Alopecia areata in children: an overview of clinical features and recent treatment options

Abstract

Alopecia areata is a chronic relapsing autoimmune disease characterized by a local or diffuse non-scarring hair loss. Statistically, 0.2% of people worldwide are affected by alopecia areata and 1.7% were diagnosed with it at some point in life. The incidence of alopecia areata in children has been rapidly increasing in recent years.

The main role in pathogenesis of alopecia areata belongs to the loss of immune privilege due to the influence of genetics and various external factors. Follicles become vulnerable to the attack by patient’s own T-lymphocytes, which results in hair shedding. Some autoimmune and allergic diseases are known to be comorbidities of alopecia areata.

The diagnosis is made on the basis of trichoscopy results, besides there are some manifestation features in children which are different than in adults.

Currently, there are several promising drugs but the number of studies (regarding pediatric patients) is extremely limited. According to a number of authors, corticosteroids and Janus kinase inhibitors have shown their effectiveness and safety in the treatment of childhood alopecia areata, although they are not approved by the United States Food and Drug Administration (FDA) at the moment.

Keywords

alopecia areata / immune privilege / corticosteroids / Janus kinase inhibitors / treatment

References

[1] Zheng C, Tosti A. Alopecia areata: New treatment options including janus kinase inhibitors. Dermatol Clin. 2021;39(3):407–415. doi: 10.1016/j.det.2021.03.005

[2] Zheng C., Tosti A. Alopecia areata: new treatment options including janus kinase inhibitors // Dermatol Clin. 2021. Vol. 39, N 3. Р. 407–415. doi: 10.1016/j.det.2021.03.005

[3] Rajabi F, Drake LA, Senna MM, Rezaei N. Alopecia areata: A review of disease pathogenesis. Br J Dermatol. 2018;179(5):1033–1048. doi: 10.1111/bjd.16808

[4] Rajabi F., Drake L.A., Senna M.M., Rezaei N. Alopecia areata: A review of disease pathogenesis // Br J Dermatol. 2018. Vol. 179, N 5. Р. 1033–1048. doi: 10.1111/bjd.16808

[5] McKenzie PL, Maltenfort M, Bruckner AL, et al. Evaluation of the prevalence and incidence of pediatric alopecia areata using electronic health record data. JAMA Dermatol. 2022;158(5):547–551. doi: 10.1001/jamadermatol.2022.0351

[6] McKenzie P.L., Maltenfort M., Bruckner A.L., et al. Evaluation of the prevalence and incidence of pediatric alopecia areata using electronic health record data // JAMA Dermatol. 2022. Vol. 158, N 5. Р. 547–551. doi: 10.1001/jamadermatol.2022.0351

[7] Rangu S, Rogers R, Castelo-Soccio L. Understanding alopecia areata characteristics in children under the age of 4 years. Pediatr Dermatol. 2019;36(6):854–858. doi: 10.1111/pde.13990

[8] Rangu S., Rogers R., Castelo-Soccio L. Understanding alopecia areata characteristics in children under the age of 4 years // Pediatr Dermatol. 2019. Vol. 36, N 6. Р. 854–858. doi: 10.1111/pde.13990

[9] Peloquin L, Castelo-Soccio L. Alopecia areata: An update on treatment options for children. Paediatr Drugs. 2017;19(5):411–422. doi: 10.1007/s40272-017-0239-z

[10] Peloquin L., Castelo-Soccio L. Alopecia areata: An update on treatment options for children // Paediatr Drugs. 2017. Vol. 19, N 5. Р. 411–422. doi: 10.1007/s40272-017-0239-z

[11] Waśkiel-Burnat A, Kołodziejak M, Sikora M, et al. Therapeutic management in paediatric alopecia areata: A systematic review. J Eur Acad Dermatol Venereol. 2021;35(6):1299–1308. doi: 10.1111/jdv.17187

[12] Waśkiel-Burnat A., Kołodziejak M., Sikora M., et al. Therapeutic management in paediatric alopecia areata: A systematic review // J Eur Acad Dermatol Venereol. 2021. Vol. 35, N 6. Р. 1299–1308. doi: 10.1111/jdv.17187

[13] Wohlmuth-Wieser I, Osei JS, Norris D, et al. Childhood alopecia areata-data from the national alopecia areata registr. Pediatr Dermatol. 2018;35(2):164–169. doi: 10.1111/pde.13387

