Alopecia Areata Universalis in the Onset of Autoimmune Polyendocrine Syndrome Type III C

Abstract

Alopecia areata (AA) is an organ-specific autoimmune disease which affects hair follicles. It usually presents as a transient patchy hair loss, but it can sometimes progress into more severe forms such as AA totalis or AA universalis (AAU). Different autoimmune diseases, as well as autoimmune polyglandular syndromes (APS), have been associated with AA, especially with Type I and Type II APS. Herein, we describe the case of a 16-year-old boy with a severe form of AAU and early onset of adult APS, Type III C. As far as we are aware, this combination of AAU, Hashimoto thyroiditis, and Type I diabetes in a teenager has not been previously described in the literature. Furthermore, the early onset of AAU followed by a premature debut of adult APS Type III is again unique, which is why we report this case.

Keywords: alopecia areata universalis; autoimmune polyendocrine syndrome; trichoscopy.

Figure 1

(a) Profile image: absence of scalp, eyebrow, and eyelash hair. (b) Nail involvement: trachyonychia and longitudinal ridges (affecting 3 out of 10 fingers)

Figure 2

Trichoscopic images of scalp hair. (a) Area with minimal hair regrowth after local caffeine treatment: one and two thin hairs per follicular unit, multiple yellow dots, and few vellus hairs. (b) Area with no hair regrowth: multiple, heterogeneous yellow dots, and the absence of follicular units