Crohns disease and alopecia areata universalis; case report and review of the literature

Alopecia areata (AA) is a non-scaring alopecia in which the characteristic initial lesion is a circumscribed totally bald, smooth patch. The term alopecia universalis is applied to total or amost total loss of all body hair. A 48-year old man presented with a two-month history of diarrhea and a twoweek history of low-grade fever. Patient was diagnosed twelve years ago with AA universalis treated with pulse use of systemic steroids. Physical examination revealed circumscribed totally bald, smooth patches in eyebrows, eyelashes, upper and lower extremities. Diffuse hair loss was apparent over the whole of the scalp without the development of bald areas. Total colonoscopy with ileoscopy showed Crohn’s disease, which was confirmed by multiple bowel biopsies. The patient was administered prednizolone systemically at a dose of 50 mg with satisfactory results. Although rare cases of AA correlation with other dermatoses and ulcerative colitis have already been reported, alopecia areata has not been reported so far in co-existence with Crohn’s disease.