To the Editor.—
In an excellent article Muller and Winkelmann1 showed that alopecia areata is associated with microscopic inflammation, with a background of hypersensitivity. Winkelmann has also suggested a relationship with atopic dermatitis.Two Russian writers2 studied 31 patients who showed a picture of vasculitis and perivasculitis in the dermis with cellular infiltration along the vessels approaching hair follicles. The infiltrate consisted of histolymphoid cells with admixture of lymphocytes and plasma cells and involved the hair follicle as well as its external root sheath. Vasculitis led to destruction of vessels with resultant reduction of vessel density.They suggested that the difference between alopecia areata and alopecia totalis of favorable clinical course was one of degree of the changes involved.These studies seem to corroborate and explain the excellent results which the author has obtained in alopecia areata by raising the patient's general or nonspecific resistance with a series
Baird KA. ALOPECIA AREATA. Arch Dermatol. 1971;104(5):562–563. doi:10.1001/archderm.1971.04000230104021
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