[14] Wohlmuth-Wieser I., Osei J.S., Norris D., et al. Childhood alopecia areata-data from the national alopecia areata registry // Pediatr Dermatol. 2018. Vol. 35, N 2. Р. 164–169. doi: 10.1111/pde.13387

[15] Hubiche T, Léauté-Labrèze C, Taïeb A, Boralevi F. Poor long term outcome of severe alopecia areata in children treated with high dose pulse corticosteroid therapy. Br J Dermatol. 2008;158(5):1136–1137. doi: 10.1111/j.1365-2133.2008.08458.x

[16] Hubiche T., Léauté-Labrèze C., Taïeb A., Boralevi F. Poor long term outcome of severe alopecia areata in children treated with high dose pulse corticosteroid therapy // Br J Dermatol. 2008. Vol. 158, N 5. Р. 1136–1137. doi: 10.1111/j.1365-2133.2008.08458.x

[17] Juárez-Rendón KJ, Rivera Sánchez G, Reyes-López MÁ, et al. Alopecia Areata. Current situation and perspectives. Alopecia areata. Actualidad y perspectivas. Arch Argent Pediatr. 2017;115(6):e404–e411. doi: 10.5546/aap.2017.eng.e404

[18] Juárez-Rendón K.J., Rivera Sánchez G., Reyes-López M.Á., et al. Alopecia Areata. Current situation and perspectives. Alopecia areata. Actualidad y perspectivas // Arch Argent Pediatr. 2017. Vol. 115, N 6. Р. e404–e411. doi: 10.5546/aap.2017.eng.e404

[19] Trüeb RM, Dias MF. Alopecia areata: a comprehensive review of pathogenesis and management. Clin Rev Allergy Immunol. 2018;54(1):68–87. doi: 10.1007/s12016-017-8620-9

[20] Trüeb R.M., Dias M.F. Alopecia areata: a comprehensive review of pathogenesis and management // Clin Rev Allergy Immunol. 2018. Vol. 54, N 1. Р. 68–87. doi: 10.1007/s12016-017-8620-9

[21] Vélez-Muñiz RD, Peralta-Pedrero ML, Jurado-Santa Cruz F, Morales-Sánchez MA. Psychological profile and quality of life of patients with alopecia areata. Skin Appendage Disord. 2019;5(5):293–298. doi: 10.1159/000497166

[22] Vélez-Muñiz R.D., Peralta-Pedrero M.L., Jurado-Santa Cruz F., Morales-Sánchez M.A. Psychological profile and quality of life of patients with alopecia areata // Skin Appendage Disord. 2019. Vol. 5, N 5. Р. 293–298. doi: 10.1159/000497166

[23] Liu LY, King BA, Craiglow BG. Alopecia areata is associated with impaired health-related quality of life: A survey of affected adults and children and their families. J Am Acad Dermatol. 2018;79(3):556–558.e1. doi: 10.1016/j.jaad.2018.01.048

[24] Liu L.Y., King B.A., Craiglow B.G. Alopecia areata is associated with impaired health-related quality of life: A survey of affected adults and children and their families // J Am Acad Dermatol. 2018. Vol. 79, N 3. Р. 556–558.e1. doi: 10.1016/j.jaad.2018.01.048

[25] Putterman E, Patel DP, Andrade G, et al. Severity of disease and quality of life in parents of children with alopecia areata, totalis, and universalis: a prospective, cross-sectional study. J Am Acad Dermatol. 2019;80(5):1389–1394. doi: 10.1016/j.jaad.2018.12.051

[26] Putterman E., Patel D.P., Andrade G., et al. Severity of disease and quality of life in parents of children with alopecia areata, totalis, and universalis: a prospective, cross-sectional study // J Am Acad Dermatol. 2019. Vol. 80, N 5. Р. 1389–1394. doi: 10.1016/j.jaad.2018.12.051

[27] Lee HH, Gwillim E, Patel KR, et al. Epidemiology of alopecia areata, ophiasis, totalis, and universalis: A systematic review and meta-analysis. J Am Acad Dermatol. 2020;82(3):675–682. doi: 10.1016/j.jaad.2019.08.032

[28] Lee H.H., Gwillim E., Patel K.R., et al. Epidemiology of alopecia areata, ophiasis, totalis, and universalis: A systematic review and meta-analysis // J Am Acad Dermatol. 2020. Vol. 82, N 3. Р. 675–682. doi: 10.1016/j.jaad.2019.08.032

