Department of Genetic Resource Sciences, The Jackson Laboratory, Bar Harbor, Maine, USA.
Department of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Nat Rev Dis Primers. 2017 Mar 16;3:17011. doi: 10.1038/nrdp.2017.11.
Alopecia areata is an autoimmune disorder characterized by transient, non-scarring hair loss and preservation of the hair follicle. Hair loss can take many forms ranging from loss in well-defined patches to diffuse or total hair loss, which can affect all hair-bearing sites. Patchy alopecia areata affecting the scalp is the most common type. Alopecia areata affects nearly 2% of the general population at some point during their lifetime. Skin biopsies of affected skin show a lymphocytic infiltrate in and around the bulb or the lower part of the hair follicle in the anagen (hair growth) phase. A breakdown of immune privilege of the hair follicle is thought to be an important driver of alopecia areata. Genetic studies in patients and mouse models have shown that alopecia areata is a complex, polygenic disease. Several genetic susceptibility loci were identified to be associated with signalling pathways that are important to hair follicle cycling and development. Alopecia areata is usually diagnosed based on clinical manifestations, but dermoscopy and histopathology can be helpful. Alopecia areata is difficult to manage medically, but recent advances in understanding the molecular mechanisms have revealed new treatments and the possibility of remission in the near future.
斑秃是一种自身免疫性疾病,其特征是短暂的、非瘢痕性脱发和毛囊的保留。脱发可以有多种形式,从定义明确的斑块脱发到弥漫性或全部脱发,可影响所有有毛发的部位。头皮斑秃是最常见的类型。斑秃在其一生中的某个时候影响近 2%的普通人群。受影响皮肤的皮肤活检显示在生长期(毛发生长)的毛囊球部或下部有淋巴细胞浸润。毛囊免疫豁免的破坏被认为是斑秃的一个重要驱动因素。患者和小鼠模型的遗传研究表明,斑秃是一种复杂的、多基因疾病。几个遗传易感性位点被确定与对毛囊周期和发育很重要的信号通路有关。斑秃通常基于临床表现进行诊断,但皮肤镜检查和组织病理学检查可能会有所帮助。斑秃的医学治疗很困难,但对分子机制的理解的最新进展揭示了新的治疗方法,并有可能在不久的将来实现缓解。