International Medical Journal, Vol. 24., Iss. 1, 2018, P. 68−73.
MODERN APPROACHES TO THE THERAPY OF PEDIATRIC ALOPECIA AREATA
Kharkiv Medical Academy of Postgraduate Education, Ukraine
Pediatric alopecia areata (AA) is a chronic inflammatory disease affecting the hair follicles. This is considered a tissue−specific autoimmune disease, mediated by autoactivated T−lymphocytes in conditions of disorders of immune tolerance of anagenic follicles. The genetic studies and analysis of expression of human genes showed significance of disorders of signal system JAK−STAT at AA development. Nowadays there is no universal method of treating AA, which would guarantee the absence of relapse in the future. Neither of the methods of treating AA has class A recommendations. The high level of spontaneous remission and insufficient amount of randomized double blind placebo−controlled studies makes evidence−based estimation of treatment methods difficult. The majority of evidence of effectiveness of the therapy in pediatric group of patients is extrapolated from the data of treating AA in adults and is characterized in even less level of reliability of the evidence base. When choosing the treatment tactic for children it is important to compare the risk level of prescribed medicine, the severity of the disease and expected therapeutic effect. At common pathologic process or at progressive course of the disease, it is important to discuss different ways of treatment with his/her parents. It is important to analyze the influence of the disease on the physical and emotional condition. Glucocorticosteroids, topical immunotherapy, dithranol, minoxidil, topical calcineurin inhibitors, psychotherapy, adjuvant therapy are used. The studies of effectiveness and safeness of oral and local inhibitors of JAK−kinase in pediatric AA are prospective.
Key words: alopecia areata, pediatrics, therapy.