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      A "hair-raising" history of alopecia areata.

      1 , 1 , 2
      Experimental dermatology
      Wiley
      alopecia areata, history, pathogenesis, treatment

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          Abstract

          A 3500-year-old papyrus from ancient Egypt provides a list of treatments for many diseases including "bite hair loss," most likely alopecia areata (AA). The treatment of AA remained largely unchanged for over 1500 years. In 30 CE, Celsus described AA presenting as scalp alopecia in spots or the "windings of a snake" and suggested treatment with caustic compounds and scarification. The first "modern" description of AA came in 1813, though treatment still largely employed caustic agents. From the mid-19th century onwards, various hypotheses of AA development were put forward including infectious microbes (1843), nerve defects (1858), physical trauma and psychological stress (1881), focal inflammation (1891), diseased teeth (1902), toxins (1912) and endocrine disorders (1913). The 1950s brought new treatment developments with the first use of corticosteroid compounds (1952), and the first suggestion that AA was an autoimmune disease (1958). Research progressively shifted towards identifying hair follicle-specific autoantibodies (1995). The potential role of lymphocytes in AA was made implicit with immunohistological studies (1980s). However, studies confirming their functional role were not published until the development of rodent models (1990s). Genetic studies, particularly genome-wide association studies, have now come to the forefront and open up a new era of AA investigation (2000s). Today, AA research is actively focused on genetics, the microbiome, dietary modulators, the role of atopy, immune cell types in AA pathogenesis, primary antigenic targets, mechanisms by which immune cells influence hair growth, and of course the development of new treatments based on these discoveries.

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          Author and article information

          Journal
          Exp Dermatol
          Experimental dermatology
          Wiley
          1600-0625
          0906-6705
          March 2020
          : 29
          : 3
          Affiliations
          [1 ] Centre for Skin Sciences, University of Bradford, Bradford, UK.
          [2 ] Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada.
          Article
          10.1111/exd.14073
          31960494
          11d3fead-a958-4c08-903a-09e220e1e3c4
          © 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
          History

          alopecia areata,history,pathogenesis,treatment
          alopecia areata, history, pathogenesis, treatment

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