Alopecia universalis

French-Icelandic actor Tómas Lemarquis with alopecia universalis

Alopecia universalis (AU), also known as alopecia areata universalis, is a medical condition involving the loss of all body hair, including eyebrows, eyelashes, chest hair, armpit hair, and pubic hair. It is the most severe form of alopecia areata.[1]

People with the disease are usually healthy, have no other symptoms, and a normal life expectancy.[2]

## Causes[edit | edit source]

Alopecia universalis can occur at any age, and is currently believed to be an autoimmune disorder, in which a person's immune system attacks the hair follicles. Genetic factors may contribute to AU, as about 20% of those affected have a family member with alopecia.[3]

## Treatment[edit | edit source]

Many treatments have been explored, including immunomodulatory agents such as imiquimod.[4] Tofacitinib citrate may also have benefits. In June 2014, a 25-year-old man with almost no hair on his body was reported to have grown full head of hair, as well as eyebrows, eyelashes, and facial, armpit, and other hair, following eight months of treatment.[5]

Contact immunotherapy involves the use of contact allergens, such as diphencyprone and squaric acid dibutylester, to induce an immune response that is thought to oppose the action of cells causing hair loss.[6][7][8] A review that combined and analyzed the findings of 45 studies comprising 2,227 patients showed any hair regrowth in 54.5% and complete hair regrowth in 24.9% of patients with AT and AU using contact immunotherapy.[9] In addition to its helpful effects in treating AU, it can have side effects that can be very serious, such as severe dermatitis.[6][10]

Topical and intralesional corticosteroids, such as clobetasol propionate, have also shown to be an effective treatment for AT and AU patients.[6][7] A controlled study comprising 28 patients found positive terminal hair growth in eight of the patients (28.5%) using a 0.05% clobetasol propionate ointment.[11] This is very similar to the results obtained from immunotherapy treatment trials. Additionally, studies suggest that intralesional applications are much more effective than topical applications of steroids. However, the main side effect is increased risk of cutaneous atrophy at the site of treatment;[7] folliculitis is also an occasional complication.[8]

Janus kinase inhibitors, previously used in the treatment of cancer and other diseases, such as arthritis, have successfully shown to be effective in the initial trials of treatment for alopecia patients.[6][7][12] Multiple cases of treatments have been successful, one of them being of a 22-year-old man with a history of AU and atopic dermatitis (AD). This man was treated with JAK inhibitor tofacitinib, and after ten months, he experienced hair regrowth on all of his affected body parts and subsequent improvement of his AD.[13][14] Current research and findings suggest that systemic JAK inhibitors eliminate and prevent the development of AA, while topical JAK inhibitors promote hair regrowth and reverse the established disease.[8][15] Many clinical trials are ongoing involving JAK inhibitors such as ruxolitinib and tofacitinib.[6][16]