[29] Bhardwaj P, Basu D, Podder I, Gharami RC. Clinico-epidemiological profile of childhood alopecia areata along with dermoscopic correlation: a cross-section, observational study. Indian Dermatol Online J. 2021;12(2):250–257. doi: 10.4103/idoj.IDOJ_451_20

[30] Bhardwaj P., Basu D., Podder I., Gharami R.C. Clinico-epidemiological profile of childhood alopecia areata along with dermoscopic correlation: a cross-section, observational study // Indian Dermatol Online J. 2021. Vol. 12, N 2. Р. 250–257. doi: 10.4103/idoj.IDOJ_451_20

[31] Simakou T, Butcher JP, Reid S, Henriquez FL. Alopecia areata: A multifactorial autoimmune condition. J Autoimmun. 2019;98:74–85. doi: 10.1016/j.jaut.2018.12.001

[32] Simakou T., Butcher J.P., Reid S., Henriquez F.L. Alopecia areata: a multifactorial autoimmune condition // J Autoimmun. 2019. Vol. 98. Р. 74–85. doi: 10.1016/j.jaut.2018.12.001

[33] Ito T, Ito N, Bettermann A, et al. Collapse and restoration of MHC class-I-dependent immune privilege: Exploiting the human hair follicle as a model. Am J Pathol. 2004;164(2):623–634. doi: 10.1016/S0002-9440(10)63151-3

[34] Ito T., Ito N., Bettermann A., et al. Collapse and restoration of MHC class-I-dependent immune privilege: exploiting the human hair follicle as a model // Am J Pathol. 2004. Vol. 164, N 2. Р. 623–634. doi: 10.1016/S0002-9440(10)63151-3

[35] Paus R, Ito N, Takigawa M, Ito T. The hair follicle and immune privilege. J Investig Dermatol Symp Proc. 2003;8(2):188–194. doi: 10.1046/j.1087-0024.2003.00807.x

[36] Paus R., Ito N., Takigawa M., Ito T. The hair follicle and immune privilege // J Investig Dermatol Symp Proc. 2003. Vol. 8, N 2. Р. 188–194. doi: 10.1046/j.1087-0024.2003.00807.x

[37] Azzawi S, Penzi LR, Senna MM. Immune privilege collapse and alopecia development: Is stress a factor. Skin Appendage Disord. 2018;4(4):236–244. doi: 10.1159/000485080

[38] Azzawi S., Penzi L.R., Senna M.M. Immune privilege collapse and alopecia development: Is stress a factor // Skin Appendage Disord. 2018. Vol. 4, N 4. Р. 236–244. doi: 10.1159/000485080

[39] Zhou C, Li X, Wang C, Zhang J. Alopecia areata: An update on etiopathogenesis, diagnosis, and management. Clin Rev Allergy Immunol. 2021;61(3):403–423. doi: 10.1007/s12016-021-08883-0

[40] Zhou C., Li X., Wang C., Zhang J. Alopecia areata: an update on etiopathogenesis, diagnosis, and management // Clin Rev Allergy Immunol. 2021. Vol. 61, N 3. Р. 403–423. doi: 10.1007/s12016-021-08883-0

[41] Wang EH, Yu M, Breitkopf T, et al. Identification of autoantigen epitopes in alopecia areata. J Invest Dermatol. 2016;136(8):1617–1626. doi: 10.1016/j.jid.2016.04.004

[42] Wang E.H., Yu M., Breitkopf T., et al. Identification of autoantigen epitopes in alopecia areata // J Invest Dermatol. 2016. Vol. 136, N 8. Р. 1617–1626. doi: 10.1016/j.jid.2016.04.004

[43] Petukhova L, Duvic M, Hordinsky M, et al. Genome-wide association study in alopecia areata implicates both innate and adaptive immunity. Nature. 2010;466(7302):113–117. doi:10.1038/nature09114

[44] Petukhova L., Duvic M., Hordinsky M., et al. Genome-wide association study in alopecia areata implicates both innate and adaptive immunity // Nature. 2010. Vol. 466, N 7302. Р. 113–117. doi: 10.1038/nature09114

[45] Bertolini M, McElwee K, Gilhar A, et al. Hair follicle immune privilege and its collapse in alopecia areata. Exp Dermatol. 2020;29(8):703–725. doi: 10.1111/exd.14155

