Sisters with Long-standing and Severe Alopecia Areata

Nakada Kaori, Toyoda Masahiko, Nakamura Motokazu, Kagoura Masayori, Morohashi Masaaki, Adachi Yuichi

doi:10.14924/dermatol.114.1793

We report Japanese sisters (aged 7 years, totalis, and 12 years, universalis) with long-standing and severe types of alopecia areata. Serological screening of both patients showed a remarkable increase in thyroid autoantibody titers, especially anti-thyroid peroxidase antibody, without clinical evidence of thyroid diseases. Examination of HLA-DNA typing revealed that the common HLA class II antigens typed for the sisters were HLA-DQB1*0301 (DQ7) and -DRB1*0401 (DR4), both of which have recently been considered to be characteristic markers of an early-onset form with long duration and greater severity of alopecia areata in the Caucasian population. To our knowledge, this is the first Japanese case of familial occurrence with two common HLA class II antigens that have been recognized as markers of severe types of the disease. In addition, this case seems to support the concept that the pathogenesis of alopecia areata may be closely associated with genetic and autoimmune factors including characteristic patterns of HLA-DNA typing as well as an increase in thyroid autoantibody titers.

Sisters with Long-standing and Severe Alopecia Areata

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