Alopecia Areata and Polyautoimmunity

Brett King, MD, PhD, is an associate professor of dermatology at Yale School of Medicine. He specializes in skin diseases resistant to first line therapies with special interests in atopic dermatitis, vitiligo, and more. He met with The Dermatologist to discuss alopecia areata and polyautoimmunity following his presentation on the topic at the Interdisciplinary Autoimmune Summit IAS 2021.

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Transcript

What questions do you think non dermatologist could ask their patient with autoimmune disease to help diagnose AA, and how can other specialties help dermatology with AA?

Dr King: In general, I don't think that patients with alopecia areata need to be asked because they will usually offer that they are missing hair, and when it's even moderate to severe, it's obvious that something is wrong, and that they have this condition.

This is an important topic and one that stands to gain ground at an interdisciplinary meeting such as this one. In fact, this question may stand to do better at this meeting than at any meeting because of the interdisciplinary nature of the meeting.

A super interesting question or area to explore is the management of patients with polyautoimmunity, meaning patients with multiple autoimmune diseases. Underlying polyautoimmunity, is likely share genetics and immune pathways, and so we should be thinking broadly about how this bears on treatment.

In order to do this though, each of us needs to step out of our disease state, our subspecialty, and learn about what is happening in other seemingly unrelated disease states and parts of medicine.

It's part of my excitement for participating in the IAS this year is this is a forum where each of us, we are interested in other disease states, and this is a great place to collaborate and think about questions like this.

Are there any tips or pearls of wisdom you'd like to offer your colleagues regarding AA?

Dr King: For me, JAK inhibitors are not only the future of alopecia areata treatment but are an important drug class across many different diseases.

Getting back to my comments regarding the patient, or our patients with polyautoimmunity, I think to the extent that one can consider JAK inhibitor treatment of the patient with alopecia areata in addition to another autoimmune disease, we may be able to provide treatment of multiple diseases at once with a single therapeutic agent.