Onset of alopecia areata after Epstein-Barr virus infectious mononucleosis

Background The pathogenesis of alopecia areata (AA) is incompletely known. A positive family history in some points to a genetic predisposition, and discordance of the disease in identical twins suggests environmental triggers exist. Objective We sought to determine whether the Epstein-Barr virus (EBV) is a possible environmental trigger for AA. Methods We queried the National AA Registry for all patients who self-reported sudden onset of AA with concurrent EBV mononucleosis. Results Among the 6256 individuals registered between December 2001 and August 2007, 1586 patients reported an environmental trigger—including 12 individuals who had an EBV infection within 6 months before the onset of AA. Limitations This study relies on self-reported data, and not all medical records confirming EBV infections were available for review. Conclusion The association between EBV and AA is worthy of further investigation.