To the Editor.—
Many patients have symptoms within the clinical spectrum of nonscarring alopecia. Most of these patients display alopecia areata, fewer display alopecia totalis, and the least number will be classed as alopecia universalis. Causal factors are varied, but there are a number of associations that range from idiopathic to autoimmune reactions and psychological trauma.A review of the literature, which included over 750 cases of the three varieties, showed that the most commonly associated processes were vitiligo, nail dystrophy, cataracts, and suspected autoimmune processes.1-4 One patient who was mentioned had alopecia areata and a concomitant brain tumor, that were considered to be unrelated.1 There was no mention of tumors related to alopecia totalis or universalis.The alopecia related to tumors is usually secondary to local infiltration of hair-bearing areas by metastatic tumor,5 mucin,6 systemic chemotherapy, or ionizing radiation.While making rounds in Detroit General
Redmond WJ. Alopecia Universalis. Arch Dermatol. 1979;115(5):642. doi:10.1001/archderm.1979.04010050066048
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