Dermatology: Edited by James DinulosAn update on alopecia areataKos, Liborkaa; Conlon, JosephbAuthor Information aDepartment of Dermatology, Medical College of Wisconsin/Children's Hospital of Wisconsin, Milwaukee, Wisconsin, USA bPediatric Dermatology, Department of Pediatrics, Springfield Clinic, LLP/Southern Illinois University School of Medicine, Springfield, Illinois, USA Correspondence to Liborka Kos, Children's Physician Group, 310 S. Greenleaf Ave., Ste 201, Gurnee, IL 60031 USA Tel: +1 847 6624380; e-mail: [email protected] Current Opinion in Pediatrics: August 2009 - Volume 21 - Issue 4 - p 475-480 doi: 10.1097/MOP.0b013e32832db986 Buy Metrics Abstract Purpose of review Alopecia areata is one of the most frequent organ-restricted autoimmune diseases, yet its pathogenesis is still unclear. In addition, although alopecia areata often results in significant psychological distress, effective treatment is lacking. Recent findings New potential susceptibility loci have been implicated, but the strongest evidence points to certain class II human leukocyte antigen alleles. There is new evidence for the collapse of hair follicle immune privilege as a key step in the pathogenesis of alopecia areata. There is also new basic science evidence for stress as a contributing factor in the development of alopecia areata. Few treatments for alopecia areata have been well evaluated in randomized trials. Summary Although multiple potential susceptibility loci have been implicated, the genetics of alopecia areata is still unclear. The role of any potential environmental contributors is also unclear. Quality evidence for efficacy of currently used treatments for alopecia areata is lacking. © 2009 Lippincott Williams & Wilkins, Inc.