[46] Bertolini M., McElwee K., Gilhar A., et al. Hair follicle immune privilege and its collapse in alopecia areata // Exp Dermatol. 2020. Vol. 29, N 8. Р. 703–725. doi: 10.1111/exd.14155

[47] Gilhar A, Laufer-Britva R, Keren A, Paus R. Frontiers in alopecia areata pathobiology research. J Allergy Clin Immunol. 2019;144(6):1478–1489. doi: 10.1016/j.jaci.2019.08.035

[48] Gilhar A., Laufer-Britva R., Keren A., Paus R. Frontiers in alopecia areata pathobiology research // J Allergy Clin Immunol. 2019. Vol. 144, N 6. Р. 1478–1489. doi: 10.1016/j.jaci.2019.08.035

[49] Afford R, Leung AK, Lam JM. Pediatric alopecia areata. Curr Pediatr Rev. 2021;17(1):45–54. doi: 10.2174/1573396316666200430084825

[50] Afford R., Leung A.K., Lam J.M. Pediatric alopecia areata // Curr Pediatr Rev. 2021. Vol. 17, N 1. Р. 45–54. doi: 10.2174/1573396316666200430084825

[51] Fukuyama M, Ito T, Ohyama M. Alopecia areata: current understanding of the pathophysiology and update on therapeutic approaches, featuring the Japanese Dermatological Association guidelines. J Dermatol. 2022;49(1):19–36. doi: 10.1111/1346-8138.16207

[52] Fukuyama M., Ito T., Ohyama M. Alopecia areata: current understanding of the pathophysiology and update on therapeutic approaches, featuring the Japanese Dermatological Association guidelines // J Dermatol. 2022. Vol. 49, N 1. Р. 19–36. doi: 10.1111/1346-8138.16207

[53] Strazzulla LC, Wang EH, Avila L, et al. Alopecia areata: disease characteristics, clinical evaluation, and new perspectives on pathogenesis. J Am Acad Dermatol. 2018;78(1):1–12. doi: 10.1016/j.jaad.2017.04.1141

[54] Strazzulla L.C., Wang E.H., Avila L., et al. Alopecia areata: Disease characteristics, clinical evaluation, and new perspectives on pathogenesis // J Am Acad Dermatol. 2018. Vol. 78, N 1. Р. 1–12. doi: 10.1016/j.jaad.2017.04.1141

[55] Feinstein AR. The pre-therapeutic classification of co-morbidity in chronic disease. J Chronic Dis. 1970;23(7):455–468. doi: 10.1016/0021-9681(70)90054-8

[56] Feinstein A.R. The pre-therapeutic classification of co-morbidity in chronic disease // J Chronic Dis. 1970. Vol. 23, N 7. Р. 455–468. doi: 10.1016/0021-9681(70)90054-8

[57] Barahmani N, Schabath MB, Duvic M.; National Alopecia Areata Registry. History of atopy or autoimmunity increases risk of alopecia areata. J Am Acad Dermatol. 2009;61(4):581–591. doi: 10.1016/j.jaad.2009.04.031

[58] Barahmani N., Schabath M.B., Duvic M.; National Alopecia Areata Registry. History of atopy or autoimmunity increases risk of alopecia areata // J Am Acad Dermatol. 2009. Vol. 61, N 4. Р. 581–591. doi: 10.1016/j.jaad.2009.04.031

[59] Meah N, Wall D, York K, et al. The alopecia areata consensus of experts (ACE) study part II: Results of an international expert opinion on diagnosis and laboratory evaluation for alopecia areata. J Am Acad Dermatol. 2021;84(6):1594–1601. doi: 10.1016/j.jaad.2020.09.028

[60] Meah N., Wall D., York K., et al. The alopecia areata consensus of experts (ACE) study part II: Results of an international expert opinion on diagnosis and laboratory evaluation for alopecia areata // J Am Acad Dermatol. 2021. Vol. 84, N 6. Р. 1594–1601. doi: 10.1016/j.jaad.2020.09.028

[61] Sung CT, Choi FD, Juhász M, Mesinkovska NA. The immunological association between alopecia areata and respiratory diseases: a systematic review. Skin Appendage Disord. 2019;5(4):230–237. doi: 10.1159/000496445

