Author(s): Alcira Torres*, Elianny Andazora, Mildred Dorta and Sandra Vivas
Alopecia areata is a non-scarring telogenetic alopecia of autoimmune pathogenesis characterized by the appearance of alopecic plaques of variable number and size . The disease has diverse clinical presentations that vary in severity from circumscribed alopecia plaques to total or universal alopecia, the extensive variety being a more severe form of alopecia areata that can cause significant hair loss. Its etiopathogenesis is mainly described as autoimmunity, it is characterized by an alteration of the immune privilege of the hair follicle. Treatment is indicated according to the severity of the alopecia, this is based on systemic and topical therapies. It should be noted that in extensive forms (extension greater than 20% as extensive, total or universal alopecia areata) oral pulses of dexamethasone and immunosuppressants such as methotrexate combined with minoxidil hair lotion are indicated. We present the case of a 30-year-old patient from Carabobo state, who began her current illness in July 2023. Phototype cutaneous IV/VI. presents dermatosis located on the scalp in the right fronto - temporo - parieto -occipital region, characterized by an alopecia plaque measuring approximately 30x19cm, with welldefined irregular edges, a smooth, shiny surface, soft consistency, without scales, non-pruritic, of years of evolution. Paraclinical studies are indicated, and digital trichoscopy is performed and based on its findings, the diagnosis of extensive alopecia areta is concluded, establishing a therapeutic plan based on methotrexate 15 mg/week, folic acid 5 mg PO OD except on the day of MTX, dexamethasone 5 mg PO twice a week and Minoxidil 5% hair lotion daily. With satisfactory evolution after 48 weeks of treatment.
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