## Images[edit | edit source]

## See also[edit | edit source]

* Alopecia areata
* Alopecia totalis

## References[edit | edit source]

1. ↑ "Alopecia universalis | Disease | Overview | Genetic and Rare Diseases Information Center (GARD) – an NCATS Program". rarediseases.info.nih.gov. Archived from the original on 2016-03-07. Retrieved 2016-03-01.
2. ↑ Nancy Garrick, Deputy Director (4 April 2017). "Alopecia Areata". National Institute of Arthritis and Musculoskeletal and Skin Diseases. Archived from the original on 27 November 2021. Retrieved 27 November 2021.
3. ↑ Robins, Douglas N. (September 2007). "Alopecia Universalis: Hair Growth following Initiation of Simvastatin and Ezetimibe Therapy". Journal of Drugs in Dermatology. 6 (9): 946–7. PMID 17941369. Archived from the original on 6 August 2020. Retrieved 31 August 2020.
4. ↑ Letada PR, Sparling JD, Norwood C (2007). "Imiquimod in the treatment of alopecia universalis". Cutis; Cutaneous Medicine for the Practitioner. 79 (2): 138–40. PMID 17388216.
5. ↑ "Hairless Man Grows Full Head Of Hair In Yale Arthritis Drug Trial". CBS Boston. 2014-06-19. Archived from the original on 2014-06-21. Retrieved 2022-04-07.
6. ↑ 6.0 6.1 6.2 6.3 6.4 Khan Mohammad Beigi, Pooya (2018), Khan Mohammad Beigi, Pooya (ed.), "Alopecia Totalis/Universalis", Alopecia Areata: A Clinician's Guide, Springer International Publishing, pp. 13–15, doi:10.1007/978-3-319-72134-7_3, ISBN 9783319721347
7. ↑ 7.0 7.1 7.2 7.3 Darwin, Evan; Hirt, PenelopeA; Fertig, Raymond; Doliner, Brett; Delcanto, Gina; Jimenez, JoaquinJ (2018). "Alopecia areata: Review of epidemiology, clinical features, pathogenesis, and new treatment options". International Journal of Trichology. 10 (2): 51–60. doi:10.4103/ijt.ijt_99_17. ISSN 0974-7753. PMC 5939003. PMID 29769777.
8. ↑ 8.0 8.1 8.2 Pratt, C. Herbert; King, Lloyd E.; Messenger, Andrew G.; Christiano, Angela M.; Sundberg, John P. (2017-03-16). "Alopecia areata". Nature Reviews Disease Primers. 3: 17011. doi:10.1038/nrdp.2017.11. ISSN 2056-676X. PMC 5573125. PMID 28300084.
9. ↑ Lee, Won-Soo; Lee, Young Bin; Kim, Beom Jun; Lee, Solam (2018-10-01). "Hair Regrowth Outcomes of Contact Immunotherapy for Patients With Alopecia Areata: A Systematic Review and Meta-analysis". JAMA Dermatology. 154 (10): 1145–1151. doi:10.1001/jamadermatol.2018.2312. ISSN 2168-6068. PMC 6233743. PMID 30073292.
10. ↑ Strazzulla, Lauren C.; Wang, Eddy Hsi Chun; Avila, Lorena; Lo Sicco, Kristen; Brinster, Nooshin; Christiano, Angela M.; Shapiro, Jerry (January 2018). "Alopecia areata: An appraisal of new treatment approaches and overview of current therapies". Journal of the American Academy of Dermatology. 78 (1): 15–24. doi:10.1016/j.jaad.2017.04.1142. ISSN 1097-6787. PMID 29241773.
11. ↑ Tosti, Antonella; Piraccini, Bianca Maria; Pazzaglia, Massimiliano; Vincenzi, Colombina (July 2003). "Clobetasol propionate 0.05% under occlusion in the treatment of alopecia totalis/universalis". Journal of the American Academy of Dermatology. 49 (1): 96–98. doi:10.1067/mjd.2003.423. ISSN 0190-9622. PMID 12833016.
12. ↑ Clynes, Raphael; Christiano, Angela M.; Vaughan, Roger; Furniss, Megan; Ulerio, Grace; Clark, Charlotte; Cerise, Jane E.; Nguyen, Nhan; Jabbari, Ali (2016-09-22). "Oral ruxolitinib induces hair regrowth in patients with moderate-to-severe alopecia areata". JCI Insight. 1 (15): e89790. doi:10.1172/jci.insight.89790. ISSN 0021-9738. PMC 5033756. PMID 27699253.
13. ↑ Morris, Gabriela M.; Nahmias, Zachary P.; Kim, Brian S. (2018-07-01). "Simultaneous improvement of alopecia universalis and atopic dermatitis in a patient treated with a JAK inhibitor". JAAD Case Reports. 4 (6): 515–517. doi:10.1016/j.jdcr.2017.12.016. ISSN 2352-5126. PMC 6047104. PMID 30023415.
14. ↑ Navarini, Alexander A.; French, Lars E.; Trüeb, Ralph M.; Kamarachev, Jivko; Maul, Julia-Tatjana; Anzengruber, Florian (2016). "Transient Efficacy of Tofacitinib in Alopecia Areata Universalis". Case Reports in Dermatology. 8 (1): 102–106. doi:10.1159/000445182. ISSN 1662-6567. PMC 4869306. PMID 27194979.
15. ↑ Clynes, Raphael; Christiano, Angela M.; Mackay-Wiggan, Julian; Petukhova, Lynn; Singh, Pallavi; Rothman, Lisa; DeStefano, Gina M.; Harel, Sivan; Jong, Annemieke de (September 2014). "Alopecia areata is driven by cytotoxic T lymphocytes and is reversed by JAK inhibition". Nature Medicine. 20 (9): 1043–1049. doi:10.1038/nm.3645. ISSN 1546-170X. PMC 4362521. PMID 25129481.
16. ↑ Craiglow, Brittany G.; King, Brett A. (December 2014). "Killing Two Birds with One Stone: Oral Tofacitinib Reverses Alopecia Universalis in a Patient with Plaque Psoriasis". Journal of Investigative Dermatology. 134 (12): 2988–2990. doi:10.1038/jid.2014.260. ISSN 0022-202X. PMID 24940651.