[62] Sung C.T., Choi F.D., Juhász M., Mesinkovska N.A. The immunological association between alopecia areata and respiratory diseases: A systematic review // Skin Appendage Disord. 2019. Vol. 5, N 4. Р. 230–237. doi: 10.1159/000496445

[63] Conic RZ, Tamashunas NL, Damiani G, et al. Comorbidities in pediatric alopecia areata. J Eur Acad Dermatol Venereol. 2020;34(12):2898–2901. doi: 10.1111/jdv.16727

[64] Conic R.Z., Tamashunas N.L., Damiani G., et al. Comorbidities in pediatric alopecia areata // J Eur Acad Dermatol Venereol. 2020. Vol. 34, N 12. Р. 2898–2901. doi: 10.1111/jdv.16727

[65] Sorrell J, Petukhova L, Reingold R, et al. Shedding light on alopecia areata in pediatrics: A retrospective analysis of comorbidities in children in the national alopecia areata registry. Pediatr Dermatol. 2017;34(5):e271–e272. doi: 10.1111/pde.13238

[66] Sorrell J., Petukhova L., Reingold R., et al. Shedding light on alopecia areata in pediatrics: A retrospective analysis of comorbidities in children in the national alopecia areata registry // Pediatr Dermatol. 2017. Vol. 34, N 5. Р. e271–e272. doi: 10.1111/pde.13238

[67] Serarslan G, Savaş N, Yenin JZ. Is atopy and autoimmunity more prevalent in patients with alopecia areata? A comparative study. J Eur Acad Dermatol Venereol. 2012;26(6):720–723. doi: 10.1111/j.1468-3083.2011.04152.x

[68] Serarslan G., Savaş N., Yenin J.Z. Is atopy and autoimmunity more prevalent in patients with alopecia areata? A comparative study // J Eur Acad Dermatol Venereol. 2012. Vol. 26, N 6. Р. 720–723. doi: 10.1111/j.1468-3083.2011.04152.x

[69] Rossi A, Muscianese M, Piraccini BM, et al. Italian guidelines in diagnosis and treatment of alopecia areata. G Ital Dermatol Venereol. 2019;154(6):609–623. doi: 10.23736/S0392-0488.19.06458-7

[70] Rossi A., Muscianese M., Piraccini B.M., et al. Italian guidelines in diagnosis and treatment of alopecia areata // G Ital Dermatol Venereol. 2019. Vol. 154, N 6. Р. 609–623. doi: 10.23736/S0392-0488.19.06458-7

[71] Waśkiel A, Rakowska A, Sikora M, et al. Trichoscopy of alopecia areata: an update. J Dermatol. 2018;45(6):692–700. doi: 10.1111/1346-8138.14283

[72] Waśkiel A., Rakowska A., Sikora M., et al. Trichoscopy of alopecia areata: an update // J Dermatol. 2018. Vol. 45, N 6. Р. 692–700. doi: 10.1111/1346-8138.14283

[73] Ekiz O, Sen BB, Rifaioğlu EN, Balta I. Trichoscopy in paediatric patients with tinea capitis: A useful method to differentiate from alopecia areata. J Eur Acad Dermatol Venereol. 2014;28(9):1255–1258. doi: 10.1111/jdv.12246

[74] Ekiz O., Sen B.B., Rifaioğlu E.N., Balta I. Trichoscopy in paediatric patients with tinea capitis: A useful method to differentiate from alopecia areata // J Eur Acad Dermatol Venereol. 2014. Vol. 28, N 9. Р. 1255–1258. doi: 10.1111/jdv.12246

[75] Iorizzo M, Oranje AP. Current and future treatments of alopecia areata and trichotillomania in children. Expert Opin Pharmacother. 2016;17(13):1767–1773. doi: 10.1080/14656566.2016.1217990

[76] Iorizzo M., Oranje A.P. Current and future treatments of alopecia areata and trichotillomania in children // Expert Opin Pharmacother. 2016. Vol. 17, N 13. Р. 1767–1773. doi: 10.1080/14656566.2016.1217990

[77] Chandran NS, Novak J, Iorizzo M, et al. Trichotillomania in children. Skin Appendage Disord. 2015;1(1):18–24. doi: 10.1159/000371809

[78] Chandran N.S., Novak J., Iorizzo M., et al. Trichotillomania in children // Skin Appendage Disord. 2015. Vol. 1, N 1. Р. 18–24. doi: 10.1159/000371809

