Alopecia areata during the COVID-19 pandemic lockdown. A case series

Context: alopecia areata is an acquired autoimmune disease with a prevalence of 25% in children. It is a non-scarring form of alopecia that can be triggered by stress. Its incidence is high and it is associated with other autoimmune diseases. Children have endured high levels of emotional stress during the COVID-19 pandemic.

Cases presented: we present 4 cases in paediatric patients managed in a primary care paediatrics clinic that occurred during the lockdown imposed due to the COVID-19 pandemic. Two of the patients received care in the paediatric dermatology unit due to rapid progression. One of the patients with an isolated plaque of alopecia had a favourable outcome without treatment, with spontaneous resolution. Two of the patients required psychological care.

Conclusions: the circumstances experienced during the pandemic have triggered outbreaks of dermatological diseases with a psychogenic component such as psoriasis, chronic urticaria, atopic dermatitis, telogen effluvium and alopecia areata; acute stress (duration <2 months) may have the greatest impact. The relationship between alopecia areata and psychiatric disorders is a vicious circle, as stress can trigger alopecia areata and in turn its development can lead to anxiety and depressive disorders with a social impact that impair quality of life and may require psychological care.