## External links[edit | edit source]

Classification|

* ICD-10: L63.1

|

* v
* t
* e

Disorders of skin appendages

Nail|

* thickness: Onychogryphosis
* Onychauxis

* color: Beau's lines
* Yellow nail syndrome
* Leukonychia
* Azure lunula

* shape: Koilonychia
* Nail clubbing

* behavior: Onychotillomania
* Onychophagia

* other: Ingrown nail
* Anonychia

* ungrouped: Paronychia
* Acute
* Chronic
* Chevron nail
* Congenital onychodysplasia of the index fingers
* Green nails
* Half and half nails
* Hangnail
* Hapalonychia
* Hook nail
* Ingrown nail
* Lichen planus of the nails
* Longitudinal erythronychia
* Malalignment of the nail plate
* Median nail dystrophy
* Mees' lines
* Melanonychia
* Muehrcke's lines
* Nail–patella syndrome
* Onychoatrophy
* Onycholysis
* Onychomadesis
* Onychomatricoma
* Onychomycosis
* Onychophosis
* Onychoptosis defluvium
* Onychorrhexis
* Onychoschizia
* Platonychia
* Pincer nails
* Plummer's nail
* Psoriatic nails
* Pterygium inversum unguis
* Pterygium unguis
* Purpura of the nail bed
* Racquet nail
* Red lunulae
* Shell nail syndrome
* Splinter hemorrhage
* Spotted lunulae
* Staining of the nail plate
* Stippled nails
* Subungual hematoma
* Terry's nails
* Twenty-nail dystrophy

Hair|

| Hair loss/
Baldness|

* noncicatricial alopecia: Alopecia
* areata
* totalis
* universalis
* Ophiasis

* Androgenic alopecia (male-pattern baldness)
* Hypotrichosis
* Telogen effluvium
* Traction alopecia
* Lichen planopilaris
* Trichorrhexis nodosa
* Alopecia neoplastica
* Anagen effluvium
* Alopecia mucinosa

* cicatricial alopecia: Pseudopelade of Brocq
* Central centrifugal cicatricial alopecia
* Pressure alopecia
* Traumatic alopecia
* Tumor alopecia
* Hot comb alopecia
* Perifolliculitis capitis abscedens et suffodiens
* Graham-Little syndrome
* Folliculitis decalvans

* ungrouped: Triangular alopecia
* Frontal fibrosing alopecia
* Marie Unna hereditary hypotrichosis

|

Hypertrichosis|

* Hirsutism
* Acquired
* localised
* generalised
* patterned
* Congenital
* generalised
* localised
* X-linked
* Prepubertal

Acneiform
eruption|

| Acne|

* Acne vulgaris
* Acne conglobata
* Acne miliaris necrotica
* Tropical acne
* Infantile acne/Neonatal acne
* Excoriated acne
* Acne fulminans
* Acne medicamentosa (e.g., steroid acne)
* Halogen acne
* Iododerma
* Bromoderma
* Chloracne
* Oil acne
* Tar acne
* Acne cosmetica
* Occupational acne
* Acne aestivalis
* Acne keloidalis nuchae
* Acne mechanica
* Acne with facial edema
* Pomade acne
* Acne necrotica
* Blackhead
* Lupus miliaris disseminatus faciei

|

Rosacea|

* Perioral dermatitis
* Granulomatous perioral dermatitis
* Phymatous rosacea
* Rhinophyma
* Blepharophyma
* Gnathophyma
* Metophyma
* Otophyma
* Papulopustular rosacea
* Lupoid rosacea
* Erythrotelangiectatic rosacea
* Glandular rosacea
* Gram-negative rosacea
* Steroid rosacea
* Ocular rosacea
* Persistent edema of rosacea
* Rosacea conglobata
* variants
* Periorificial dermatitis
* Pyoderma faciale

Ungrouped|

* Granulomatous facial dermatitis
* Idiopathic facial aseptic granuloma
* Periorbital dermatitis
* SAPHO syndrome

Follicular cysts|

* "Sebaceous cyst"
* Epidermoid cyst
* Trichilemmal cyst
* Steatocystoma
* simplex
* multiplex
* Milia

Inflammation|

* Folliculitis
* Folliculitis nares perforans
* Tufted folliculitis
* Pseudofolliculitis barbae

* Hidradenitis
* Hidradenitis suppurativa
* Recurrent palmoplantar hidradenitis
* Neutrophilic eccrine hidradenitis

Ungrouped|

* Acrokeratosis paraneoplastica of Bazex
* Acroosteolysis
* Bubble hair deformity
* Disseminate and recurrent infundibulofolliculitis
* Erosive pustular dermatitis of the scalp
* Erythromelanosis follicularis faciei et colli
* Hair casts
* Hair follicle nevus
* Intermittent hair–follicle dystrophy
* Keratosis pilaris atropicans
* Kinking hair
* Koenen's tumor
* Lichen planopilaris
* Lichen spinulosus
* Loose anagen syndrome
* Menkes kinky hair syndrome
* Monilethrix
* Parakeratosis pustulosa
* Pili (Pili annulati
* Pili bifurcati
* Pili multigemini
* Pili pseudoannulati
* Pili torti)
* Pityriasis amiantacea
* Plica neuropathica
* Poliosis
* Rubinstein–Taybi syndrome
* Setleis syndrome
* Traumatic anserine folliculosis
* Trichomegaly
* Trichomycosis axillaris
* Trichorrhexis (Trichorrhexis invaginata
* Trichorrhexis nodosa)
* Trichostasis spinulosa
* Uncombable hair syndrome
* Wooly hair nevus