[79] Waśkiel-Burnat A, Rakowska A, Sikora M, et al. Trichoscopy of alopecia areata in children. A retrospective comparative analysis of 50 children and 50 adults. Pediatr Dermatol. 2019;36(5):640–645. doi: 10.1111/pde.13912

[80] Waśkiel-Burnat A., Rakowska A., Sikora M., et al. Trichoscopy of alopecia areata in children. A retrospective comparative analysis of 50 children and 50 adults // Pediatr Dermatol. 2019. Vol. 36, N 5. Р. 640–645. doi: 10.1111/pde.13912

[81] Amer M, Helmy A, Amer A. Trichoscopy as a useful method to differentiate tinea capitis from alopecia areata in children at zagazig university hospitals. Int J Dermatol. 2017;56(1):116–120. doi: 10.1111/ijd.13217

[82] Amer M., Helmy A., Amer A. Trichoscopy as a useful method to differentiate tinea capitis from alopecia areata in children at zagazig university hospitals // Int J Dermatol. 2017. Vol. 56, N 1. Р. 116–120. doi: 10.1111/ijd.13217

[83] Meah N, Wall D, York K, et al. The alopecia areata consensus of experts (ACE) study: Results of an international expert opinion on treatments for alopecia areata. J Am Acad Dermatol. 2020;83(1):123–130. doi: 10.1016/j.jaad.2020.03.004

[84] Meah N., Wall D., York K., et al. The alopecia areata consensus of experts (ACE) study: Results of an international expert opinion on treatments for alopecia areata // J Am Acad Dermatol. 2020. Vol. 83, N 1. Р. 123–130. doi: 10.1016/j.jaad.2020.03.004

[85] Tan E, Tay YK, Giam YC. A clinical study of childhood alopecia areata in Singapore. Pediatr Dermatol. 2002;19(4):298–301. doi: 10.1046/j.1525-1470.2002.00088.x

[86] Tan E., Tay Y.K., Giam Y.C. A clinical study of childhood alopecia areata in Singapore // Pediatr Dermatol. 2002. Vol. 19, N 4. Р. 298–301. doi: 10.1046/j.1525-1470.2002.00088.x

[87] McLenon J, Rogers MA. The fear of needles: a systematic review and meta-analysis. J Adv Nurs. 2019;75(1):30–42. doi: 10.1111/jan.13818

[88] McLenon J., Rogers M.A. The fear of needles: A systematic review and meta-analysis // J Adv Nurs. 2019. Vol. 75, N 1. Р. 30–42. doi: 10.1111/jan.13818

[89] Lenane P, Macarthur C, Parkin PC, et al. Clobetasol propionate, 0.05%, vs hydrocortisone, 1%, for alopecia areata in children: a randomized clinical trial. JAMA Dermatol. 2014;150(1):47–50. doi: 10.1001/jamadermatol.2013.5764

[90] Lenane P., Macarthur C., Parkin P.C., et al. Clobetasol propionate, 0.05%, vs hydrocortisone, 1%, for alopecia areata in children: a randomized clinical trial // JAMA Dermatol. 2014. Vol. 150, N 1. Р. 47–50. doi: 10.1001/jamadermatol.2013.5764

[91] Barton VR, Toussi A, Awasthi S, Kiuru M. Treatment of pediatric alopecia areata: A systematic review. J Am Acad Dermatol. 2022;86(6):1318–1334. doi: 10.1016/j.jaad.2021.04.077

[92] Barton V.R., Toussi A., Awasthi S., Kiuru M. Treatment of pediatric alopecia areata: a systematic review // J Am Acad Dermatol. 2022. Vol. 86, N 6. Р. 1318–1334. doi: 10.1016/j.jaad.2021.04.077

[93] Stefanaki C, Kontochristopoulos G, Hatzidimitraki E, et al. A Retrospective study on alopecia areata in children: clinical characteristics and treatment choices. Skin Appendage Disord. 2021;7(6):454–459. doi: 10.1159/000518042

[94] Stefanaki C., Kontochristopoulos G., Hatzidimitraki E., et al. A retrospective study on alopecia areata in children: clinical characteristics and treatment choices // Skin Appendage Disord. 2021. Vol. 7, N 6. Р. 454–459. doi: 10.1159/000518042

