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斑秃:发病机制、诊断和治疗的最新进展。

Alopecia Areata: an Update on Etiopathogenesis, Diagnosis, and Management.

机构信息

Department of Dermatology, Peking University People's Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing, China.

出版信息

Clin Rev Allergy Immunol. 2021 Dec;61(3):403-423. doi: 10.1007/s12016-021-08883-0. Epub 2021 Aug 17.

Abstract

Alopecia areata (AA) is a common chronic tissue-specific autoimmune disease, resulting in hair loss, that affects up to 2% of the general population. The exact pathobiology of AA has still remained elusive, while the common theory is the collapse of the immune privilege of the hair follicle caused by immunological mechanism. Multiple genetic and environment factors contribute to the pathogenesis of AA. There are several clinical treatments for AA, varying from one or multiple well-defined patches to more diffuse or total hair loss of the scalp (alopecia totalis) or hair loss of the entire body (alopecia universalis). The available treatments for AA, such as corticosteroids and other immunomodulators, minoxidil, and contact immunotherapy, are of limited efficacy with a high risk of adverse effects and high recurrence rates, especially for patients with severe AA. Recent insights into the pathogenesis of AA have led to the development of new treatment strategies, such as Janus kinase (JAK) inhibitors, biologics, and several small molecular agents. In addition, modern therapies for AA, including antihistamines, platelet-rich plasma (PRP) injection, and other novel therapies have been well explored. In this review, we discussed the recent advances in the pathogenesis, diagnosis, and treatment of AA.

摘要

斑秃(AA)是一种常见的慢性组织特异性自身免疫性疾病,导致脱发,影响高达 2%的普通人群。AA 的确切发病机制仍然难以捉摸,而常见的理论是免疫机制导致毛囊免疫特权的崩溃。多种遗传和环境因素促成了 AA 的发病机制。AA 有几种临床治疗方法,从一个或多个明确的斑块到更弥漫或头皮全部脱发(全秃)或整个身体脱发(普秃)不等。AA 的现有治疗方法,如皮质类固醇和其他免疫调节剂、米诺地尔和接触免疫疗法,疗效有限,不良反应风险高,复发率高,尤其是对于严重 AA 的患者。最近对 AA 发病机制的深入了解导致了新的治疗策略的发展,如 Janus 激酶(JAK)抑制剂、生物制剂和几种小分子药物。此外,AA 的现代治疗方法,包括抗组胺药、富血小板血浆(PRP)注射和其他新型治疗方法也得到了很好的探索。在这篇综述中,我们讨论了 AA 的发病机制、诊断和治疗的最新进展。

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