Sweat
glands|

| Eccrine|

* Miliaria
* Colloid milium
* Miliaria crystalline
* Miliaria profunda
* Miliaria pustulosa
* Miliaria rubra
* Occlusion miliaria
* Postmiliarial hypohidrosis
* Granulosis rubra nasi
* Ross’ syndrome
* Anhidrosis
* Hyperhidrosis
* Generalized
* Gustatory
* Palmoplantar

|

Apocrine|

* Body odor
* Chromhidrosis
* Fox–Fordyce disease

Sebaceous|

* Sebaceous hyperplasia

* v
* t
* e

Human hair

Classification|

| by type|

* Lanugo
* Androgenic
* Terminal
* Vellus

|

by location|

* Body
* Ear
* Nose
* Eyebrow
* unibrow
* Eyelash
* Underarm
* Chest
* Abdominal
* Pubic
* Leg

Head hairstyles
(list)|

* Afro
* Afro puffs
* Asymmetric cut
* Bald
* Bangs
* Beehive
* Big hair
* Blowout
* Bob cut
* Bouffant
* Bowl cut
* Braid
* Brush cut
* Bun (odango)
* Bunches
* Burr
* Businessman cut
* Butch cut
* Buzz cut
* Caesar cut
* Chignon
* Chonmage
* Chupryna
* Comb over
* Conk
* Cornrows
* Crew cut
* Crochet braids
* Croydon facelift
* Curly hair
* Curtained hair
* Devilock
* Dido flip
* Digital perm
* Dreadlocks
* Duck's ass
* Eton crop
* Extensions
* Feathered hair
* Finger wave
* Flattop
* Fontange
* French braid
* French twist
* Fringe
* Frosted tips
* Hair crimping
* Harvard clip
* High and tight
* Hime cut
* Historical Christian hairstyles
* Hi-top fade
* Induction cut
* Ivy League
* Jewfro
* Jheri curl
* Kiss curl
* Layered hair
* Liberty spikes
* Long hair
* Lob cut
* Marcelling
* Mod cut
* Mohawk
* Mullet
* 1950s
* 1980s
* Pageboy
* Part
* Payot
* Pigtail
* Pixie cut
* Polish halfshaven head
* Pompadour
* Ponytail
* Punch perm
* Princeton
* Professional cut
* Queue
* Quiff
* Rattail
* Razor cut
* Regular haircut
* Ringlets
* Shag
* Shape-Up
* Shimada
* Short back and sides
* Short brush cut
* Short hair
* Spiky hair
* Straight hair
* Standard haircut
* Surfer hair
* Taper cut
* Temple Fade
* Tonsure
* Updo
* Undercut
* Victory rolls
* Waves
* Widow's peak
* Wings

Facial hair
(list)|

* Beard
* Chinstrap
* Goatee
* Shenandoah
* Soul patch
* Van Dyke
* Moustache
* Fu Manchu
* handlebar
* horseshoe
* pencil
* toothbrush
* walrus
* Designer stubble
* Sideburns

Hair subtraction|

| cosmetic|

* Removal
* waxing
* threading
* plucking
* chemical
* electric
* laser
* IPL
* Shaving
* head
* leg
* cream
* brush
* soap
* Razor
* electric
* safety
* straight

|

disorders|

* Alopecia
* areata
* totalis
* universalis
* Frictional alopecia
* Male-pattern hair loss
* Hypertrichosis
* Management
* Trichophilia
* Trichotillomania
* Pogonophobia

Haircare products|

* Brush
* Clay
* Clipper
* Comb
* Conditioner
* Dryer
* Gel
* Hot comb
* Iron
* Mousse
* Pomade
* Relaxer
* Rollers
* Shampoo
* Spray
* Wax

Haircare techniques|

* Backcombing
* Hair coloring
* Crimping
* Curly Girl Method
* Hair cutting
* Perm
* Shampoo and set
* Straightening

Related topics|

* Afro-textured hair (kinky hair)
* Beard and haircut laws by country
* Bearded lady
* Barber (pole)
* Eponymous hairstyle
* Frizz
* Good hair
* Hairdresser
* Hair fetishism (pubic)
* Hair follicle
* Hair growth

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