[95] Lalosevic J, Gajic-Veljic M, Bonaci-Nikolic B, Nikolic M. Combined oral pulse and topical corticosteroid therapy for severe alopecia areata in children: A long-term follow-up study. Dermatol Ther. 2015;28(5):309–317. doi: 10.1111/dth.12255

[96] Lalosevic J., Gajic-Veljic M., Bonaci-Nikolic B., Nikolic M. Combined oral pulse and topical corticosteroid therapy for severe alopecia areata in children: A long-term follow-up study // Dermatol Ther. 2015. Vol. 28, N 5. Р. 309–317. doi: 10.1111/dth.12255

[97] Tosti A, Piraccini BM, Pazzaglia M, Vincenzi C. Clobetasol propionate 0.05% under occlusion in the treatment of alopecia totalis/universalis. J Am Acad Dermatol. 2003;49(1):96–98. doi: 10.1067/mjd.2003.423

[98] Tosti A., Piraccini B.M., Pazzaglia M., Vincenzi C. Clobetasol propionate 0.05% under occlusion in the treatment of alopecia totalis/universalis // J Am Acad Dermatol. 2003. Vol. 49, N 1. Р. 96–98. doi: 10.1067/mjd.2003.423

[99] Pascher F, Kurtin S, Andrade R. Assay of 0.2 percent fluocinolone acetonide cream for alopecia areata and totalis. Efficacy and side effects including histologic study of the ensuing localized acneform response. Dermatologica. 1970;141(3):193–202.

[100] Pascher F., Kurtin S., Andrade R. Assay of 0.2 percent fluocinolone acetonide cream for alopecia areata and totalis. Efficacy and side effects including histologic study of the ensuing localized acneform response // Dermatologica. 1970. Vol. 141, N 3. Р. 193–202.

[101] Cowley BJ, Dong J. Use of oral corticosteroids in the treatment of alopecia areata. Arch Dis Child. 2020;105(1):96–98. doi: 10.1136/archdischild-2019-317956

[102] Cowley B.J., Dong J. Use of oral corticosteroids in the treatment of alopecia areata // Arch Dis Child. 2020. Vol. 105, N 1. Р. 96–98. doi: 10.1136/archdischild-2019-317956

[103] Lalosevic J, Gajic-Veljic M, Bonaci-Nikolic B, et al. Combined intravenous pulse and topical corticosteroid therapy for severe alopecia areata in children: Comparison of two regimens. Dermatol Ther. 2019;32(6):e13092. doi: 10.1111/dth.13092

[104] Lalosevic J., Gajic-Veljic M., Bonaci-Nikolic B., et al. Combined intravenous pulse and topical corticosteroid therapy for severe alopecia areata in children: comparison of two regimens // Dermatol Ther. 2019. Vol. 32, N 6. Р. e13092. doi: 10.1111/dth.13092

[105] Hamilton CE, Craiglow BG. JAK Inhibitors for the treatment of pediatric alopecia areata. J Investig Dermatol Symp Proc. 2020;20(1):S31–S36. doi: 10.1016/j.jisp.2020.04.005

[106] Hamilton C.E., Craiglow B.G. JAK Inhibitors for the treatment of pediatric alopecia areata // J Investig Dermatol Symp Proc. 2020. Vol. 20, N 1. Р. S31–S36. doi: 10.1016/j.jisp.2020.04.005

[107] Kibbie J, Kines K, Norris D, Dunnick CA. Oral tofacitinib for the treatment of alopecia areata in pediatric patients. Pediatr Dermatol. 2022;39(1):31–34. doi: 10.1111/pde.14855

[108] Kibbie J., Kines K., Norris D., Dunnick C.A. Oral tofacitinib for the treatment of alopecia areata in pediatric patients // Pediatr Dermatol. 2022. Vol. 39, N 1. Р. 31–34. doi: 10.1111/pde.14855

[109] Putterman E, Castelo-Soccio L. Topical 2% tofacitinib for children with alopecia areata, alopecia totalis, and alopecia universalis. J Am Acad Dermatol. 2018;78(6):1207–1209.e1. doi: 10.1016/j.jaad.2018.02.031

[110] Putterman E., Castelo-Soccio L. Topical 2% tofacitinib for children with alopecia areata, alopecia totalis, and alopecia universalis // J Am Acad Dermatol. 2018. Vol. 78, N 6. Р. 1207–1209.e1. doi: 10.1016/j.jaad.2018.02.031

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Fomina D.E., Pinegin V.B.