Hidradenitis Suppurativa Increases Alopecia Risk
Synopsis:
Our findings are consistent with those of Lee et al3 and showed an increased risk of AA in a US-based HS sample. As currently understood, AA is caused by the loss of immune privilege at the hair follicle either because of local hair follicle epithelium disruption or a dysregulated immune response.2 HS pathogenesis involves hair follicle disruption and a sustained dysregulated immune response.4 Both AA and HS likely involve an inciting event at the hair follicle that leads to subsequent inflammation. In support of this hypothesis, the lesions of patients with HS and AA have considerable overlap in the expression of key inflammatory cytokines, including tumor necrosis factor α, interleukin 17, interferons, chemokine ligands 9 and 10, granzyme B, and others.4, 5 The similarities in the gene expression profiles of patients with HS and AA may explain why AA is more common in patients with HS. The results of this study encourage more research to investigate the molecular, genetic, and environmental factors contributing to this increased risk relationship between AA and HS. Clinicians should also be aware of the increased risk of AA in people with HS.
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