Jornal de Pesquisa em Dermatologia Clínica e Experimental
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Coexistent Sarcoidosis and Alopecia Areata or Vitiligo: A Case Series and Review of the Literature

Laura Melnick, Karolyn A Wanat, Roberto Novoa, John Harris, George Cotsarelis and Misha Rosenbach

Importance: Sarcoidosis is a multi-system inflammatory disease that frequently affects the lungs, lymph nodes, eyes and skin. The immunopathogenesis underlying sarcoidosis continues to be an area of active research. The presence of other diseases, such as vitiligo or alopecia, in individuals with sarcoidosis proposes a potential overlap in the immunological and inflammatory pathways of these diseases.

Observations: We present 4 patients with sarcoidosis and coexistent alopecia or vitiligo. Patients 1 and 2 had subcutaneous sarcoidosis and pulmonary sarcoidosis, respectively, and presented with alopecia areata. Patient 3 had a history of alopecia universalis and presented with cutaneous sarcoidosis. Lastly, patient 4 had a history of cutaneous sarcoidosis and presented with vitiligo.

Conclusions and relevance: The presence of prominent Th1 and possible Th17 inflammatory profiles in sarcoidosis, alopecia and vitiligo suggests a possible overlap in the immunological and inflammatory pathways of these diseases. Given the relatively rare combination of these diseases, large scale databases and genetic linkage studies are necessary to further explore the immunopathophysiology underlying these diseases and eventually lead to new therapeutic advances.