯拉奥·德拉帕斯夸医生皮肤科诊所对65名斑秃男女患者和65名患有其他皮肤病的对照患者进行了研究。患者年龄在18至59岁之间。头皮疾病患者被排除在对照组之外。在所有病例中，询问患者过去6个月内的免疫接种情况，并对咽拭子进行培养。
免疫接种史（优势比[OR]，3.3；95%置信区间[CI]，1.6 - 6.7；P = 0.001）、口咽部细菌病原体的存在（OR，2.6；95% CI，1.1 - 6.2；P = 0.033）以及作为化脓性链球菌携带者（OR，2.1；95% CI，1.7 - 2.5；P = 0.042）是斑秃的危险因素。从培养物中分离出肺炎克雷伯菌、化脓性链球菌、铜绿假单胞菌、肺炎链球菌、黏质沙雷菌和大肠杆菌。
这是第一项表明斑秃与细菌病原体的咽部携带或免疫接种史之间存在关联的研究，这些因素是该疾病发生的危险因素。鉴于我们研究人群的特征，这种关联对于脱发少于25%且病程在1年以下的患者似乎是有效的。
