Clinical case of alopecia totalis in pediatric practice

Abstract

Alopecia (baldness) is a pathological hair loss. A chronic relapsing course leads to a violation of the emotional sphere of the child, worsens the quality of life. Alopecia is considered autoimmune, since it is characterized by hair loss due to lymphocytic infiltration around the hair follicles. It can be secondary as a result of infectious and inflammatory processes. Purpose - is to conduct own clinical observation of a child with total alopecia to increase the awareness of doctors about this pathology in children. Clinical case. The article presents a clinical case of total alopecia in an 11-year-old child. It is known from the anamnesis that in 9 months the child began to lose hair on his head, at 2 years old - eyebrows and eyelashes, at 3 years old he was diagnosed with total alopecia. The patient had a complex clinical and laboratory examination with the involvement of a multidisciplinary team, since alopecia can occur under the mask of autoimmune diseases and immunodeficiencies. Total alopecia, atopic dermatitis, changes in immunological status in the anamnesis, cases of early mortality among family members, as well as a history of alopecia areata in the father gave us reason to suspect a genetic disease in the patient, including autoimmune polyendocrinopathy candidiasis-ectodermal dystophia (APECED syndrome) with mutation in the AIRE gene. Conclusions. For verification the diagnosis and choose a treatment strategy, the patient needs an additional examination: sequencing of the relevant locus of the AIRE gene to detect mutations characteristic of APECED syndrome, as well as a serological test to detect the titer of antibodies to Candida and a puncture biopsy of the scalp. Considering the above, the prognosis for recovery is unfavorable. The research was carried out in accordance with the principles of the Declaration of Helsinki. Informed consent of parents was obtained for the study. No conflict of interests was declared by the authors.

Keywords

• alopecia
• autoimmune polyendocrine syndrome (apeced)
• immunodeficiency
• treatment
• obesity