Anatomical Colocalization of Vitiligo and Alopecia Areata

Alopecia areata (AA) and vitiligo are two common disorders in general population and coincidence of these two diseases is thus to be expected. However, anatomical coexistence of both conditions had rarely been reported. Many different etiological hypotheses have been suggested for both diseases. While alopecia areata is considered a T-cell medi- ated autoimmune disease, in the pathogenesis of vitiligo, both T cells and autoantibodies may play a role. Here we report a case which supports the hypothesis that vitiligo-induced autoimmunity could trigger AA and bulb melanocytes could act as a possible target in AA. We report the case of a 53-year-old woman which was referred to Dermatology Department for treatment of AA. Twenty years previously, she had developed areas of vitiligo on the face and arms which remained stable for years. She presented with a 1-year history of alopecia on the scalp, with a loss of skin and hair color in the same location during this period. In our case, the chronological appearance, association and co-localization of vitiligo and AA could emphasize the hypothesis that melanocytes-derived antigens released during vitiligo pathogenesis could act as auto-antigens, inducing hair loss.